Journal List > J Nutr Health > v.48(5) > 1081412

J Nutr Health. 2015 Oct;48(5):429-440. Korean.
Published online October 30, 2015.
© 2015 The Korean Nutrition Society
Nutrition knowledge, eating attitudes, nutrition behavior, self-efficacy of childcare center foodservice employees by stages of behavioral change in reducing sodium intake
Yun Ahn,1 Kyung Won Kim,2 Kyungmin Kim,3 Jinwon Pyun,4 Ikhyun Yeo,1 and Kisun Nam1
1Division of Diet Research, Institute of Food and Culture, Pulmuone Co., Ltd., Seoul 03722, Korea.
2Department of Food and Nutrition, Seoul Women's University, Seoul 01797, Korea.
3Department of Food and Nutrition, Baewha Women's University, Seoul 03039, Korea.
4Department of Food and Nutrition, Suwon Women's University, Gyeonggi 16632, Korea.

To whom correspondence should be addressed. tel: +82-2-3277-8516, Email:
Received April 08, 2015; Revised April 22, 2015; Accepted October 07, 2015.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



The purpose of this study was to examine sodium-related nutrition knowledge, eating attitudes, eating behaviors, and self-efficacy by stages of behavioral change in reducing sodium intake among childcare center foodservice employees.


Subjects (n = 333) were categorized according to two groups based on the stages of change; Pre-action stage (PA group: precontemplation/contemplation/preparation stage), Action stage (A group: action/maintenance stage).


A major source of sodium-related nutrition information was TV/radio (56.6%) and only 166 people (49.8%) have experienced nutrition education specific to sodium. Although the A group showed slightly higher scores for nutrition knowledge than the PA group, the difference was not significant. The percentages of correct answers for 'daily goal of sodium intake for adults (27.0%)', 'calculation of sodium content in nutrition labeling (30.3%)' were low for both groups. The A group (total score: 40.3) had more desirable eating attitudes regarding reducing sodium intake than the PA group (36.6, p < 0.001). The total score for eating behaviors was slightly higher in the A group (49.6) than in the PA group (48.5), but without statistical significance. The A group (total score: 58.2) also received higher scores for self-efficacy regarding reducing sodium intake than the PA group (52.5, p < 0.001).


This study suggests that nutrition education for childcare center foodservice employees should be expanded and customized education should be implemented according to the stages in reducing sodium intake. It is also suggested that food companies make efforts to develop low-sodium products.

Keywords: sodium reduction; stages of change; nutrition knowledge; eating attitudes; self-efficacy


