Objectives This study investigated whether outcome expectations, self-efficacy, eating environment, and eating behaviors differed according to the stages of change in adequate sodium intake among university students. Methods: The participants were students recruited from nine universities in Seoul, Korea. An online survey was conducted, and data from 351 participants were analyzed. Participants were classified into pre-action and action stages based on adequate sodium intake. Data were analyzed using t-test, χ2-test, analysis of covariance, and correlation analysis. Results: Participants in the action stage (22.8%) felt fewer disadvantages of eating sodium adequately compared to those in the pre-action stage (77.2%, P < 0.001) and perceived more self-efficacy for healthy eating behaviors (P < 0.001) and controlling sodium intake (P < 0.01). The participants in the action stage also showed more desirable eating behaviors than those in the pre-action stage, including general eating behaviors, behaviors related to sodium intake, and sodium checks (P < 0.001). The physical environment in the action stage was more supportive of adequate sodium intake (P < 0.05). Eating behaviors, self-efficacy, and outcome expectations were significantly correlated with the stages of change; however, some differences were noticed in the correlation of the subscales of variables with the stages of change when examined by sex. Conclusion: We observed differences in factors according to the stages of change in adequate sodium intake. For the pre-action stage, nutrition education can be planned to modify negative expectations of eating adequate sodium, foster self-efficacy, and practice general eating behaviors and behaviors to gradually reduce sodium intake. It is also necessary to alter the physical environment to reduce sodium intake. In the action stage, support and reinforcement are needed to continually practice and maintain desirable eating behaviors. Nutrition education for women may be planned using multiple paths, whereas a simple strategy may be useful for men.
Objectives This study aimed to evaluate the importance and performance of sodium reduction practices among childcare center cooks in the Yongin area before and after a 3-month salinometer support program.
Methods In total, 313 cooks employed in childcare centers in Yongin were surveyed before and after participating in a salinometer support program. The survey included questions on general information, sodium-related dietary habits, and perceived importance and performance levels of sodium reduction approaches in the purchasing, cooking, and serving areas. The centers were divided into childcare centers registered as group-feeding facilities (FS group, n = 68) and those not registered as such (non-FS group, n = 245). The differences between the two groups were analyzed.
Results The overall importance levels increased significantly after the program in both the FS-group (P < 0.001) and non-FS group (P = 0.005). The overall performance levels also increased significantly in both groups (P < 0.001 for all). Consequently, the significant difference between the importance and performance levels disappeared in both groups after the program. However, unlike the FS group, which showed no significant differences between the importance and performance levels after the program in all three areas, the non-FS group still demonstrated lower performance levels than importance levels in the purchasing (P = 0.011) and serving (P = 0.034) areas after the program.
Conclusions The use of salinometers significantly enhanced the performance and importance of low-sodium management practices among cooks in childcare centers, especially in the FS group. The continuous monitoring of salinity measurements and tailored education specialized for the FS and non-FS groups are recommended.
Objectives The sodium index is an index that converts the estimated sodium intake calculated using a verified and reliable sodium estimation formula. This study aimed to determine the relationship between the sodium index and obesity indicators and the potential impact of excessive sodium consumption on obesity.
Methods Obesity indicators, such as body mass index (BMI), body fat percentage, waist-to-hip ratio (WHR), and visceral fat levels, were analyzed in 120 university students (60 men and 60 women). The sodium index was calculated by indexing the estimated sodium intake according to age, sex, BMI, salt-eating habits, and salt-eating behaviors. The relationship between sodium index and obesity indicators was analyzed using multiple logistic regression.
Results The estimated sodium intake was 3,907.1 mg, with 76.7% of the participants categorized under the “careful” level of sodium index and 10.8% under the “moderate” level. As the sodium index increased, the BMI, body fat percentage, WHR, and visceral fat levels significantly increased. All obesity indicators significantly increased in patients with a “severe” sodium index than in those with a “moderate” sodium index. In addition, a strong positive correlation was identified between obesity indicators and sodium index. When the “severe” sodium index was compared with the “moderate” sodium index, the risk of obesity based on body fat percentage increased by 2.181 times (95% confidence interval [CI], 1.526–3.118), while the risk of obesity based on visceral fat level increased by 4.073 times (95% CI, 2.097–7.911).
Conclusions Our findings suggest a correlation between excessive sodium intake and obesity. Moreover, the sodium index can be used to determine sodium intake.
