Korean Journal of Community Nutrition

Research Article

[English]
Validity of Estimating Sodium Intake using a Mobile Phone Application of 24-hour Dietary Recall with Meal Photos: Seo-Yoon Kim, Sang-Jin Chung; Korean J Community Nutr 2020;25(4):317-328. Published online August 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.4.317

Objective
The objective of this study was to verify the validity of a mobile phone application (app) that applies a 24-hour dietary recall with meal photos, as a means of being a more accurate method of estimating dietary sodium intake.
Methods
Of the 203 subjects enrolled, 172 subjects (84 males and 88 females) were selected for the final analysis, excluding those with an intake less than 500 kcal and urine output less than 500 ml. Dietary sodium assessment methods used for comparing with the 24-hour urinary sodium excretion are as follows: 1) face-to-face 24-hour dietary recall, 2) 24-hour dietary recall using the mobile app, 3) face-to-face 24-hour dietary recall considering liquid intakes from soup, stew, water kimchi and noodle, etc (liquid-based dishes), 4) 24-hour dietary recall using the mobile app considering liquid intakes from liquid-based dishes, and 5) food frequency questionnaire. Repeated ANOVA with Bonferroni method was used for comparing the average sodium intake, and Pearson’s correlation was applied to correlate the methods used.
Results
In women, no significant difference was observed in the average sodium intake between all methods. Moreover, analysis in men and total adults revealed no significant difference between the 24-hour urinary sodium secretion, and 24-hour dietary recall using the app and 24-hour dietary recall using the app considering liquid intakes. 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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Dietary Sodium and Fluid Restriction for Patients with Heart Failure
Eloisa Colin-Ramirez, Amitai Segev, Meghan Rozmahel, Justin Ezekowitz
Current Treatment Options in Cardiovascular Medicine.2024; 26(12): 347. CrossRef
Comparison between 24-hour diet recall and 24-hour urine collection for estimating sodium and potassium intakes and their ratio among Korean adults
Taisun Hyun, Mi-Kyeong Choi, Young-Ran Heo, Heekyong Ro, Young-Hee Han, Yeon-Kyung Lee
Nutrition Research and Practice.2023; 17(2): 284. CrossRef
Validity of Interviewer-Administered 24-h Dietary Recalls in Older Korean Women: A Pilot Study
Seunghee Kim, Clara Y. Park
Nutrients.2023; 15(7): 1757. CrossRef

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Original Articles

[English]
Association between Sodium Excretion and Obesity of Adults in Gwangju: Mijin Jo, Young Ran Heo; Korean J Community Nutr 2018;23(1):38-47. Published online February 28, 2018; DOI: https://doi.org/10.5720/kjcn.2018.23.1.38

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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: (â‰¤ 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: 1.13â€“11.25) times greater, and the risk of obesity of T3 increased significantly by 3.33 times (95% CI: 1.05â€“10.59). After correcting for sex and age, the obesity risk of T2 increased significantly by 4.23 times (95% CI: 1.11â€“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: 1.44â€“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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Preventive Effects of Whole Grain Cereals on Sarcopenic Obesity in High-fat Diet-induced Obese Mice
Mi-Bo Kim, Sein Lee, Changhee Kim, Jae-Kwan Hwang
Food Engineering Progress.2018; 22(4): 358. CrossRef

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[English]
Associations between 24-hour Urine Sodium Excretion Level and Obesity-related Metabolic Risk Factors: Hyun Woo Oh, Hyun Jung Kim, Dae Won Jun, Seung Min Lee; Korean J Community Nutr 2015;20(6):460-467. Published online December 31, 2015; DOI: https://doi.org/10.5720/kjcn.2015.20.6.460

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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.

Citations

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Relationship of sodium index with the obesity indicators of university students in Daegu, South Korea: a cross-sectional study
Young-Won Jang, Jian Ma, Yeon-Kyung Lee
Korean Journal of Community Nutrition.2024; 29(3): 189. CrossRef
Dietary salt intake and kidney function in rural Senegalese populations: a cross-sectional study
Ndongo Modou, Lot Nehemie Motoula Latou, Toure Maimouna, Amadou Diop Dia, Sidy Mohamed Seck
Journal of Health, Population and Nutrition.2024;[Epub] CrossRef
The association between dietary sodium intake and obesity in adults by sodium intake assessment methods: a review of systematic reviews and re-meta-analysis
Jounghee Lee, Cheongmin Sohn, Oh-Yoen Kim, Young-Min Lee, Mi Ock Yoon, Myoungsook Lee
Nutrition Research and Practice.2023; 17(2): 175. CrossRef
Relationship between urinary sodium-creatinine ratios and insulin resistance in Korean children and adolescents with obesity
So Yoon Han, Nan Hee Kim, Do Hoon Kim, Kyungdo Han, Seon Mee Kim
Journal of Pediatric Endocrinology and Metabolism.2018; 31(4): 375. CrossRef
Association between Sodium Excretion and Obesity of Adults in Gwangju
Mijin Jo, Young-Ran Heo
Korean Journal of Community Nutrition.2018; 23(1): 38. CrossRef
Relationship of sodium consumption with obesity in Korean adults based on Korea National Health and Nutrition Examination Survey 2010~2014
Se Young Cheon, Hye Won Wang, Hwa Jung Lee, Kyung Mi Hwang, Hae Seong Yoon, Yoon Jung Kang
Journal of Nutrition and Health.2017; 50(1): 64. CrossRef
Associations of Obesity and Dyslipidemia with Intake of Sodium, Fat, and Sugar among Koreans: a Qualitative Systematic Review
Yoon Jung Kang, Hye Won Wang, Se Young Cheon, Hwa Jung Lee, Kyung Mi Hwang, Hae Seong Yoon
Clinical Nutrition Research.2016; 5(4): 290. CrossRef

