• Nutrition Research and Practice
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• v.16 no.sup1
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• pp.70-88
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• 2022

Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake-response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong. However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.

• Korean Journal of Community Nutrition
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• v.21 no.6
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• pp.558-573
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• 2016

Objectives: The purpose of this study was to evaluate the main sources of dietary sodium and potassium intake in Koreans by gender, age and regions. Methods: We used the data from 2010-2012 KNHANES. A total of 20,387 subjects aged 8 years and older were included. Intakes were compared by gender, age (8-18, 19-49 and >50 years) and geographical regions in Korea. Dishes were classified into 28 dish groups based on cooking methods. Statistical analysis was performed by using the SAS 9.3 and SUDAAN 11.0.1 software. Results: The mean sodium intake of Koreans was $4866.5{\pm}35.9mg/day$, which was 2.4 times higher than the adequate intake (AI) of sodium for Koreans. We found that daily sodium intakes were significantly different by age, gender and regions. Men and aged over 50 years had significantly higher sodium intake than women and other age groups. The mean potassium intake in Koreans was $3002.2{\pm}19.4mg/day$ and daily potassium intakes were significantly different by age, gender and regions. Women and age 50 years and over had significantly higher potassium intakes than men and other age groups. The average Na/K ratio was $2.89{\pm}0.01$ and was highest in men and in the age group of 19-49 years. The major sources of dietary sodium were soup and stew, followed by Kimchi, noodles and dumpling, pickled vegetables and seasonings, which represented 63.1 % of total sodium intakes. Soup and stew or Kimchi were the primary sources of dietary sodium intake. The major sources of dietary potassium were cooked rice, followed by soup and stew, Kimchi, fruits and beverages. Conclusions: Sodium and potassium intakes and the major sources of those were significantly different by gender, age groups and regions. Therefore, different approaches based on gender, age and regions are needed to decrease sodium intake and increase potassium intake.

• Journal of Nutrition and Health
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• v.57 no.1
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• pp.65-74
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• 2024

Purpose: Sodium is essentially required for homeostasis and physiological functions, but excessive sodium consumption increases the risk of obesity and other chronic disorders. Korean studies on the sodium-obesity relationship are limited, and thus, this study was undertaken to determine the nature of the relationship between sodium intake and obesity in Korean adults. Methods: Forty-two participants were divided into 2 groups according to body mass index (BMI, non-obese BMI < 25 kg/m², obese BMI ≥ 25 kg/m²). Dietary intakes and eating habits were analyzed using 3-day food records and a food frequency questionnaire. Anthropometric data were obtained from bioimpedance results, and fasting glucose and lipid levels were measured. Results: Mean weight, BMI, waist and hip circumferences, and body fat mass were greater in the obese group than in the non-obese group for men and women. Skeletal muscle mass and body fat mass were higher in obese women than in non-obese women. Biochemical data were no different in these two subgroups except triglycerides (TGs), which were higher in obese women. Nutrient intakes were not significantly different in obese and non-obese groups. However, obese men consumed excessive sodium, while obese women consumed slightly more than non-obese women. Obese men preferred salty foods and tended to overeat. Positive correlations were found between sodium intake and weight in men and percent body fat mass (PBFM) in women. Correlation analysis (adjusted for energy intake) of the relation between sodium intake and obesity-related factors showed sodium intake was positively correlated with PBFM and TG in women. Conclusion: This anthropometric and biochemical data analysis emphasizes the need for awareness and interventions to mitigate the health risks of elevated sodium consumption. Our findings should aid future studies on the relationship between sodium and obesity and contribute to preventing and managing this metabolic condition.

