DOI QR코드

DOI QR Code

The Effects of Korean DASH Diet Education with Calcium/Vitamin D Supplements on Nutrient Intakes, Food Consumption, Bone Turnover Markers and Bone Mineral Density among Korean Elderly Women

한국형 DASH 식이 교육과 칼슘/비타민 D 보충 영양중재 프로그램이 노인여성의 영양소 섭취량 및 식품 섭취 빈도, 골표지자, 골밀도에 미치는 효과

  • Lee, Haeyoung (Department of Nursing.Research Institute for Basic Science, Hoseo University) ;
  • Choi-Kwon, Smi (College of Nursing.The Research Institute of Nursing Science, Seoul National University) ;
  • Choi, Seung-Hye (Department of Nursing Science, Suwon University)
  • 이해영 (호서대학교 간호학과.기초과학연구소) ;
  • 최스미 (서울대학교 간호학과.간호과학연구소) ;
  • 최승혜 (수원대학교 간호학과)
  • Received : 2014.12.19
  • Accepted : 2015.02.11
  • Published : 2015.02.28

Abstract

Purpose: This study was aimed to investigate the effects of the nutritional intervention program including DASH diet education and calcium/vitamin D supplements in Korean elderly women. Methods: This was a quasi-experimental study employing non-equivalent control group pretest-posttest design. The experimental group (n=26) was given DASH diet education and supplements (calcium 1200mg and vitamin 800 IU) while the control group (n=16) was given only general health consults. After the interventions, differences were analyzed in nutrient intake, bone turnover markers and bone mineral density between the two groups. Results: After one year, bone mineral density was found reduced in both groups, but showed higher levels (p=.003) in the experimental group than the control group. After research, nutrient intakes of participants improved generally, yet there was no significant difference between the two groups. The experimental group was divided into subgroups after interventions according to the level of calcium intake, and bone density and bone markers were compared between the subgroups. In a subgroup whose calcium intake was in the normal range, bone mineral density was significantly high (p=.002) while CTx and osteocalcin were significantly low (p=.003, p=.006, respectively). Conclusion: This study is significant in that it provided a nutritional intervention program for one year to elderly women who are susceptible to osteoporosis and severely low in dietary calcium intake and it proved to be effective.

