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탄산음료 섭취와 성인 아토피 피부염 진단 및 현재 유병과의 관련성: 국민건강영양조사(2015-2016년) 자료를 바탕으로

Relationship between intake of soft drinks and current prevalence of adult atopic dermatitis: based on the Korea National Health and Nutrition Examination Survey data (2015-2016)

  • 김혜원 (안양대학교 식품영양학과) ;
  • 김지명 (신한대학교 식품조리과학부 식품영양전공)
  • Kim, Hye Won (Department of Food and Nutrition, Anyang University) ;
  • Kim, Ji-Myung (Food and Nutrition Major, Division of Food Science & Culinary Arts, Shinhan University)
  • 투고 : 2021.06.22
  • 심사 : 2021.08.24
  • 발행 : 2021.10.31

초록

본 연구에서는 국민건강영양조사 자료를 활용하여 탄산음료 섭취와 우리나라 성인의 AD진단 및 현재 유병여부의 관련성을 살펴보았다. 조사대상자는 AD 여부에 따른 비교를 위해 AD진단군과 non-AD군 (대조군)으로 구분하였다. 또, AD진단군 중에서 현재 AD 유병여부에 따른 비교를 위해 현재 AD 증상이 있는 유증상 AD군과 현재 증상이 없는 무증상 AD군으로 나누었다. 분석 결과, 섭취 에너지 1,000 kcal 당 영양소 섭취량을 비교했을 때에는, AD진단군에서 non-AD군에 비해 지질 섭취량은 높았으나 탄수화물, 식이섬유소, 칼슘, 인, 철, 칼륨, 비타민 A, 티아민, 비타민 C의 섭취량은 낮았다. AD진단군의 1일 탄산음료 섭취량은 non-AD군 보다 많았으며, '하루에 0.5회 제공량 이상 섭취'라고 응답한 비율도 non-AD군보다 높았다. 또한, 탄산음료 섭취빈도도 AD진단군에서 '주 1회 이상 섭취'하는 비율이 non-AD군 보다 높았다. 탄산음료 섭취와 AD 위험도에 대한 결과에서는 유의미한 관련성을 보이지 않았으나, 탄산음료 섭취와 현재 유병 위험도와의 관계는 탄산음료를 '하루에 0.5회 제공량 미만'으로 섭취 시 그 위험도가 증가하였으나, 탄산음료 섭취량에 따른 AD 유병위험도의 판단은 보정변수 조정을 통한 후속연구가 필요하다. 결론적으로, 성인 AD진단군에서는 영양불균형과 탄산음료 섭취량이 높았으며, AD로 진단받은 성인의 현재 AD 유병 위험이 탄산음료 섭취량과 관련성이 있었다. 이러한 결과로 보았을 때, 탄산 음료 섭취 제한을 성인 AD 환자의 증상 관리 방안 중 하나로 제안할 수 있겠다.

Purpose: The purpose of this study was to provide basic data for the management of atopic dermatitis (AD) in adults by analyzing the relationship between AD and intake of soft drinks in adults. Methods: This study was conducted on 5,931 adults aged 19 to 64 who completed the food frequency questionnaire (FFQ) for participants in the Korea National Health and Nutrition Examination Survey VII-3 and VII-1. Subjects were divided into an AD-diagnosed group and a non-AD group according to the diagnosis of AD. In addition, the group diagnosed with AD was divided into a 'symptom-AD' group and a 'no symptom-AD' group. The amount, frequency of intake, and nutritional status of soft drinks were analyzed using the FFQ. Results: Compared with the nutrient intake per 1,000 kcal of energy consumption, fat intake was higher in the AD-diagnosed group than in the non-AD group, and carbohydrate, dietary fiber, calcium, phosphorus, iron, potassium, vitamin A, thiamin, and vitamin C were lower in AD-diagnosed group. The daily intake of soft drinks and the percentage of 'more than 0.5 servings per day' were also higher in the AD-diagnosed group than in the non-AD group. Also, the frequency of the intake of soft drinks was significantly higher in the AD-diagnosed group than in the non-AD group. The odds ratio of AD symptoms due to the intake of soft drinks increased 2.6 times when the intake was 'less than 0.5 serving per day'. Conclusion: AD in adults appears to be related to malnutrition and excessive consumption of soft drinks, and the current prevalence of AD symptoms may also be related to the intake of soft drinks. Based on these results, we suggest that one of the ways to manage AD in adults would be to limit their intake of soft drinks.

