Blood Pressure, Sodium Intake and Dietary Behavior Changes by Session Attendance on Salt Reduction Education Program for Pre-hypertensive Adults in a Public Health Center

Article information

Korean J Community Nutr. 2013;18(6):626-643

Publication date (electronic) : 2013 December 31

doi : https://doi.org/10.5720/kjcn.2013.18.6.626

Eun-Jin Jung , Jong-Sook Kwon ¹, So-Hyun Ahn , Sook Mee Son

Department of Food Science & Nutrition, The Catholic University of Korea, Bucheon, Korea.

¹Department of Food & Nutrition, Shingu College, Songnam, Korea.

Corresponding author: Sook Mee Son, Department of Food Science & Nutrition, The Catholic University of Korea, 43 Jibong-ro, Womi-gu Bucheon-Si, Gyeonggi-do 420-743, Korea. Tel: (02) 2164-4318, Fax: (02) 2164-4310, sonsm@catholic.ac.kr

Received 2013 August 19; Revised 2013 October 31; Accepted 2013 November 13.

Abstract

This study was performed to evaluate the differences in blood pressure, sodium intake and dietary behavior changes according to the extent of session attendance on sodium reduction education program for pre-hypertensive adults in a public health center. Sodium reduction education program consisted of 8 sessions for 8 weeks. Fifty three patients who completed the pre and post nutritional assessments were classified into 2 groups according to the session attendance rate. Nineteen participants who attended the education program 3 times or less (≤ 3) were categorized into the less attendance (LA) group and 34 participants attended 4 times or more (≥ 4) into the more attendance (MA) group. Blood pressure, anthropometric measurements, serum lipid profile, nutrient intakes including sodium, nutrition knowledge and dietary behavior score were assessed before and after the nutrition education program. Mean sodium intakes (p < 0.001), systolic/diastolic blood pressure (p < 0.001), and weight (p < 0.001) were significantly decreased in the MA group after sodium reduction education program. Compared to the MA group, mean sodium intakes, systolic/diastolic blood pressure were not significantly changed after the education program even with significantly increased nutrition knowledge (p < 0.05) and dietary behavior score (p < 0.01) in the LA group. It appears that pre-hypertensive adults need to attend the sodium reduction education program for at least 4 times or more to gain beneficial effects from the intervention. Positive feedback of healthcare team or offering more cooking classes may be needed to raise the attendance rate in the sodium reduction education program.

Keywords: high blood pressure; sodium intake; session attendance; salt reduction education program; prehypertensive adults

Notes

This research was supported by a grant of the Food-hygiene Fund, 2007, the Gyeonggi-Province.

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This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Funded by : Food-hygiene Fund

Table 1

Kinds of dish items included in each dish group

Table 2

Salt reduction nutrition education program for the hypertension

Table 3

General characteristics of the subjects

1) N (%)

2) Mean ± SD

^*: p < 0.05 by χ² test

Table 4

Changes of anthropometric characteristics during the nutrition education program between less attendance and more attendance groups

1) Mean ± SD

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001 by paired t-test between baseline and 8 weeks within group

^# p < 0.05 by t-test between differences of less attendance and more attendance group

Table 5

Changes of biochemical characteristics during the nutrition education program between less attendance and more attendance groups

1) Mean ± SD

^*: p < 0.05, ^***: p < 0.001 by paired t-test between baseline and 8 weeks within group

^# p < 0.05 by t-test between differences of less attendance and more attendance group

Table 6

Changes of nutrients intakes during the nutrition education program between less attendance and more attendance groups

1) Mean ± SD

2) Mean % of RNI(Recommended Nutrient Intake for Dietary Reference Intake for Koreans)

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001 by paired t-test between baseline and 8 weeks within group

^#: p < 0.05, ^##: p < 0.01 by t-test between differences of less attendance and more attendance group

Table 7

Changes of Nutrients intakes per 1000kcal during the nutrition education program between less attendance and more attendance groups