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[English]
Evaluation of Consumer Nutrition Education Program to Reduce Sodium Intake Based on Social Cognitive Theory: So Hyun Ahn, Jong Sook Kwon, Kyung Min Kim, Jin Sook Yoon, Hye Kyeong Kim; Korean J Community Nutr 2015;20(6):433-446. Published online December 31, 2015; DOI: https://doi.org/10.5720/kjcn.2015.20.6.433

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OBJECTIVES
This study was performed to evaluate the consumer education program for reducing sodium intake based on social cognitive theory (SCT) and investigate consumer perceptions of environmental, cognitive and behavioral factors.
METHODS
Consumers (n=4,439) were recruited nationwide in Korea to participate in a nutrition education program for reducing sodium intake which was targeted on senior housewives (SH), parents (P), and office workers (OW). Questions regarding main factors of SCT were asked both before and after the education program.
RESULTS
SH and P recognized external social efforts and information to reduce sodium including nutrition labeling more than OW. The main barriers to practice reducing sodium intake were limited choice of low sodium food and menu, interference with social relationship when dining with others, and limited information, knowledge and skills. SH had lower barriers to practice reducing sodium intake and OW perceived 'preference to soup or stew' and 'preference to Kimchi, salted fish and fermented sauces' as barriers more than other groups at the baseline. Less than 50% of participants knew the relationship between sodium and salt, sodium in nutrition labeling, and recommended sodium intake. In addition, OW had little knowledge for capability to reduce sodium intake and lower self-efficacy to practice compared with SH and P. After education, positive outcome expectations such as lowering blood pressure, prevention of cardiovascular disease and osteoporosis were increased and barriers to practice reducing sodium intake were decreased in all groups (p < 0.05). The knowledge for behavioral capability and self-efficacy to reduce sodium intake were also improved but OW had still lower scores compared with other groups.
CONCLUSIONS
These results suggested that nutrition education programs could be an effective tool to impact general population by facilitating awareness and increased capability to reduce sodium intake.

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Consumer acceptance of reduced sodium white and multigrain bread: Impact of flavor enhancement and ingredient information on sample liking
Aubrey N. Dunteman, Soo‐Yeun Lee
Journal of Food Science.2023; 88(1): 417. CrossRef
The frequency of convenience food consumption and attitude of sodium and sugar reduction among middle and high school students in Seoul: a descriptive study
Seoyeon Park, Yeonhee Shin, Seoyeon Lee, Heejung Park
Korean Journal of Community Nutrition.2023; 28(4): 269. CrossRef
Development and evaluation of a nutrition education program for housewives to reduce sodium intake: application of the social cognitive theory and a transtheoretical model
Sohyun Ahn, Jong-Sook Kwon, Kyungmin Kim, Hye-Kyeong Kim
Journal of Nutrition and Health.2022; 55(1): 174. CrossRef
Customers' Perceptions of Operational Status of and Needs for Sodium Reduction in the Industry Foodservice in Seoul
Na-Young Yi
Korean Journal of Community Nutrition.2020; 25(1): 21. CrossRef

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[English]
Sodium Related Recognition, Dietary Attitude and Education Needs of Dietitians Working at Customized Home Visiting Health Service: Yun Jeong Mo, Sook Bae Kim; Korean J Community Nutr 2014;19(6):558-567. Published online December 31, 2014; DOI: https://doi.org/10.5720/kjcn.2014.19.6.558

Abstract PDF PubReader: 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.

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[English]
Blood Pressure and Dietary Related Risk Factors Associated with High Sodium Intake Assessed with 24-hour Urine Analysis for Korean Adults: Yeon Seon Jeong, Hwa Jae Lim, Sook Bae Kim, Hee Jun Kim, Sook Mee Son; Korean J Community Nutr 2014;19(6):537-549. Published online December 31, 2014; DOI: https://doi.org/10.5720/kjcn.2014.19.6.537

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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.