• The Korean Journal of Food And Nutrition
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• v.29 no.1
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• pp.104-114
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• 2016

In this study, we investigated protection motivation and behavioral intention to prevent serious illnesses related to excessive sodium intake among the university students in Gyeongnam and Busan. Within the protection motivation theory (PMT) framework, a survey questionnaire was developed to measure participants' perceptions on the severity of and the vulnerability to the threat of serious diseases due to the high sodium intake as well as the effectiveness of preventive measures (response efficacy), and the ability to perform them (self-efficacy) along with their willingness to follow recommendations (behavioral intention). Data was collected in June 2015. Study participants were divided into either low (n=117) or high (n=177) sodium intake behavior groups based on their current behaviors. Exploratory factor analysis was performed to measure construct validity and Cronbach's alpha was calculated to check reliability of measurement items. The high sodium intake behavior group perceived higher vulnerability than the low sodium intake behavior group among four PMT factors. Differences of the other three factors were not significant between the two groups. The results of hierarchical regression analysis indicated that self-efficacy and response efficacy affected behavioral intention of high sodium intake behavior among students. Hence, development of strategies to increase self-efficacy and response efficacy are strongly recommended.

• Journal of the Korean Society of Food Culture
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• v.33 no.5
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• pp.426-436
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• 2018

This study assessed effective strategies to reduce the sodium intake among consumers using pork cutlet sauce as a model food system. Original pork cutlet sauce and sodium-reduced sauce (29% reduced by a salt substitute) were analyzed to characterize the sensory properties using descriptive analysis. The effects of sodium-reduction of the sauce, consumer type (nutrition teachers vs. general consumers), information related to the sodium content, serving method, and consumer's health, taste and sodium-related attitudes on the consumer's preference, perception, and intake of the sauce were analyzed using a consumer test. In descriptive analysis, the original and sodium-reduced sauce showed similar sensory characteristics but did not differ in saltiness. In the consumer test, there were no significant differences in the overall preference levels between the two sauces. On the other hand, there were significant differences in preference and perception between nutrition teachers and general consumer groups, which were due largely to their age as well as the health and sodium-related attitudes and nutritional knowledge differences. Sodium-reduced information decreased the perceived saltiness intensity. In addition, reducing sodium intake by serving pork cutlet sauce in a bottle can be an effective strategy because this serving method increased the acceptance and induced the smaller intake of sauce.

• The Korean Journal of Food And Nutrition
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• v.30 no.1
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• pp.166-174
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• 2017

The purpose of this study was to compare dietary self-efficacy for sodium intake reduction and dietary behaviors by eating areas. Subjects (797 males and 767 females) were classified according to perceived dietary habit levels related to sodium intake (lowest: ${\leq}10$ (n=434), low: $11{\sim}{\leq}13$ (n=471), high: $14{\sim}{\leq}15$ (n=360), highest: $16{\leq}$ (n=299)) using an online survey with a sample that was geographically representative of the population. The highest group was significantly younger and had a higher student proportion than the lowest group. Dining contexts regarding home led to a significantly higher sodium intake in the highest group, but it was eating out for the lowest group. The highest group had a significantly lower intention to reduce sodium intake compared to the lowest group. In the home cooked meals, the highest group displayed a significantly lower cooking frequency, less effort with respect to a low sodium diet and cooking habits related to sodium intake as compared to the lowest group. Also, regarding eating out and food service, the highest group exhibited significantly lower efforts and dietary behaviors to reduce sodium intake than the lowest group. The dietary score for sodium reduction behavior in the highest group was significantly lower compared to the lowest group, for home cooked meals, eating out, as well as food service. Thus, dietary guidelines and nutrition education for the reduction of sodium intake by eating areas need to be developed and provided.

• Journal of Nutrition and Health
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• v.43 no.2
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• pp.132-140
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• 2010

High sodium intake is one of the risk factors for the development of hypertension. According to 2007 Korean National Health and Nutrition Examination Survey, sodium intake of Korean was three times higher than adequate intake (1.5 g/day) recommended by Korean Dietary Reference Intakes. High sodium intake is related to high threshold and preference of salty taste. And zinc status is known to affect taste acuity. The hypothesis of this study is that zinc status is associated with salty taste acuity, preference, sodium intake and blood pressure. The subjects included in this study were 50 men and 41 women aged 20-29 y who did not smoke and not take supplements or medications regularly. Dietary intake data for 3 days were collected by 24-h recall for 1 day and dietary record for 2-days. Salty taste acuity and preference were determined by sensory test. Fasting serum concentration of zinc, height, weight, body composition and blood pressure data were collected. Salt taste preference in high zinc intake group ($\geq$ estimated average requirement, EAR; men-8.1 mg/day, women-7 mg/day) was higher than that in low zinc intake group (< EAR). Salty taste preference was inversely correlated with serum zinc concentration in people with low concentration of serum zinc (${\leqq}\;81\;{\mu}g/dL$)(r = -0.3520, p < 0.05). Diastolic blood pressure was higher in high sodium intake group than in low sodium intake group (p < 0.05), positively correlated with salty taste preference (r = 0.3866, p < 0.05) in subjects with daily zinc intake below the EAR. We conclude that low zinc status may be related to high salty taste preference and high blood pressure in Korean young adults.

