Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
권호 표지
DOI QR코드

DOI QR Code

2020 Dietary Reference Intakes of water for Koreans: establishment and future tasks

2020 한국인 수분 섭취기준 설정과 앞으로의 과제

  • Lee, Jae Hyun (Major of Exercise Rehabilitation, Woosong College) ;
  • Kim, Sun Hyo (Department of Technology and Home Economics Education, Kongju National University)
  • 이재현 (우송정보대학 운동재활전공) ;
  • 김선효 (공주대학교 기술가정교육과)
  • Received : 2022.04.24
  • Accepted : 2022.06.29
  • Published : 2022.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Water accounts for the largest proportion of body weight and is an essential element for the physiological functioning of the human body. According to 2013-2017 Korea National Health and Nutrition Examination Survey (KNHANES) data, the average water intake of Koreans was 2,167.3 mL/day and 62% of them did not meet the Dietary Reference Intakes for Koreans (KDRIs) for water. However, the consumption of beverages is continuously increasing. KDRIs sets the adequate intake (AI) for water, but tolerable upper intake level (UL) and chronic disease risk reduction intake (CDRR) are not provided. Compared to 2015, the AI of total water from both food and fluids in the 2020 KDRIs slightly increased or decreased according to age. The AI for children 1-2 years old, boys 6-8 years and 9-11 years old, and girls 6-8 years old decreased by 100 mL/day, while that of boys 12-14 years old increased by 100 mL/day. The AI of total water was the sum of the water intake from food and fluids reported by the KNHANES, with an extra milk intake of 200 mL/day. Therefore, it is not appropriate to use the AI of total water intakes for the reference of beverage intakes. It is preferable to consume water or milk rather than beverages containing sugar and others including caffeine, sodium, etc. when drinking fluid water. We suggest the following improvements in the future KDRIs for water: improving the adequacy of the water content ratio of Korean conventional foods, supplementing the fluid water intake survey, reflecting the current water intake status by life cycle, setting KDRIs for water for the elderly considering the physiological changes, health status and dietary habits, and promotion of research on the relationship between water intake and health for Koreans.

수분은 인체에서 가장 많은 비율을 차지하는 성분으로 인체의 원활한 생리작용을 위해 필수적인 요소이다. 2013-2017 국민건강영양조사 자료를 근거로 하였을 때 우리나라 사람들의 평균 1일 수분 섭취량은 2,167.3 mL/day이며 그 중 62%가 섭취기준을 충족하지 못하고 있다. 반면 음료 섭취는 계속해서 증가하고 있는 추세다. 수분 섭취기준은 충분섭취량으로 제시되며, 상한섭취량과 만성질환위험감소섭취량은 제시하지 않고 있다. 2015년과 비교해 2020년 수분 충분섭취량은 연령에 따라 소폭 증가하거나 감소되었는데 유아기 1-2세, 남자 6-8세, 9-11세, 여아 6-8세는 100 mL/day씩 감소하였으며, 남자 12-14세는 100 mL/day 증가하였다. 수분 섭취기준으로 제시되는 수분 충분섭취량은 음식 수분 섭취량과 액체 수분 섭취량을 합한 값이며, 액체 수분 섭취량은 물 섭취량 중앙값, 음료 섭취량 중앙값, 우유 섭취량 200 mL/day을 합해서 산출한 수치이다. 이와 같이 수분 섭취기준에는 음식 수분 섭취량도 포함되어 있으므로, 물과 음료의 섭취기준으로 총수분 섭취기준을 적용하는 것은 적절하지 않으며 액체 섭취기준을 적용해야 한다. 그리고 액체 수분을 섭취할 때에는 당류, 카페인 등이 함유된 음료보다 물이나 우유를 섭취하는 것이 바람직하다. 한국인 수분 섭취기준 설정에 있어서 향후 개선하고 보완해야 할 사항으로 한국인 일상식에서 수분 함량비의 정확성 제고, 액체 수분 섭취량에 관한 조사방법 보완, 생애주기별 수분 섭취 실태에 대한 다각적인 검토, 노인기의 생리적 변화와 건강상태 반영, 한국인 대상 수분 섭취와 건강에 관한 연구 활성화와 반영 등을 제안한다.

Keywords

Acknowledgement

This research was supported by the Policy Research Program for Project No. 20180415A13-00, 25193068200, 25203084501 from the Ministry of Health and Welfare in 2018-2020.