Table 1
General characteristics of the subjects
Click for larger image

Table 2
Nutrition knowledge regarding sodium
Click for larger image

Table 3
Eating attitudes regarding reducing sodium intake
Click for larger image

Table 4
Eating behaviors
Click for larger image

Table 5
Self-efficacy regarding reducing sodium intake
Click for larger image

Table 6
Pearson correlation coefficient among variables
Click for larger image

1. Ministry of Health and Welfare. Korea for Disease Control and Prevention. Korea Health Statics 2013: Korea National Health and Nutrition Examination Survey (KNHANES VI-1). Cheongwon: Korea Centers for Disease Control and Prevention; 2013.
2. Koo S, Kim Y, Kim MK, Yoon JS, Park K. Nutrient intake, lifestyle factors and prevalent hypertension in Korean adults: results from 2007-2008 Korean National Health and Nutrition Examination Survey. Korean J Community Nutr 2012;17(3):329–340.
3. Ministry of Health and Welfare (KR). Health plan 2020. Seoul: Ministry of Health and Welfare; 2011.
4. Lee C, Kim DI, Hong J, Koh E, Kang BW, Kim JW, Park HK, Kim CI. Cost-benefit analysis of sodium intake reduction policy in Korea. Korean J Community Nutr 2012;17(3):341–352.
5. Kim MK, Han JI, Chung YJ. Dietary behavior related to salty food intake of adults living in a rural area according to saline sensitivity. Korean J Nutr 2011;44(6):537–550.
6. 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.
7. Yoon JS, Lee MJ. Calcium status and bone mineral density by the level of sodium intake in young women. Korean J Community Nutr 2013;18(2):125–133.
8. Lim HJ. A study on the sodium and potassium intakes and urinary excretion of adults in Busan. Korean J Community Nutr 2012;17(6):737–751.
9. The Korean Nutrition Society. Dietary reference intakes for Koreans. 1st revision. Seoul: The Korean Nutrition Society; 2010.
10. Yon M, Lee Y, Kim D, Lee J, Koh E, Nam E, Shin H, Kang BW, Kim JW, Heo S, Cho HY, Kim CI. Major sources of sodium intake of the Korean population at prepared dish level: based on the KNHANES 2008 & 2009. Korean J Community Nutr 2011;16(4):473–487.
11. Park YH, Kang M, Baik HW, Oh SW, Park SJ, Paik HY, Choe JS, Lee JY, Kang MS, Joung H. A study on the perception as HANSIK (Korean food) for the common dishes in Korean adults residing in Seoul and metropolitan area. Korean J Community Nutr 2012;17(5):555–578.
12. Park S, Kim DJ, Shin WS. Adaptability and preference to Korean food with foreigners who reside in Seoul, Korea. Korean J Community Nutr 2012;17(6):782–794.
13. Park SJ, Paik HY, Lee SY. The influence of mixed NaCl-KCl salt on sodium intake and urinary excretion of sodium and potassium. Korean J Nutr 2007;40(6):500–508.
14. Ahn S, Park S, Kim JN, Han SN, Jeong SB, Kim HK. Salt content of school meals and comparison of perception related to sodium intake in elementary, middle, and high schools. Nutr Res Pract 2013;7(1):59–65.
15. Moon EH, Kim KW. Evaluation of nutrition education for hypertension patients aged 50 years and over. Korean J Community Nutr 2011;16(1):62–74.
16. Jung EJ, Son SM, Kwon JS. The effect of sodium reduction education program of a public health center on the blood pressure, blood biochemical profile and sodium intake of hypertensive adults. Korean J Community Nutr 2012;17(6):752–771.
17. Jung YY, Shin EK, Lee HJ, Lee NH, Chun BY, Ann MY, Lee YK. Development and evaluation of a nutrition education program on sodium reduction in elementary school students. Korean J Community Nutr 2009;14(6):746–755.
18. Kim JN, Park S, Ahn S, Kim HK. A survey on the salt content of kindergarten lunch meals and meal providers' dietary attitude to sodium intake in Gyeonggi-do area. Korean J Community Nutr 2013;18(5):478–490.
19. Shin H, Lee Y. The effectiveness of Na reduction program for cook in child-care center: focus on self-reevaluation and strengthen consciousness. Korean J Community Nutr 2014;19(5):425–435.
20. Lee JH, Ryu K. Influence of school food service employees' nutrition education on nutrition knowledge. J East Asian Soc Diet Life 2006;16(6):777–786.
21. Shin EK, Lee HJ, Jun SY, Park EJ, Jung YY, Ahn MY, Lee YK. Development and evaluation of nutrition education program for sodium reduction in foodservice operations. Korean J Community Nutr 2008;13(2):216–227.
22. Choi MY, Kim HY. Nutrition knowledge, dietary self-efficacy and eating habits according to student's stage of regular breakfast or exercise. Korean J Community Nutr 2008;13(5):653–662.
23. Wolf RL, Lepore SJ, Vandergrift JL, Wetmore-Arkader L, McGinty E, Pietrzak G, Yaroch AL. Knowledge, barriers, and stage of change as correlates of fruit and vegetable consumption among urban and mostly immigrant black men. J Am Diet Assoc 2008;108(8):1315–1322.
24. Suh Y, Chung YJ. The effect of nutrition education on the improvement of psychosocial factors related to vegetable and fruit intake of elementary school children in pre-action stages. Korean J Nutr 2010;43(6):597–606.
25. Ahn Y, Kim KW. Beliefs regarding vegetable consumption, self-efficacy and eating behaviors according to the stages of change in vegetable consumption among college students. Korean J Community Nutr 2012;17(1):1–13.
26. Prochaska JO, DiClemente CC. Stages and processes of selfchange of smoking: toward an integrative model of change. J Consult Clin Psychol 1983;51(3):390–395.
27. Ahn SH, Kwon JS, Kim K, Yoon JS, Kang BW, Kim JW, Heo S, Cho HY, Kim HK. Study on the eating habits and practicability of guidelines for reducing sodium intake according to the stage of change in housewives. Korean J Community Nutr 2012;17(6):724–736.
28. Suh Y, Seok YH, Chung YJ. Relationship of dietary self-efficacy and illness beliefs, perceived benefits and perceived barriers for the reduction of sodium intake in the elderly. Korean J Nutr 2012;45(4):324–335.
29. Jung EJ, Kwon JS, Ahn SH, Son SM. 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. Korean J Community Nutr 2013;18(6):626–643.
30. Song DY, Park JE, Shim JE, Lee JE. Trends in the major dish groups and food groups contributing to sodium intake in the Korea National Health and Nutrition Examination Survey 1998-2010. Korean J Nutr 2013;46(1):72–85.
31. Cho MH, Kim SJ, Lee KH. A study on preference of salinity and temperature of soups served in the institutional foodservice establishments. J East Asian Soc Diet Life 2008;18(4):601–607.
32. Kim SJ, Cho MH, Lee KH. Comparative study between the salinities of soups preferred by customers and provided at institutional foodservice establishments. J East Asian Soc Diet Life 2009;19(3):444–450.
33. Kim HH, Lee YK. Analysis of presumed sodium intake of office workers using 24-hour urine analysis and correlation matrix between variables. Korean J Nutr 2013;46(1):26–33.
34. Chang SO. Effect of a 6-month low sodium diet on the salt taste perception and pleasantness, blood pressure and the urinary sodium excretion in female college students. Korean J Nutr 2010;43(5):433–442.
35. Choi YS, Chang N, Joung H, Cho SH, Park HK. A study on the guideline amounts of sugar, sodium and fats in processed foods met to children's taste. Korean J Nutr 2008;41(6):561–572.
36. Kim JA, Kim YH, Ann MY, Lee YK. Measurements of salinity and salt content by menu types served at industry foodservice operations in Daegu. Korean J Community Nutr 2012;17(5):637–651.
37. Chang SO. The amount of sodium in the processed foods, the use of sodium information on the nutrition label and the acceptance of sodium reduced ramen in the female college students. Korean J Nutr 2006;39(6):585–591.