• Journal of Nutrition and Health
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• v.49 no.2
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• pp.88-98
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• 2016

Purpose: We recruited 118 women in their early 20's to examine the relationship between sodium intake and salty taste thresholds and preference. We also examined the association of salty taste preference with sodium-related dietary behaviors and major dishes contributing to sodium intake. Methods: Daily sodium intake was estimated using a 127-item dish-frequency questionnaire. Salty taste thresholds and preference were measured using rating scales using water solution of NaCl and a self-administered questionnaire based on a Likert scale, respectively. Results: Salty taste preference showed positive correlation with daily sodium intake and sodium intake-increasing behaviors, and inverse association with sodium intake-decreasing behaviors, including salt and soy sauce use at the table, the frequency of eating out and home delivery of foods, broth consumption of soup, stew or noodle soup, the use of ready-to-serve or processed foods, fresh vegetable intake, and the accommodating attitude toward bland food. Intake of sodium-contributing dishes, including ramen, spicy soft-tofu stew, radish kimchi, and dishes containing kimchi, also showed positive association with salty taste preference. Unexpectedly, detection and recognition thresholds of salty taste showed no association with salty taste preference, sodium intake, and sodium-related dietary behaviors. Conclusion: These findings suggest that salty taste preference could reflect sodium intake of individuals rather than thresholds of saltiness, and may be used as a simple and effective proxy for usual sodium intake.

• The Korean Journal of Community Living Science
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• v.26 no.1
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• pp.167-176
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• 2015

This study compares salt-related dietary patterns according to sodium intake. A survey was conducted with 257 college students(130 male and 127 female students) in the Busan area. Dish Frequency Questionnaire 70(DFQ 70) was used to quantitatively estimate sodium intake. A short dish frequency questionnaire(DFQ 15) was used to screen subjects with high or low- salt intake. The sodium intake of male students based on DFQ 70 was significantly higher than that of female students(p<0.05). Sodium intake has significant negative effects on systolic and diastolic blood pressure(p<0.05). In the high-salt intake(HS) group, classified by DFQ 15, the number of male students was significantly higher than that of female students(p<0.01). The systolic blood pressure of the HS group was significantly higher than that of the low-salt intake(LS) group(p<0.05). Salt-related dietary behavior score and eating habit score for the HS group were significantly higher than those for the LS group(p<0.01). The sodium intake of the HS group based on DFQ 70 was significantly higher than that of the LS group(p<0.01). In these results, college students in Busan area showed high blood pressure and high sodium intake compared to Korean DRIs. The results indicate a need for various education programs to help college students practice a low-sodium diet.

• Journal of Nutrition and Health
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• v.46 no.1
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• pp.26-33
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• 2013

The purpose of this study was to investigate the sodium intake of office workers using 24-hour urine analysis and to analyze the correlation matrix between variables. The sodium intake of the subjects (n = 137), based on a 24-hr sodium excretion period, was male (n = 56) 6072.4 mg and female (n = 81) 5,168.2 mg. Urinary sodium excretion showed significant positive correlation with BMI, frequency of eating out, expenditure of eating out, salty taste assessment and high-salt dietary behavior. Analysis of urinary sodium excretion showed significant positive correlation with intake frequencies of cabbage kimchi, broiled fish, feast noodle and rice with leaf wraps. Based on the results of multiple regression, urinary sodium excretion was found to be related to intake frequencies of cabbage kimchi, broiled fish, rice with leaf wraps and high score of high-salt dietary behavior.