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우리나라 19-69세의 수면시간에 따른 견과류 섭취와 고혈압의 연관성: 2010~2016 국민건강영양조사 자료를 이용하여

Association Between Nut Consumption and Hypertension According to Sleep Duration Among Korean Adults (Aged 19-69 Years): 2010~2016 Korea National Health and Nutrition Examination Survey

  • 범설영 (고려대학교 대학원 생활과학과) ;
  • 김유경 (고려대학교 가정교육과) ;
  • 신우경 (서울대학교 의과대학 예방의학교실)
  • Fan, Xueying (Department of Human Ecology, Graduate School, Korea University) ;
  • Kim, Yookyung (Department of Home Economics Education, Korea University) ;
  • Shin, Woo-Kyoung (Department of Preventive Medicine, College of Medicine, Seoul National University)
  • 투고 : 2021.12.24
  • 심사 : 2022.01.05
  • 발행 : 2021.12.31

초록

본 연구의 목적은 한국 성인(19-69세)들의 견과류 섭취량과 고혈압의 연관성 및 성인들의 수면시간에 따른 견과류 섭취량과 고혈압의 연관성을 분석하는 것이다. 2010-2016 국민건강영양조사 자료를 활용하여 분석하였고, 25,359명의 연구 대상자가 포함되었다. 본 연구에서는 수면시간에 따른 견과류섭취와 고혈압의 연관성을 분석하였다. 수면시간에 따른 견과류섭취와 고혈압의 연관성을 알아보기위해 로지스틱 회귀분석(logistic regression)을 사용하여 교차비(odds ratio, OR)와 95% 신뢰구간(confidence interval, CI)으로 제시하였다. 자료의 통계처리 및 분석은 SAS 9.4 for windows(SAS Institute Inc, Cary, NC USA)를 이용하였고, 통계적 유의수준은 α=0.05로 설정하였다. 분석결과, 견과류 섭취량이 증가할수록 고혈압 유병률이 통계적으로 유의하게 감소한 것으로 나타났다(p for trend=0.02). 또한, 수면시간이 6시간 이상 7시간 미만인 대상자의 경우에는, 견과류 섭취량이 증가할수록 고혈압 유병률이 통계적으로 유의하게 감소하는 경향을 보였고(p for trend=0.03), DBP가 감소하는 것을 알 수 있었다(p for trend=0.01). 결론적으로, 견과류 섭취와 고혈압유병은 연관성이 있었고, 특히 수면시간이 6시간 이상, 7시간 미만 또는 7시간 이상 8시간 미만인 경우에도 견과류를 많이 섭취할수록 고혈압 유병률이 감소하였다.

Nuts are cholesterol free with high poly-unsaturated fatty acids(PUFA) and have lower intakes of sodium than non-consumers, and thus they can decrease blood pressure. Hypertension is a common primary diagnosis in Korea. Because of extending exposure to 24-hour raised blood pressure and heart rate hypertension is likely to be caused by prolonged short sleep durations. This study examined the relationship between nut consumption and hypertension according to sleep duration among Korean adult. Based on data from the 2010-2016 Korea National Health and Nutrition Examination Survey(KNHANES), the final analytic sample(n=25,359) was used for current analysis. The dietary intake was assessed through a 24-hour recall method. Associations of nut consumption with sleep duration and hypertension were determined using multiple logistic regression with odds ratio(95% CI). All the analyses were carried out in SAS version 9.4, and the significance level was set at p<0.05. With increasing nut intake, the prevalence of hypertension significantly decreased(p for trend=0.02). After controlling for sleep duration, the nut consumption showed significant association with the prevalence of hypertension when sleep duration was 6 to 6.9 h per day(p for trend=0.03) or 7 to 7.9 h per day(p for trend=0.03). In conclusion, dietary total nut intake was found to be significantly associated with the prevalence of hypertension.

키워드

참고문헌

  1. Adams, P. F., & Schoenborn, C. A. (2010). Health behaviors of adults. Vital Health Stat, 10, 245, 1-132.
  2. Alasalvar, C., & Shahidi, F. (2008). Tree nuts: Composition, phytochemicals, and health effects. Boca Raton, FL: CRC Press.
