Although many people initially enroll in health education programs, there are many instances of erratic participation and dropouts. Inconsistent participation in intervention programs minimizes their impact on health promotion. Therefore, a theoretical understanding of factors influencing participation in these programs can potentially enhance the effectiveness of its educational strategy. This study used the Pender's Health Promotion Model to examine specific factors influencing incentives to participate in an elderly nutrition education program. The Elderly Nutrition Counseling and Education Program was conducted with 147 volunteers (76 males, 71 females), aged 60 to 87, at 5 separate community elderly centers, by public health dietitians from February to April 1997. Some participants dropped out during the program. Overall, 61 people(18 males, 43 females) finished all 7 steps over 2 months. Pre-intervention data were collected by trained dietitians. This data included individual cognitive-perceptual factors(perceived benefits of nutrition improvement, importance of health, perceived control over health by multidimensional health locus of control, self esteem, perceived health status, concern about health, depression scale and social health scale), which were known to influence the likelihood of health behavior, and modifying factors(socioeconomic variables, biological characteristics, behavioral factors, such as smoking, alcohol drinking and exercise). Male finalists had a significantly lower chance for health locus of control, and better social health status with their children and grandchildren, compared to males who dropped out. Female finalists had a significantly higher locus of control regarding food behavior, higher self-esteem, better recognized nutritional status, worse self-recognized health status and lower concern about health than those who dropped out. There was no significant difference between the attendees and dropouts in age, BMI( kg/m2), Nutritional Risk Index, depression scale and daily nutrient intake. These results suggest that elderly nutrition intervention plans should focus on the individual cognitive and perceptual factors, with interpersonal influences, to increase participation in nutrition in nutrition improvement programs.
Aged* ; Alcohol Drinking ; Child ; Counseling ; Depression ; Education* ; Female ; Health Behavior ; Health Education ; Health Promotion* ; Humans ; Internal-External Control ; Male ; Motivation ; Nutritional Status ; Nutritionists ; Patient Dropouts ; Population Characteristics ; Public Health ; Self Concept ; Smoke ; Smoking ; Volunteers

This cross-sectional study was conducted to describe the changes of plasma cardiovascular disease(CVD) risk factors in Korea. Overnight fasting plasma levels of total cholesterol, high density lipoprotein(HDL)-cholesterol, triacylglycerol and glucose were analyzed. Blood pressure and anthropometric data were also measured. Health practice factors such as smoking status, alcohol consumption and frequency fo exercise were evaluated by a self-administered questionnaire. Questions regarding dietary habits and food preferences were also asked. Seventy eight percent of the subjects had more than one CVD risk factor. Plasma total cholesterol, triacylglycerol, and fasting blood glucose were significantly increased according to the subjects body mass index(kg/m2, BMI), whereas HDL-cholesterol, low density lipoprotein(LDL)-cholesterol and blood pressure showed no significant differences with BMI. Current smokers had significantly high plasma total cholesterol, LDL-cholesterol and triacylglycerol levels. Alcohol consumption significantly increased plasma total cholesterol and fasting blood sugar, but regular exercise had no effects on the plasma CVD risk factors. Overeating and frequency of fast food consumption were positively correlated with the CVD risk score, whereas intake of grains, meats and vegetables were negatively correlated with that score. A stepwise multiple regression analysis was performed to examine the effects of specific dietary factors on plasma lipid levels. For plasma total cholesterol level, the frequency of fast food intake explained 8% of the variance, followed by habitual overeating, frequency of grain intake and high cholesterol food intake(Model R2=22.4%). For plasma triacylglycerol level, preference of oily foods accounted for 7.5% of the variance, followed by eating breakfast, preference of fruit and frequency of grain intake(Model R2=22.0%). The findings suggest that intervention programs to reduce the risk of CVD should focus on health practice through reducing BMI, smoking cessation and moderate or no alcohol drinking. Moreover, desirable dietary habits such as eating breakfast, not overeating and reduced intake of fast food may improve CVD risk.
Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Breakfast ; Cardiovascular Diseases* ; Edible Grain ; Cholesterol ; Cross-Sectional Studies ; Eating ; Fast Foods ; Fasting ; Food Habits* ; Food Preferences ; Fruit ; Glucose ; Humans ; Hyperphagia ; Korea ; Male* ; Meat ; Plasma* ; Risk Factors* ; Smoke ; Smoking ; Smoking Cessation ; Triglycerides ; Vegetables ; Surveys and Questionnaires