Objectives This study aimed to examine the frequency of convenience food consumption at convenience stores (CVS) and the CVS usage patterns of middle and high school students as well as to understand students’ attitude toward sodium and sugar reduction. Methods We used an online questionnaire for data collection. The questionnaire comprised five distinct categories: general characteristics, CVS usage, frequency of consumption according to convenience food menus at CVS, attitude toward sodium and sugar reduction, and adherence to dietary guidelines. Results A total of 75 students from Seoul (14 middle school students and 61 high school students) participated in the study. Most respondents visit CVS 3-5 times a week. CVS are predominantly used during weekdays, mostly during lunch, and dinner. The students mostly checked the caloric content and expiration date as food labeling information. The participants were aware of the need to reduce their sugar and sodium intake. Among frequent CVS convenience food consumers, there was an increased consideration of the need to reduce their sugar and sodium consumption, despite their actual selection of foods with high sugar and sodium content. Additionally, they did not check the sugar and sodium levels indicated in food labeling. Further, the dietary action guide from the Ministry of Health and Welfare were poorly followed by most students. Conclusions There is a need for nutrition education specifically addressing the sugar and sodium content of the convenience foods predominantly consumed by students. Additionally, educating students with frequent convenience food consumption to actively check the sugar and sodium information on food labels could help promote healthier food choices.
Objectives Based on the results from the Korean Total Diet Study (KTDS), the sodium (Na) and potassium (K) intake of Koreans were estimated and compared with intake estimates from the Food & Nutrient Database (FNDB), as in the Korea National Health and Nutrition Examination Survey (KNHANES) to verify the validity of these estimates. Methods One hundred and thirty-four representative foods (RFs) covering 92.5% of the total food intake of Koreans were selected, and 228 pairs of corresponding ‘RF x representative cooking method’ were derived by reflecting the methods used mainly in terms of frequency and quantity in their cooking.
RF samples were collected from three cities with a larger population size in three regions (nine cities) nationwide, and six composite samples were made for each RF, considering its regional and/or seasonal characteristics. One thousand three hundred and sixty-eight ‘RF x representative cooking method’ pair samples were prepared, and the Na and K contents were assessed using inductively coupled plasma atomic emission spectrometry (ICP-MS). The Na and K intake of the Korean population was estimated by linking the content with the food intake data from the 7th KNHANES. Results The mean Na and K intake of Koreans were 2,807.4 mg and 2,335.0 mg per person per day, respectively. A comparison with the Na and K intake from KNHANES, including only RFs of KTDS, showed comparable results with less than 5% variation. While the contribution and ranking of food items to Na intake were similar between KNHANES and KTDS, there were differences in K intake.
This was attributed to the large discrepancies in the K content of rice and coffee between KTDS results and the values in the 9th Revision of the National Food Composition Table used in KNHANES. Conclusions The Na and K intake of Koreans estimated based on the KTDS, which performed nutrient analysis on samples prepared to a ‘table-ready’ state using foods of the representative collection, was similar and comparable with that of KNHANES. This supports the validity and usefulness of FNDB-based nutrient intake estimation at the population level. The list of nutrients studied in KTDS is expected to be expanded, allowing for intake estimation of nutrients with currently insufficient or absent information in the FNDBs in use.
Objectives The purposes of this study were to compare the degree of sodium reduction practice and estimate sodium intake by salty food preference. Methods Sodium reduction practices, salty food preferences and estimated sodium intake were surveyed for restaurant owners (n = 80), employees (n = 82) and customers (n = 727) at the restaurants participating in the sodium reduction project in Daegu, Korea. Estimated sodium intake was performed by examining sex, age, body mass index (BMI), salty eating habit and dietary behaviors. Results The degree of sodium reduction practice was significantly higher in salinity meter use (P < 0.001), low salt seasonings (P < 0.001) and efforts to make the foods as bland as possible overall (P < 0.001) in the restaurants participating in sodium reduction project than in homes (P < 0.001). The degree of sodium reduction practice appeared lower in the high salty food preference group than in the low-preference group in such items as efforts to make the foods as bland as possible overall (P < 0.05) and washing the salty taste and then cooking (P < 0.05). The high-preference group showed high-salt dietary behavior, including eating all the soup until nothing was left (P < 0.05) more than the low-preference group, but low-salt dietary behavior included checking the sodium content in processed foods (P < 0 .0 5) less than the low-preference group. The high-preference group was higher in the soup and stew intake frequency than the low-preference group (P < 0.05) and much lower in nuts (P < 0.05) and fruits (P < 0.05) intake frequency. The high-preference group had a higher salty eating habit (P < 0.05), salty taste assessment (P < 0.05) and estimated sodium intake (P < 0.05) than the low-preference group. Conclusions The present study showed that the salty food preference was strongly associated with lower sodium reduction practice and higher estimated sodium intake.
