Objectives This paper aimed to provide an in-depth analysis of the factors influencing the dietary habits of male and female workers at a facility in Gwangju and their awareness of the same. Methods A total of 32 workers were divided into eight groups based on work type, gender, and age, and focus group interviews (FGIs) were conducted. The FGIs included cognitive, behavioral, and environmental questionnaires based on dietary habits and the social cognitive theory. The interviews were analyzed by subject and sub-subject using audio recordings and transcriptions. Results Male workers in the concerned company favored meat while female workers preferred vegetables, yet by and large, the preferences were irregular. Male workers living alone frequently ate ready meals and female workers often skipped meals. An analysis of the factors influencing the study subjects’ dietary habits from the cognitive, behavioral, and environmental perspectives showed that the main factors negatively affecting their dietary habits were shiftwork, living alone, and drinking. Workers were unaware of these factors and their poor eating habits. Instead, male workers complained of poor cooking skills, while female workers complained of loneliness. Workers thus appeared to need the support of nutrition education and a counseling assistant to cope with this situation. Conclusions The study identified the fact that the absence of nutrition education left the workers unaware of their poor eating habits. The workers would need counseling and support to help them build healthy dietary habits. It would also be necessary to focus on raising the workers’ cognitive awareness of dietary habits and enhancing their behavioral ability to cope with bad eating habits through nutrition education that reflects the reality of their situation.
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OBJECTIVES Reduced glucose utilization in the main parts of the brain involved in memory is a major cause of Alzheimer's disease, in which ketone bodies are used as the only and effective alternative energy source of glucose. This study examined the effects of a low-carbohydrate and high-fat (LCHF) diet supplemented with a ketogenic nutrition drink on cognitive function and physical activity in the elderly at high risk for dementia. METHODS The participants of this study were 28 healthy elderly aged 60-91 years showing a high risk factor of dementia or whose Korean Mini-Mental State Examination (K-MMSE) score was less than 24 points. Over 3 weeks, the case group was given an LCHF diet with nutrition drinks consisting of a ketone/non-ketone ratio of 1.73:1, whereas the control group consumed well-balanced nutrition drinks while maintaining a normal diet. After 3 weeks, K-MMSE, body composition, urine ketone bodies, and physical ability were all evaluated. RESULTS Urine ketone bodies of all case group subjects were positive, and K-MMSE score was significantly elevated in the case group only (p=0.021). Weight and BMI were elevated in the control group only (p<0.05). Grip strength was elevated in all subjects (p<0.01), and measurements of gait speed and one leg balance were improved only in the case group (p<0.05). CONCLUSIONS We suggest that adherence to the LCHF diet supplemented with a ketogenic drink could possibly influence cognitive and physical function in the elderly with a high risk factor for dementia. Further, we confirmed the applicability of this dietary intervention in the elderly based on its lack of any side effects or changes in nutritional status.
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To Keto or Not to Keto? A Systematic Review of Randomized Controlled Trials Assessing the Effects of Ketogenic Therapy on Alzheimer Disease Maria G Grammatikopoulou, Dimitrios G Goulis, Konstantinos Gkiouras, Xenophon Theodoridis, Kalliopi K Gkouskou, Athanasios Evangeliou, Efthimis Dardiotis, Dimitrios P Bogdanos Advances in Nutrition.2020; 11(6): 1583. CrossRef
OBJECTIVES The purpose of this study was to evaluate the effect of nutrition education using materials based on social cognitive theory. Education topics focused on improving health-related and dietary self-awareness and behavior capability in adolescents. METHODS Participants were recruited from a middle school for girls; 67 students (educated group, n=34 and control group, n=33) participated. The education group received 12 lessons in club activity class. Self-administered surveys were conducted for each group before and after the nutrition education program. The questionnaires consisted of variables such as self-efficacy, outcome expectation, outcome expectancy, knowledge, and dietary practices based on the social cognitive theory. Education satisfaction was evaluated using a five-point Likert scale for two sections: a) teaching and learning and b) education results. The data were analyzed using a t-test and Chi Square-test (significance level: p < 0.05). RESULTS In the education group, post-education, there were significant differences in self-efficacy (p < 0.05), knowledge (p < 0.01), and dietary practices (p < 0.05), whereas outcome expectation and expectancy did not show any significant differences. None of the variables showed any significant differences in the control group. Educational satisfaction scores were 4.38 ± 0.12 (teaching and learning) and 4.14 ± 0.15 (education results). CONCLUSIONS This study showed that improving adolescent's awareness and behavior capability has a positive effect on their dietary practices. Moreover, this study suggested that a theory-based determinant should be considered to improve dietary behavior among adolescents.