Hypertension is the major risk factor for cardiovascular disease which is considered the leading cause of death in Korea. Since nonpharmarologic dietary intervention is recommended as the first step in the management of hypertension, evaluation of intervention programs is needed to formulate strategies for improving patients' dietary adherence. This study was designed to evaluate the overall effectiveness of a hypertension nutrition education program (HNEP) at a public health center, by assessing changes in nutrition knowledge, food attitude, self-efficacy, dietary behavior, and nutrient intake after program completion. An HNEP was conducted in Suwon city for 5 months in 1999 by a public health center. The program provided 3 sessions of group education with individual nutrition counseling. Thirty-five patients participated fully in the program out of 62 enrollees. Data about nutrition knowledge, food attitude, self-efficacy, dietary behavior, and intake (24-hour recall) were collected before (baseline) and after the program. Post program results indicate the following : 1) nutrition knowledge and perception of importance of nutrition significantly increased, 2) food attitudes also improved, 3) the self-efficacy for maintaining a low salt diet was increased significantly, whereas self-efficacy for maintaining a low fat diet or dietary guidelines was not improved, 4) frequency of intake of processed food, animal fat, and sweets as well as frequency of dining out were significantly reduced, 5) nutrient intake was not improved after the program, 6) the most serious barrier for participating in the program and practicing diet therapy was lack of time and willingness. In conclusion, it appears that HNEP might improve food attitudes, individual perceptions and self-efficacy for desirable eating behavior, but it might not improve dietary intake. It follows then, that a long term intervention program may need to increase effectiveness of patient dietary adherence.
Animals ; Cardiovascular Diseases ; Cause of Death ; Counseling ; Diet ; Diet Therapy ; Education* ; Feeding Behavior ; Gyeonggi-do ; Humans ; Hypertension ; Korea ; Nutrition Policy ; Public Health ; Risk Factors

A deep understanding of the dietary patterns and nutrient intake is important for assessment of possilbe nutritional risk and for establishing nutrition improvement strategies. This study was conducted toexamine the dietary characteristics of a nutritionally poor elderly group compared to the middle-and highly-nourished group. Elderly participant was recruited from local elderly centers in Suwon city in 1998. Trained dietitians interviewed 119 elderly(35 males, 84 females) aged 60 years and over for collecting dietary data(24-hour recall) and related variables. Male and female subjects were grouped into high, middle, and low according to the mean nutrient adequancy ratio(MAR) tertiles. An analysisof the percentage of RDA(Recommended Daily Allowances of Korea) for each of the 10 nutrients showed that the male low-MAR group consumed below the RDA in all kinds of nutrients, and the female low-MAR group consumed nutrients below the RDA except vitamin C. An evaluation of nutrient density by Index of Nutritonal Quality(INQ) also showed a similar tendency. Thus, the INQ level of the male low-MAR group was significantly lower than the middle-or high-MAR group, especially in protein, vitamin A, thiamin, riboflavin, and phosphorus(p<0.05). Moreover, INQ level of female low-MAR group was significantly lower than that of the high group(p<0.05) in all nutrients. The female low-MAR group's daily food intake were also lower than those of the high-MARgroup in gains, fish, fruits, oil and beverages. The energy distribution from carbohydrates, fats and proteins showed that the male low-MAR group had significantly higher carbohydrate and lower fat proportions compared to each gender high-MAR group, respectively. The male and female low-MAR group had low scores about eating all side dishes. These findings indicate that a moderate increase of the meat/egg/fishes intake was needed by the male low-MAR group for improving nutrition adequacy, and an overall increase of the food quantity and quality was desired for the female low-MAR group. These data could be used for planning a community elderly nutrition program and establishing strategies for tailored guidelines for the individuals.
Aged* ; Ascorbic Acid ; Beverages ; Carbohydrates ; Eating ; Fats ; Female ; Fruit ; Gyeonggi-do ; Humans ; Male ; Nutritionists ; Riboflavin ; Vitamin A

