第五章 討論
第二節 建議
對照組的介入
本研究不屬於隨機化的分組，造成兩組在教育程度上有所差 異，除此之外，在介入前，營養知識、飲食行為和自我效能總分上 也有顯著差異。因此本研究在營養教育的成效評估上，著重各組間 的前後差異值。對照組的部分，因本研究不作任何形式的營養教育 介入，以致有部分的受試者認為無法從飲食營養的教育中獲益，而 降低其參與意願。因此，建議未來在對照組的介入上，可考慮以非 得舒飲食的營養教育介入，如高血壓的生活形態改變，也可藉此 比較兩種高血壓教育的成效差異。或者對照組可提供多次且不涉及 得舒飲食的個人飲食諮詢，如此一來，在不影響受試者的參與意願 前提下，即可進行隨機分組，減少研究上的系統誤差。
得舒飲食對藥物服用與否的降血壓成效
本研究發現：得舒組(n=34)的服藥者(n=20)在介入後其血壓的改 變幅度優於無服藥者(n=14)。但因人數進一步分層，以致人數減少，
可能影響研究效果（effect size）。因此建議在未來的研究上，可針對 服藥者和無服藥者各自分組，並且提高各組的樣本數，即可確認其成 效。
得舒飲食問卷與血壓、題位測量之相關性分析
本研究的介入成效顯示：得舒組(n=34)在介入後，其營養知識、
飲食行為和收縮壓及舒張壓皆有顯著改善。但由相關性結果得知，得 舒組(n=34)營養知識、飲食行為與自我效能與舒張壓呈顯著的負相關 性(-0.29, -0.26, 0.31, p<0.05)，但未能與收縮壓呈現顯著的相關性。
推測可能原因是得舒組的樣本數有限，以致於統計分析的相關性 不 易 達 到 。 因 此 建 議 本 研 究 在 未 來 可 擴 大 樣 本 數 ， 以 便 進 行 cross-sectional 之調查，確認得舒問卷與血壓之間的相關性。
生活形態調整之納入
本研究在不涉及高血壓的生活形態調整之介入，其得舒組(n=34) 介入後血壓有明顯降低成效。因此未來本研究在發展教學上，可考慮 納入生活形態調整之介入，包括一組以得舒營養教育為主，一組以得 舒營養教育+生活形態調整介入，探討兩組之間在血壓改善成效上是 否不同。
營養素的定量分析
本研究未來擬針對高血壓者進一步探討飲食營養素的定量分 析，以瞭解高血壓者在介入後的三大營養素和得舒營養強調的個別營 養素：鈣、鉀、鎂、膳食纖維的攝取量是否明顯改變。而著眼於本研 究得舒組(n=34)高血壓者的年齡較長，平均年齡：60.35±10.4 歲，
故未來針對受試者之收案條件將界定年齡的範圍：如 30-50 歲的高血 壓成人，以便實施 24 小時回憶法和三天飲食記錄法的飲食評估。
參考文獻
英文部分
Abood, D.A., Black, D.R. & Birnbaum, R.D. (2004) Nutrition education intervention for college female athletes.J Nutr Educ Behav.
36:135-137.
Abood, D.A., Black, D.R. & Feral D. (2003) Nutrition education worksite intervention for university staff: application of the health belief model.J Nutr Educ Behav. 35:260-267.
Alderman, M.H., Cohen, H.& Madhavan, S. (1999) Diabetes
and cardiovascular events in hypertensive patients. Hypertention.
33:1130-1134.
Allender, P.S., Cutler, J.A., Follmann, D., Cappuccio, F.P., Pryer, J. & Elliott P. (1999) Dietary calcium and blood pressure: a meta-analysis of randomized clinical trials. Ann Intern Med.124:825-31.
Anderson, E.S., Winett, R.A. & Wojcik, J.R. (2007) Self-regulation, self-efficacy, outcome expectations, and social support: social cognitive theory and nutrition behavior. Ann. Behav. Med.
34:304-312.
Appel, L.J., Brands, M.W., Daniels, S.R., Karanja, N., Elmer, P.J. &
Sacks,F.M.(2006) Dietary approaches to prevent and treat
hypertension: a scientific statement from the American Heart Association. Hypertention. 47:296-308.