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Objectives The purpose of this study was to evaluate the effect of the sodium and sugar reduction practices of the Samsam foodservice project of Daegu, in comparison with that of general foodservices in Daegu.
Methods: A survey was conducted on 80 Samsam foodservice workers and 80 general foodservice workers from Sep. to Oct. 2020. We compared each worker's taste preferences, stage of behavior change and dietary behavior regarding sodium and sugar, and each foodservice's practices regarding sodium and sugar reduction.
Results: There was no significant difference between the salty taste and sweet taste preferences between the workers at the Samsam foodservices and those at the general foodservices. The percentage of foodservice workers in action or maintenance stage of behavior change for eating less salty was higher in the Samsam foodservices than in the general foodservices (P < 0.05). In addition, regarding the degree of saltiness and sweetness of meals, the workers at the general foodservices perceived their meals to be saltier (P < 0.001) and sweeter (P < 0.01) than the workers at Samsam foodservices.
The workers at Samsam foodservices had fewer salty dietary behaviors compared to the workers at general foodservices (P < 0.01). The sodium reduction practice was significantly higher in the Samsam foodservices than the general foodservices (P < 0.001), especially in “efforts to make the food as bland as possible overall” (P < 0.001), and “serving less soup and stew” (P < 0.001). The sugar reduction practice too was significantly higher in the Samsam foodservices than the general foodservices (P < 0.001).
Conclusions: The Samsam foodservices were shown to be better in the practice of sodium and sugar reduction compared to general foodservices. Therefore, it is necessary to provide continuous and practical support and incentives at the national level to expand the sodium and sugar reduction practices in foodservices.
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Objectives The aim of this study was to investigate sodium reduction practices in school foodservice in Daegu.
Methods The survey included 199 nutrition teachers and dietitians working at elementary, middle and high schools in Daegu. The survey topics included the following: the frequency of salinity measurement, workers in charge of the measurement, average salinity of the soup and stew served, frequency and difficulties of offering low-sodium meals, Importance-Performance Analysis (IPA) of sodium reduction methods in school foodservice and the need for political support in encouraging sodium reduction.
Results The mean salinity of the soup and stew was higher in high school foodservice than in elementary and middle school foodservice. Middle and high schools have difficulties in offering low-sodium meals due to concerns of decreasing satisfaction for the meals. The results of the IPA of programs to reduce sodium in school meals showed that most of the items in the cooking and serving stages were in the 2nd quadrant (Keep up the good work), and all purchasing and menu planning stages occupied the 3rd quadrant (Low priority). To reduce sodium in school meals, government support is required in developing low-sodium recipes for school foodservice, encouraging education on sodium reduction for school foodservice officials and developing low-sodium food for institutional foodservice.
Conclusions To encourage sodium reduction in school meals, the priority is to make low-sodium recipes available. Also, it is necessary to develop a program that calculates the sodium content in menus and processed foods through National Education Information System and to establish standards for sodium levels in school foodservice.
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Sodium intake by food frequency questionnaire was significantly different when compared with the intake determined from 24-hour urinary sodium excretion. Sodium intake from all methods (except food frequency questionnaire) significantly correlated with values obtained from 24-hour urine sodium excretion. Conclusions Results of this study validated a mobile phone app using a 24-hour dietary recall with meal photos to better estimate dietary sodium intakes. It is believed that further studies in the future will enable the application as a tool to more accurately determine sodium intake.