1) Mean ± SD

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001 by paired t-test between baseline and 8 weeks within group

^#: p < 0.05 by t-test between differences of less attendance and more attendance group

Table 8

Changes of dish consumption frequencies during the nutrition education program for less attendance and more attendance groups

1) Mean ± SD

^**: p < 0.01 by paired t-test between baseline and 8 weeks within group

Table 9

Changes of nutrition knowledge related to hypertension or sodium intakes between less attendance and more attendance groups

1) Mean ± SD

2) Summated score of each item. Full score = 100, the correct answer for each question was scored 10, incorrect answer 0

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001 by paired t-test between baseline and 8 weeks within group

1. Nutrition labeling shows sodium contents of processed food

2. Canned foods and instant foods contain lots of sodium

3. Using spices such as vinegar, mustard or soybean sauce instead of salt can reduce sodium intake

4. Salt substitute is a good way to reduce sodium intake

5. Increased risk of hypertension is associated with high level of serum triglycerides

6. Having family history of hypertension can elevate incidence of hypertension to descendent

7. Lowering body weight can reduce blood pressure

8. All the elderly has high blood pressure

9. Stress can lead to elevate blood pressure

10. Pregnancy can lead to elevated blood pressure in females

Table 10

Changes of dietary behavior related to sodium intakes during the nutrition education program between less attendance and more attendance groups

1) Mean ± SD

2) Summated score of each item. Total score = 100, 'yes' answer for each item was scored 10, 'no' answer 0

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001 by paired t-test between baseline and 8 weeks within group

^##: p < 0.01 by t-test between differences of less attendance and more attendance group

1. Enjoy dried seafood or seasoned fish

2. Enjoy salted fish such as salted spicy pollack roe

3. Enjoy cooked rice topped with seasoned meats/seafood or one-dish meal

4. Usually eat all the broth of soup or stew

5. Enjoy instant foods such as ramyon, canned food, or ham.

6. Eating-out or taking delivery dishes more than twice a week

7. Enjoy Kimchi and pickled vegetables

8. Adding lots of soy-sauce or vinegar-hot pepper paste to fried foods, pan-fried foods or sashimi

9. Enjoy salty taste and thinking that salty taste is important one

10. Usually us soy-sauce rather than vinegar when cooking vegetables

Table 11

Changes of general dietary habits during the nutrition education program between less attendance and more attendance groups

1) Mean ± SD

2) Summated score of each item. Full score of general dietary habits = 25

3) Summated score of each item. Full score of well-balanced dietary habits = 45

'yes' answer for each item (except 4 and 5) was scored 5, 'no' answer 0

'no' answer for each item 4 and 5 was scored 5, 'yes' answer 0

^*: p < 0.05, ^** : p < 0.01, ^*** : p < 0.001 by paired t-test between baseline and 8 weeks within group

^#: p < 0.05, ^##: p < 0.01 by t-test between differences of less attendance and more attendance group

1. Having 3 meals a day without missing any meal

2. Having breakfast everyday

3. Having enough time when eating

4. Having meals often after 10 PM.

5. Eating until feeling full.

6. Having cereals such as rice, breads, noodles, potatoes every meal.

7. Having meats or eggs more than once a day.

8. Having fishes more than once a day

9. Having soybean products such as tofu or soymilk everyday

10. Having vegetable dishes (except kimchi) everyday

11. Having dishes cooked with oils every meal

12. Having milk or dairy products everyday

13. Having fruits everyday

14. Trying to have various foods in a day

Table 12

Evaluation for the nutrition education program between less attendance and more attendance groups

1) Strongly disagree: 0, moderately disagree: 5, neutral: 10. moderately agree: 15, strongly agree: 20

2) Mean ± SD

3) Numbers of the subjects who responded 'yes'

4) N (%)

^*: p < 0.05 by t-test between groups

^#: p < 0.05 by χ²-test between groups