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The Effects of Low-sodium Diet Education Program on Dietary Habits, Diet Quality and Obesity Index in Overweight and Obese Middle-aged Women
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Research Article
The Effects of Low-sodium Diet Education Program on Dietary Habits, Diet Quality and Obesity Index in Overweight and Obese Middle-aged Women
Soo Bin Jeong, Seoyun Park, Sohyun Ahn, Jin Nam Kim, Hye-Kyeong Kim
Korean Journal of Community Nutrition 2014;19(6):513-526.
DOI: https://doi.org/10.5720/kjcn.2014.19.6.513
Published online: December 31, 2014

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

Corresponding author: Hye-Kyeong Kim. Department of Food Science & Nutrition, The Catholic University of Korea, Jibongro 43, Wonmi-gu, Bucheon, Gyeonggi-do 420-743, Korea. Tel: (02) 2164-4314, Fax: (02) 2164-4314, hkyeong@catholic.ac.kr
• Received: October 27, 2014   • Revised: December 15, 2014   • Accepted: December 23, 2014

Copyright © 2014 The Korean Society of Community Nutrition

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.

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  • Objectives
    This study was conducted to investigate the effect of low sodium diet education program on dietary habits, diet quality, and measures of obesity in overweight or obese middle-aged women.
  • Methods
    Subjects were 81 individuals aged 45 years or over, who completed an 8-week nutrition education. The subjects were divided into a normal group (N = 30) and an overweight-obese group (N = 51) according to the BMI. The effects were evaluated by anthropometric measurement, biochemical analysis, questionnaire, and diet records before and after the program.
  • Results
    Overweight-obese group showed significant decreases in weight (p < 0.0001), BMI (p < 0.0001), percent of body fat (p = 0.0087), waist circumference (p < 0.0001), systolic (p = 0.0003) and diastolic blood pressure (p = 0.0261). Nutrients intakes were not different between the two groups and only sodium intake was decreased after education. Total score of general dietary habits, dietary behavior related to sodium intake, dietary diversity score (DDS), diet variety score (DVS), and diet quality index-international (DQI-I) were improved in both groups compared to the baseline. Overweight-obese group showed significant improvement in 'having fruits everyday', 'having fish everyday', 'trying to eat many kinds of food', 'eating less broth when eating soup, stew, and noodles', 'eating less kimchi and salt-fermented vegetable', and 'propensity to think that dishes should be pretty seasoned'. In addition, moderation of empty calories food (p = 0.0064) and macronutrient ratio (p = 0.0004) were improved in the overweigh-obese group, but in the normal group, the results did not reach statistical significance.
  • Conclusions
    These results suggested that low sodium diet education program may contribute to obesity management by improving diet quality and dietary habits in middle-aged women.
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Fig. 1
The protocol of the study.
kjcn-19-513-g001.jpg
Table 1
Components of the Diet Quality Index-International (DQI-I)
kjcn-19-513-i001.jpg

Adapted from Yun et al. (2009)

1) The criteria of score is based on the RI value for Korean

2) RI: recommended intakes

3) Ratio of energy from carbohydrate to protein to fat following DRIs for Korean

4) P/S: ratio of PUFA to SFA intake

5) M/S: ratio of MUFA to SFA intake

6) MUFA: monounsaturated fatty acids

7) SFA: saturated fatty acids

Table 2
General characteristics of the study subjects
kjcn-19-513-i002.jpg

1) p value by t-test or chi-sqaure test between groups, 2) Mean±SD, 3) N (%)

Table 3
The changes in anthropometric, blood pressure and biochemical characteristics according to BMI classification
kjcn-19-513-i003.jpg

1) p value by paired t-test within groups, 2) p value by t-test between groups at pre-education stage, 3) p value by t-test between groups at post-education stage, 4) Mean±SD, 5) NS : not significant, 6) BMI; body mass index, 7) PBF; percentage of body fat 8) WC; waist circumference, 9) SBP; systolic blood pressure, 10) DBP; diastolic blood pressure, 11) FBS; fasting blood sugar, 12) TC; total cholesterol, 13) AI; atherogenic index, 14) FFA; free fatty acid