Citations

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Comparison between 24-hour diet recall and 24-hour urine collection for estimating sodium and potassium intakes and their ratio among Korean adults
Taisun Hyun, Mi-Kyeong Choi, Young-Ran Heo, Heekyong Ro, Young-Hee Han, Yeon-Kyung Lee
Nutrition Research and Practice.2023; 17(2): 284. CrossRef
Development and application of the sodium index to estimate and assess sodium intake for Korean adults
Yeon-Kyung Lee, Taisun Hyun, Heekyong Ro, Young-Ran Heo, Mi-Kyeong Choi
Nutrition Research and Practice.2022; 16(3): 366. CrossRef
Comparison of Sodium-Related Dietary Behavior and Low-Salt Dietary Attitude Based on the Gender and Salty Taste Assessment of Chinese International Students in the Jeonbuk Area
Qi Li, Ji Eun Lee, Jeong Ok Rho
Journal of the East Asian Society of Dietary Life.2021; 31(2): 91. CrossRef
Estimation model for habitual 24-hour urinary-sodium excretion using simple questionnaires from normotensive Koreans
Ji-Sook Kong, Yeon-Kyung Lee, Mi Kyung Kim, Mi-Kyeong Choi, Young-Ran Heo, Taisun Hyun, Sun Mee Kim, Eun-Soon Lyu, Se-Young Oh, Hae-Ryun Park, Moo-Yong Rhee, Hee-Kyong Ro, Mi Kyung Song, Tatsuo Shimosawa
PLOS ONE.2018; 13(2): e0192588. CrossRef
Relationship of sodium consumption with obesity in Korean adults based on Korea National Health and Nutrition Examination Survey 2010~2014
Se Young Cheon, Hye Won Wang, Hwa Jung Lee, Kyung Mi Hwang, Hae Seong Yoon, Yoon Jung Kang
Journal of Nutrition and Health.2017; 50(1): 64. CrossRef
Study of the characteristics of dietary behavior and the effects of nutrition education for sodium reduction according to the stages of behavioral change in sodium reduction of male adult subjects in Gwangju·Jeonnam regions
Young Ran Heo, Hyun Young Oh, Hee Kyong Ro
Journal of Nutrition and Health.2017; 50(5): 472. CrossRef
Correlation analysis of sodium-related knowledge, dietary behavior, attitudes towards a low-salt diet and meal attitude guidance for elementary school teachers in Jeonbuk area
Hyun Ok Moon, Jeong Ok Rho
Journal of Nutrition and Health.2017; 50(2): 180. CrossRef
Verification of Utility of Simple Mensuration of Cl-from Urine to Estimate the Amount of Sodium Intake
Sung-Ho Lee, Chae-Joon Lee, Sung-Mi Ju, Hyun-Joo Lee, Wang-Yeon Ra, Soon-Ok Kim
The Korean Journal of Food And Nutrition.2016; 29(1): 27. CrossRef

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[English]
Development of Nutrition Education Program for Consumers to Reduce Sodium Intake Applying the Social Cognitive Theory: Based on Focus Group Interviews: So Hyun Ahn, Hye Kyeong Kim, Kyung Min Kim, Jin Sook Yoon, Jong Sook Kwon; Korean J Community Nutr 2014;19(4):342-360. Published online August 31, 2014; DOI: https://doi.org/10.5720/kjcn.2014.19.4.342