Rapid shift to western dietary patterns and social drive of thinness would lead to increase the likelihood of developing eating disorders. This study was performed to analyze the associated factors between dietary pattern and self visualization in terms of body shape, which may increase the risk of disturbed eating attitudes among high school students in Korea. A cross-sectional study was conducted from 2009 to 2010 for high school students including both male and female students, from 6 schools in Gyunggi Province, Korea. A total of 766 students self-reported a questionnaire, including weight control practice, perceptions of self body image and ideal body image, dietary habit, and EAT-26 (Eating Attitude Test-26). Logistic regression analysis was used to fine the factors potentially associated with disturbed eating attitudes. Statistical analysis was conducted using SAS program (version 9.1). Results showed that disturbed eating attitudes were found in 8.7% of male high school students, and in 20.8% of female high school students. Experience of body weight control was reported by 56.2% of male students and by 87.3% of female students. According to multiple logistic regression analysis, obesity was independently associated with high risk of disturbed eating attitudes in male students [Odds Ratios (OR) 2.96, 95% Confidence Interval (CI) 0.90-9.71]. Body image dissatisfaction (OR 2.77, 95%CI 1.37-5.62) and extended family type (OR 2.70, 95%CI 1.05-6.90) were independently associated with high risk of disturbed eating attitudes, especially in female students. In conclusion, proper efforts in education for obesity and developing self-esteem to reduce the risks of disturbed eating attitudes should be implemented in high school nutrition program.
Body Image ; Body Weight ; Cross-Sectional Studies ; Eating ; Feeding and Eating Disorders ; Female ; Food Habits ; Humans ; Korea ; Logistic Models ; Male ; Obesity ; Phenothiazines ; Surveys and Questionnaires ; Thinness

Undernutrition could be a significant deterrent to healthy aging and could negatively affect health outcomes in elderly. This study aimed to assess health-related factors which are associated with nutritional risks in middle-aged and elderly individuals by a cross-sectional study. Interviews were conducted with 2660 subjects (847 males, 1813 females), aged 50 years and over, in 15 cities in Korea. Data on food intake were obtained through a validated semi-quantitative food frequency questionnaires. Nutritional status were analyzed according to health-related factors including cigarette smoking, alcohol drinking, exercise, stress and depression level. Less regular exercise was associated with a higher likelihood of a poor nutrition [odds ratio (OR) 1.94; 95% confidence intervals (CI) 1.43-2.65] of middle-aged and elderly male subjects. Cigarette smoking (OR 1.84; 95% CI 1.24-2.71), less exercise (OR 2.58; 95% CI 2.07-3.21), stress (OR 1.73; 95% CI 1.36-2.22), and depression (OR 1.34; 95% CI 1.08-1.67) of middle-aged and elderly female subjects was associated with a higher likelihood of a poor nutrition. The results of the multiple regression analysis showed that less exercise proved to be the strongest predictors for the poor nutrition, followed by stress, smoking, and depression (model R2= 9.0%). It suggests that guidance to promote regular exercise, to quit smoking, to minimize stress and depression level might help to improve nutritional status of middle-aged and elderly in Korea. These findings also suggest that having recommendable health behaviors are beneficial to the good nutrition of subjects aged 50 years and over.
Aged ; Aging ; Alcohol Drinking ; Cross-Sectional Studies ; Depression ; Drinking ; Eating ; Female ; Health Behavior ; Humans ; Korea ; Male ; Malnutrition ; Nutritional Status ; Smoke ; Smoking

Low energy intakes, poor nutritional quality, and low food diversity are among the factors affecting the nutritional status of elderly in Korea. Therefore, a nutrition counseling and education program was conducted to promote dietary change and to improve nutritional status of elderly. The 7 step program consisted of a individual nutrition counseling and weekly or biweekly group nutrition education programs. Pre- and post-test measurings of dietary behaviors, attitudes, nutrition knowledge, and 24-hour dietary recall data were collected. Positive changes in the attitude related to diet were noted, whereas nutritional knowledge scores were not improved. Significant increases were noted in the frequency of vegetable consumption in female and diversity of food consumption in male. The densities of vitamin C(male & female), B1, B2, and niacin, calculated using the INQ(Index of Nutritional Quality), were significantly improved by nutrition counseling and education programs. These results suggest the appropriateness of nutrition intervention programs for the improvement of elderly nutrition.
Aged* ; Community Health Centers* ; Counseling* ; Diet ; Education* ; Female ; Humans ; Korea ; Male ; Niacin ; Nutritional Status ; Nutritive Value ; Vegetables ; Vitamins