  3. Albert, C. M., Gaziano, J. M., Willett, W. C., & Manson, J. E. (2002). Nut consumption and decreased risk of sudden cardiac death in the physicians' health study. Archives of Internal Medicine, 162(12), 1382-1387. https://doi.org/10.1001/archinte.162.12.1382
  4. Arab, L., & Ang, A. (2015). A cross sectional study of the association between walnut consumption and cognitive function among adult us populations represented in NHANES. The Journal of Nutrition, Health & Aging, 19(3), 284-290. https://doi.org/10.1007/s12603-014-0569-2
  5. Bae, Y. J., Kim, M. H., & Choi, M. K. (2021). Dietary mineral intake from nuts and its relationship to hypertension among Korean adults. Biological Trace Element Research, 1-10.
  6. Bansil, P., Kuklina, E. V., Merritt, R. K., & Yoon, P. W. (2011). Associations between sleep disorders, sleep duration, quality of sleep, and hypertension: Results from the National Health and Nutrition Examination Survey, 2005 to 2008. The Journal of Clinical Hypertension, 13(10), 739-743. https://doi.org/10.1111/j.1751-7176.2011.00500.x
  7. Bathgate, C. J., Edinger, J. D., Wyatt, J. K., & Krystal, A. D. (2016). Objective but not subjective short sleep duration associated with increased risk for hypertension in individuals with insomnia. Sleep, 39(5), 1037-1045. https://doi.org/10.5665/sleep.5748
  8. Blask, D. E. (2009). Melatonin, sleep disturbance and cancer risk. Sleep Medicine Reviews, 13(4), 257-264. https://doi.org/10.1016/j.smrv.2008.07.007
  9. Bolling, B. W., Chen, C.-Y. O., McKay, D. L., & Blumberg, J. B. (2011). Tree nut phytochemicals: Composition, antioxidant capacity, bioactivity, impact factors.: A systematic review of almonds, Brazils, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts. Nutrition Research Reviews, 24(2), 244-275. https://doi.org/10.1017/S095442241100014X
  10. Brown, R. C., Tey, S. L., Gray, A. R., Chisholm, A., Smith, C., Fleming, E., & Parnell, W. (2016). Nut consumption is associated with better nutrient intakes: Results from the 2008/09 New Zealand adult nutrition survey. British Journal of Nutrition, 115(1), 105-112. https://doi.org/10.1017/S0007114515004122
  11. Brufau, G., Boatella, J., & Rafecas, M. (2006). Nuts: Source of energy and macronutrients. British Journal of Nutrition, 96(S2), S24-S28. https://doi.org/10.1017/BJN20061860
  12. Cai, H., Shu, X.-O., Xiang, Y.-B., Yang, G., Li, H., Ji, B.-T.,...Zheng, W. (2015). Sleep duration and mortality: A prospective study of 113, 138 middle-aged and elderly Chinese men and women. Sleep, 38(4), 529-536. https://doi.org/10.5665/sleep.4564
  13. Cappuccio, F. P., Cooper, D., D'Elia, L., Strazzullo, P., & Miller, M. A. (2011). Sleep duration predicts cardiovascular outcomes: A systematic review and meta-analysis of prospective studies. European Heart Journal, 32(12), 1484-1492. https://doi.org/10.1093/eurheartj/ehr007
  14. Choi, K., Lee, J., Park, H., Baik, S., Choi, D., & Kim, S. (2008). Relationship between sleep duration and the metabolic syndrome: Korean National Health and Nutrition Survey 2001. International Journal of Obesity, 32(7), 1091. https://doi.org/10.1038/ijo.2008.62
  15. De Wilde, M. C., Hogyes, E., Kiliaan, A. J., Farkas, T., Luiten, P. G., & Farkas, E. (2003). Dietary fatty acids alter blood pressure, behavior and brain membrane composition of hypertensive rats. Brain Research, 988(1-2), 9-19. https://doi.org/10.1016/S0006-8993(03)03320-1
  16. Dreher, M. L. (2018). Dietary fiber in health and disease. Basel, Switzerland: Birkhauser Verlag AG.
  17. Ellsworth, J., Kushi, L., & Folsom, A. (2001). Frequent nut intake and risk of death from coronary heart disease and all causes in postmenopausal women: The Iowa women's health study. Nutrition, Metabolism, and Cardiovascular Diseases: NMCD, 11(6), 372-377.