Table 4
The dietary intake changes of the subjects after low-sodium diet education according to BMI classification
kjcn-19-513-i004.jpg

1) p value by paired t-test within groups

2) p value by t-test between groups at pre-education stage

3) p value by t-test between groups at post-education stage

4) Mean±SD

5) NS: not significance

Table 5
The change in general dietary habits of the subjects after low-sodium diet education according to BMI classification
kjcn-19-513-i005.jpg

1) p value by paired t-test within groups

2) p value by t-test between groups at pre-education stage

3) p value by t-test between groups at post-education stage

4) Mean±SD

5) NS: not significance

Score: 0.5 = less than once a week, 3 = 2-4 times a week, 5 = 5 times a week (Question 3, 5, 11, 15~19 are inverse-coded)

Table 6
The changes in dietary behavior associated with sodium after low-sodium diet education according to BMI classification
kjcn-19-513-i006.jpg

1) p value by paired t-test within groups

2) p value by t-test between groups at pre-education stage

3) p value by t-test between groups at post-education stage

4) Mean±SD

5) NS: not significance

Score: Yes = 0, No = 1

Table 7
The changes in dietary diversity score (DDS) and dietary variety score (DVS) after low-sodium diet education according to BMI classification
kjcn-19-513-i007.jpg

1) p value by paired t-test or chi-square test within groups

2) p value by t-test or chi-square test between groups at pre-education stage

3) p value by t-test or chi-square test between groups at post-education stage

4) Values are Mean±SD

5) NS: not significant

6) N (%)

Table 8
DQI-I score change of the subjects after low-sodium diet education according to BMI classification
kjcn-19-513-i008.jpg

1) p value by paired t-test within groups

2) p value by t-test between groups at pre-education stage

3) p value by t-test between groups at post-education stage

4) This score means perfect score of each evaluation standard presented in Table 1

5) Mean±SD

6) NS: not significant

Figure & Data

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        The Effects of Low-sodium Diet Education Program on Dietary Habits, Diet Quality and Obesity Index in Overweight and Obese Middle-aged Women
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      The Effects of Low-sodium Diet Education Program on Dietary Habits, Diet Quality and Obesity Index in Overweight and Obese Middle-aged Women
      Image
      Fig. 1 The protocol of the study.
      The Effects of Low-sodium Diet Education Program on Dietary Habits, Diet Quality and Obesity Index in Overweight and Obese Middle-aged Women

      Components of the Diet Quality Index-International (DQI-I)

      Adapted from Yun et al. (2009)

      1) The criteria of score is based on the RI value for Korean

      2) RI: recommended intakes

      3) Ratio of energy from carbohydrate to protein to fat following DRIs for Korean

      4) P/S: ratio of PUFA to SFA intake

      5) M/S: ratio of MUFA to SFA intake

      6) MUFA: monounsaturated fatty acids

      7) SFA: saturated fatty acids

      General characteristics of the study subjects

      1) p value by t-test or chi-sqaure test between groups, 2) Mean±SD, 3) N (%)

      The changes in anthropometric, blood pressure and biochemical characteristics according to BMI classification

      1) p value by paired t-test within groups, 2) p value by t-test between groups at pre-education stage, 3) p value by t-test between groups at post-education stage, 4) Mean±SD, 5) NS : not significant, 6) BMI; body mass index, 7) PBF; percentage of body fat 8) WC; waist circumference, 9) SBP; systolic blood pressure, 10) DBP; diastolic blood pressure, 11) FBS; fasting blood sugar, 12) TC; total cholesterol, 13) AI; atherogenic index, 14) FFA; free fatty acid

      The dietary intake changes of the subjects after low-sodium diet education according to BMI classification

      1) p value by paired t-test within groups

      2) p value by t-test between groups at pre-education stage

      3) p value by t-test between groups at post-education stage

      4) Mean±SD

      5) NS: not significance

      The change in general dietary habits of the subjects after low-sodium diet education according to BMI classification

      1) p value by paired t-test within groups

      2) p value by t-test between groups at pre-education stage

      3) p value by t-test between groups at post-education stage

      4) Mean±SD

      5) NS: not significance

      Score: 0.5 = less than once a week, 3 = 2-4 times a week, 5 = 5 times a week (Question 3, 5, 11, 15~19 are inverse-coded)

