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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

보건소를 방문한 경계성 고혈압 환자의 저염식생활 영양교육 참여정도에 따른 혈압, 나트륨 섭취 및 식행동 변화에 관한 연구

  • Jung, Eun-Jin (Department of Food Science & Nutrition, The Catholic University of Korea) ;
  • Kwon, Jong-Sook (Department of Food & Nutrition, Shingu College) ;
  • Ahn, So-Hyun (Department of Food Science & Nutrition, The Catholic University of Korea) ;
  • Son, Sook Mee (Department of Food Science & Nutrition, The Catholic University of Korea)
  • 정은진 (가톨릭대학교 생활과학부 식품영양학전공) ;
  • 권종숙 (신구대학교 식품영양학과) ;
  • 안소현 (가톨릭대학교 생활과학부 식품영양학전공) ;
  • 손숙미 (가톨릭대학교 생활과학부 식품영양학전공)
  • Received : 2013.08.19
  • Accepted : 2013.11.13
  • Published : 2013.12.31

Abstract

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 (${\leq}3$) were categorized into the less attendance (LA) group and 34 participants attended 4 times or more (${\geq}4$) 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.

Keywords

References

  1. Ard JD, Svetkey LP (2005): Diet and blood pressure: Applying the evidence to clinical practice. Am Heart J 149(5): 804-812 https://doi.org/10.1016/j.ahj.2005.01.040
  2. Beauchamp GK, Engelman K (1991): High salt intake, sensory and behavioral factors. Hypertens 17: 1179-1181
  3. Blaustein MP, Hamlyn JM (1991): Pathogenesis of essential hypertension : A link between dietary salt and high blood pressure. Hypertens 18(55): 184-195
  4. Carvalho JM, Baruzzi RG, Howard PF, Poulter N, Alpers MP, Franco LJ, Marcopito LF, Spooner VJ, Dyer AR, Elliott P, Stamler J, Stamler R (1989): Blood presure in four remote populations in the INTERSALT study. Hypertens 14: 238-246 https://doi.org/10.1161/01.HYP.14.3.238
  5. Culter JA, Follmann D, Allender PS (1997): Randomized trials of sodium reduction: an overview. Am J Clin Nutr 65: 6435-651S
  6. De Wardener HE, MacGregor GA (2002): Harmful effects of the dietary salt in addition to hypertension. J Human Hypertens 16: 213-223 https://doi.org/10.1038/sj.jhh.1001374
  7. Evers SE, Bass M, Donner A, McWhinney IR (1987): Lack of impact of salt restriction advice on hypertensive patients. Prev Med 16: 213-220 https://doi.org/10.1016/0091-7435(87)90085-5
  8. Fielding JE (1982): Effectiveness of employee health improvement programs. J Occupational Med 24: 907-916
  9. Huff LS, Zitterman L, DeAlleaume L, Bernstein J, Chavez R, Sutte C, LeBlanc WG, Parnes B (2011): What keeps patients from adhering to home blood pressure program. J Am Board Fam Med 24(4): 370-379 https://doi.org/10.3122/jabfm.2011.04.100266
  10. Jung YY, Shin EK, Lee HJ, Lee NH, Chun BY, Ann MY, Lee YK (2009): Development and evaluation of nutrition education program on sodium reduction in elementary school students. Korean J Community Nutr 14(6): 746-755
  11. Jung EJ, Son SM, Kwon JS (2012): The effect of sodium reduction program of a public health center on blood pressure, blood biochemical profile and sodium intake of hypertensive adults. Korean J Community Nutr 17(6): 752-771 https://doi.org/10.5720/kjcn.2012.17.6.752
  12. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK. He J (2005): Global burden of hypertension: analysis of worldwide data. Lancet 365(9455): 217-223 https://doi.org/10.1016/S0140-6736(05)17741-1
  13. Kim YS, Paik HY (1987): Measurement of Na intake in Korean adult females. Korean J Nutr 20(5): 341-349
  14. Kolasa KM (2003): Summary of the JNC 7 guidelines for the prevention and treatment of high blood pressure. J Nutr Edu Behav 35(5): 226-227 https://doi.org/10.1016/S1499-4046(06)60052-3
  15. Luft FC, Morris CD, Weinberger MH (1997): Compliance to a low salt diet. Am J Clin Nutr 65(suppl): 698S-703S
  16. Mattes RD (1997): The taste for salt in humans. Am J Clin Nutr 65(suppl): 692S-697S
  17. Ministry of Health and Welfare, Korea Centers for Disease Contol and Prevention (2011): Korea health statistics 2010: Korea National Health and Nutrition Examination Survey (KNHANES V-1 2010)
