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Original Article
- Effectiveness of Nutrition Education and Counseling on the Salty Taste Assessment, Nutrition Knowledge and Dietary Attitude of Hemodialysis Patients
- Young-Mi Lee, Yeon-Kyung Lee
-
Korean Journal of Community Nutrition 2013;18(4):402-412.
DOI: https://doi.org/10.5720/kjcn.2013.18.4.402
Published online: August 31, 2013
Nutrition Education Major, Graduate School of Education, Kyungpook National University, Daegu, Korea.
1Department of Food Science and Nutrition, Kyungpook National University, Daegu, Korea.
- Corresponding author: Yeon-Kyung Lee, Department of Food Science and Nutrition, Kyungpook National University, 1370 Sankyuk Dong, Buk-ku, Daegu 702-201, Korea. Tel: (053) 950-6234, Fax: (053) 950-6229, yklee@knu.ac.kr
• Received: July 31, 2013 • Revised: August 20, 2013 • Accepted: August 26, 2013
Copyright © 2013 The Korean Society of Community Nutrition
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
- The purpose of this study was to evaluate the effectiveness of nutrition education and counseling on the salty taste assessment, nutrition knowledge and dietary attitude of 21 hemodialysis patients. Five times of the nutrition education and three times of nutrition counseling were performed for a period of 5 months. Biochemical analysis revealed that creatinine was significantly high (p < 0.001), blood urea nitrogen and serum albumin were significantly low (p < 0.05, p < 0.01) and Na, K, Cl, K, P and uric acid were not significantly different. The distribution rate of unsalty taste preference were significantly high and the distribution rate of salty taste preference were significantly low after nutrition education and counseling (p < 0.001). Nutrition knowledge significantly improved following 5th month of education and counseling (p < 0.01). Particularly, the scores for questions related to sodium were improved. The dietary attitude was significantly improved during the counseling period (p < 0.05). There were improvements in responses to 'use food exchange list on diet' and 'habitually add salt or soy sauce before the meal'. According to these results, salty taste assessment, nutrition knowledge and dietary attitude were significantly improved by the hemodialysis diet therapy practices of hemodialysis patients. Therefore, we conclude that there was a need for low-salt diet education and nutrition counseling to help them recognize the taste of low-salt foods and strive towards a preference for less salty tasting foods and the consumption of a low-salt diet.
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REFERENCES
Table 2Anthropometric measurements of the subjects
1) Z-value by Mann-Whitney Test
2) Mean ± SD
BMI: Body Mass Index [weight (kg)/height (m2)], PIBW: Percent Ideal Body Weight, LBM: Lean Body Mass, BFM: Body Fat Mass, %BF: Percent Body Fat, WHR: Waist-Hip circumference Ratio, Pre-HD : Pre-hemodialysis, Post-HD : Post-hemodialysis, SBP : Systolic Blood Pressure, DBP : Diastolic Blood Pressure
*:p < 0.05, **:p < 0.01, ***:p < 0.001 by Mann-Whitney Test
Table 7Nutrition knowledge of the subjects before and after counseling
1) p-value by Mcnemar Test
2) N (%)