  18. Engler, M. M., Engler, M. B., Pierson, D. M., Molteni, L. B., & Molteni, A. (2003). Effects of docosahexaenoic acid on vascular pathology and reactivity in hypertension. Experimental Biology and Medicine, 228(3), 299-307. https://doi.org/10.1177/153537020322800309
  19. Feigin, V. L., Roth, G. A., Naghavi, M., Parmar, P., Krishnamurthi, R., Chugh, S.,...Study, R. F. (2016). Global burden of stroke and risk factors in 188 countries, during 1990-2013: A systematic analysis for the global burden of disease study 2013. The Lancet Neurology, 15(9), 913-924. https://doi.org/10.1016/S1474-4422(16)30073-4
  20. Gangwisch, J. E. (2014). A review of evidence for the link between sleep duration and hypertension. American Journal of Hypertension, 27(10), 1235-1242. https://doi.org/10.1093/ajh/hpu071
  21. Gangwisch, J. E., Heymsfield, S. B., Boden-Albala, B., Buijs, R. M., Kreier, F., Pickering, T. G.,...Malaspina, D. (2006). Short sleep duration as a risk factor for hypertension: Analyses of the first National Health and Nutrition Examination Survey. Hypertension, 47(5), 833-839. https://doi.org/10.1161/01.HYP.0000217362.34748.e0
  22. Gebhardt, S., Lemar, L., Haytowitz, D., Pehrsson, P., Nickle, M., Showell, B.,...Holden, J. (2008). USDA national nutrient database for standard reference, release 21. Washington D.C.: United States Department of Agriculture Agricultural Research Service.
  23. Gottlieb, D. J., Redline, S., Nieto, F. J., Baldwin, C. M., Newman, A. B., Resnick, H. E., & Punjabi, N. M. (2006). Association of usual sleep duration with hypertension: The Sleep Heart Health Study. Sleep, 29(8), 1009-1014. https://doi.org/10.1093/sleep/29.8.1009
  24. Griel, A. E., & Kris-Etherton, P. M. (2006). Tree nuts and the lipid profile: A review of clinical studies. British Journal of Nutrition, 96(S2), S68-S78. https://doi.org/10.1017/BJN20061866
  25. Hong, S., Linton, J., Shim, J., Lee, H., & Kang, H. (2016). Association of alcohol consumption pattern with risk of hypertension in Korean adults based on the 2010-2012 KNHANES. Alcohol, 54, 17-22. https://doi.org/10.1016/j.alcohol.2016.05.006
  26. Iannuzzi, A., Celentano, E., Panico, S., Galasso, R., Covetti, G., Sacchetti, L.,...Rubba, P. (2002). Dietary and circulating antioxidant vitamins in relation to carotid plaques in middle-aged women. The American Journal of Clinical Nutrition, 76(3), 582-587. https://doi.org/10.1093/ajcn/76.3.582
  27. Jackson, S. L., King, S., Zhao, L., & Cogswell, M. E. (2016). Prevalence of excess sodium intake in the United States-NHANES, 2009-2012. Morb Mortal Wkly Rep, 64(52), 1393-1397. https://doi.org/10.15585/mmwr.mm6452a1
  28. Jenkins, D. J., Kendall, C. W., Axelsen, M., Augustin, L. S., & Vuksan, V. (2000). Viscous and nonviscous fibres, nonabsorbable and low glycaemic index carbohydrates, blood lipids and coronary heart disease. Current Opinion in Lipidology, 11(1), 49-56. https://doi.org/10.1097/00041433-200002000-00008
  29. Jo, I., Ahn, Y., Lee, J., Shin, K. R., Lee, H. K., & Shin, C. (2001). Prevalence, awareness, treatment, control and risk factors of hypertension in Korea: The Ansan study. Journal of Hypertension, 19(9), 1523-1532. https://doi.org/10.1097/00004872-200109000-00002
  30. Jung, C. H., Park, J. S., Lee, W. Y., & Kim, S. W. (2002). Effects of smoking, alcohol, exercise, level of education, and family history on the metabolic syndrome in Korean adults. Korean Journal of Medicine, 63(6), 649-659.