Abstract PDF PubReader

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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Development and evaluation of a nutrition education program for housewives to reduce sodium intake: application of the social cognitive theory and a transtheoretical model
Sohyun Ahn, Jong-Sook Kwon, Kyungmin Kim, Hye-Kyeong Kim
Journal of Nutrition and Health.2022; 55(1): 174. CrossRef
A Qualitative Study of the Awareness and Influencing Factors of the Dietary Habits of the Male and Female Workers' at a Manufacturing Facility in Gwangju
Ji Suk Yim, Young-Ran Heo
Korean Journal of Community Nutrition.2022; 27(1): 12. CrossRef
Reach Out Emergency Department: Partnering With an Economically Disadvantaged Community in the Development of a Text-Messaging Intervention to Address High Blood Pressure
Emily Champoux, Rory Price, Joan E. Cowdery, Mackenzie Dinh, William J. Meurer, Narmeen Rehman, Caitlin Schille, Alina Oliver, Devin L. Brown, Jordan Killingsworth, Lesli E. Skolarus
Health Promotion Practice.2020; 21(5): 791. CrossRef
Factors contributing to the reduction of sodium intake by food manufacture and cooking venues according to the national sodium reduction policies
Kirang Kim, Sohyun Park, Jee Young Kim
Journal of Nutrition and Health.2020; 53(6): 648. CrossRef
A Comparative Study on the Awareness of Health Risks and the Risk Reduction Measures Related to Sodium Intake between Female and Male University Students in Busan and Gyeongnam: An Application of Protection Motivation Theory
Soo-Hyun Jang, Eunju Yoon
Korean Journal of Food & Cookery Science.2016; 32(1): 136. CrossRef
School Dietitian Awareness, Practice, and Sodium Reduction Plan in School Meal Service
Eun Kyung Kim, Hae Young Kim
Korean Journal of Food & Cookery Science.2016; 32(2): 222. CrossRef
Evaluation of a Nutrition Education Program Designed to Reduce Sugar Intake in Preschool Children
Ma-Young Yeom, Youn-Ok Cho
Journal of the Korean Dietetic Association.2016; 22(3): 179. CrossRef
Perception on Optimal Diet, Diet Problems and Factors Related to Optimal Diet Among Young Adult Women Using Focus Group Interviews: Based on Social Cognitive Theory
Hye Jin Kim, A Reum Lee, Kyung Won Kim
Korean Journal of Community Nutrition.2016; 21(4): 332. CrossRef
‘When operating a cafeteria, sales come before nutrition’ – finding barriers and facilitators to serving reduced-sodium meals in worksite cafeterias
Sohyun Park, Jounghee Lee
Public Health Nutrition.2016; 19(8): 1506. CrossRef
Study on Energy and Nutrient Intake and Food Preference of the Elderly in Care Facilities
Jong-Sook Kwon, Seung Hee Lee, Kang Min Lee, Yoonna Lee
Korean Journal of Community Nutrition.2016; 21(2): 200. CrossRef
Evaluation of Consumer Nutrition Education Program to Reduce Sodium Intake Based on Social Cognitive Theory
So-Hyun Ahn, Jong Sook Kwon, Kyung Min Kim, Jin-Sook Yoon, Hye-Kyeong Kim
Korean Journal of Community Nutrition.2015; 20(6): 433. CrossRef
The Development of a Nutrition Education Program for Low-income Family Children by applying the Social Cognitive Theory and Health Belief Model
Saes-byoul Lee, Yu-Ri Jeong, Hyo-Jin Ahn, Min-Ji Ahn, Su-A Ryu, Nam-E Kang, Se-Young Oh
Korean Journal of Community Nutrition.2015; 20(3): 165. CrossRef

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[English]
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: Eun Jin Jung, Jong Sook Kwon, So Hyun Ahn, Sook Mee Son; Korean J Community Nutr 2013;18(6):626-643. Published online December 31, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.6.626

Abstract PDF PubReader

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 (< or = 3) were categorized into the less attendance (LA) group and 34 participants attended 4 times or more (> or = 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.

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Sang Jin Yoon, Kun Og Kang
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Study of the characteristics of dietary behavior and the effects of nutrition education for sodium reduction according to the stages of behavioral change in sodium reduction of male adult subjects in Gwangju·Jeonnam regions
Young Ran Heo, Hyun Young Oh, Hee Kyong Ro
Journal of Nutrition and Health.2017; 50(5): 472. CrossRef
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Journal of the Korean Society of Food Science and Nutrition.2016; 45(9): 1366. CrossRef
Dietary Life related to Sodium of Participants in Hypertension and Diabetes Preventive Education at the Public Health Center
Hee-Ok Pak, Chun-Young Sohn, Jung-Hwa Park
The Korean Journal of Food And Nutrition.2015; 28(2): 219. CrossRef
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Soojin Park, Sung Hee Min
Journal of The Korean Society of Food Culture.2015; 30(1): 20. CrossRef
Nutrition knowledge, eating attitudes, nutrition behavior, self-efficacy of childcare center foodservice employees by stages of behavioral change in reducing sodium intake
Yun Ahn, Kyung Won Kim, Kyungmin Kim, Jinwon Pyun, Ikhyun Yeo, Kisun Nam
Journal of Nutrition and Health.2015; 48(5): 429. CrossRef
The Study on Dietary Behavior and Health Related Behaviors of Self Perceived Sodium Intake Groups
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Journal of The Korean Society of Food Culture.2014; 29(6): 511. CrossRef
The Relationship between Dietary Behaviors/health Risk Factors and Preference for Salty Taste among Korean Elderly People Living in Rural Areas
Mee Sook Lee
Korean Journal of Community Nutrition.2014; 19(5): 448. CrossRef

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[English]
A Survey on the Salt Content of Kindergarten Lunch Meals and Meal Providers' Dietary Attitude to Sodium Intake in Gyeonggi-do Area: Jin Nam Kim, Seoyun Park, Sohyun Ahn, Hye Kyeong Kim; Korean J Community Nutr 2013;18(5):478-490. Published online October 31, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.5.478

