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1 2011 Vol.60 No.4 p Usefulness of regional education program for dietary salt reduction: Self-monitoring of urinary salt excretion Kenichiro YASUTAKE[1] Kayoko SAWANO[1] Shoko YAMAGUCHI[1] Hiroko SAKAI[2] Yasue MIYAI[2] Hatsumi AMADERA[2] Takuya TSUCHIHASHI[3] [1]Department of Health and Nutrition Science Nishikyushu University Kanzaki Japan [2]Department of Health Promotion Tosu Health Center [3]Division of Hypertension, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan : Ozaki, Kanzaki-machi, Kanzaki-shi, Saga-ken , Japan. Tel: FAX: [email protected] [ ] 332

2 Abstract [Objectives] This study was performed to evaluate the usefulness of an education program involving self-monitoring of estimating 24-h urinary salt excretion levels, as estimated on the basis of nocturnal urinary salt excretion. [Methods] Forty-seven healthy individuals participated in this study, conducted between December 2009 and December 2010 (intervention period, 9 months after the start of the study; observation period, 3 months after completion of the intervention). Physical examinations, including blood pressure measurement, were performed at 0 and 9 months after the start of the study. The subjects participating in this education program aimed at dietary salt reduction at 2, 4 and 6 months. Self-monitoring of estimated daily urinary salt excretion levels was performed at home for 2 consecutive weeks at 0, 2, 4, 6, 9, and 12 months. After 9 months, a questionnaire was distributed to all subjects to determine their awareness regarding dietary salt reduction. [Results] Systolic and diastolic blood pressure levels were significantly lower after as compared to those before the intervention. Estimated daily urinary salt excretion was significantly reduced after the intervention. Mean 2-week urinary salt excretion, the maximum value, and the magnitude of change in urinary salt excretion changed from 8.28 ± 1.33 g to 7.49 ± 1.20 g, ± 1.85 g to 9.55 ± 1.80 g, and 5.15 ± 1.99 g to 3.91 ± 1.65 g, respectively. However, the values of all parameters, except the magnitude of change, tended to rise again at 12 months (the end of the observation period). Upon completion of the intervention, significant positive correlations were noted between systolic blood pressure and body weight, body mass index, and the magnitude of change in urinary salt excretion, as well as between diastolic blood pressure and height, body weight, and the magnitude of change in urinary salt excretion. Multiple regression analysis revealed body weight and magnitude of change in urinary salt excretion to be explanatory variables for systolic and diastolic blood pressures, respectively. The questionnaire survey revealed improved awareness of salt restriction and eating behavior in the group in which salt intake and urinary salt excretion improved with self-monitoring. [Conclusion] These results suggested that our education program aimed at dietary salt reduction is a useful intervention for the prevention and treatment of hypertension. Keywords: urinary salt excretion hypertension blood pressure dietary salt reduction education self-monitoring (accepted for publication, 25th August 2011) 333

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