Appel, L.J., Champagne, C.M., Harsha, D.W., Cooper, L.S., Obarzanek, E., Elmer, P.J., Stevens, V.J., Vollmer, W.M., Lin, P.H., Svetkey, L.P., Stedman, S.W.& Young, D.R. Writing Group of the PREMIER Collaborative Research Group. (2003) Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA. 289 :2083-2093.
Appel, L.J., Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM,
Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N.(1997) A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J
Med.336:1117-1124
American Heart Association (2010) High blood pressure- what cab be done.http://www.americanheart.org/presenter.jhtml?identifier=4630 2010/03/16
Ammerman, A.S., Lindquist, C.H., Lohr, K.N. & Hersey, J. (2002). The efficacy of behavioral interventions to modify dietary fat and fruit and vegetable intake: a review of the evidence. Prev. Med. 35:25-41.
Anderson, E.S., Winett, R.A., & Wojcik, J.R. (2007) Self-regulation, self-efficacy, outcome expectations, and social support: social cognitive theory and nutrition behavior. Ann. Behav. Med.
34:304-312.
Anderson, E.S., Winett, R.A., Wojcik, J.R., Winett, S.G. & Bowden T.
(2001) A computerized social cognitive intervention for nutrition behavior: direct and mediated effects on fat, fiber, fruits, and vegetables, self-efficacy, and outcome expectations among food shoppers. Ann. Behav. Med. 23:88-100.
Aono, Y., Ohkubo, T., Kikuya, M., Hara, A., Kondo, T., Obara, T., Metoki H, Inoue, R., Asayama, K., Shintani, Y., Hashimoto, J., Totsune, K., Hoshi, H., Satoh, H., Izumi, S. & Imai Y. (2007) Plasma fibrinogen, ambulatory blood pressure, and silent cerebrovascular lesions:the Ohasama study. Arterioscle.r Thromb. Vasc. Biol. 27:963-968 Ard, J.D., Coffman, C.J., Lin, P.H. & Svetkey, L.P., (2004) One-year
follow-up study of blood pressure and dietary patterns in dietary approaches to stop hypertension (DASH)-sodium participants.Am. J.
Hypertens.17:1156-1162.
Aucott, L., Rothnie, H., McIntyre. L., Thapa, M., Waweru, C. & Gray, D.
(2009) Long-term weight loss from lifestyle intervention benefits blood pressure?: a systematic review. Hypertension. 54:756-762.
Bakris, G.L., Williams, M., Dworkin, L., Elliott, W.J., Epstein, M., Toto, R., Tuttle, K., Douglas, J., Hsueh, W. & Sowers, J. (2000) Preserving renal function in adults with hypertension and diabetes: a consensus approach. National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group. Am. J. Kidney.
Dis.36:646-661.
Bassett, DR. Jr., Fitzhugh, E.C., Crespo, C.J., King, G.A. & McLaughlin, J.E.（2002）Physical activity and ethnic differences in hypertension prevalence in the United States.Prev. Med. 34:179-186.
Bandura, A. (1997) Self-efficacy: The exercise of control New York: W.H.
Freeman and Company
Bandura, A. (1977) Self-efficacy: Toward a unifying theory of behavioral change. Psychol. Rev. 84:191-215.
Bandura, A. Barbaranelli C and Caprara GV (2001)Soeicognitive self-regulatory mechanism govering transgressive behavior.
J. Pers. Soc. Psychol. 80:125-135.
Bandura, A. (2004) Health promotion by social cognitive means. Health.
Educ. Behav. 31:143-164.
Bandura, A. (2001). Social cognitive theory: an agentic perspective.
Annu. Rev. Psychol. 52:1-26.
Beydoun, M.A. & Wang, Y. (2008) Do nutrition knowledge and beliefs modify the association of socio-economic factors and diet quality among US adults? Prev. Med. 46:145-153.
Blumenthal, J.A., Babyak, M.A., Hinderliter, A., Watkins, L.L., Craighead L., Lin, P.H., Caccia, C., Johnson, J., Waugh, R. & Sherwood, A.
(2010) Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch. Intern. Med. 170:126-135.
Blumenthal, J.A., Sherwood, A., Gullette, E.C., Babyak, M., Waugh, R., Georgiades, A., Craighead, L.W., Tweedy, D., Feinglos, M.,
Appelbaum, M., Hayano, J. & Hinderliter, A. (2000) Exercise and weight loss reduce blood pressure in men and women with mild hypertension: effects on cardiovascular, metabolic, and
hemodynamic functioning. Arch. Intern. Med. 160:1947-1958.