Abstract PDF PubReader

Dietary habit of excess sodium consumption is formed mainly by excessive salt intake from the younger age and this may lead to hypertension, stroke, and stomach cancer. This study was performed to estimate the salt content in kindergarten meals and provide basic data on meal providers' dietary attitude to sodium intake for nutrition education. We collected data on161 food items from 16 institutions in Gyeonggi-do and salt content was calculated from salinity and weight of individual food items. The average salt content from lunch meals was 2.2 g, which was about daily adequate intake of sodium for children aged 3 to 5 years old. Greatest contributor to the salt content in a meal was soup and stew (47.8%). The most salty dishes were sauces and kimchi followed by stir-fried food, deep-fried food, braised food, and grilled food. The salt content was higher in soup and stew despite of low salinity, due to the large quantity per serving. The salt contents of soups and kimchi were 40.6% and 14.3%, respectively of the total salt content in dish groups. Staff members and caregivers at home who prepared food for the child showed preference for one-dish rice meal, dried fish and salted mackerel, and broth when eating soup, stew, and noodles. Caregivers showed higher sodium index score and had higher preference for processed food such as Ramen, canned food, and ham compared with staff members (p < 0.05). These results suggested that monitoring salt content of kindergarten meals and nutrition education for those prepare meals for children are needed to lower sodium intake in childhood.

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[English]
Calcium Status and Bone Mineral Density by the Level of Sodium Intake in Young Women: Jin Sook Yoon, Mi Jung Lee; Korean J Community Nutr 2013;18(2):125-133. Published online April 30, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.2.125

Abstract PDF PubReader

Previous studies have shown that sodium excretion is positively related to calcium excretion in the urine. As excessive sodium intake is a common nutritional problem in Korea, we intended to investigate associations among sodium intake levels and calcium status, evaluated by 24 hour recall method and urinary excretion, and bone status. We collected dietary information for non-consecutive three days from 139 young adult women 19~29 years. After classifying the subjects into 4 groups based on the dietary sodium levels by daily total sodium intake (mg) and sodium density (sodium intake per 1000 kcal energy intake), we compared the bone status, nutrient intakes, urinary calcium and sodium excretions. The results showed a positive association between total daily sodium intake and intake of other nutrients. However, no significant differences in nutrients intakes were observed among subject groups classified by sodium density levels. There were no significant differences of bone density among groups by total daily sodium intake as well as by sodium density. While total daily sodium intake showed significantly positive relationship with urinary sodium (p < 0.05) and calcium (p < 0.05), sodium density was not related to urinary excretion of calcium and sodium. Our results suggested that promoting balanced meals providing appropriate amounts of energy intake is the essential component of nutrition education for improving calcium status of young Korean women with excessive sodium intake.

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[English]
Study on the Eating Habits and Practicability of Guidelines for Reducing Sodium Intake according to the Stage of Change in Housewives: So Hyun Ahn, Jong Sook Kwon, Kyungmin Kim, Jin Sook Yoon, Baeg Won Kang, Jong Wook Kim, Seok Heo, Hea Young Cho, Hye Kyeong Kim; Korean J Community Nutr 2012;17(6):724-736. Published online December 31, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.6.724

Abstract PDF PubReader

This study was intended to investigate the sodium-related perception, dietary behavior, and practicability of methods for reducing sodium intake(RSI) according to the stage of change in consumers. The survey was conducted to 770 housewives, among them 553 subjects who answered the key questions for the stage of change were categorized into ''aintenance (M)' stage (maintaining reduced salt intake for more than 6 months; n = 287, 51.90%), 'Action (A)' stage (maintaining reduced salt intake for less than 6 months; n=139, 25.14%), and 'Pre-Action (P)'stage (not starting reduced salt intake; n = 127, 22.97%). The subjects in M and A were significantly older than those in P (p < 0.01). The scores of desirable dietary habit and dietary balance were the highest in M followed by A and P. When eating out, the subjects in P considered 'price' more and 'healthiness of food' less than those in M and A did. Among the guidelines for RSI, 'Avoid Processed Foods', 'Eat enough vegetables and fruits' and 'Add little amount of dipping sauce for fried food' were selected as the three easiest items to perform. With regard to the sodium-related perception, the subjects in M considered eating-out food to be more salty than homemade dishes, read nutrition labels more, avoided table salt or dipping sauce for fried food more, and had 'own low-sodium recipe' than those in P (p < 0.001). It is suggested that practicability of actions for RSI and the stage of change should be considered to develop effective personalized education program and nutrition guidance.

