Grace X Ma1,2, Steven E Shive1,3, Guo Zhang1, Jennifer Aquilante4, Yin Tan1, Meagan Pharis4, Cheryl Bettigole4, Hannah Lawman4, Amanda Wagner4, Lin Zhu1, Qiaoling Zeng5, Min Qi Wang6. 1. 1 Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA. 2. 2 Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA. 3. 3 Department of Health Studies, East Stroudsburg University, East Stroudsburg, PA, USA. 4. 4 Philadelphia Department of Public Health, Philadelphia, PA, USA. 5. 5 Asian Community Health Coalition, Philadelphia, PA, USA. 6. 6 Department of Public and Community Health, University of Maryland, College Park, MD, USA.
Abstract
OBJECTIVES: Sodium reduction in restaurant foods is important because 77% of sodium in the United States is consumed by eating prepared and restaurant foods. We evaluated a sodium-reduction intervention, Healthy Chinese Take-Out Initiative, among Chinese take-out restaurants in low-income neighborhoods in Philadelphia, Pennsylvania. Our objectives were to (1) analyze changes in the sodium content of food samples and (2) collect data on changes in chefs' and owners' knowledge about the health risks of sodium overconsumption, perceptions of the need for sodium reduction, self-efficacy for lowering sodium use, and perceptions of training needs for sodium-reduction strategies. METHODS: The initiative trained chefs from 206 Chinese take-out restaurants on strategies to reduce sodium in prepared dishes. We analyzed changes in the sodium content of the 3 most frequently ordered dishes-shrimp and broccoli, chicken lo mein, and General Tso's chicken-from baseline (July-September 2012) to 36 months after baseline (July-September 2015) among 40 restaurants. We conducted a survey to examine the changes in chefs' and owners' knowledge, perceptions, and self-efficacy of sodium reduction. We used multilevel analysis and repeated-measures analysis of variance to examine effects of the intervention on various outcomes. RESULTS: We found significant reductions in the sodium content of all 3 dishes 36 months after a low-sodium cooking training intervention (coefficients range, -1.06 to -1.69, P < .001 for all). Mean knowledge (range, 9.2-11.1), perceptions (range, 4.6-6.0), and self-efficacy (range, 4.2-5.9) ( P < .001 for all) of sodium reduction improved significantly from baseline (August 2012) to posttraining (also August 2012), but perceptions of the need for sodium reduction and self-efficacy for lowering sodium use returned to baseline levels 36 months later (August 2015). CONCLUSIONS: The intervention was a useful population health approach that led to engaging restaurants in sodium-reduction practices. Local public health agencies and professionals could partner with independent restaurants to introduce environmental changes that can affect population health on a broad scale, particularly for vulnerable populations.
OBJECTIVES:Sodium reduction in restaurant foods is important because 77% of sodium in the United States is consumed by eating prepared and restaurant foods. We evaluated a sodium-reduction intervention, Healthy Chinese Take-Out Initiative, among Chinese take-out restaurants in low-income neighborhoods in Philadelphia, Pennsylvania. Our objectives were to (1) analyze changes in the sodium content of food samples and (2) collect data on changes in chefs' and owners' knowledge about the health risks of sodium overconsumption, perceptions of the need for sodium reduction, self-efficacy for lowering sodium use, and perceptions of training needs for sodium-reduction strategies. METHODS: The initiative trained chefs from 206 Chinese take-out restaurants on strategies to reduce sodium in prepared dishes. We analyzed changes in the sodium content of the 3 most frequently ordered dishes-shrimp and broccoli, chicken lo mein, and General Tso's chicken-from baseline (July-September 2012) to 36 months after baseline (July-September 2015) among 40 restaurants. We conducted a survey to examine the changes in chefs' and owners' knowledge, perceptions, and self-efficacy of sodium reduction. We used multilevel analysis and repeated-measures analysis of variance to examine effects of the intervention on various outcomes. RESULTS: We found significant reductions in the sodium content of all 3 dishes 36 months after a low-sodium cooking training intervention (coefficients range, -1.06 to -1.69, P < .001 for all). Mean knowledge (range, 9.2-11.1), perceptions (range, 4.6-6.0), and self-efficacy (range, 4.2-5.9) ( P < .001 for all) of sodium reduction improved significantly from baseline (August 2012) to posttraining (also August 2012), but perceptions of the need for sodium reduction and self-efficacy for lowering sodium use returned to baseline levels 36 months later (August 2015). CONCLUSIONS: The intervention was a useful population health approach that led to engaging restaurants in sodium-reduction practices. Local public health agencies and professionals could partner with independent restaurants to introduce environmental changes that can affect population health on a broad scale, particularly for vulnerable populations.
Entities:
Keywords:
African Americans; Chinese restaurants; cardiovascular disease; hypertension; minority health; sodium reduction; underserved population
Authors: Lawrence J Appel; Edward D Frohlich; John E Hall; Thomas A Pearson; Ralph L Sacco; Douglas R Seals; Frank M Sacks; Sidney C Smith; Dorothea K Vafiadis; Linda V Van Horn Journal: Circulation Date: 2011-01-13 Impact factor: 29.690
Authors: Elliott M Antman; Lawrence J Appel; Douglas Balentine; Rachel K Johnson; Lyn M Steffen; Emily Ann Miller; Antigoni Pappas; Kimberly F Stitzel; Dorothea K Vafiadis; Laurie Whitsel Journal: Circulation Date: 2014-05-05 Impact factor: 29.690
Authors: Kirsten Bibbins-Domingo; Glenn M Chertow; Pamela G Coxson; Andrew Moran; James M Lightwood; Mark J Pletcher; Lee Goldman Journal: N Engl J Med Date: 2010-01-20 Impact factor: 91.245
Authors: Martha L Daviglus; Gregory A Talavera; M Larissa Avilés-Santa; Matthew Allison; Jianwen Cai; Michael H Criqui; Marc Gellman; Aida L Giachello; Natalia Gouskova; Robert C Kaplan; Lisa LaVange; Frank Penedo; Krista Perreira; Amber Pirzada; Neil Schneiderman; Sylvia Wassertheil-Smoller; Paul D Sorlie; Jeremiah Stamler Journal: JAMA Date: 2012-11-07 Impact factor: 56.272
Authors: Minsun Lee; Danielle Hu; Gabrielle Bunney; Crystal A Gadegbeku; Daniel Edmundowicz; Steve R Houser; Hong Wang; Grace X Ma Journal: Prev Med Rep Date: 2018-06-02
Authors: Ann C Klassen; Suruchi Sood; Amber Summers; Udara Perera; Michelle Shuster; Jessica P Lopez; Andrea McCord; Jared Stokes; Joann White; Amanda Wagner Journal: Front Public Health Date: 2021-01-15
Authors: Melissa Fuster; Margaret A Handley; Tamara Alam; Lee Ann Fullington; Brian Elbel; Krishnendu Ray; Terry T-K Huang Journal: Int J Environ Res Public Health Date: 2021-02-04 Impact factor: 3.390