Brown, C.D., Higgins, M., Donato, K.A., Rohde, F.C., Garrison, R., Obarzanek, E., Ernst, N.D. & Horan, M. (2000) Body mass index and the prevalence of hypertension and dyslipidemia. Obes. Res.
8:605-619.
Burt, V.L., Whelton, P., Roccella, E.J., Brown, C., Cutler, J.A., Higgins, M., Horan, M.J. & Labarthe, D. (1995) Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey,1988-1991. Hypertension. 25:305-13.
Cappuccio, F.P. & MacGregor, G.A. (1991) Does potassium
supplementation lower blood pressure? A meta-analysis of published trials. J. Hypertens. 5:465-473.
Centers for Disease Control and Prevention (2010) National Health and Nutrition Examination Survey2005-2006
http://www.cdc.gov/nchs/nhanes/nhanes2005-2006/nhanes05_06htm 2010/03/16
Champion, V.L. (1987) Instrument development for health belief model constructs. ANS. Adv. Nurs. Sci. 6:73-85.
Chapman-Novakofski, K. & Karduck, J. (2005) Improvement in
knowledge, social cognitive theory variables, and movement through stages of change after a community-based diabetes education
program. J. Am. Diet. Assoc. 105:1613-1316.
Chew, F., Palmer, S.& Kim, S. (1998) Testing the influence of the health belief model and a television program on nutrition behavior. Health.
Commun. 10:227-245.
Chobanian, A.V.(2006) Prehypertension revisited. Hypertension. 48:812 Choi, K.M., Park, H.S., Han, J.H., Lee, J.S., Lee, J., Ryu, O.H., Lee, K.W.,
Cho, K.H., Yoon, D., Baik, S.H., Choi, D.S. & Kim, S.M. (2006) Prevalence of prehypertension and hypertension in a Korean population: Korean National Health and Nutrition Survey 2001. J Hypertens.8:1515-1521.
Clark, N.M. & Dodge, J.A. (1999) Exploring self-efficacy as a predictor of disease management. Health. Educ. Behav. 26:72-89.
Conlin, P.R., Erlinger, T.P., Bohannon, A., Miller, E.R. 3rd., Appel, L.J., Svetkey, L.P. & Moore, T.J. (2003) The DASH diet enhances the blood pressure response to losartan in hypertensive patients. Am. J.
Hypertens. 16:337-342.
Coresh. J., Wei, GL., McQuillan, G., Brancati, F.L., Levey, A.S., Jones, C.& Klag, M.J. (2001) Prevalence of high blood pressure and elevated serum creatinine level in the United States: findings from the third National Health and Nutrition Examination Survey
(1988-1994). Arch. Intern. Med. 161:1207-1216.
Craddick, S.R., Elmer, P.J., Obarzanek, E., Vollmer, W.M., Svetkey, L.P. &
Swain, M.C. (2003) The DASH diet and blood pressure. Curr.
Atheroscler. Rep. 5:484-491.
Cutler JA,Sorlie PD,Wolz M,Thom T,Fields LE and Roccella EJ.(2008) Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988-1994 and 1999-2004.Hypertension 52:818-27.
Couch, S.C., Saelens, B.E., Levin, L., Dart, K., Falciglia, G. & Daniels, S.R.
(2008) The efficacy of a clinic-based behavioral nutrition
intervention emphasizing a DASH-type diet for adolescents with elevated blood pressure. J. Pediatr. 152:494-501.
Deshpande, S., Basi,l M.D. & Basil, D.Z. (2009) Factors influencing healthy eating habits among college students: an application of the
health belief model. Health. Mark. Q. 26:145-164.
Doerksen, S.E., Estabrooks, P.A, (2007) Brief fruit and vegetable messages integrated within a community physical activity program
successfully change behaviour. Int. J. Behav. Nutr. Phys. Act.4:12.
Fagard, R.H.（2006）Exercise is good for your blood pressure: effects of endurance training and resistance training. Clin. Exp. Pharmacol.
Physiol. 33:853-856.
Fagard, R.H. & Cornelissen, V.A. (2007) Effect of exercise on blood pressure control in hypertensive patients. Eur. J. Cardiovasc. Prev.
Rehabil. 14:12-19.
Fields, L.E., Burt, V.L., Cutler, J.A., Hughes, J., Roccella, E.J. & Sorlie, P.
