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Moon and Kim: Evaluation of Nutrition Education for Hypertension Patients Aged 50 Years and Over
Original Article
Korean Journal of Community Nutrition

Korean Journal of Community Nutrition 2011; 16(1): 62-74.

Published online: 28 February 2011

DOI: https://doi.org/10.5720/kjcn.2011.16.1.62

Evaluation of Nutrition Education for Hypertension Patients Aged 50 Years and Over

Eun Hye Moon, Kyung Won Kim

Food & Nutrition, College of Natural Sciences, Seoul Women's University, Seoul, Korea.

Corresponding author: Kyung Won Kim, Food & Nutrition, College of Natural Sciences, Seoul Women's University, 126 Kongnung-2-dong, Nowon-gu, Seoul 139-774, Korea. Tel: (02) 970-5647, Fax: (02) 976-4049, kwkim@swu.ac.kr

Received 21 September 2010       Revised 31 December 2010       Accepted 4 January 2011

Copyright © 2011 The Korean Society of Community Nutrition

Abstract

This study was designed to implement and evaluate a nutrition education program for hypertensive patients aged between 50 and over. Nutrition education consisted of four sessions and, 35 out of 51 patients completed all education sessions at the public health center. To assess program effectiveness (effectively), data about blood pressure, blood cholesterol, anthropometry, nutrition knowledge, eating behavior and dietary intake were collected before and after nutrition education. Data were analyzed using SAS package (ver. 9.2) and significant difference was evaluated by paired t-test, x2-test and Wilcoxon signed rank test. Blood cholesterol was significantly reduced from 200.7 mg/dL to 188.7 mg/dL after nutrition education, although there were not significant changes in blood pressure or blood triglyceride level. Weight (p < 0.05), % body fat (p < 0.001), BMI (p < 0.05) were significantly reduced, especially in women, after nutrition education. Nutrition knowledge was increased significantly (p < 0.05), and some eating behaviors such as 'having fruits & vegetables for snack' and 'having brown rice, barley rice than white rice' were improved after nutrition education (p < 0.05). Sodium intake was reduced from 3,888.9 mg/day to 3,157.4 mg/day after nutrition education (p < 0.05). Except protein and iron intakes, the nutrient intake of hypertensive patients was much below the recommended level for Koreans. Dietary intakes of most of nutrients were not significantly different between pre-test and post-test. It appeared that nutrition education for the aged hypertensive patients was effective in reducing the percentage of % body fat and BMI, increasing the nutrition knowledge and some dietary behaviors. This nutrition education can be implemented at public health centers or senior centers for hypertensive patients.

Keywords: hypertension, nutrition education, effectiveness evaluation, adults aged 50 and over

Figures and Tables

Table 1
Nutrition Education Program for hypertension
kjcn-16-62-i001
Table 2
General characteristics of subjects
kjcn-16-62-i002

1) Mean ± SE, 2) ***: p < 0.001 by t-test, 3) N (%), 4) χ2-test

Table 3
Comparison of biochemical and anthropometric assessment between pre-test and post-test
kjcn-16-62-i003

1) Mean ± SE

2) *: p < 0.05, **: p < 0.01, ***: p < 0.001 by paired t-test for total subjects, and Wilcoxon signed rank test for examining by sex

Table 4
Comparison of nutrition knowledge between pre-test and post-test
kjcn-16-62-i004

1) N (%) of correct answers

2) *: p < 0.05 by χ2-test

3) Correct answer was given a point. Higher score indicates having more nutrition knowledge, with a possible score of 0 - 15

4) Mean ± SE

5) *: p < 0.05 by paired t-test

Table 5
Comparison of eating behavior between pre-test and post-test
kjcn-16-62-i005

1) Mean ± SE. Variables were measured from 1 (not at all) to 4 (almost every day, 6 - 7 days/week). Scores on undesirable behaviors were reversely coded. The higher the score, the better the eating behavior