Keywords

References

  1. Korean Statistical Information Service [Internet]. Seoul: [cited 2012 December 11]. Available from: http://kosis.kr/abroad/abroad_01List.jsp
  2. Park YH, Suh EE. The risk of malnutrition, depression, and the perceived health status of older adults. Journal of Korean Academy of Nursing, 200737(6):941-8. https://doi.org/10.4040/jkan.2007.37.6.941
  3. Korean Ministry of Health and Welfare. The fifth Korea national health and nutrition examination survey V-3(KNHANES V-3). Seoul: 2013.
  4. Korean Society for Bone and Mineral Research. Physician's guide for diagnosis and treatment of osteoporosis in 2011. Seoul: 2011.
  5. Koo JO. Association of bone mineral density and blood pressure, calcium intake among adult women in Seoul.Kyunggi area -Based on 2011 KNHANES-. Korean Journal of Community Nursing. 201318(3):269-82. https://doi.org/10.5720/kjcn.2013.18.3.269
  6. Park KA, Kim SJ, Park YH, Suh EY, Park MS, Kim ES, et al. A study on the health and nutritional status and nutrient intakes in elderly Korean female. Journal of Korean Biological Nursing Science. 201012(1):39-47.
  7. Kim JH, Smi CK, Park YH, Park KA, Suh MH, Lee SO. The effect of the dietary approaches to stop hypertension (DASH) diet education program on bone mineral density in the middleaged women: a pilot study. Journal of Korean Biological Nursing Science. 201012(3):195-205.
  8. Lin PH, Ginty F, Appel LJ, Aickin M, Bohannon A, Garnero P, et al. The DASH diet and sodium reduction improve markers of bone turnover and calcium metabolism in adults. The Journal of Nutrition. 2003133(10):3130-6. https://doi.org/10.1093/jn/133.10.3130
  9. Bae YJ, Choi MK, Kim MH, Kim EY, Lee JY, Sung CJ. The relation between net rate of endogenous noncarbonic acid production from diet potassium and protein intakes and bone mineral density in Korean women. Journal of the Korean Society of Food Science and Nutrition. 200635(9):1200-6. https://doi.org/10.3746/jkfn.2006.35.9.1200
  10. Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet. 2007370(9588):657-66. https://doi.org/10.1016/S0140-6736(07)61342-7
  11. Bonnick SL, Shulman L. Monitoring osteoporosis therapy: bone mineral density, bone turnover marker, or both. The American Journal of Medicine. 2006119 (suppl 1):S25-S31.
  12. The Korean Nutrition Society. Computer aided nutritional analysis program(CAN-Pro) version 3.0: 2007.
  13. The Korean Nutrition Society. Dietary reference of intakes for Koreans(1st revision). Seoul: 2010.
  14. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the mini nutritional assessment as part of the geriatric evaluation. Nutrition Reviews. 199654(1):S59-S65. https://doi.org/10.1111/j.1753-4887.1996.tb03793.x
  15. Leskela H, Risteli J, Niskanen S, Koivunen J, Ivaska K, Lehenkaria P. Osteoblast recruitment from stem cells does not decrease by age at late adulthood. Biochemical and Biophysical Research Communications. 2003311:1008-13. https://doi.org/10.1016/j.bbrc.2003.10.095
  16. Holick MF. Vitamin D deficiency. New England Journal of Medicine. 2007357:266-81. https://doi.org/10.1056/NEJMra070553
  17. Massey LK, Whiting SJ. Dietary salt, urinary calcium, and bone loss. Journal of Bone and Mineral Metabolism. 199611(6):731-6.
  18. Bae YJ, Sung CJ. A comparison between postmenopausal osteoporosis women and normal women of their nutrient intakes and the evaluation of diet quality. Korean Journal of Community Nursing. 200510(2):205-15. https://doi.org/10.12968/bjcn.2005.10.5.18048
  19. Lee SH. Association of bone mineral density with dietary intake and health-related behavior among Korean postmenopausal women. [dissertation]. Seoul: Myong-ji University 2012.
  20. Carbone LD, Bush AJ, Barrow KD, Kang AH. The relationship of sodium intake to calcium and sodium excretion and bone mineral density of the hip in postmenopausal African-American and Caucasian women. Journal of Bone and Mineral Metabolism. 200321(6):415-20. https://doi.org/10.1007/s00774-003-0437-3
  21. Evans CE, Chughtai AY, Blumsohn A, Giles M, Eastell R. The effect of dietary sodium on calcium metabolism in premenopausal and postmenopausal women. European Journal of Clinical Nutrition. 199751(6):394-9. https://doi.org/10.1038/sj.ejcn.1600420
  22. Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. British Medical Journal. 2010;341:c3691. http://dx.doi.org/10.1136/bmj.c3691
  23. Wang L, Manson JE, Song Y, Sesso HD. Systematic review: vitamin D and calcium supplementation in prevention of cardiovascular events. Annals of Internal Medicine. 2010152(5):315-23. https://doi.org/10.7326/0003-4819-152-5-201003020-00010
  24. Xiao Q, Murphy RA, Houston DK, Harris TB, Chow WH, Park Y. Dietary and supplemental calcium intake and cardiovascular disease mortality: the national institutes of Health-AARP diet and health study. JAMA Internal Medicine. 2013173(8):639-46. http://dx.doi.org/10.1001/jamainternmed.2013.3283.

Cited by

  1. The Effect of a Comprehensive Intervention Program on the Functional Status and Bone Density of the Socially-Vulnerable and Frail Elderly vol.27, pp.1, 2016, https://doi.org/10.12799/jkachn.2016.27.1.51