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Self-Reported Diet Management and Adherence to Dietary Guidelines in Korean Adults with Hypertension.

ABSTRACT: BACKGROUND AND OBJECTIVES:Although dietary management is strongly recommended in patients with hypertension, little is known about how many manage their diet and follow the guidelines for hypertension. We investigated the prevalence of dietary management among adults with known hypertension and evaluated their compliance to the dietary guidelines. METHODS:Data from the Korea National Health and Nutrition Examination Survey 2013-2016 were used. Among 15,870 adults aged 30-79 years, 4,162 reported a physician-diagnosed hypertension. Diet management behavior was defined by self-report response. Actual dietary intake was assessed by a 24-hour dietary recall. Dietary quality was evaluated using the Korean Healthy Eating Index (KHEI). RESULTS:Among adults with hypertension, 28.0% reported that they were managing their diet. Those with hypertension consumed significantly less dietary sodium (p value<0.01), but also less potassium (p value<0.01), resulting in no difference of sodium-to-potassium ratio compared to those without hypertension (p value=0.66). Among those with hypertension, diet-managing adults had better KHEI score (66.9, p value<0.01) and consumed less sodium (3,354.3 mg, p value<0.01) than not-managing adults (63.6 score and 3,554.5 mg, respectively). However, total KHEI score was rather lower in those with hypertension (p value<0.01) than those without hypertension and their sodium intake was still over the recommended amount. CONCLUSIONS:More than two-thirds of Korean adults with hypertension did not manage their diet in daily life. More effective strategies are needed to increase the level of compliance with dietary recommendations for people with high blood pressure.

SUBMITTER: Shim JS

PROVIDER: S-EPMC7098818 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Self-Reported Diet Management and Adherence to Dietary Guidelines in Korean Adults with Hypertension.

Shim Jee Seon JS Oh Kyungwon K Jung Sun Jae SJ Kim Hyeon Chang HC

Korean circulation journal 20200120 5

<h4>Background and objectives</h4>Although dietary management is strongly recommended in patients with hypertension, little is known about how many manage their diet and follow the guidelines for hypertension. We investigated the prevalence of dietary management among adults with known hypertension and evaluated their compliance to the dietary guidelines.<h4>Methods</h4>Data from the Korea National Health and Nutrition Examination Survey 2013-2016 were used. Among 15,870 adults aged 30-79 years, ...[more]

PMID: 32096363

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Project description:Background:Although dietary modification is strongly recommended for prevention and treatment of hypertension, little is known about which factors are associated with adherence to dietary guidelines. We investigated knowledge and attitude, perceived benefits of, barriers to, and self-efficacy of dietary therapy, and identified the factors associated with dietary adherence among adults with and without hypertension. Methods:We collected information on the knowledge/attitudes and perceived benefits of dietary therapy, as well as barriers to and self-efficacy regarding dietary adherence from 497 middle-aged (34-69?years) adults who participated in the follow-up examination of the Cardiovascular and Metabolic Diseases Etiology Center (CMERC) cohort study during December 2018 and February 2019. Results:Among people without hypertension, 95.5% (343/359) and 95.8% (344/359) answered that they would limit sodium intake and consume health diet, respectively, if diagnosed hypertension. However, among people with hypertension, only 79.7% (110/138) and 77.5% (107/138) reported they were limiting dietary sodium intake and having healthy diet, respectively. Frequency of diet management was not different between normotensive (34.0%) and hypertensive (35.5%) groups. Compared to normotensives, hypertensive people were more likely to have lower dietary adherence score, think they need to change their diet, think dietary change impossible, and report lower self-efficacy for following diet guidelines. Dietary management was significantly associated with cardiometabolic risk factors (OR: 1.63) and dietary education (OR: 2.19) among normotensives, while it was associated only with awareness that lifestyle modification is necessary regardless of antihypertensive medication (OR: 6.29) among hypertensive people. Good dietary adherence had significant associations with perceived barriers (OR: 0.71), self-efficacy (OR: 3.71), and dietary education (OR: 1.98) among normotensives; and with perceived barriers (OR: 0.54), self-efficacy (OR: 4.06), and dietary management (OR: 4.16) among hypertensive people. Conclusions:Many Koreans have relatively low adherence to dietary guidelines for hypertension prevention and treatment. Knowledge, dietary practices, and factors affecting dietary adherence were different between adults with and without hypertension. A targeted approach will be needed to improve blood pressure control of the Korean population.

Project description:BackgroundThe China Dietary Guidelines Index (CDGI) is a diet quality evaluation index that can present the overall diet quality and is comparable between individuals. The aim of this study was to revise CDGI for Chinese adults according to the Chinese Dietary Guidelines 2016 (CDG-2016), evaluate adherence to recommended diets between 1991 and 2015, and analyze the trend, variation, and determinants of diet quality.MethodsFood, cooking oil, and condiment intakes were estimated based on twenty-four-hour dietary recalls over three consecutive days and the household weighing method. Based on the food and nutrients recommendations for people with different energy requirements in CDG-2016, CDGI was revised as China Dietary Guidelines Index (2019)-Adults (CDGI(2019)-A) by equal weight continuity scoring. Three-level random intercept-slope growth models were applied to analyze the trend, variation, and determinants at both the community and individual levels.ResultsCDGI(2019)-A, the sum of fourteen component scores with a range of 0-110 points, increased significantly from 38.2 in 1991 to 47.3 in 2015. Components with a score of less than half were milk (91.6%), fruits (72.0%), nuts (82.5%), other cereals and beans (82.6%), and seafood (77.7%). Between-individual accounted for 25.6% of the total score variation, of which 87.4% derived from the community level. CDGI(2019)-A score displayed a positive association with being female, having higher education, having higher income, living in an urban area, and knowing the CDG-2016 recommendations. The impact of income and awareness of CDG-2016 varied significantly across communities.ConclusionsAlthough quality of diet has been improving in China, overall quality remains poor, primarily because of inadequate intake of milk and dairy products, nuts, fruits, other cereals and miscellaneous beans, and seafood. Intervention at the community level may improve diet quality more efficiently than at the individual level, and the most effective intervention should be selected in different communities according to local conditions.

Dataset Information

Self-Reported Diet Management and Adherence to Dietary Guidelines in Korean Adults with Hypertension.

Publications

Self-Reported Diet Management and Adherence to Dietary Guidelines in Korean Adults with Hypertension.

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