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OBJECTIVES Calcium (Ca) is an insufficiently consumed nutrient, whereas phosphorus (P) intake has exceeded the recommended intake level in Korea over the past decade. The purpose of this study was to analyze dietary Ca and P intakes and their contribution rate according to dish groups. METHODS A 24-hour dietary recall survey of 640 healthy adults (aged 19–69 years) was undertaken twice in four Korean provinces. Dietary Ca and P intakes and their rates of contribution from 31 major dish groups were analyzed and compared by gender, age group, and region. RESULTS The average Ca and P intakes of the subjects were 542.1 ± 222.2 mg/d and 1,068.3 ± 329.0 mg/d, respectively. The intakes of Ca and P as percentages of recommended nutrients intake (RNI%) were 71.7 ± 29.8% and 152.6 ± 47%, respectively, and the percentages under the estimated average requirement were 60.3% for Ca and 3.8% for P. The RNI% of Ca was not significantly different between males and females, but was significantly higher in subjects in the sixties age group than in other age groups and was significantly lower in the Korean capital than in other regions. The RNI% of P did not significantly differ by gender or age groups, but it was significantly higher in the capital than in Gyeong-sang. The five major dish groups contributing to Ca intake (contribution rate) were milks/dairy products 69.2 ± 109.2 mg/d (12.6%), soups 55.6 ± 69.6 mg/d (10.1%), stir-fried foods 53.1 ± 70.7 mg/d (9.7%), stews 43.4 ± 85.4 mg/d (7.9%), and kimchi 38.4 ± 31.8 mg/d (7.0%). The five major dish group contributing to P intake (contribution rate) were cooked rice 160.7 ± 107.1 mg/d (14.9%), stir-fried foods 88.5 ± 89.4 mg/d (8.2%), soups 76.7 ± 85.8 mg/d (7.1%), one-dish meals 63.3 ± 94.4 mg/d (5.9%), and stews 62.6 ± 89.3 mg/d (5.8%). The dish groups contributing to Ca and P intakes differed somewhat by gender, age group, and region. CONCLUSIONS Programs to improve the nutritional status of Ca and P intakes should consider the differences in Ca and P contribution rates by dish groups as well as by gender, age group, and region.
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OBJECTIVES This study aimed to compare customers' perceptions of the need for a low-sodium diet and sodium-reduced operations in the industry foodservice by age. The relationships between health concerns and perceptions of the need for sodium-reduced operations and low-sodium diets in the industry foodservice were analyzed. METHODS A survey was conducted among 340 industry foodservice customers aged 20–50 years and residing in Seoul, Korea. This study investigated the respondents' health concerns, their perception of the need for sodium-reduced foodservice operations, their perception of a sodium-reduced diet, and the general details of the foodservices they used. A cross-tabulation analysis and ANOVA were performed to identify differences in measurement items by age, and a simple regression analysis was performed to examine relationships between measurement items. RESULTS For the customers' perception of the need for a sodium-reduced foodservice operation, the item “it is necessary to provide separate spices and sauces to reduce sodium intake†achieved the highest score (3.88 points out of a possible 5 points). For the perception of a sodium-reduced diet, the item “I think it is helpful for one's health†obtained the highest score (4.13 points). Respondents' health concerns had a positive effect on increasing the level of perception of the need for sodium-reduced foodservice operations and that of a sodium-reduced diet. CONCLUSIONS Foodservice nutritionists could help enhance their customers' perceptions of the needs for sodium-reduced foodservice operations and sodium-reduced diets by frequently providing them with sodium-related health information.
OBJECTIVES This study examined the salinity of soups provided at childcare centers by measuring the salinity for three years and providing basic data for sodium reduction. METHODS The soup salinity was measured using a Bluetooth salinity meter from January 2015 to December 2017 at 80 childcare foodservice establishments enrolled in the Suseong Center for Children's Foodservice Management in Daegu. RESULTS An analysis of the soup salinity each year showed that the salinity decreased significantly from 0.48% in 2015 to 0.41% in 2017, particularly in clear soups and soybean soups compared to other soups (P < 0.05). The salinity and sodium content in seafood soups (0.45% and 179.1 mg/100 g, respectively) were highest, followed by soybean soups (0.44%, 175.2 mg/100 g), with perilla seed soups containing the lowest (0.42%, 167.2 mg/100 g) (P < 0.05). The salinity was significantly higher in institutional foodservice establishments than small foodservice establishments (P < 0.001). The salinity and sodium content were the highest in foodservice establishments with a small number of measurements, and the salinity was the lowest in foodservice establishments with salinity measurements performed an average of 151 times each year (three times a week) or more (P < 0.05). The soup salinity was low in the order of winter, spring, summer, and autumn, and the salinity decreased significantly year by year in all seasons. (P < 0.05). CONCLUSIONS The soup salinity was significantly lower in foodservice establishments where the salinity was measured more than three times a week, indicating that continuous salinity management is effective.