  18. Moon EH (2005): Implementation and evaluation of nutrition education program for hypertensive patients among adults aged 50 and over. MS thesis, Seoul Women's University, pp.18-53
  19. Moon EH, Kim KW (2011): Evaluation of nutrition education for hypertension patients aged 50 years and over. Korean J Community Nutr 16(1): 62-74 https://doi.org/10.5720/kjcn.2011.16.1.62
  20. Obarzanek E, Sacks FM, Vollmer WM (2001): Effects of blood lipids of a blood pressure-lowering diet: the dietary approaches to stop hypertension (DASH) trial. Am J Clin Nutr 74: 80-89
  21. Park YS, Son SM, Lim WJ, Kim SB, Chung YS (2008): Comparison of dietary behaviors related to sodium intake by gender and age. Korean J Community Nutr 13(1): 1-12
  22. Ruppert M, Diehl J, Kolloch R, Overlack A, Kratf K, Gobel B, Hitte N, Stumpe Ko (1991): Short term dietary sodium restriction increases serum lipids and insulin in salt-sensitive and salt resistant normotensive adults. Klin Wonchenschr 69: 51-57 https://doi.org/10.1007/BF01649060
  23. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ. Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER. Simons-Morton D (2001): Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. N Engl J Med 344: 3-10 https://doi.org/10.1056/NEJM200101043440101
  24. Shin EK, Lee HJ, Jun SY, Park EJ, Jung YY, Ahn MY, Lee YK (2008): Development and evaluation of nutrition education program for sodium reduction in food service operations. Korean J Community Nutr 13(2): 216-227
  25. Son SM, Huh GY, Lee HS (2005): Development and evaluation of validity of dish frequency questionnaire (DFQ) and short DFQ using Na index for estimation of habitual sodium intake. Korean J Community Nutr 10(5): 677-692
  26. Son SM, Huh GY (2006): Dietary risk factors associated with hypertension in patients. Korean J Community Nutr 11(5): 661-672
  27. Son SM, Park YS, Lim HJ, Kim SB, Jeong YS (2006): Pilot study for low salt consumption projects for Korean people. Ministry of Health & Welfare
  28. Son SM, Park YS, Lim HJ, Kim SB, Jeong YS (2007): 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. Korean J Community Nutr 12(5): 545-558
  29. Song DY, Park JE, shim JE, Lee JE (2013): Trends in the major dish groups and food groups contributing to sodium intake in the Korea national health and nutrition examination suvey 1998-2010. Korean J Community Nutr 46(1): 72-85 https://doi.org/10.4163/kjn.2013.46.1.72
  30. Stamler J, Stamler R, Neaton JD (1993): Blood pressure, systolic and diastolic, and cardiovascular risk: US populatuib data. Arch Intern Med 153: 598-615 https://doi.org/10.1001/archinte.1993.00410050036006
  31. Svetkey LP, Harsha DW, Vollmer WM, Stevens VJ, Obarzanek E, Elmer PJ (2003): A comprehensive lifestyle modification for blood pressure control: Rationale, design and baseline characteristics. Am Epidemiol 13: 462-471 https://doi.org/10.1016/S1047-2797(03)00006-1
  32. The Korean Nutrition Society (2010): Dietary reference intakes for Koreans. 1st revision, Seoul, The Korean Nutrition Society, P.367
  33. Wee LE, Koh GC (2011): The effect of neighborhood, socioeconomic status and a community based program on multi-disease health screening in an Asian population: a controlled intervention study. Prev Med 53(1-2): 64-69 https://doi.org/10.1016/j.ypmed.2011.05.005
  34. Whelton PK, HE J, Appel LJ (2002): Primary prevention of hypertension: Clinical and public health advisory from the national high blood pressure education program. JAMA 288: 1882-1888 https://doi.org/10.1001/jama.288.15.1882
  35. Yim KS (1998): Analysis of the characteristics of an attendee in an elderly nutrition education program. Korean J Community Nutr 3(4): 609-621
  36. Yim KS (2008): The effects of a nutrition education program for hypertensive female elderly at the public health center. Korean J Community Nutr 13(5): 640-652

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