Physiological changes that affect nutrient absorption and utilization occur in older adults, and the collection of nutritional information is an important part of examining the nutrition and health issue. A nutritional survey using the 24-hour recall method was performed to identify nutritional quality and leading patterns of food group intake for protein, vitamin C, P and Fe were over 1, whereas those for vitamin A, B1, B2, niacin and Ca were below 1. The MAR(Mean Adequacy Ratio) was relatively low(0.75). The percentage of energy from carbohydrate, protein, and fat was 65.1, 15.6, and 19.5, respectively, thus the quantities of energy source were ideal. The Older subjects revealed poorer nutrition quality than the younger subjects did. The food group intake pattern of the elderly was not diverse, only 9% of them consumed all food groups in a day. These results suggest that nutritional guiflines for older Koreans should focus on the maintenance of adequate energy intake. In addition, selection of foods with high protein and calcium, such as dairy food, should be emphasized, particularly in the older elderly. Nutrition programs should target individuals at risk of not receiving enough nutrients, like the oldest elderly, and persons with lower education.
Absorption ; Adult ; Aged* ; Ascorbic Acid ; Calcium ; Community Health Centers* ; Education ; Energy Intake ; Humans ; Niacin ; Nutrition Surveys ; Nutritive Value* ; Vitamin A

The elderly are the most rapidly growing segment of the population in Korea and the largest consumers of expensive medical care. It is reasonable to believe that improving the nutritional status would be beneficial to reducing morbidity and to improving the quality of their lives. This study was conducted to assess the health status and the Nutritional Risk Index of the elderly, and to provide the basic data for the Elderly Nutrition Improvement Program at the Public Health Center. One hundred and forty seven(76 males. 71 females) aged 60 years and over living in Suwon, were assessed with anthropometric measurements, body fat analysis, blood pressure measurements, and a set of about health and other related variables. Over half of them had less than a junior middle school education and were considered low income. The percentage of overweight and obese subjects was 33% by the BMI(Body Mass Index), and the prevalence of hypertension was 28%(males) and 31%(females). They had a lot of self-recognized health problems, the male elderly complained about more than the female elderly. In the case of psychological health status, however, the female elderly showed a higher proportions of depression than the male elderly(p<0.05). In social health status, the elderly had good relationships with friends and collegues, whereas they had poor relationships with their families. They had many nutritional risk factors, and smoking was the most prevalent risk factor for the male elderly and anemia was for the female elderly. The results of this study suggest that Elderly Nutrition Improvement Programs should be planned that can be easily followed. It would be helpful to design a program focusing on individual phychological and social health status, this would increase the efficiency of the program.
Adipose Tissue ; Aged* ; Anemia ; Blood Pressure ; Depression ; Education ; Female ; Friends ; Gyeonggi-do ; Humans ; Hypertension ; Korea ; Male ; Nutritional Status ; Overweight ; Prevalence ; Public Health ; Risk Factors ; Smoke ; Smoking ; Surveys and Questionnaires

Hypertension is among the most common and important risk factors for stroke, heart attack, and heart failure which is considered to be the leading cause of death in Korea. The prevalence rate of hypertension in Korea is 27.9%, according to the 2006 Korea National Health and Nutrition Survey. Since non-pharmacologic nutrition education is recommended as the first step in the management of hypertension, evaluation of nutrition program is needed to form strategies for improving patients' dietary adherence. This study was designed to evaluate the overall effectiveness of a hypertension nutrition education program (HNEP) for reducing the salt intake, at a public health center located in Gyunggi-province. The HNEP was offered for 16 weeks from May to September in 2007. Nutrition education activities included cooking classes, food preparation demonstrations, physical fitness programs, salty taste preference test sessions, games, case-study presentations, planning and evaluation of menus, etc. Forty patients participated fully in the program which had 47 female enrollees. Data about nutrient intake (24-hour recall), nutrition knowledge, food behavior were collected before (baseline) and after the program. Changes after program completion indicated the following: 1) diastolic blood pressure was decreased (p < 0.05), 2) sodium (salt) intake was also decreased (p < 0.01), especially baseline high salt intake group, 3) nutrition knowledge was improved (p<0.001), 4) dietary behaviors for maintaining a low salt diet was improved (p < 0.001), 5) participants preferred cooking class from nutrition education methods. As a conclusion, it appears that a nutrition education program for hypertensive female elderly for reducing the salt intake might effectively decrease blood pressure and salt intake. It also improves nutrition knowledge, dietary behavior, and finally adherence to a recommendable low-sodium diet.
Aged ; Blood Pressure ; Cause of Death ; Cooking ; Diet ; Diet, Sodium-Restricted ; Female ; Heart ; Heart Failure ; Humans ; Hypertension ; Korea ; Nutrition Surveys ; Physical Fitness ; Prevalence ; Public Health ; Resin Cements ; Risk Factors ; Sodium ; Stroke