(2004) The burden of adult hypertension in the United States 1999 to 2000: a rising tide. Hypertension. 44:398-404
Frohlich, E.D. & Varagic, J.（2004）The role of sodium in hypertension is more complex than simply elevating arterial pressure. Nat. Clin.
Pract. Cardiovasc. Med. 1:24-30.
Frost, P.H., Davis, B.R., Burlando, A.J., Curb, J.D., Guthrie, G.P., Isaacsohn, J.L., Wassertheil-Smoller, S., Wilson, A.C. & Stamler, J. (1996)
Coronary heart disease risk factors in men and women aged 60 years and older: findings from the systolic hypertension in the elderly program. Circulation. 94:26-34.
Geller, K.S., Dzewaltowski, D.A., Rosenkranz, R.R., Karteroliotis, K. (2009) Measuring children's self-efficacy and proxy efficacy related to fruit and vegetable consumption. J. Sch. Health. 79:51-57.
Geleijnse, J.M., Kok, F.J. & Grobbee, D.E. (2003) Blood pressure response to changes in sodium and potassium intake: a metaregression
analysis of randomised trials. J. Hum. Hypertens.7:471-480.
Gu, D., Reynolds, K., Wu, X., Chen, J., Duan, X., Muntner, P., Huang, G., Reynolds, R.F., Su, S., Whelton, P.K. & He, J.; Inter ASIA
Collaborative Group. The International Collaborative Study of Cardiovascular Disease in ASIA. (2002) Prevalence, awareness,
treatment, and control of hypertension in china. Hypertension.
40:920-927.
Gupta, N., Balasekaran, G., Victor, GV., Hwa C.Y. and Shun, L.M. (2011) Comparison of body composition with bioelectric impedance (BIA) and dual energy X-ray absorptiometry (DEXA) among Singapore Chinese. J. Sci. Med. Sport. 14:33-35.
Hajjar, I. & Kotchen, T.A. (2003) Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA. 290:199-206.
Harnden, K.E., Frayn, K.N. & Hodson, L. (2009) Dietary Approaches to Stop Hypertension (DASH) diet: applicability and acceptability to a UK population. J. Hum. Nutr. Diet. 23:3-10.
Harsha, D.W., Lin. P.H., Obarzanek, E., Karanja, N.M., Moore, T.J. &
Caballero, B.(1999) Dietary Approaches to Stop Hypertension: a summary of study results. DASH Collaborative Research Group. J . Am. Diet. Asso. 99:S35-39
He, J., Whelton, P.K., Appel, LJ., Charleston, J. & Klag, M.J. (2000) Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Hypertension. 35:544-549.
He, J., Whelton, P.K., Wu, X., Burt, V.L., Tao, S., Roccella, E.J. & Klag, M.J. (1996). Comparsion of secular trends in prevalence of
hypertension in the People’s Republic of China and the United States of America. AM. J. Hypertens. 9: 74 A
Hulshof, K.F., Brussaard, J.H., Kruizinga, A.G., Telman, J.& Löwik, M.R.(2003) Socio-economic status, dietary intake and 10 y trends:
the Dutch National Food Consumption Survey.Eur J Clin Nutr.57:128-137.
Iseki, K., Ikemiya, Y. & Fukiyama, K. (1996) Blood pressure and risk of end-stage renal disease in a screened cohort. Kidney. Int. Suppl. 55:
S69–71
Iso, H., Terao, A., Kitamura, A., Sato, S., Naito, Y., Kiyama, M., Tanigaki, M., Iida, M., Konishi, M. & Shimamoto, T. (1991) Calcium intake and blood pressure in seven Japanese populations.
Am. J. Epidemiol. 133:776-783.
Izzo, J.J., Levy, D. & Black, H.R. (2000) Clinical Advisory Statement.
Importance of systolic blood pressure in older Americans.
Hypertension. 35: 1021-1024.
Jee, SH., Miller, E.R. 3rd., Guallar, E., Singh, V.K., Appel, L.J. & Klag, M.J. (2002) The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. Am. J.
Hypertens. 8:691-696.
Jones, WJ., Williams, L.S. & Bruno, A. (2003) Hypertension and cerebrovascular disease. Semins. in. cerer. disea. and stro. 3
144-154
Jorgensen, HS., Nakayama, H., Raaschou, H.O. & Olsen, T.S. (1994) Effects of blood pressure and diabetes on stroke in progression.