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OBJECTIVES This study was conducted to analyze the salinity of representative Korean foods high in sodium to generate data for use as a fundamental resource for setting salinity standards in foods. METHODS A total of 480 foods from 16 representative Korean foods high in sodium were collected from 10 households, 10 industry foodservice establishments, and 10 Korean restaurants in four regions (Capital area, Chungcheong Province, Gyeongsang Province, and Jeolla Province) and analyzed for salinity. RESULTS Among the foods, stir-fried anchovies (4.07~4.45%) showed the highest salinity, followed by pickled onion (1.86~2.62%), cabbage kimchi (1.83~2.2%), braised burdock and lotus root (1.79~2.17%), and sliced radish kimchi (1.78~1.89%) (p < 0.001). The salinity of kimchi from home meals (2.2%) was significantly higher than that of foodservice (1.83%) and restaurant (1.93%) kimchi (p < 0.05). Salinity in each group of food was highest in kimchi (1.83~2.04%), followed by braised dishes (1.54~1.78%), steamed dishes (1.0~1.22%), stir-fried dishes (1.02~1.18%), and soup or stew (0.74~1.02%) (p < 0.001). The salinity of soup and stew from restaurants (1.02%) was significantly higher than that of home meal (0.84%) and foodservice (0.74%) soup and stew. CONCLUSIONS Determination of the salinity of representative Korean foods known to be high in sodium by eating place is expected to be useful to establishing guidelines for reduction of salinity.
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PURPOSE The aim of this study was to analyze the association between sodium excretion and obesity for healthy adults in the Gwangju area. METHODS The participants included 80 healthy adults aged 19 to 69 years in Gwangju. The dietary intake and sodium excretion were obtained using the 24-hour recall method and 24 hour urine collection. The participants were classified into two groups according to the amount of urinary sodium excretion: (≤ 141.75 mmol/dL, > 141.75 mmol/dL). RESULTS After adjusting for sex, age, smoking history, and income, the high excretion of sodium group was significantly higher for weight, body mass index, body fat mass, percent body fat, visceral fat area (VFA), waist circumference, hip circumference, and WHR. The energy and nutrients intake were significant after adjusting for sex, age, smoking history, and income. The LSE group had a significantly higher fat intake and Na/K intake ratio. The HSE group had significantly higher fiber intake, and K intake. As the amount of urinary sodium excretion increased, the risk of obesity before correction was 3.57 (95% CI: 1.13–11.25) times greater, and the risk of obesity of T3 increased significantly by 3.33 times (95% CI: 1.05–10.59). After correcting for sex and age, the obesity risk of T2 increased significantly by 4.23 times (95% CI: 1.11–16.06), and after correcting for sex, age, smoking history, and income, the obesity risk of T2 increased significantly by 6.81 times (95% CI: 1.44–32.19) the risk of obesity. CONCLUSIONS An association exists between sodium excretion and obesity in Korean adults. In this study, the high excretion of sodium group was obese and the risk of obesity was higher than the low excretion of sodium group.
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OBJECTIVES The purpose of the study was to develop communication strategies for effective nutrition education targeting pregnant women and to create nutrition education contents. METHODS The format and the contents of online resources on nutrition information for pregnant women provided by reliable institutions were analyzed. Possible solutions to overcome barriers of nutrition education as well as communication strategies for effective nutrition education were identified by a brainstorming process. Based on the communication strategies, contents for nutrition education were created. Understandability, level of interest, applicability to daily life, harmony of text and illustration, and overall satisfaction of the contents were evaluated by dietitians and pregnant women. RESULTS The four communication strategies were developed; (1) to focus on a few important messages, (2) to provide evidence-based information, (3) to create illustrations or infographics with a minimum amount of text, and (4) to provide tips on how to improve the current diet options. Based on these strategies, the contents were focused on three important nutrients for pregnant women, folate, iron, and calcium. The percentages of the recommended nutrient intakes of the three nutrients on selected menu and its improved version by adding a dish or changing a dish into another dish were calculated and provided. Finally, the contents were delivered as illustrations with a minimum amount of text. Overall, dietitians and pregnant women were satisfied with the contents. CONCLUSIONS The contents developed in this study can be used in a pamphlet or a pregnancy diary, or can be shared in social networking services. Further contents on other nutrients and various menu are expected to be developed using these communication strategies.