  31. Kang, Y., & Kim, J. (2016). Association between fried food consumption and hypertension in Korean adults. British Journal of Nutrition, 115(1), 87-94. https://doi.org/10.1017/S000711451500402X
  32. Kim, D., & Kim, J. (2017). Dairy consumption is associated with a lower incidence of the metabolic syndrome in middle-aged and older Korean adults: The Korean Genome and Epidemiology Study (KoGES). British Journal of Nutrition, 117(1), 148-160. https://doi.org/10.1017/S000711451600444X
  33. Kim, H. C., & Cho, M. C. (2018). Korea hypertension fact sheet 2018. Clinical Hypertension, 24(1), 1-4. https://doi.org/10.1186/s40885-018-0087-3
  34. Klingman, K. J., & Boyce, A. A. (2018). Sleep association with borderline diabetes hypertension: A cross-sectional analysis. The Journal for Nurse Practitioners, 14(5), 409-413. https://doi.org/10.1016/j.nurpra.2017.12.027
  35. Kong, J. S. (2016). Nuts consumption and suicidal ideation, depression and perceived stress among Korean adults: The Korea national health and nutrition examination survey(KNHANES IV, V) from 2007 to 2012. Unpublished doctoral dissertation, Ewha University, Seoul, Korea.
  36. Korean Ministry of Health and Welfare (2017). Korea National Health and Nutrition Examination Survey (KNHANES VI-1). Sejong: Author
  37. Liu, R.-Q., Qian, Z., Trevathan, E., Chang, J.-J., Zelicoff, A., Hao, Y.-T.,...Dong, G.-H. (2016). Poor sleep quality associated with high risk of hypertension and elevated blood pressure in China: Results from a large population-based study. Hypertension Research, 39(1), 54-59. https://doi.org/10.1038/hr.2015.98
  38. Lopez, A. D., Mathers, C. D., Ezzati, M., Jamison, D. T., & Murray, C. J. (2006). Global and regional burden of disease and risk factors, 2001: Systematic analysis of population health data. Lancet, 367(9524), 1747-1757. https://doi.org/10.1016/S0140-6736(06)68770-9
  39. Ma, J., Folsom, A. R., Melnick, S. L., Eckfeldt, J. H., Sharrett, A. R., Nabulsi, A. A.,...Metcalf, P. A. (1995). Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: The ARIC study. Journal of Clinical Epidemiology, 48(7), 927-940. https://doi.org/10.1016/0895-4356(94)00200-A
  40. Maguire, L., O'sullivan, S., Galvin, K., O'connor, T., & O'brien, N. (2004). Fatty acid profile, tocopherol, squalene and phytosterol content of walnuts, almonds, peanuts, hazelnuts and the macadamia nut. International Journal of Food Sciences and Nutrition, 55(3), 171-178. https://doi.org/10.1080/09637480410001725175
  41. Morris, M. C., Evans, D. A., Bienias, J. L., Tangney, C. C., & Wilson, R. S. (2002). Vitamin E and cognitive decline in older persons. Archives of Neurology, 59(7), 1125-1132. https://doi.org/10.1001/archneur.59.7.1125
  42. Nothwehr, F., & Perkins, A. J. (2002). Relationships between comorbidity and health behaviors related to hypertension in NHANES III. Preventive Medicine, 34(1), 66-71. https://doi.org/10.1006/pmed.2001.0955
  43. O'Neil, C. E., Fulgoni, V. L., & Nicklas, T. A. (2015). Tree Nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in US Adults: NHANES 2005-2010. Nutrition Journal, 14(1), 1-8. https://doi.org/10.1186/1475-2891-14-1