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[English]
Cost-benefit Analysis of Sodium Intake Reduction Policy in Korea: Chulhee Lee, Dae Il Kim, Jeonglim Hong, Eunmi Koh, Baeg Won Kang, Jong Wook Kim, Hye Kyung Park, Cho Il Kim; Korean J Community Nutr 2012;17(3):341-352. Published online June 30, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.3.341

Abstract PDF PubReader

It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

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[English]
A Comparison of Salty Taste Assessments and Dietary Attitudes and Dietary Behaviors Associated with High-Salt Diets in Four Regions in Korea: Hyun Hee Kim, Yun Young Jung, Yeon Kyung Lee; Korean J Community Nutr 2012;17(1):38-48. Published online February 29, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.1.38

Abstract PDF PubReader

The purpose of this study was to compare regional differences in salty taste assessments, nutrition knowledge, dietary attitudes and dietary behaviors associated with high-salt diets in four national regions in Korea (Region 1: Seoul, Sokcho, Region 2: Buyeo, Jecheon, Gong Ju, Region 3: Daegu, Gyeongsan, Region 4: Jeon Ju). Subjects were 860 persons who participated in sodium reduction campaign. The result of the salty taste assessment by region was not significantly different. The nutrition knowledge score of subjects in Region 1 was the highest. Dietary attitude scores that showed preference for high-salt diets of Region 2 and Region 4 subjects were higher than those of Regions 1 and 3 subjects (p < 0.001). Dietary behavior scores were not significantly different among regions. The correlation between sodium intake and salty taste assessment was significant (p < 0.01). Older subjects who had high blood pressure levels and lower nutrition knowledge were more likely to have high sodium intakes. Even though the salty taste assessment and dietary behavior scores by region were not significantly different, the salty taste assessment scores had a significant negative correlation with nutrition knowledge and had a significant positive correlation with dietary attitude and dietary behavior in terms of preference for high-salt diets. Therefore, nationwide education regarding salt intake reduction and health and a campaign to encourage favorable attitudes and behavioral changes regarding consumption of a no-salt / low-salt diet is needed.

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[English]
Major Sources of Sodium Intake of the Korean Population at Prepared Dish Level: Based on the KNHANES 2008 & 2009: Miyong Yon, Yoonna Lee, Dohee Kim, Jeeyeon Lee, Eunmi Koh, Eunjeong Nam, Hyehyung Shin, Baeg won Kang, Jong Wook Kim, Seok Heo, Hea young Cho, Cho il Kim; Korean J Community Nutr 2011;16(4):473-487. Published online August 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.4.473

Abstract PDF PubReader

We attempted to define the sources of sodium intake for the Korean population at prepared dish level to provide a basis for developing sustainable nutrition policies and feasible programs for sodium intake reduction. Dietary intake data from 2008 and 2009 Korea National Health and Nutrition Examination Survey was used in the analysis for sodium intake sources. Sodium intake from individual dish consumed by each subject was calculated and used in delineating major sodium sources at dish and dish group level for sub-populations of different sex and age. Also, sodium intake was compared between eaters and non-eaters of some specific dish groups with considerable contribution to total sodium intake. The number of subjects included in the analysis was 18,022 and mean sodium intake was 4,600 mg/capita/day. Major sources of sodium intake at dish group level were in the following order: kimchi (1125 mg, 24.5%), noodles (572 mg, 12.4%), soups (488 mg, 10.6%), stews (399 mg, 8.7%), and cooked rice (284 mg, 6.2%). The magnitude of contribution to total sodium intake by soups and stews was different by age group. Sodium intake difference between eaters and non-eaters was much larger for kimchi group (2,343 mg for male, 1,452 mg for female) than for soups or stews. Interaction between consumption of aforementioned specific dish groups and age was highly significant (p < 0.0005) for both sexes. This study revealed an importance of having not only the control over sodium content of foods/dishes, but also the customized approach for different groups of population to accomplish an appreciable reduction in sodium intake.

Citations

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[English]
A Study on the Calcium and Sodium Intakes and Urinary Calcium Excretion of Adults in Busan: Hwa Jae Lim; Korean J Community Nutr 2011;16(2):215-226. Published online April 30, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.2.215

Abstract PDF PubReader

The purpose of this study was to assess calcium and sodium intakes and urinary excretion of adults in Busan and to evaluate the relationship between urinary calcium excretion (UCa) and the status of anthropometric, blood pressure, urine analysis, and nutrient intake of subjects. Nutrient intake by 24 hr recall, 24 hr urinary calcium and sodium excretion (UNa) were measured with 87 adults aged 20-59 yrs (42 men and 45 women). The mean calcium intake was 88.0% for men and 103.0% for women of Recommended Intake. The mean sodium intake was 283.4% for men and 250.5% for women of Adequate Intake (AI). The mean 24hr UCa was 127.4 mg in men and 107.3 mg in women. The mean 24 hr UNa was 3650.6mg in men and 3276.4mg in women. The intake and urinary excretion of calcium and sodium were not significantly different by gender. UCa showed significantly positive correlations with sodium intake and UNa in men (p < 0.001, p < 0.05) and women (p < 0.001, p < 0.001) and with age, systolic blood pressure (SBP) and sodium density in women (p < 0.05, p < 0.05, p < 0.01). The UCa/creatinine showed significantly positive correlations with age, sodium intake, sodium density, and UNa in women (p < 0.05, p < 0.01, p < 0.01, p < 0.01). When UCa was stratified into quartile (Q1-Q4), age, SBP, UCa, UNa, sodium intake, and AI percentage of sodium (p < 0.01, p < 0.05, p < 0.001, p < 0.001, p < 0.001, p < 0.001) were significantly higher in Q4. The mean intake and AI percentage of sodium in Q4 were 4768.8mg and 329.0. Based on the results, UCa was related to age, SBP, UNa, and sodium intake. Therefore, nutritional education of decreasing sodium intake for decreasing UCa is needed.