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OBJECTIVES The purpose of this study was to evaluate the main sources of dietary sodium and potassium intake in Koreans by gender, age and regions. METHODS We used the data from 2010-2012 KNHANES. A total of 20,387 subjects aged 8 years and older were included. Intakes were compared by gender, age (8-18, 19-49 and >50 years) and geographical regions in Korea. Dishes were classified into 28 dish groups based on cooking methods. Statistical analysis was performed by using the SAS 9.3 and SUDAAN 11.0.1 software. RESULTS The mean sodium intake of Koreans was 4866.5 ± 35.9 mg/day, which was 2.4 times higher than the adequate intake (AI) of sodium for Koreans. We found that daily sodium intakes were significantly different by age, gender and regions. Men and aged over 50 years had significantly higher sodium intake than women and other age groups. The mean potassium intake in Koreans was 3002.2 ± 19.4 mg/day and daily potassium intakes were significantly different by age, gender and regions. Women and age 50 years and over had significantly higher potassium intakes than men and other age groups. The average Na/K ratio was 2.89 ± 0.01 and was highest in men and in the age group of 19-49 years. The major sources of dietary sodium were soup and stew, followed by Kimchi, noodles and dumpling, pickled vegetables and seasonings, which represented 63.1 % of total sodium intakes. Soup and stew or Kimchi were the primary sources of dietary sodium intake. The major sources of dietary potassium were cooked rice, followed by soup and stew, Kimchi, fruits and beverages. CONCLUSIONS Sodium and potassium intakes and the major sources of those were significantly different by gender, age groups and regions. Therefore, different approaches based on gender, age and regions are needed to decrease sodium intake and increase potassium intake.
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OBJECTIVES New retinol activity equivalent (RAE) was introduced as vitamin A unit in Dietary Reference Intake (DRI) for Koreans 2015. The purpose of this study was to evaluate the adequacy of 2015 reference intake (RI) of vitamin A in RAE unit by the comparison with RI and dietary intake of vitamin A. METHODS Analyses on RI of vitamin A were based on the Recommended Dietary Allowances (RDA) for Koreans (1962~2000) and DRIs for Koreans (2005~2015). Analyses on Koreans dietary intake of vitamin A were based on the Korea National Health and Nutrition Examination Survey (KNHNES) reports (1969-2014). For recalculation of RI and dietary intake of vitamin A in RE to RAE, 2013 Koreans intake of retinol: carotenoids ratio of 13: 87 was applied. RESULTS RI of vitamin A was 600~750 RE for Korean adult, and 339~425 RAE when calculated by applying the retinol and carotenoids intake ratio. Vitamin A intakes of Koreans were <100% RI, 267~668 RE from 1969 to 2001. From 2005, vitamin A intake had increased to >700 RE, >100% RI. When vitamin A intake was converted from RE to RAE (2005~2014), 718~864 RE became 405.8~488.1 RAE, decreased to 56.5% level. The recent 2015 RI of vitamin A is 850 RAE, two times of 2005 & 2010 RI of 425 RAE for adult male. CONCLUSIONS When nutritional status of vitamin A was assessed for Koreans using the estimated average requirement (EAR) of 2015 (570, 460 RAE for male, female adults, respectively), ratio of deficient people increased significantly when judged based on the previous intake of Koreans, <490 RAE. We needs to examine the 2015 RI (EAR) of vitamin A, find a way to measure the accurate intake of dietary vitamin A, and to increase the dietary intake of this vitamin.
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OBJECTIVES Excess sodium intake has been linked to obesity and obesity-related indices. However, the scientific evidence for this association is inadequate. The purpose of this study was to investigate the association between urinary sodium excretion and obesity-related indices among Korean adults. METHODS A convenience sample of 120 subjects (60 obese and 60 non-obese subjects) were recruited applying frequency matching for sex and age between two groups. Sodium intake level was assessed through 24-hour urine collection. Obesity-related metabolic risk factors, including fasting blood lipid indices, subcutaneous and visceral fat through computed tomography (CT), insulin resistance indices, blood pressure and liver enzymes were measured in all subjects. These obesity-related metabolic risk factors were compared between obese and non-obese group according to sodium excretion levels (<110 mEq/day, 110~180 mEq/day, >180 mEq/day). RESULTS After adjusting for age, gender, health behaviors (smoking, exercise, drinking), and energy intake, several obesity-related metabolic risk factors, including abdominal circumference, body fat percentage, subcutaneous and visceral fat, triglyceride, and systolic blood pressure were found to be significantly deteriorated as the sodium excretion level increases. In addition, multivariate adjusted-odds ratios of abdominal obesity, high blood triglyceride, and high blood pressure were found significantly higher in the highest sodium excretion group compared to the lowest group. The mean number of metabolic syndrome risk factors was also significantly greater in the highest sodium excretion group than in the lowest group. CONCLUSIONS The current study findings suggested that high sodium intake can affect obesity and metabolic syndrome risk negatively, implying the necessity of future research on low-sodium diet intervention in relation to obesity and related health problems.