References

  1. Jequier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J Clin Nutr 2010; 64(2): 115-123. https://doi.org/10.1038/ejcn.2009.111
  2. Guyton AC, Hall JE. Textbook of medical physiology. Philadelphia (PA): W. B. Saunders Company; 2000.
  3. Popkin BM, D'Anci KE, Rosenberg IH. Water, hydration, and health. Nutr Rev 2010; 68(8): 439-458. https://doi.org/10.1111/j.1753-4887.2010.00304.x
  4. Daniels MC, Popkin BM. Impact of water intake on energy intake and weight status: a systematic review. Nutr Rev 2010; 68(9): 505-521. https://doi.org/10.1111/j.1753-4887.2010.00311.x
  5. Read W, Hoyt AH. Environmental influences on body fluid balance during exercise: altitude. In: Buskrik ER, Puhl SM, editors. Body Fluid Balance: Exercise and Sport. Boca Raton (FL): CRC Press; 1996. p.183-196.
  6. Ministry of Health and Welfare; The Korean Nutrition Society. Dietary Reference Intakes for Koreans 2015. Sejong: Ministry of Health and Welfare; 2016.
  7. Korea Disease Control and Prevention Agency. 2020 National Health Statistics. Cheongju: Korea Disease Control and Prevention Agency; 2022.
  8. Institute of Medicine. Dietary Reference Intakes for water, potassium, sodium, chloride, and sulfate. Washington, D.C.: The National Academies Press; 2005.
  9. Park YS. Effects of dietary factors on urinary sodium excretion and establishing simplified method to estimate salt intake [dissertation]. Seoul: Seoul National University; 1988.
  10. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Report presentation of the Korea National Health and Nutrition Examination Survey (KNHANES) VI, VII; 2013-2017. Sejong: Ministry of Health and Welfare; 2018.
  11. Choi EJ. Breastfeeding-related social environmental factors and their policy implications. Korea Inst Health Soc Affairs 2017; 249: 72-81.
  12. McArdle WD, Katch FI, Katch VL. Essentials of exercise physiology. Philadelphia (PA): Lippincott, Williams & Wilkins; 2010.
  13. Hillyer M, Menon K, Singh R. The effects of dehydration on skill-based performance. Int J Sports Sci 2015; 5(3): 99-107.
  14. Lee J, Kim SH. Establishment of reference intake of water for Korean adults in 2015. J Nutr Health 2017; 50(2): 121-132. https://doi.org/10.4163/jnh.2017.50.2.121
  15. Clark WF, Sontrop JM, Macnab JJ, Suri RS, Moist L, Salvadori M, et al. Urine volume and change in estimated GFR in a community-based cohort study. Clin J Am Soc Nephrol 2011; 6(11): 2634-2641. https://doi.org/10.2215/CJN.01990211
  16. Strippoli GF, Craig JC, Rochtchina E, Flood VM, Wang JJ, Mitchell P. Fluid and nutrient intake and risk of chronic kidney disease. Nephrology (Carlton) 2011; 16(3): 326-334. https://doi.org/10.1111/j.1440-1797.2010.01415.x
  17. Sontrop JM, Dixon SN, Garg AX, Buendia-Jimenez I, Dohein O, Huang SH, et al. Association between water intake, chronic kidney disease, and cardiovascular disease: a cross-sectional analysis of NHANES data. Am J Nephrol 2013; 37(5): 434-442. https://doi.org/10.1159/000350377
  18. Altieri A, La Vecchia C, Negri E. Fluid intake and risk of bladder and other cancers. Eur J Clin Nutr 2003; 57 Suppl 2: S59-S68. https://doi.org/10.1038/sj.ejcn.1601903
  19. Manz F, Wentz A. The importance of good hydration for the prevention of chronic diseases. Nutr Rev 2005; 63(6 Pt 2): S2-S5. https://doi.org/10.1111/j.1753-4887.2005.tb00150.x
  20. Pan A, Malik VS, Schulze MB, Manson JE, Willett WC, Hu FB. Plain-water intake and risk of type 2 diabetes in young and middle-aged women. Am J Clin Nutr 2012; 95(6): 1454-1460. https://doi.org/10.3945/ajcn.111.032698
  21. Roussel R, Fezeu L, Bouby N, Balkau B, Lantieri O, Alhenc-Gelas F, et al. Low water intake and risk for new-onset hyperglycemia. Diabetes Care 2011; 34(12): 2551-2554. https://doi.org/10.2337/dc11-0652
  22. Davy BM, Dennis EA, Dengo AL, Wilson KL, Davy KP. Water consumption reduces energy intake at a breakfast meal in obese older adults. J Am Diet Assoc 2008; 108(7): 1236-1239. https://doi.org/10.1016/j.jada.2008.04.013
  23. Dennis EA, Dengo AL, Comber DL, Flack KD, Savla J, Davy KP, et al. Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults. Obesity (Silver Spring) 2010; 18(2): 300-307. https://doi.org/10.1038/oby.2009.235
  24. Stookey JD, Constant F, Popkin BM, Gardner CD. Drinking water is associated with weight loss in overweight dieting women independent of diet and activity. Obesity (Silver Spring) 2008; 16(11): 2481-2488. https://doi.org/10.1038/oby.2008.409
  25. Kenney EL, Cradock AL, Long MW, Barrett JL, Giles CM, Ward ZJ, et al. Cost-effectiveness of water promotion strategies in schools for preventing childhood obesity and increasing water intake. Obesity (Silver Spring) 2019; 27(12): 2037-2045. https://doi.org/10.1002/oby.22615