  44. O'Neil, C. E., Keast, D. R., Nicklas, T. A., & Fulgoni III, V. L. (2011). Nut consumption is associated with decreased health risk factors for cardiovascular disease and metabolic syndrome in US adults: NHANES 1999-2004. Journal of the American College of Nutrition, 30(6), 502-510. https://doi.org/10.1080/07315724.2011.10719996
  45. Ostchega, Y., Hughes, J. P., Terry, A., Fakhouri, T. H., & Miller, I. (2012). Abdominal obesity, body mass index, and hypertension in US adults: NHANES 2007-2010. American Journal of Hypertension, 25(12), 1271-1278. https://doi.org/10.1038/ajh.2012.120
  46. Pan, A., Sun, Q., Manson, J. E., Willett, W. C., & Hu, F. B. (2013). Walnut consumption is associated with lower risk of type 2 diabetes in women 1, 2. The Journal of Nutrition, 143(4), 512-518. https://doi.org/10.3945/jn.112.172171
  47. Region, WHO-Western Pacific (2000). The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia
  48. Sauder, K. A., McCrea, C. E., Ulbrecht, J. S., Kris-Etherton, P. M., & West, S. G. (2014). Pistachio nut consumption modifies systemic hemodynamics, increases heart rate variability, and reduces ambulatory blood pressure in well-controlled type 2 diabetes: A randomized trial. Journal of the American Heart Association, 3(4), e000873, 1-9. https://doi.org/10.1161/JAHA.114.000873
  49. Shan, Z., Ma, H., Xie, M., Yan, P., Guo, Y., Bao, W.,...,Liu, L. (2015). Sleep duration and risk of type 2 diabetes: A meta-analysis of prospective studies. Diabetes Care, 38(3), 529-537. https://doi.org/10.2337/dc14-2073
  50. The Korean Society of Hypertention (2018). Guidelines of the Korean society of hypertension. Seoul: Author
  51. Torres, M. R. S. G., & Sanjuliani, A. F. (2012). Does calcium intake affect cardiovascular risk factors and/or events? Clinics, 67(7), 839-844. https://doi.org/10.6061/clinics/2012(07)22
  52. Tucker, K. L., Hannan, M. T., Chen, H., Cupples, L. A., Wilson, P. W., & Kiel, D. P. (1999). Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. The American Journal of Clinical Nutrition, 69(4), 727-736. https://doi.org/10.1093/ajcn/69.4.727
  53. Uiterwaal, C. S., Verschuren, W. M., Bueno-de-Mesquita, H. B., Ocke, M., Geleijnse, J. M., Boshuizen, H. C., ... & Grobbee, D. E. (2007). Coffee intake and incidence of hypertension. The American Journal of Clinical Nutrition, 85(3), 718-723. https://doi.org/10.1093/ajcn/85.3.718
  54. US Food and Drug Administration (2003). Qualified health claims: Letter of enforcement discretion-nuts and coronary heart disease. Rockville, MD: Author.
  55. Willett, W. (2012). Nutritional epidemiology. London, UK: Oxford University Press.
  56. Wu, L., Piotrowski, K., Rau, T., Waldmann, E., Broedl, U. C., Demmelmair, H.,...Mantzoros, C. S. (2014). Walnut-enriched diet reduces fasting non-HDL-cholesterol and apolipoprotein B in healthy Caucasian subjects: A randomized controlled cross-over clinical trial. Metabolism, 63(3), 382-391. https://doi.org/10.1016/j.metabol.2013.11.005
  57. Yazdekhasti, N., Mohammadifard, N., Sarrafzadegan, N., Mozaffarian, D., Nazem, M., & Taheri, M. (2013). The relationship between nut consumption and blood pressure in an Iranian adult population: Isfahan Healthy Heart Program. Nutrition, Metabolism and Cardiovascular Diseases, 23(10), 929-936. https://doi.org/10.1016/j.numecd.2013.04.014