Citations

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Association between dietary intake, body measurements, and urinary bone resorption markers in young adults with osteopenia and osteoporosis: a cross-sectional study
Mi-Hyun Kim, Mi-Kyeong Choi
Korean Journal of Community Nutrition.2023; 28(4): 282. CrossRef
Sex- and age group-specific associations between intakes of dairy foods and pulses and bone health in Koreans aged 50 years and older: Based on 2008~2011 Korea National Health and Nutrition Examination Survey
Hyun-Bi Seo, Young-Sun Choi
Journal of Nutrition and Health.2016; 49(3): 165. CrossRef
Comparison of sodium content of workplace and homemade meals through chemical analysis and salinity measurements
Eun-Kyung Shin, Yeon-Kyung Lee
Nutrition Research and Practice.2014; 8(5): 558. CrossRef
Calcium Status and Bone Mineral Density by the Level of Sodium Intake in Young Women
Jin-Sook Yoon, Mi Jung Lee
Korean Journal of Community Nutrition.2013; 18(2): 125. CrossRef
A Study on Dietary Mineral Intakes, Urinary Mineral Excretions, and Bone Mineral Density in Korean Postmenopausal Women
Jee-Young Yeon, Chung Ja Sung
Korean Journal of Community Nutrition.2011; 16(5): 569. CrossRef

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[English]
Dishes Contributing to Sodium Intake of Elderly Living in Rural Areas: Hyun Kyung Moon, Soon Ok Choi, Jung Eun Kim; Korean J Community Nutr 2009;14(1):123-136. Published online February 28, 2009

Abstract PDF: Sodium is a necessary element for the body. Excessive intake of sodium is known as one of the risk factors for chronic diseases. Recently, increasing numbers of people in Korea are suffering from chronic diseases. Major causes of deaths were chronic degenerative disease with the rising aging population. Especially, the population of rural areas is growing older fast. In rural areas, it is known that under nutrition and high sodium intake were major nutritional problems. For sodium intake, there were some studies about contributing food items. They were not enough to show diets relate to sodium intakes. Thus, this study analyzed dishes contributing to sodium intakes of elderly living in rural areas. Dietary intakes using "the 24hour recall method" were used. For the analysis for sodium intakes, "Can-pro3.0" was used. Ranking of dishes by contributions of sodium intakes were Korean cabbage, kimchi (19.6%), seasoned soybean paste (5.3%), soybean paste (4.6%), soybean paste soup dried radish leaves (3.5%), hot pork and kimchi stew (3.4%) in order. Ranking of dish groups by sodium intakes was kimchies (28.3%), soup and hot soups (22.8%), stews and casseroles (9.7%), seasonings (8.2%),and seasoned vegetables (6.0%) in order. One-dish meals among cooked rice, wheat noodles among noodle and mandu, soups using the soybean paste, stews using soybean paste and kimchi, salted fish among grilled foods, stir-fried anchovy among stir-fried foods, seasoned spinach, and Korean cabbage kimchi contributed to sodium intakes. As the nutrition deficiency of the elderly living in rural areas could be a problem, and excessive sodium intakes is threatening to their health, it is needed for the senior citizens to have adequate knowledge for diets containing less sodium. And recipes for healthy food and nutrition education based on their diets are needed.

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[English]
Sodium Intakes of Korean Adults with 24-hour Urine Analysis and Dish Frequency Questionnaire and Comparison of Sodium Intakes According to the Regional Area and Dish Group: Sook Mee Son, Young Sook Park, Hwa Jae Lim, Sook Bae Kim, Yeon Seon Jeong; Korean J Community Nutr 2007;12(5):545-558. Published online October 31, 2007