3) χ2-value by Wilcoxon Test
NS: Not Significant between groups by Wilcoxon Test
*:p < 0.05, **:p < 0.01
1. Of the following information, what is incorrect information for hemodialysis patients?
2. What is the correct way to supplement nutritional energy in the diets of hemodialysis patients?
3. Which high-quality protein is not good for hemodialysis patients?
4. Hemodialysis patients should limit the intake of which nutrient (s)?
5. What is the daily allowance of sodium intake for hemodialysis patients?
6. What is the daily allowance of water intake for hemodialysis patients?
7. Which food do you have to limit because of its high potassium content?
8. Which foods are rich in phosphorus and therefore, you do not need to limit their consumption?
9. What seasoning does not require limited usage?
10. What problems occur when eating out?
11. It is recommended to eat frozen or chilled fruits between meals because it is a good way to relieve thirst. (O)
12. Put water in a large container so that water is available for you to drink when you are thirsty and need to drink water. (O)
13. When cooking vegetables, use stems rather than leaves or hearts. (×)
14. If you eat raw vegetables, eat them only after they have been chopped and then, rinsed several times in water. (O)
15. It is better to use the water used for blanching vegetables when you cook. (×)
16. Hemodialysis patients do not need to restrict their calorie or protein intake. (×)
17. Eat several raw vegetables such as seaweed and spinach for dietary fiber. (×)
18. Sodium, as a component of salt, is 40% of salt. (O)
19. Salt can help balance moisture content in our bodies. (O)
20. Food additives in manufactured foods such as baking powder, raising agent, and sodium bicarbonate are harmful to human health. However, food additives do not contain sodium. (×)
Table 8Comparison of dietary attitude score before and after counseling
1) χ2-value by Friedman Test
2) Mean ± SD
3) Total score = 75 point, Quite agree: 5 points, Not agree at all: 1 point
*:p < 0.05, **:p < 0.01 by Friedman Test
1. I try to apply nutrition knowledge to my daily diet.
2. I apply the food exchange list to my daily diet.
3. When I prepare and/or eat a meal, I am interested in the food ingredients.
4. When I prepare and/or eat a meal, I consider nutritional balance.
5. When I eat out, I am careful of sodium, phosphorus and potassium intake.
6. I try not to overeat on holidays or when eating out.
7. When I buy processed foods, I carefully read the nutrition facts.
8. When I buy processed foods, I check the amount of sodium on nutrition labels.
9. When I cook, I try to reduce salty flavor.
10. I have the habit of adding salt or soy sauce before I eat certain foods.
11. When the food is not salty, I add more salt or soy sauce.
12. When I eat bread, I spread plenty of margarine or butter on it.
13. When I eat soup or stew, I eat a lot of soup broth.
14. I eat a lot of kimchi at every meal.
15. When I eat out, I ask them to prepare my food with less/no salt
Figure & Data
REFERENCES
Citations
Citations to this article as recorded by 
- Comparison Between Semi-Quantitative Frequency Methods and 7-day Dietary Records Methods in Food and Nutrition Intake Status For Hemodialysis Patients
Dong-Ryeol Ryu, Jung-Hyun Kim, Hyun-Jung Kim, Min-Sook Kyung, Jung-Tak Park
Korean Journal of Community Nutrition.2017; 22(5): 426. CrossRef
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XML DownloadEffectiveness of Nutrition Education and Counseling on the Salty Taste Assessment, Nutrition Knowledge and Dietary Attitude of Hemodialysis Patients
Effectiveness of Nutrition Education and Counseling on the Salty Taste Assessment, Nutrition Knowledge and Dietary Attitude of Hemodialysis Patients
Flow chart of nutrition education and counseling
Anthropometric measurements of the subjects
1) Z-value by Mann-Whitney Test
2) Mean ± SD
BMI: Body Mass Index [weight (kg)/height (m2)], PIBW: Percent Ideal Body Weight, LBM: Lean Body Mass, BFM: Body Fat Mass, %BF: Percent Body Fat, WHR: Waist-Hip circumference Ratio, Pre-HD : Pre-hemodialysis, Post-HD : Post-hemodialysis, SBP : Systolic Blood Pressure, DBP : Diastolic Blood Pressure
*:p < 0.05, **:p < 0.01, ***:p < 0.001 by Mann-Whitney Test
Changes in the biochemical data of the subjects after the intervention
1) χ2-value by Friedman Test
2) Mean ± SD
Hb: Hemoglobin, Hct: Hematocrit, T-P: Total protein, Alb: Albumin, CHO: Total cholesterol, T-G: Triglyceride, BUN: Blood urea nitrogen, Crea: Creatinine
*p < 0.05, **:p < 0.01, ***: p < 0.001 by Friedman Test
Changes in salty taste assessment of the subjects before and after counseling
1) N (%)
NS: Not Significant among 3 periods by Friedman Test
***:p < 0.001 by chi-square Test
Comparison of the intensity1) by salt concentration
1) Unsalty; 1, slighty unsalty; 2, neither unsalty nor salty; 3, slighty salty; 4, salty; 5
2) Mean ± SD
NS: Not Significant among 3 periods by Friedman Test
***:p < 0.001 by Kruskal-Wallis Test
Comparison of the preference1) for salty taste during counseling
1) Dislike: 1 point, Like: 5 points
2) Mean ± SD
NS: Not Significant among 3 periods by Friedman Test
***:p < 0.001 by Kruskal-Wallis Test
Nutrition knowledge of the subjects before and after counseling
1) p-value by Mcnemar Test
2) N (%)