2) *: p < 0.05 by paired t-test

3) Summated score of each item. Scores on undesirable behaviors were reversed to calculate total score. Higher score indicates more desirable eating behavior, with a possible score from 17 to 68

Table 6
Comparison of nutrient intakes between pre-test and post-test
kjcn-16-62-i006

*: p < 0.05, **: p < 0.01

1) Mean ± SE, 2) %EER, 3) %RI, 4) %AI, 5) Statistical analysis by paired t-test for total subjects, and by Wilcoxon signed rank test for examining by sex at p < 0.05

Table 7
Comparison of INQ between pre-test and post-test
kjcn-16-62-i007

1) INQ Mean ± SE

2) Statistical analysis by paired t-test for total subjects, and by Wilcoxon signed rank test for examining by sex at p < 0.05

Notes

This study was supported by a grant of the Korea Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (00-PJ1-PG1-CH17-0006).

References

1. Alderman MH, Cohen H, Madhavan S. Diabetes and cardiovascular events in hypertensive patients. Hypertension. 1999. 33(5):1130–1134.
2. Baek SH, Cho HJ. The management of hypertension by internists and family physicians in general hospital. J Korean Acad Fam Med. 1997. 18(8):793–801.
3. Cho KO, Kwon SH. A comparative study on food habits and nutrient intakes with body mass index of hypertensive patients commuting to a local health center. J Korean Diet Assoc. 2002. 8(2):185–198.
4. Choi YJ, Park YS, Kim C, Chang YK. Evaluation of functional ability and nutritional risk according to self-rated health (SRH) of the elderly in Seoul and Kyunggi-do. Korean J Nutr. 2004. 37(3):223–235.
5. Eum SO, Kim SD, Lee JS. Effects of hypertension education programs on knowledge, attitude and practice in hypertension patients. Korean Public Health Res. 2007. 33(2):162–174.
6. Green LW, Kreuter MW. Health program planning - An educaitonal and ecological approach. 2005. New York: McGraw Hill.
7. Kang EJ, Kim NY, Seok JY. An estimation of health-adjusted life expectancy (HALE) for Koreans. Korean J Health Policy Adm. 2008. 18(1):108–126.
8. Kang HJ, Shin EM, Kim KW. Evaluation of nutrition education for diabetes mellitus management of older adults. Korean J Community Nutr. 2009. 14(6):734–745.
9. Kim GN, Lee KS. Nutrition knowledge, dietary attitudes, and food behaviors of college students. Korean J Community Nutr. 1996. 1(1):89–99.
10. Kim GN, Lee JW, Park YS, Hyun TS. Nutritional status of the elderly living in Cheongju - I. Health-related habits, dietary behaviors and nutrient intakes -. Korean J Community Nutr. 1997. 2(4):556–567.
11. Kim KR, Hong SA, Kim MK. Nutritional status and food insufficiency of Korean population through the life-course by education level based on 2005 National Health and Nutrition Survey. Korean J Nutr. 2008. 41(7):667–681.
12. Kim KW. Issues and directions in developing nutrition education for older adults in Korea. Korean J Community Nutr. 2000. 2(1):71–84.
13. Kim KW, Kang HJ, Shin EM, Kim HS. Development of the booklet "prevention and management of hypertension for older adults". Korean J Community Nutr. 2004. 6(1):26–34.
14. Kim TY, Eom SH. Older adults with type 2 diabetes improve glycemic control after nutritional education program at the public health center. J Korean Diet Assoc. 2004. 10(2):205–217.
15. Kim YM, Choi HR, Park DY, Lim JB, Won CW, Kim BS, Park YW. The comparison of the quality of life between the well-controlled hypertension group and the uncontrolled hypertension group. J Korean Acad Fam Med. 2001. 22(4):565–574.
16. Korean Dietetic Association. Eye measurement of food using pictures. 1999. Seoul: Korean Dietetic Association.
17. South Korean's Life expectancy. 2006. Korea National Statistics Office;Available from http://kosis.kr/abroad/abroad_01List.jsp.
