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

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 (≤ 3) were categorized into the less attendance (LA) group and 34 participants attended 4 times or more (≥ 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. (Korean J Community Nutr 18(6) : 626~643, 2013)

Effect of nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults

“…Although the LSHP group was emphasized to increase potassium intake, it did not improve after nutrition education. Other studies on hypertension patients also recommended increasing potassium intake in low sodium nutrition education, there was a only decrease in sodium intake after education, but no significant change in potassium intake [11,23]. In this study, subjects were taught to eat raw vegetables or salads instead of herbs to reduce sodium intake and increase potassium intake.…”

“…The study on the evaluation of nutrition education for hypertension patients aged 50 yrs and over have shown only a significant decrease in blood cholesterol level after nutrition education [11]. However, Jung et al [23] have reported an increase in serum cholesterol after nutrition education in a study on effects of education by session attendance on salt reduction education program for pre-hypertensive adults. The exact mechanism involved in changes in blood lipid compositions remains unclear.…”

“…A study of Moon and Kim [ 11 ], Son and Kim [ 13 ] on hypertension patients in Korea has shown a tendency of decrease in systolic and diastolic blood pressures after nutrition education for 4 weeks and 7 weeks, respectively. Jung et al [ 23 ] have investigated patients with pre-hypertension and found that systolic and diastolic blood pressures are decreased significantly after 16 weeks of nutrition education. The present study also showed that both systolic and diastolic blood pressures were decreased after 12 weeks of nutrition education, indicating that changes in blood pressure might be associated with the duration of education.…”

“…The exact mechanism involved in changes in blood lipid compositions remains unclear. However, the DASH diet may be effective in improving cholesterol and LDL-cholesterol levels [ 23 24 ]. In the present study, low sodium high potassium education applied the concept of DASH diet to educate various intakes of whole grains, fruits, and vegetables containing high potassium while teaching low sodium diet.…”