3) χ2-value by Wilcoxon Test
NS: Not Significant between groups by Wilcoxon Test
*:p < 0.05, **:p < 0.01
1. Of the following information, what is incorrect information for hemodialysis patients?
2. What is the correct way to supplement nutritional energy in the diets of hemodialysis patients?
3. Which high-quality protein is not good for hemodialysis patients?
4. Hemodialysis patients should limit the intake of which nutrient (s)?
5. What is the daily allowance of sodium intake for hemodialysis patients?
6. What is the daily allowance of water intake for hemodialysis patients?
7. Which food do you have to limit because of its high potassium content?
8. Which foods are rich in phosphorus and therefore, you do not need to limit their consumption?
9. What seasoning does not require limited usage?
10. What problems occur when eating out?
11. It is recommended to eat frozen or chilled fruits between meals because it is a good way to relieve thirst. (O)
12. Put water in a large container so that water is available for you to drink when you are thirsty and need to drink water. (O)
13. When cooking vegetables, use stems rather than leaves or hearts. (×)
14. If you eat raw vegetables, eat them only after they have been chopped and then, rinsed several times in water. (O)
15. It is better to use the water used for blanching vegetables when you cook. (×)
16. Hemodialysis patients do not need to restrict their calorie or protein intake. (×)
17. Eat several raw vegetables such as seaweed and spinach for dietary fiber. (×)
18. Sodium, as a component of salt, is 40% of salt. (O)
19. Salt can help balance moisture content in our bodies. (O)
20. Food additives in manufactured foods such as baking powder, raising agent, and sodium bicarbonate are harmful to human health. However, food additives do not contain sodium. (×)