18. Korean Nutrition Society. Dietary reference intakes for Koreans. 2005. Seoul: Korean Nutrition Society.
19. Kolasa KM. Summary of the JNC 7 guidelines for the prevention and treatment of high blood pressure. J Nutr Educ Behav. 2003. 35(5):226–227.
20. Kwak EH, Lee SL, Lee HS, Kwun IS. Relation dietary and urinary Na, K, and Ca level to blood pressure in elderly people in rural area. Korean J Nutr. 2003. 36(1):75–82.
21. Lee HJ. Effect of individual health education the medical clinic of public health centers on knowledge, self-efficacy, and self-care behavior in clients with hypertension. J Korea Community Health Nurs Acad Soc. 2004. 18(1):80–89.
22. Lee YS, Kim HK. Nutritional status and cognitive status of the elderly using public health center in Ulsan. Korean J Nutr. 2002. 35(10):1070–1080.
23. Ministry for Health, Welfare and Family Affairs & Korea Centers for Disease Control and Prevention. 2007 National Health Statistics - The 4th Korea National Health and Nutrition Examination Survey. the first year(2007). 2008. Korea: Korea Centers for Disease Control and Prevention.
24. Ministry of Health and Welfare, Korea Institute for Health and Social Welfares. The Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005. 2006. Seoul:
25. Moon HK, Joung HJ. Dietary risk factors of hypertension in the elderly. Korean J Nutr. 1999. 32(1):90–100.
26. Morrison AC, Bray MS, Folsom AR, Boerwinkle E. ADD1 460W Allele associated with cardiovascular disease in hypertensive individuals. Hypertension. 2002. 39(6):1053–1057.
27. Park NH. The effect of self-help programs for hypertensives in community areas. J Korean Soc Health Educ Promot. 2003. 20(3):207–219.
28. Rajgopal R, Cox RH, Lambur M, Lewis EC. Cost-benefit indicates the positive economic benefits of the expanded food and nutrition education program related to chronic disease prevention. J Nutr Educ Behav. 2002. 34(1):26–37.
29. Sahyoun NR. Nutrition education for the healthy elderly population: Isn's it time? J Nutr Educ Behav. 2002. 34:Suppl 1. S42–S47.
30. Sesso HD, Chen RS, L'Italien GJ, Lapuerta P, Lee WC, Glynn RJ. Blood pressure lowering and life expectancy based on a Markov model of cardiovascular events. Hypertension. 2003. 42(5):885–890.
31. Son SM, Kim MJ. The effect of nutrition education program for various chronic disease in elderly visiting public health center. Korean J Community Nutr. 2001. 6(4):668–677.
32. Yim KS. Analysis of the characteristics of an attendee in an elderly nutrition education program - Using the factors of health promotion model -. Korean J Community Nutr. 1998. 3(4):609–621.
33. Yim KS. Strategies to improve elderly nutrition : Comparisons of dietary behavior according to the mean nutrient adequacy ratio. Korean J Community Nutr. 1999. 4(1):46–56.
34. Yim KS, Min YH, Lee HY, Kim YJ. Strategies to improve elderly nutrition through nutrition education : Evaluation of the effectiveness of the program. Korean J Community Nutr. 1999. 4(2):207–218.
35. Yim KS. Evaluation of the effectiveness of a nutrition education program for hypertensive patients at the community level. Korean J Community Nutr. 2000. 5(4):654–661.
36. Yim KS, Han MH, Kang YH, Park HR, Kim CH. Analysis of dietary characteristics of participants attending the nutrition education program for hypertensive patients at a public health center. J Korean Diet Assoc. 2000. 6(2):125–135.
37. Yim KS. The effects of a nutrition education program for hypertensive female elderly at the public health center. Korean J Community Nutr. 2008. 13(5):640–652.
38. Yoon JS, Jeong YH, Park JA, Oh HM. The effect of individualized nutritional education on adults having two or more symptoms of chronic degenerative disease. Korean J Community Nutr. 2002. 7(6):794–802.
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