키워드

참고문헌

  1. Park SJ, Lee JS, Ahn K, Chung SJ. The comparison of growth and nutrient intakes in children with and without atopic dermatitis. Korean J Community Nutr 2012; 17(3): 271-279. https://doi.org/10.5720/kjcn.2012.17.3.271
  2. Kim MJ, Kang TW, Cho EA, Kim HS, Min JA, Park H, et al. Prevalence of atopic dermatitis among Korean adults visiting health service center of the Catholic Medical Center in Seoul Metropolitan Area, Korea. J Korean Med Sci 2010; 25(12): 1828-1830. https://doi.org/10.3346/jkms.2010.25.12.1828
  3. Healthcare Bigdata Hub. Disease Statistics [Internet]. Wonju: Health Insurance Review & Assessment Service; 2021 [cited 2021 May 26]. Available from: http://opendata.hira.or.kr/op/opc/olap3thDsInfo.do.
  4. Park NS, Jeon ES, Kim YN, Cho KD, Baek OH, Lee BH. Comparative study on eating habits, dietary intake patterns, and nutrient intakes between elementary school children with and without atopic dermatitis. J Korean Soc Food Sci Nutr 2009; 38(11): 1543-1550. https://doi.org/10.3746/JKFN.2009.38.11.1543
  5. Ministry of Agriculture, Food and Rural Affairs, Korea Agro-Fisheries and Food Trade Corporation. 2015 Report on Processed Food Consumption and Consumer Behavior. Naju: Korea Agro-Fisheries and Food Trade Corporation; 2015.
  6. Kim HY, Lee YJ, Hong KH, Ha SC, Ahn MS, Jo JS, et al. Intake of food additives in foods by total diet. Korean J Food Sci Technol 1998; 30(4): 767-774.
  7. Yi Y, Hyun SJ, Lee J, An JY. Severity of atopic dermatitis and associated factors in Korean adolescents by Sex. J Korean Soc Sch Health 2017; 30(2): 164-173. https://doi.org/10.15434/KSSH.2017.30.2.164
  8. Oh JW. Food additives and allergic disease in childhood. Hanyang Med Rev 2011; 31(4): 261-268. https://doi.org/10.7599/hmr.2011.31.4.261
  9. Lee S, Lee H, Han Y, Ahn K, Lee S, Chung SJ. Excessive food restriction in children with atopic dermatitis. Korean J Community Nutr 2011; 16(6): 627-635. https://doi.org/10.5720/kjcn.2011.16.6.627
  10. You SM, Ahn SE, Oh HI, Oh JE, Oh JE. Effect of food-related lifestyle on beverage selection attributes of adolescents. J Korean Soc Food Sci Nutr 2018; 47(6): 649-656. https://doi.org/10.3746/jkfn.2018.47.6.649
  11. Korea Health Industry Development Institute. National Food and Nutrition Statistics [Internet]. Cheongju: Korea Health Industry Development Institute [cited 2021 May 26]. Available from: https://www.khidi.or.kr/kps/dhraStat/result3?menuId=MENU01654&gubun=age1&year=2016.
  12. Kang HE, Yang HJ, Kim SM, An SY, Lee KN, Seok SA. Association between food intake frequency and therapeutic experience of atopic dermatitis for patients with atopic dermatitis in Korean middle and high school students: The 10th (2014) Youth Health Behavior Online Survey. Korean J Fam Pract 2016; 6(6): 546-552. https://doi.org/10.21215/kjfp.2016.6.6.546
  13. Pyun BY. Relationship between atopic dermatitis, wheezing during infancy and asthma development. J Korean Med Assoc 2007; 50(6): 533-538. https://doi.org/10.5124/jkma.2007.50.6.533
  14. DeChristopher LR, Tucker KL. Excess free fructose, high-fructose corn syrup and adult asthma: the Framingham Offspring Cohort. Br J Nutr 2018; 119(10): 1157-1167. https://doi.org/10.1017/S0007114518000417
  15. Kim KH, Park AY, Kim JS. Factors associated with atopic dermatitis in Korean adults: The Korean National Health and Nutrition Survey 2008. Korean J Rehabil Nurs 2012; 15(2): 83-90. https://doi.org/10.7587/kjrehn.2012.83