Comparison of dietary attitude score before and after counseling
1) χ2-value by Friedman Test
2) Mean ± SD
3) Total score = 75 point, Quite agree: 5 points, Not agree at all: 1 point
*:p < 0.05, **:p < 0.01 by Friedman Test
1. I try to apply nutrition knowledge to my daily diet.
2. I apply the food exchange list to my daily diet.
3. When I prepare and/or eat a meal, I am interested in the food ingredients.
4. When I prepare and/or eat a meal, I consider nutritional balance.
5. When I eat out, I am careful of sodium, phosphorus and potassium intake.
6. I try not to overeat on holidays or when eating out.
7. When I buy processed foods, I carefully read the nutrition facts.
8. When I buy processed foods, I check the amount of sodium on nutrition labels.
9. When I cook, I try to reduce salty flavor.
10. I have the habit of adding salt or soy sauce before I eat certain foods.
11. When the food is not salty, I add more salt or soy sauce.
12. When I eat bread, I spread plenty of margarine or butter on it.
13. When I eat soup or stew, I eat a lot of soup broth.
14. I eat a lot of kimchi at every meal.
15. When I eat out, I ask them to prepare my food with less/no salt
Table 1
Flow chart of nutrition education and counseling
Table 2
Anthropometric measurements of the subjects
1) Z-value by Mann-Whitney Test 2) Mean ± SD BMI: Body Mass Index [weight (kg)/height (m2)], PIBW: Percent Ideal Body Weight, LBM: Lean Body Mass, BFM: Body Fat Mass, %BF: Percent Body Fat, WHR: Waist-Hip circumference Ratio, Pre-HD : Pre-hemodialysis, Post-HD : Post-hemodialysis, SBP : Systolic Blood Pressure, DBP : Diastolic Blood Pressure *:p < 0.05, **:p < 0.01, ***:p < 0.001 by Mann-Whitney Test
Table 3
Changes in the biochemical data of the subjects after the intervention
1) χ2-value by Friedman Test 2) Mean ± SD Hb: Hemoglobin, Hct: Hematocrit, T-P: Total protein, Alb: Albumin, CHO: Total cholesterol, T-G: Triglyceride, BUN: Blood urea nitrogen, Crea: Creatinine *p < 0.05, **:p < 0.01, ***: p < 0.001 by Friedman Test
Table 4
Changes in salty taste assessment of the subjects before and after counseling
1) N (%) NS: Not Significant among 3 periods by Friedman Test ***:p < 0.001 by chi-square Test
Table 5
Comparison of the intensity1) by salt concentration
1) Unsalty; 1, slighty unsalty; 2, neither unsalty nor salty; 3, slighty salty; 4, salty; 5 2) Mean ± SD NS: Not Significant among 3 periods by Friedman Test ***:p < 0.001 by Kruskal-Wallis Test
Table 6
Comparison of the preference1) for salty taste during counseling
1) Dislike: 1 point, Like: 5 points 2) Mean ± SD NS: Not Significant among 3 periods by Friedman Test ***:p < 0.001 by Kruskal-Wallis Test
Table 7
Nutrition knowledge of the subjects before and after counseling
1) p-value by Mcnemar Test 2) N (%) 3) χ2-value by Wilcoxon Test NS: Not Significant between groups by Wilcoxon Test *:p < 0.05, **:p < 0.01 1. Of the following information, what is incorrect information for hemodialysis patients? 2. What is the correct way to supplement nutritional energy in the diets of hemodialysis patients? 3. Which high-quality protein is not good for hemodialysis patients? 4. Hemodialysis patients should limit the intake of which nutrient (s)? 5. What is the daily allowance of sodium intake for hemodialysis patients? 6. What is the daily allowance of water intake for hemodialysis patients? 7. Which food do you have to limit because of its high potassium content? 8. Which foods are rich in phosphorus and therefore, you do not need to limit their consumption? 9. What seasoning does not require limited usage? 10. What problems occur when eating out? 11. It is recommended to eat frozen or chilled fruits between meals because it is a good way to relieve thirst. (O) 12. Put water in a large container so that water is available for you to drink when you are thirsty and need to drink water. (O) 13. When cooking vegetables, use stems rather than leaves or hearts. (×) 14. If you eat raw vegetables, eat them only after they have been chopped and then, rinsed several times in water. (O) 15. It is better to use the water used for blanching vegetables when you cook. (×) 16. Hemodialysis patients do not need to restrict their calorie or protein intake. (×) 17. Eat several raw vegetables such as seaweed and spinach for dietary fiber. (×) 18. Sodium, as a component of salt, is 40% of salt. (O) 19. Salt can help balance moisture content in our bodies. (O) 20. Food additives in manufactured foods such as baking powder, raising agent, and sodium bicarbonate are harmful to human health. However, food additives do not contain sodium. (×)
Table 8
Comparison of dietary attitude score before and after counseling
1) χ2-value by Friedman Test 2) Mean ± SD 3) Total score = 75 point, Quite agree: 5 points, Not agree at all: 1 point *:p < 0.05, **:p < 0.01 by Friedman Test 1. I try to apply nutrition knowledge to my daily diet. 2. I apply the food exchange list to my daily diet. 3. When I prepare and/or eat a meal, I am interested in the food ingredients. 4. When I prepare and/or eat a meal, I consider nutritional balance. 5. When I eat out, I am careful of sodium, phosphorus and potassium intake. 6. I try not to overeat on holidays or when eating out. 7. When I buy processed foods, I carefully read the nutrition facts. 8. When I buy processed foods, I check the amount of sodium on nutrition labels. 9. When I cook, I try to reduce salty flavor. 10. I have the habit of adding salt or soy sauce before I eat certain foods. 11. When the food is not salty, I add more salt or soy sauce. 12. When I eat bread, I spread plenty of margarine or butter on it. 13. When I eat soup or stew, I eat a lot of soup broth. 14. I eat a lot of kimchi at every meal. 15. When I eat out, I ask them to prepare my food with less/no salt