Abstract PDF: This study was performed to assess the sodium intakes of Korean adults using a 24-hr urine analysis and dish frequency questionnaire (DFQ) according to each dish group and the regional area. The subjects of this study were comprised of 552 adults (male: 267, female: 285), aged 20-59yr residing in the metropolitan area (N = 200), Chungcheng-Do (N = 117), Jeolla-Do (N = 117), and Gueongsang-Do provinces (N = 118). The subjects were recruited from the residents who once participated or are participating in the various health programs offered by the public health center. The number of subjects who completed the 24-hr urine collection was 205 (male : 110, female : 95).The mean age and BMI of the subjects were 39.0+/-11.7 y and 23.1+/-2.9 kg/m2, respectively. The mean systolic and diastolic blood pressure was 119.5+/-15.4 mmHg, and 77.1+/-11.1 mmHg, respectively. Eighteen percent of the subjects responded that they are currently smoking, 36% drinking and 50.4% exercising. Twenty point six percent of the subjects were assessed as having hypertension according to their systolic or diastolic blood pressure(SBP > or = 140 mmHg or DBP > or = 90 mmHg) measurements in the present study. Salt intake of the subject estimated with 24-hr sodium excretion was 12.7 g/d (male : 13.4 g/d, female : 12.1 g/d) based on the sodium excretion rate as 82%. Salt intake estimated with DFQ was 14.7 g/d (male : 16.2 g/d, female : 13.4 g/d), 2 g more than the salt intake estimated with 24-hr urine analysis. The four dish groups that contributed most to the sodium intake in order were kimchi (I1571.4mg), soup and stew (1260.5 mg), fish and shellfish (706.3 mg) and noodle and ramyeon (644.3mg). Salt intake estimated with DFQ was the highest in the subjects of Gueongsang-Do (17.0 g/d), second highest Chungcheong-Do (16.4 g/d) and the lowest in the metropolitan area (13.0 g/d). Subjects of Gueongsang-Do showed the highest sodium intakes in most of the dish group, whereas subjects of the metropolitan area showed the lowest. Residents of Chuncheong-Do revealed the highest sodium intake with kimchi and ofJeolla-Do the higher sodium intake with the main dish (meat, fish and beans). The highest salt percentage of kimchi (3.0+/-0.8%) and soybean paste (14.5 +/-5.1%) were observed in Gueongsang-Do, whereas individuals of the metropolitan area were observed as having kimchi (1.6 +/-0.5%) and soybean paste (7.4 +/-1.6%) with the lowest salt percentage. Men were observed as having more salty kimchi (2.4 +/-0.1%) than women (2.1 +/-0.1%).

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Validation Studies

[English]
Development and Evaluation of Validity of Dish Frequency Questionnaire (DFQ) and Short DFQ Using Na Index for Estimation of Habitual Sodium Intake: Sook Mee Son, Gwui Yeop Huh, Hong Sup Lee; Korean J Community Nutr 2005;10(5):677-692. Published online October 31, 2005

Abstract PDF: The assessment of sodium intake is complex because of the variety and nature of dietary sodium. This study intended to develop a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and a short DFQ for screening subjects with high or low sodium intake. For DFQ112, one hundred and twelve dish items were selected based on the information of sodium content of the one serving size and consumption frequency. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. One hundred seventy one adults (male: 78, female: 93) who visited hypertension or health examination clinic participated in the validation study. DFQ55 was developed from DFQ112 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. To develop a short DFQs for classifying subjects with low or high sodium intakes, the weighed score according to the sodium content of one protion size was given to each dish item of DFQ25 or DFQ14 and multiplied with the consumption frequency score. A sum index of all the dish items was formed and called sodium index (Na index). For validation study the DFQ112, 2-day diet record and one 24-hour urine collection were analyzed to estimate sodium intakes. The sodium intakes estimated with DFQ112 and 24-h urine analysis showed 65% agreement to be classified into the same quartile and showed significant correlation (r = 0.563 p < 0.05). However, the actual amount of sodium intake estimated with DFQ112 (male: 6221.9 mg, female: 6127.6 mg) showed substantial difference with that of 24-h urine analysis (male: 4556.9 mg, female: 5107.4 mg). The sodium intake estimated with DFQ55 (male: 4848.5 mg, female: 4884.3 mg) showed small difference from that estimated with 24-h urine analysis, higher proportion to be classfied into the same quartile and higher correlation with the sodium intakes estimated with 24-h urine analysis and systolic blood pressure. It seems DFQ55 can be used as a tool for quantitative estimation of sodium intake. Na index25 or Na index14 showed 39~50% agreement to be classified into the same quartile, substantial correlations with the sodium intake estimated with DFQ55 and significant correlations with the sodium intake estimated with 24-h urine analysis. When point 119 for Na index25 was used as a criterion of low sodium intake, sensitivity, specificity and positive predictive value was 62.5%, 81.8% and 53.2%, respectively. When point 102 for Na index14 was used as a criterion of high sodium intake, sensitivity, specificity and positive predictive value were 73.8%, 84.0%, 62.0%, respectively. It seems the short DFQs using Na index14 or Na index25 are simple, easy and proper instruments to classify the low or high sodium intake group.

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