Lancet. 344:156-159.
Kannel, W.B., McGee, D. & Gordon, T. (1976). A general cardiovascular risk profile: the Framingham Study. Am. J. Cardiol. 38:46-51.
Kannel, WB., Zhang, T. & Garrison, R.J. (1990) Is obesity-related
hypertension less of a cardiovascular risk? The Framingham Study.
Am. Heart. J. 120:1195-1201.
Karanja, N.M., Obarzanek, E., Lin, P.H., McCullough, M.L., Phillips, K.M., Swain JF., Champagne CM and Hoben KP.(1999) Descriptive
characteristics of the dietary patterns used in the Dietary Approaches to Stop Hypertension Trial. DASH Collaborative
Kathryn, M.K. & Miller, M.G. (1996) New Developments in Nutrition Education Using Computer Technology. J. Nutr. Educ. Behav.
28:7-14
Kearney, P.M., Whelton, M., Reynolds, K., Whelton, P.K.. & He, J. (2004) Worldwide prevalence of hypertension: a systematic review
J. Hypertens. 22:11-19.
Kim, K.E., Onesti, G., Schwartz, A.B., Chinitz, J.L. & Swartz, C. (1972) Hemodynamics of hypertension in chronic end-stage renal disease.
Circulation. 46:456–464
Kirpizidis, H., Stavrati, A. & Geleris, P. (2005) Assessment of quality of life in a randomized clinical trial of candesartan only or in
combination with DASH diet for hypertensive patients.J. Cardiol.
46:177-182.
Kjeld H. (2000). Diet, blood pressure and hypertension. Br. J. Nutr. 83. 1:
S113-119
Klag, M.J., Whelton, P.K., Randall, B.L., Neaton, J.D., Brancati, F.L., Ford, C.E., Shulman, N.B. & Stamler, J. (1996) Blood pressure and end-stage renal disease in men. N. Engl. J. Med. 334:13-21.
Kloeblen, A.S. & Batish, S.S. (1999) Understanding the intention to permanently follow a high folate diet among a sample of low-income pregnant women according to the Health Belief Model.
Health. Educ. Res. 14:327-338.
Kotchen, T.A. (2007) Hypertension control trends, approaches, and goals Hypertension. 49:19
Landin, K., Tengborn, L. & Smith, U. (1991) Treating insulin resistance in hypertension with metformin reduces both blood pressure and metabolic risk factors. J. Intern. Med. 229:181-188.
Lewington, S., Clarke, R., Qizilbash, N., Peto, R. & Collins, R. Prospective Studies Collaboration. (2002) Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 360:1903-1916.
Lloyd-Jones, D., Adams, R.J., Brown, T.M., Carnethon, M., Dai, S., DeSimone, G., Ferguson, T.B., Ford, E., Furie, K., Gillespie, C.,
Go, A., Greenlund, K., Haase, N., Hailpern, S., Ho, P.M., Howard, V., Kissela, B., Kittner, S., Lackland, D., Lisabeth, L., McDermott M.M., Meigs, J., Mozaffarian, D., Mussolino, M., Nichol, G., Roger,V.L., Rosamond, W., Sacco, R., Sorlie, P., Stafford, R., Thom,
T., Wasserthiel-Smoller, S., Wong, N.D., & Wylie-Rosett, J.
American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2010) Executive summary: heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 23:121 948-954
MacMahon, S., Alderman, M.H., Lindholm, L.H., Liu, L., Sanchez, R.A, &
Seedat, Y.K. (2008) Blood pressure related disease is a global health priority. AM. J. Hypertens. 21:843-844.
Maggio, A.B., Aggoun, Y., Marchand, L.M., Martin, X.E., Herrmann, F., Beghetti, M. & Farpour-Lamber,t N.J. (2008) Associations among obesity, blood pressure, and left ventricular mass. J. Pediatr.
152:489-493
Mark, S.D.,Wang, W., Fraumeni, JF.Jr., Li, J.Y., Taylor, P.R., Wang, G.Q., Guo, W., Dawsey, S.M., Li, B. & Blot, W.J. (1996) Lowered risks of hypertension and cerebrovascular disease after vitamin/mineral supplementation: the Linxian Nutrition Intervention Trial. Am. J.
Epidemiol. 143:658-664.