      The changes in dietary behavior associated with sodium after low-sodium diet education according to BMI classification

      1) p value by paired t-test within groups

      2) p value by t-test between groups at pre-education stage

      3) p value by t-test between groups at post-education stage

      4) Mean±SD

      5) NS: not significance

      Score: Yes = 0, No = 1

      The changes in dietary diversity score (DDS) and dietary variety score (DVS) after low-sodium diet education according to BMI classification

      1) p value by paired t-test or chi-square test within groups

      2) p value by t-test or chi-square test between groups at pre-education stage

      3) p value by t-test or chi-square test between groups at post-education stage

      4) Values are Mean±SD

      5) NS: not significant

      6) N (%)

      DQI-I score change of the subjects after low-sodium diet education according to BMI classification

      1) p value by paired t-test within groups

      2) p value by t-test between groups at pre-education stage

      3) p value by t-test between groups at post-education stage

      4) This score means perfect score of each evaluation standard presented in Table 1

      5) Mean±SD

      6) NS: not significant

      Table 1 Components of the Diet Quality Index-International (DQI-I)

      Adapted from Yun et al. (2009)

      1) The criteria of score is based on the RI value for Korean

      2) RI: recommended intakes

      3) Ratio of energy from carbohydrate to protein to fat following DRIs for Korean

      4) P/S: ratio of PUFA to SFA intake

      5) M/S: ratio of MUFA to SFA intake

      6) MUFA: monounsaturated fatty acids

      7) SFA: saturated fatty acids

      Table 2 General characteristics of the study subjects

      1) p value by t-test or chi-sqaure test between groups, 2) Mean±SD, 3) N (%)

      Table 3 The changes in anthropometric, blood pressure and biochemical characteristics according to BMI classification

      1) p value by paired t-test within groups, 2) p value by t-test between groups at pre-education stage, 3) p value by t-test between groups at post-education stage, 4) Mean±SD, 5) NS : not significant, 6) BMI; body mass index, 7) PBF; percentage of body fat 8) WC; waist circumference, 9) SBP; systolic blood pressure, 10) DBP; diastolic blood pressure, 11) FBS; fasting blood sugar, 12) TC; total cholesterol, 13) AI; atherogenic index, 14) FFA; free fatty acid

      Table 4 The dietary intake changes of the subjects after low-sodium diet education according to BMI classification

      1) p value by paired t-test within groups

      2) p value by t-test between groups at pre-education stage

      3) p value by t-test between groups at post-education stage

      4) Mean±SD

      5) NS: not significance

      Table 5 The change in general dietary habits of the subjects after low-sodium diet education according to BMI classification

      1) p value by paired t-test within groups

      2) p value by t-test between groups at pre-education stage

      3) p value by t-test between groups at post-education stage

      4) Mean±SD

      5) NS: not significance

      Score: 0.5 = less than once a week, 3 = 2-4 times a week, 5 = 5 times a week (Question 3, 5, 11, 15~19 are inverse-coded)

      Table 6 The changes in dietary behavior associated with sodium after low-sodium diet education according to BMI classification

      1) p value by paired t-test within groups

      2) p value by t-test between groups at pre-education stage

      3) p value by t-test between groups at post-education stage

      4) Mean±SD

      5) NS: not significance

      Score: Yes = 0, No = 1

      Table 7 The changes in dietary diversity score (DDS) and dietary variety score (DVS) after low-sodium diet education according to BMI classification

      1) p value by paired t-test or chi-square test within groups

      2) p value by t-test or chi-square test between groups at pre-education stage

      3) p value by t-test or chi-square test between groups at post-education stage

      4) Values are Mean±SD

      5) NS: not significant

      6) N (%)

      Table 8 DQI-I score change of the subjects after low-sodium diet education according to BMI classification

      1) p value by paired t-test within groups

      2) p value by t-test between groups at pre-education stage

      3) p value by t-test between groups at post-education stage

      4) This score means perfect score of each evaluation standard presented in Table 1

      5) Mean±SD

      6) NS: not significant


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