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OBJECTIVES Study purpose was to investigate perception on diet, diet problems and related factors among young adult women using focus group interviews (FGI) based on the Social Cognitive Theory (SCT). METHODS Eight groups of FGI were conducted with 47 female undergraduate or graduate students. Guide for FGI included questions regarding perception on optimal diet, diet problems and cognitive, behavioral, and environmental factors of SCT. FGI were video, audio-taped, transcribed and analyzed by themes and sub-themes. RESULTS Subjects showed irregular eating habits (skipping breakfast, irregular meal time) and selection of unhealthy foods as the main diet problems. Regarding cognitive factors related to optimal diet, subjects mentioned positive outcome expectations (e.g., health promotion, skin health, improvement in eating habits, etc.) and negative outcome expectations (e.g., annoying, hungry, expensive, taste). Factors that promoted optimal diet were mainly received from information from mobile or internet and access to menu or recipes. Factors that prevented optimal diet included influence from friends, lack of time and cooking skills. Behavioral factors for optimal diet included behavioral capability regarding snacks, healthy eating and smart food selection. Subjects mentioned mass media (mobile, internet, TV) as the influential physical environment, and significant others (parents, friends, grandparents) as the influential social environment in optimal diet. For education topics, subjects wanted to learn about healthy meals, basic nutrition, disease and nutrition, and weight control. They wanted to learn those aspects by using mobile or internet, lectures (cooking classes), campaign and events. CONCLUSIONS Study results might be used for planning education regarding optimal diet for young adult women. Education programs need to focus on increasing positive outcome expectations (e.g., health) and behavioral capability for healthy eating and food selection, reducing negative outcome expectations (e.g., cost, taste) and barriers, making supportive environments for optimal diet, and incorporating topics and methods found in this study.
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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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OBJECTIVES A higher consumption of vegetables is emphasized as the core component of most dietary guidelines. Thus, this research investigated the dietary habits and influencing factors of vegetable preferences of adolescents. METHODS This study was conducted by using a self-administered questionnaire. 400 students from two high schools in Gyeongnam (193 boys, 207 girls) participated in the survey. The questionnaire consisted of the following variables: dietary habit, dietary action guide and factors based on Social Cognitive Theory (SCT). RESULTS The dietary habits of subjects showed significant differences depending on whether they prefer vegetables or not. The subjects in the group who liked vegetables had better dietary habits than the other group. Also, the study determined that the most important reason for liking or disliking vegetables is due to the taste. In the practice of dietary guidelines, the group of subjects who liked vegetables followed dietary guidelines more closely than the other group (p < 0.001). When the factors based on SCT were analyzed, personal factors showed significant differences between the groups: outcome expectation (p < 0.001), self-efficacy (p < 0.001) and affective attitude (p < 0.001). Personal factors and rated vegetable preferences showed a significant correlation in multiple regression analysis (F=42.015, p < 0.001). CONCLUSIONS These results showed that vegetable preference is associated with a key point of desirable dietary habits among subjects. In order to increase vegetable preference or consumption, it is important to focus on strengthening not only self-efficacy of students, but also affective attitude of vegetable.
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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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It was well received that well grounded behavioral theories were important in the development of effective nutrition education programs, but there are only a few programs available for Korean women. The objective of this study was to develop nutrition education programs for childbearing-aged women in Korea. Based on the findings of the needs assessment for the program and theoretical backgrounds, we developed behaviorally oriented tailored nutrition education program including motivation (MT), modifying (MD) and maintenance (MA) stages. The key concepts of the stages were motivation promotion for MT, increasing behavioral capabilities for MD, and strengthening self-management and building favorable environmental condition for MA. The education program was intended to be need in individual nutrition counseling, but it could be well used for group education by developing materials using the relevant contents. The primary users of the program were nutrition educators, however it could be also used by clients as needed. The introductory chapter provided dietary assessment tools and nutrition education tips. MT chapter included subjects such as nutritional status screening, costs of inappropriate nutrition and weight management, benefits of eating right, and activities for motivation promotion. MD stage chapter dealt with topics of healthy weight, knowledges and skills for better eating habits and physical activity status, and activities related to setting tailored behavioral objectives. MA stage focused on facilitating self management skills and building helping relationships. Each stage underlined activities using various educational tools in order to promote active participation of the client (s). For better use of this program, it was recommended to conduct program validation study.