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OBJECTIVES Dietary life is closely associated with dietary attitude and diet-related knowledge. Particularly, dietary habit such as sodium intake can be affected by various dietary behaviors such as food choices, dietary attitude toward salty food and a preference for salty taste. The purpose of this study was to assess sodium-related nutrition knowledge and to identify sodium-related attitude and behaviors according to the level of sodium-related knowledge of university students. METHODS Anthropometric measurements were provided by 408 students who participated in this study. The study participants answered questionnaires to provide information on general dietary behaviors, sodium-related dietary attitude and other behavioral factors. A total score of nutrition knowledge was used to categorize study participants in to two groups, namely, low level in sodium-related knowledge (LNaK) or high level in sodium-related knowledge (HNaK) and the attitude and the behaviors of students toward sodium intake were compared between these two groups. RESULTS The ratio of female students in HNaK group was higher than that in the LNaK group. HNaK group had a higher score in checking nutrition label of processed food than the LNaK group. Total score of sodium-related attitude and behaviors of HNaK group were 34.81 and 32.75, respectively and these scores were significantly higher than that of the LNaK group whose scores were 32.57 and 30.57, respectively. Total energy intake was not different between two groups but the intakes of calcium, vitamin B2 and folate were higher in HNaK group than in the LNaK group. Correlation analysis adjusted for age and gender revealed that total score of sodium-related nutrition knowledge was positively correlated with total score of sodium-related attitude and behaviors. CONCLUSIONS In conclusion, students who had high level of sodium-related nutrition knowledge had desirable attitude and behaviors toward sodium intake and these results can be considered in nutrition education for university students.
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OBJECTIVES The purpose of this study was to investigate recognition, dietary attitude and education needs for reducing sodium intakes of dietitian at customized home visiting health service (CHVHS). METHODS The subjects were 75 dietitian at CHVHS. We investigated several variables (recognition, dietary attitude, education needs for reducing sodium intakes) and determined sodium intakes level of subjects as 'low', 'middle' and 'high' by Dish Frequency Questionnaire 25 (DFQ 25). Also, we assessed the differences in recognition, dietary attitude, sodium intake level and education needs by dietitian career period (under 3 yrs vs. over 3 yrs) at CHVHS. RESULTS In recognition related reducing sodium intake, they showed 'checking a sodium content in nutrition labeling' score 2.5/4.0 and 'perception difference between sodium and salt' score 3.1/4.0. There was no difference in the recognition between under 3yrs' group and over 3yrs' group. In dietary attitude related reducing sodium intake, they showed 'palatability for salty taste' score 0.8/1.0, 'attitude in related soups' 0.7/1.0, 'attitude in related using natural spice' 0.6/1.0. There was a difference in 'attitude in related soups' between under 3yrs' group and over 3yrs' group (0.6 vs. 0.7). In sodium intake level by DFQ 25, they showed 'low group' 41.3%, 'middle group' 41.3% and 'high group' 17.3%. There was no difference in the distribution of sodium intake level by the career. In education needs related reducing sodium intakes, there were 'teaching experience' 93.3%, 'have a difficulty in teaching about reducing sodium intakes' 86.6%, and 'necessity of education for CHVHS dietitians' 100.0%. 'Needed education contents for CHVHS dietitians' were ranked as 'cooking way to reduce sodium intake' 58.7%, 'relation between hypertension and sodium' 17.3%, 'composing way to reduce sodium intake' 17.3%. There was a difference in needed education contents 'relationship between hypertension and sodium' (33.3% vs. 2.6%) and 'The cooking way to reduce sodium intake' (38.9% vs. 76.9%) by the career. CONCLUSIONS The results suggested that a capacity training program for reducing sodium intake may be needed for dietitians at CHVHS to improve health of the community elderly. For effective training program related reducing sodium intake for dietitians at CHVHS, it may be necessary to consider the career period as dietitians at CHVHS.