  16. Solvoll K, Soyland E, Sandstad B, Drevon CA. Dietary habits among patients with atopic dermatitis. Eur J Clin Nutr 2000; 54(2): 93-97. https://doi.org/10.1038/sj.ejcn.1600901
  17. Park S, Choi HS, Bae JH. Instant noodles, processed food intake, and dietary pattern are associated with atopic dermatitis in an adult population (KNHANES 2009-2011). Asia Pac J Clin Nutr 2016; 25(3): 602-613.
  18. Choi KM, Kim KY, Lee MS, Hong JY, Bae SH, Hwang HJ. The related factors of atopic dermatitis severity in elementary school students. J Korea Acad Ind Coop Soc 2011; 12(2): 759-764. https://doi.org/10.5762/KAIS.2011.12.2.759
  19. Trak-Fellermeier MA, Brasche S, Winkler G, Koletzko B, Heinrich J. Food and fatty acid intake and atopic disease in adults. Eur Respir J 2004; 23(4): 575-582. https://doi.org/10.1183/09031936.04.00074404
  20. Kim EJ, Kim HJ, Kim SY, Kim YY, Lee HJ, Kang MH, et al. Dietary habits and nutrient intakes of elementary school students with atopic dermatitis in Chungnam. J East Asian Soc Diet Life 2014; 24(3): 315-324.
  21. Kim JM. Relation of polyunsaturated fatty acid, n-3 fatty acid and n-6 fatty acid intakes and atopic dermatitis in the 9-11 year old children: KNHANES 2013-2015. J Nutr Health 2019; 52(1): 47-57. https://doi.org/10.4163/jnh.2019.52.1.47
  22. Kim SY, Sim S, Park B, Kim JH, Choi HG. High-fat and low-carbohydrate diets are associated with allergic rhinitis but not asthma or atopic dermatitis in children. PLoS One 2016; 11(2): e0150202. https://doi.org/10.1371/journal.pone.0150202
  23. Garn H, Renz H. Epidemiological and immunological evidence for the hygiene hypothesis. Immunobiology 2007; 212(6): 441-452. https://doi.org/10.1016/j.imbio.2007.03.006
  24. Chung YM, Kim BS, Kim NI, Lee EY, Choue R. Study of nutritional status, dietary patterns, and dietary quality of atopic dermatitis patients. J Nutr Health 2005; 38(6): 419-431.
  25. Kim J, Kwon J, Noh G, Lee SS. The effects of elimination diet on nutritional status in subjects with atopic dermatitis. Nutr Res Pract 2013; 7(6): 488-494. https://doi.org/10.4162/nrp.2013.7.6.488
  26. Shi Z, Dal Grande E, Taylor AW, Gill TK, Adams R, Wittert GA. Association between soft drink consumption and asthma and chronic obstructive pulmonary disease among adults in Australia. Respirology 2012; 17(2): 363-369. https://doi.org/10.1111/j.1440-1843.2011.02115.x
  27. Steinman HA, Weinberg EG. The effects of soft-drink preservatives on asthmatic children. S Afr Med J 1986; 70(7): 404-406.
  28. Kim YH. A study on the dietary treatments of atopic dermatitis. Thesis Collect Res Inst Korean Med 2005; 14(1): 1-14.
  29. Maslova E, Strom M, Olsen SF, Halldorsson TI. Consumption of artificially-sweetened soft drinks in pregnancy and risk of child asthma and allergic rhinitis. PLoS One 2013; 8(2): e57261. https://doi.org/10.1371/journal.pone.0057261
  30. Aeberli I, Gerber PA, Hochuli M, Kohler S, Haile SR, Gouni-Berthold I, et al. Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. Am J Clin Nutr 2011; 94(2): 479-485. https://doi.org/10.3945/ajcn.111.013540
  31. Yoon EK. Current status of Korean sugar intake and reduction policy. Food Ind Nutr 2018; 23(2): 10-13.
  32. Bedard A, Northstone K, Henderson AJ, Shaheen SO. Maternal intake of sugar during pregnancy and childhood respiratory and atopic outcomes. Eur Respir J 2017; 50(1): 1700073. https://doi.org/10.1183/13993003.00073-2017
  33. Ehlers I, Worm M, Sterry W, Zuberbier T. Sugar is not an aggravating factor in atopic dermatitis. Acta Derm Venereol 2001; 81(4): 282-284. https://doi.org/10.1080/00015550152572930