McCarron, D.A., Morris, C.D. & Cole, C. (1982) Dietary calcium in human hypertension. Science 217:267-269.
Meck Higgins, M. & Clarke Barkley, M. (2004) Group nutrition education classes for older adults.J. Nutr. Elder. 23:67-98.
Meneely, G.R. & Battarbee, H.D. (1976) High sodium-low potassium environment and hypertension. Am. J. Cardiol. 38:768-785.
Miller, E.R. 3rd., Erlinger, T.P., & Appel, L.J. (2006) The effects of macronutrients on blood pressure and lipids: an overview of the
DASH and OmniHeart trials. Curr. Atheroscler. Rep.8:460-465.
Miller, E.R. 3rd., Erlinger, T.P, Young, D.R., Jehn, M., Charleston, J., Rhodes, D., Wasan, S.K. and Appel, L.J. (2002). Results of the Diet, Exercise, and Weight Loss Intervention Trial (DEW-IT). Hypertension. 40:
612-618.
Mizushima, S., Cappuccio, F.P., Nichols, R. & Elliott, P. (1998) Dietary magnesium intake and blood pressure: a qualitative overview of the observational studies. J. Hum. Hypertens.7:447-453.
Moore, T.J., Alsabeeh, N., Apovian, C.M., Murphy, M.C., Coffman, G.A., Cullum-Dugan, D., Jenkins, M. & Cabral, H. (2008) Weight, blood pressure, and dietary benefits after 12 months of a Web-based Nutrition Education Program (DASH for health): longitudinal observational study. J. Med. Internet. Res. 10: e52
Moore. T.J, Conlin, P.R., Ard, J. & Svetkey, L.P. (2003) DASH (Dietary Approaches to Stop Hypertension) diet is effective treatment for stage 1 isolated systolic hypertension. Am. J. Hypertens.
216:337-342.
Nation Heart, Lung and Blood Institute. (2003) The Seventh Report of the Joint National Committee on Prevention, Detection,Evaluation, and Treatment of High Blood Pressure http://www.nhlbi.nih.gov /guidelines/hypertension/jnc7full.htm. 2010/03/16
National Institute of Health and Nutrition. (2007) National Health and Nutrition Survey Japan 2001-2006.
http://www.nih.go.jp/eiken/english/research/project_nhns.html 2010/03/16
Neter, J.E., Stam, B.E., Kok, F.J., Grobbee, D.E. & Geleijnse, J.M. (2003) Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 42:878-884
Ni Mhurchu, C., Margetts, B.M. & Speller, V.M. (1997) Applying the
stages-of-change model to dietary change. Nutr. Rev. 55:10-16.
Nissinen, A., Böthig, S., Granroth, H. & Lopez, A.D. (1998) Hypertension in developing countries. World Health Stat Q.41:141-54.
O'Shaughnessy, K.M. & Karet, F.E., (2006) Salt handling and hypertension.
Annu. Rev. Nutr. 26:343-365.
Paffenbarger, R. (2000) Physical exercise to reduce cardiovascular disease risk. Proc. Nutr. Soc. 59:421-422.
Pan, W.H., Chang, H.Y., Yeh, W.T., Hsiao, S.Y. & Hung, Y.T. (2001) Prevalence, awareness, treatment and control of hypertension in Taiwan: results of Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996. J. Hum. Hypertens. 15:793-798.
Pan, W.H., Wu, H.J., Yeh, C.J., Chuang, S.Y., Chang, H.Y., Yeh, N.H. &
Hsieh, Y.T. (2011) Diet and health trends in Taiwan: comparison of two nutrition and health surveys from 1993-1996 and 2005-2008.
Asia Pac J Clin Nutr. 20:238-250.
Parmenter, K., Waller, J. & Wardle, J. (2000) Demographic variation in nutrition knowledge in England. Health. Educ. Res. 15:163-174.
Patrick, K., Calfas, K.J., Norman, G.J., Zabinski, M.F., Sallis, J.F., Rupp, J., Covin, J.& Cella. J.(2006) Randomized controlled trial of a primary care and home-based intervention for physical activity and nutrition behaviors: PACE+ for adolescents. Arch. Pediatr. Adolesc. Med.
160:128-136.
Perneger, T.V., Nieto. F.J., Whelton, P.K., Klag, M.J., Comstock, G.W. &
Perneger, T.V., Nieto. F.J., Whelton, P.K., Klag, M.J., Comstock, G.W. &