OBJECTIVES This study was conducted to examine blood pressure and other characteristics of a high sodium intake group assessed with 24-hr urine analysis and the dietary factors related to the risk of high sodium intake among Korean adults. METHODS A cross-sectional study was conducted with adults aged 20-59 years. Subjects who completed 24-hr urine collection (N = 205) were divided into 3 groups (tertile) according to the sodium intake estimated with 24-hour urine analysis. We compared the blood pressure, BMI and dietary related factors of the 3 groups (low, medium, high sodium intake group) with General Linear Model (GLM) and Duncan's multiple range test (p < 0.05). The risk factors related to high sodium intake were assessed with odds ratio (p < 0.05). RESULTS The sodium intake (mg/day) of the 3 groups were 3359.8 +/- 627.9, 4900.3 +/- 395.1 and 6770.6 +/- 873.9, respectively, corresponding to daily salt intake (g/day) 8.5, 12.4 and 17.2, respectively. High sodium group showed significantly elevated age, BMI and systolic/diastolic blood pressure. Being male gender was associated with significantly increased risk of sodium intake (OR = 1.972; 95%CI: 1.083-3.593). The other factors related to high sodium intake were higher BMI (> or = 25) (OR = 2.619; 95% CI: 1.368-5.015), current alcohol consumption (OR = 1.943; 95%CI: 1.060-3.564), and having salty soybean paste with salt percentage > 14% (OR = 3.99; 95% CI: 1.404-6.841). The dietary attitude related to increased risk of high sodium intake included 'enjoy dried fish and salted mackerel' (p < 0.001) and 'eat all broth of soup, stew or noodle' (p < 0.001). CONCLUSIONS Because high sodium intake was associated with higher blood pressure, nutrition education should focus on alcohol consumption, emphasis on related dietary factors such as using low salt soybean paste, improvements in the habit of eating dried fish and salted mackerel or eating all broth of soup, stew or noodle.
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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.
OBJECTIVES This study aimed to develop nutrition education program for consumers to reduce sodium intake based on social cognitive theory (SCT). METHODS The main factors of SCT related to low sodium diet were investigated by using focus group interview (FGI) with 30 women who participated in consumer organizations. RESULTS The main target groups for the education program were housewives (H), parents (P), and the office workers (OW), for which we considered their influences on other people and the surroundings. According to the results of FGI, in carrying out low sodium diet, 'positive outcome expectation' were prevention of chronic disease and healthy dietary habit, and 'negative outcome expectation' were low palatability of foods, difficulty in cooking meals, and limited choice of foods. The contents of the program and education materials were individualized by each group to raise self-efficacy and behavioral capability, which reflected the results of the FGI. The program included 'salt intake and health' to raise positive outcome expectation. For improving the ability to practice low-sodium diet, the program contained the contents that focused on 'cooking' and 'food purchasing' for H, on 'purchasing and selection of low-sodium food with the children' for P, and on 'way of selecting restaurant menu' for OW. Also the program included 'way of choosing the low-sodium foods when eating out' with suggestions on sodium content of the dishes and snacks. Further, 'dietary guidelines to reduce sodium intake' was also suggested to help self-regulation. CONCLUSIONS This nutrition education program and education materials could be utilized for the community education and provide the basis for further consumer targeted education program for reducing sodium intake.
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OBJECTIVES To investigate the use frequency and amount of food sources of sodium and knowledge requirement, and job satisfaction with school food services according to the school types in Busan. METHODS A total of 98 schools were surveyed and knowledge requirement and job satisfaction were assessed using a questionnaire. In addition, the use frequency and amount of food sources of sodium for 10 school days were examined. RESULTS The response rate of the most difficult area among dietitians' tasks was significantly high in 'nutrition education and counseling' for elementary schools and 'hygiene management' for high schools (p < .05). The response rate of the factors to be considered in meal planning was significantly high in 'energy and nutrients requirement' for elementary schools and 'menu/taste preference of students' for middle and high schools (p < .05). The response rate of whether school food services affect health and eating habits of students or not was significant high in 'very helpful' for elementary schools (p < .001). The average sodium contents in the meals of elementary, middle and high schools was 1981.4 mg/meal/person/day, 1867.3 mg/meal/person/day and 1,329.9 mg/meal/person/day, respectively. For foods in highest sodium, Kimchi, Oribulgogi, and Kare rice were ranked 1st, 2nd and 3rd respectively. The main reason for not providing the fruits was 'price' among all groups. The knowledge requirement such as 'nutrition and menu management', 'nutrition education', and 'nutrition counseling' was significantly higher in elementary school compared with middle and high school (p < .001, p < .01, and p < .01 respectively). The dietitians and nutrition teachers of elementary schools have a higher job satisfaction compared with those of middle schools (p < .01). The job satisfaction was positively correlated with knowledge requirement of dietitians and nutrition teachers of elementary and middle schools. CONCLUSIONS The results suggest that developing dietitians' education program about knowledge requirement contribute to increasing the school food service and job satisfaction in elementary and middle schools.
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