The purpose of the study was to find the sociopsychological factors predicting the intention of compliance with the dietary regimen in diabetes with a questionnaire. Data were collected from 282 adult noninsulin-dependent diabetics in Seoul, Kyoggida, and Kyongsangbukdo in Korea. Stepwise multiple regression analysis was conducted with predictor variables from theories of the Health Belief Model, Social Cognitive Model, The Theory of Reasoned Action, and Social Support. The behavioral intention of compliance with the prescribed diet was the independent variable. Subjects norm self-efficacy knowledge about diet therapy, outcome expectation, relationship with medical team, threat of deterioration of disease, and social support were the independent variables, The mean score of behavior intention was high ie 35.3 out to 42. Subjective norm and self-efficacy were the significant variables to predict the intention of dietary compliance. These variables comprised 39% of the common variance. To increase dietary compliance by influence of the referents and improve self-efficacy significant referents must be included and concrete and practical methods to follow the dietary regimen must be provided in nutrition education.
Although many people initially enroll in health education programs, there are many instances of erratic participation and dropouts. Inconsistent participation in intervention programs minimizes their impact on health promotion. Therefore, a theoretical understanding of factors influencing participation in these programs can potentially enhance the effectiveness of its educational strategy. This study used the Pender's Health Promotion Model to examine specific factors influencing incentives to participate in an elderly nutrition education program. The Elderly Nutrition Counseling and Education Program was conducted with 147 volunteers (76 males, 71 females), aged 60 to 87, at 5 separate community elderly centers, by public health dietitians from February to April 1997. Some participants dropped out during the program. Overall, 61 people(18 males, 43 females) finished all 7 steps over 2 months. Pre-intervention data were collected by trained dietitians. This data included individual cognitive-perceptual factors(perceived benefits of nutrition improvement, importance of health, perceived control over health by multidimensional health locus of control, self esteem, perceived health status, concern about health, depression scale and social health scale), which were known to influence the likelihood of health behavior, and modifying factors(socioeconomic variables, biological characteristics, behavioral factors, such as smoking, alcohol drinking and exercise). Male finalists had a significantly lower chance for health locus of control, and better social health status with their children and grandchildren, compared to males who dropped out. Female finalists had a significantly higher locus of control regarding food behavior, higher self-esteem, better recognized nutritional status, worse self-recognized health status and lower concern about health than those who dropped out. There was no significant difference between the attendees and dropouts in age, BMI( kg/m2), Nutritional Risk Index, depression scale and daily nutrient intake. These results suggest that elderly nutrition intervention plans should focus on the individual cognitive and perceptual factors, with interpersonal influences, to increase participation in nutrition in nutrition improvement programs.
The purpose of this study was to investigate the dietary intake, obesity index and psychosocial factors influencing obesity among 200 high school girls in Seoul. The Social Cognitive Theory provided the Conceptual basis for this study. A cross-sectional survey was conducted to examine factors related to obesity, including self-efficacy for controlling overeating, social support for eating behavior, perception of body image and weight control, nutrition knowledge, and attitudes toward obesity. The data were analyzed using t-test and multiple logistic regression. The results of this study are as follows : 1) The mean age of the girls was 16.4 years, and the rate of overweight and obesity(measured by obesity index) was 27.0%. 2) The mean energy intake of subjects was 1832.3+/-384.0kcal. The energy derived from carbohydrates, proteins and fats was 62.7%, 13.8%, and 23.5%, respectively. There was no significant difference between the obese and the comparison group in energy intake. 3) The result of multivariate analysis indicated that obesity had a significant relation to the perception of ideal body image, social support for eating behavior, and self-efficacy for controlling overeating(p<0.01). As subjects preferred thinner body images(OR=0.39) and received less social support(OR=0.93), the odds of being classified as obese increased. The odds of being obese were also associated with self-efficacy, however, the relation was not strong(OR=1.04). 4) Specific social support was related to obesity among adolescent girls. As subjects received more support from family member, the odds of being obese decreased. The emotional support as well as family member's positive nutrition behavior plays a significant role. In addition, instrumental support from friends was associated with obesity. With repect to self-efficacy, the odds of being obese were increased as subjects felt less confident in controlling overeating when tempting food was placed in front of them or after an argument. In contrast, the obese group felt more confident in controlling overeating for the rest of the specific situations examined. These findings suggest that educational interventions for weight control should incorporate strategies to help participants realize their degree of obesity, to reduce the discrepancy between current and ideal body image, to elicit and maintain social support from friends and family, and to increase the self-efficacy for changing eating behaviors.