  34. Yano C, Saeki H, Ishiji T, Ishiuji Y, Sato J, Tofuku Y, et al. Impact of disease severity on work productivity and activity impairment in Japanese patients with atopic dermatitis. J Dermatol 2013; 40(9): 736-739. https://doi.org/10.1111/1346-8138.12220
  35. Eckert L, Gupta S, Amand C, Gadkari A, Mahajan P, Gelfand JM. Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: an analysis using the National Health and Wellness Survey. J Am Acad Dermatol 2017; 77(2): 274-279.e3. https://doi.org/10.1016/j.jaad.2017.04.019
  36. Holm EA, Esmann S, Jemec GB. The handicap caused by atopic dermatitis--sick leave and job avoidance. J Eur Acad Dermatol Venereol 2006; 20(3): 255-259. https://doi.org/10.1111/j.1468-3083.2006.01416.x
  37. Choi HJ, Kim KH, Kim MN, Kim JW, Ro YS, Park CW, et al. Report of ADRG: a study on triggering factors in Korean adult atopic dermatitis through questionnaire. Korean J Dermatol 2004; 42(9): 1152-1160.
  38. Linneberg A, Hertzum I. The association between alcohol consumption and atopy in Danish adults. J Allergy Clin Immunol 2006; 117(2): S132-S133.
  39. Drucker AM, Li WQ, Lin L, Cho E, Li T, Camargo CA Jr, et al. Atopic dermatitis (eczema) in US female nurses: lifestyle risk factors and atopic comorbidities. Br J Dermatol 2016; 174(6): 1395-1397. https://doi.org/10.1111/bjd.14373
  40. Lonne-Rahm SB, Sundstrom I, Nordlind K, Engstrom LM. Adult atopic dermatitis patients and physical exercise: a Swedish questionnaire study. Acta Derm Venereol 2014; 94(2): 185-187. https://doi.org/10.2340/00015555-1556
  41. Kaneko S, Murota H, Murata S, Katayama I, Morita E. Usefulness of sweat management for patients with adult atopic dermatitis, regardless of sweat allergy: a Pilot Study. BioMed Res Int 2017; 2017: 8746745.
  42. Silverberg JI, Song J, Pinto D, Yu SH, Gilbert AL, Dunlop DD, et al. Atopic dermatitis is associated with less physical activity in US adults. J Invest Dermatol 2016; 136(8): 1714-1716. https://doi.org/10.1016/j.jid.2016.04.025
  43. Kim J. Low-intensity tower climbing resistance exercise reduces experimentally induced atopic dermatitis in mice. J Exerc Rehabil 2019; 15(4): 518-525. https://doi.org/10.12965/jer.1938276.138
  44. Son WK, Yoon W, Kim S, Byeon JH, Lee JS, Kim D, et al. Can moderate-intensity aerobic exercise ameliorate atopic dermatitis? Exp Dermatol 2020; 29(8): 699-702. https://doi.org/10.1111/exd.14138
  45. Kong S, Koo J, Lim SK. Associations between stress and physical activity in Korean adolescents with atopic dermatitis based on the 2018-2019 Korea Youth Risk Behavior Web-Based Survey. Int J Environ Res Public Health 2020; 17(21): 8175. https://doi.org/10.3390/ijerph17218175
  46. Choi M, Kim M, Kim S. Factors affecting the improvement of adult atopic dermatitis in their 20s and 30s: The Seventh Korean National Health and Nutrition Examination Survey, 2016-2018. Korean J Fam Pract 2020; 10(6): 431-435. https://doi.org/10.21215/kjfp.2020.10.6.431
  47. Kelsay K, Klinnert M, Bender B. Addressing psychosocial aspects of atopic dermatitis. Immunol Allergy Clin North Am 2010; 30(3): 385-396. https://doi.org/10.1016/j.iac.2010.05.003
  48. Yun YH, Choi IH. Quality of life and economic impact of adult atopic dermatitis patients in Seoul. J Korean Med Ophthalmol Otolaryngol Dermatol 2010; 23(1): 199-214.
  49. Son JH, Chung BY, Kim HO, Park CW. Clinical features of atopic dermatitis in adults are different according to onset. J Korean Med Sci 2017; 32(8): 1360-1366. https://doi.org/10.3346/jkms.2017.32.8.1360