• Korean Journal of Community Nutrition
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• v.29 no.3
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• pp.189-198
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• 2024

Objectives: The sodium index is an index that converts the estimated sodium intake calculated using a verified and reliable sodium estimation formula. This study aimed to determine the relationship between the sodium index and obesity indicators and the potential impact of excessive sodium consumption on obesity. Methods: Obesity indicators, such as body mass index (BMI), body fat percentage, waist-to-hip ratio (WHR), and visceral fat levels, were analyzed in 120 university students (60 men and 60 women). The sodium index was calculated by indexing the estimated sodium intake according to age, sex, BMI, salt-eating habits, and salt-eating behaviors. The relationship between sodium index and obesity indicators was analyzed using multiple logistic regression. Results: The estimated sodium intake was 3,907.1 mg, with 76.7% of the participants categorized under the "careful" level of sodium index and 10.8% under the "moderate" level. As the sodium index increased, the BMI, body fat percentage, WHR, and visceral fat levels significantly increased. All obesity indicators significantly increased in patients with a "severe" sodium index than in those with a "moderate" sodium index. In addition, a strong positive correlation was identified between obesity indicators and sodium index. When the "severe" sodium index was compared with the "moderate" sodium index, the risk of obesity based on body fat percentage increased by 2.181 times (95% confidence interval [CI], 1.526-3.118), while the risk of obesity based on visceral fat level increased by 4.073 times (95% CI, 2.097-7.911). Conclusions: Our findings suggest a correlation between excessive sodium intake and obesity. Moreover, the sodium index can be used to determine sodium intake.

• Journal of the East Asian Society of Dietary Life
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• v.25 no.6
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• pp.963-969
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• 2015

High sodium intake in many countries has become the leading cause of chronic diseases. This situation requires correct dietary behavior to ensure proper sodium intake in the younger population. The purpose of the present study was to assess eating behavior regarding sodium intake and identify its correlation with common dietary attitudes in children. This cross-sectional study was conducted by surveying 588 elementary school children in Korea. Sodium-related dietary behavior and common eating attitudes were examined through questionnaires, and analyses were conducted by comparing the results between boys and girls. The most undesirable sodium-related dietary behavior in subjects was they 'eat kimchi with every meal' followed by the 'tendency to eat hot and spicy food'. Girls had better dietary behavior regarding sodium intake than boys (P<0.05). However, the common eating attitude between boys and girls was not significantly different. For all subjects, sodium-related dietary behavior and eating attitude showed a significant positive correlation (P=0.0032). The present study shows that a common eating attitude is better when the sodium-related dietary behavior is more desirable in children.

• Korean Journal of Community Nutrition
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• v.23 no.1
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• pp.38-47
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• 2018

Purpose: The aim of this study was to analyze the association between sodium excretion and obesity for healthy adults in the Gwangju area. Methods: The participants included 80 healthy adults aged 19 to 69 years in Gwangju. The dietary intake and sodium excretion were obtained using the 24-hour recall method and 24 hour urine collection. The participants were classified into two groups according to the amount of urinary sodium excretion: (${\leq}141.75mmol/dL$, > 141.75 mmol/dL). Results: After adjusting for sex, age, smoking history, and income, the high excretion of sodium group was significantly higher for weight, body mass index, body fat mass, percent body fat, visceral fat area (VFA), waist circumference, hip circumference, and WHR. The energy and nutrients intake were significant after adjusting for sex, age, smoking history, and income. The LSE group had a significantly higher fat intake and Na/K intake ratio. The HSE group had significantly higher fiber intake, and K intake. As the amount of urinary sodium excretion increased, the risk of obesity before correction was 3.57 (95% CI: 1.13-11.25) times greater, and the risk of obesity of T3 increased significantly by 3.33 times (95% CI: 1.05-10.59). After correcting for sex and age, the obesity risk of T2 increased significantly by 4.23 times (95% CI: 1.11-16.06), and after correcting for sex, age, smoking history, and income, the obesity risk of T2 increased significantly by 6.81 times (95% CI: 1.44-32.19) the risk of obesity. Conclusions: An association exists between sodium excretion and obesity in Korean adults. In this study, the high excretion of sodium group was obese and the risk of obesity was higher than the low excretion of sodium group.

• Nutrition Research and Practice
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• v.14 no.5
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• pp.540-552
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• 2020

BACKGROUND/OBJECTIVES: Hypertension is the major risk factor for cardiovascular disease, a leading cause of deaths in Korea. The objective of this study was to evaluate the effect of a nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults. SUBJECTS/METHODS: Subjects who participated in this study were 88 adults (28 males and 60 females) who were pre-hypertension or untreated hypertensive patients aged ≥ 30 yrs in Gyeonggi Province, Korea. These subjects were divided into 2 groups: a lowsodium education (LS) group and a low-sodium high-potassium education (LSHP) group. Nutrition education of 3 sessions for 12 weeks was conducted. Blood pressure, blood and urine components, nutrient intake, and dietary behavior were compared between the two education groups. RESULT: Blood pressure was decreased in both groups after the nutrition education (P < 0.05). In the LSHP group, levels of blood glucose (P < 0.05), total cholesterol (P < 0.01), and lowdensity lipoprotein-cholesterol (P < 0.05) were decreased after the program completion. Sodium intake was decreased in both groups after the nutrition education (P < 0.05). However, Na/K ratio was only decreased in the LS group (P < 0.05). Intake frequency of fish & shellfish was only significantly reduced in the LS group (P < 0.05), while intake frequencies of cooked rice, noodles & dumplings, breads & snacks, stew, kimchi, and fish & shellfish were reduced in the LSHP group (P < 0.05). Total score of dietary behavior appeared to be effectively decreased in both groups after the education program (P < 0.001). CONCLUSIONS: This education for reducing sodium intake was effective in reducing blood pressure and sodium intake. The education for enhancing potassium intake resulted in positive changes in blood glucose and serum cholesterol levels.

• The Korean Journal of Food And Nutrition
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• v.31 no.6
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• pp.897-910
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• 2018

The purpose of this study was to examine sodium intakes from soup, stew and noodle in school lunch using sodium content database separately developed for the solid part, liquid part of soup and stew (liquid based dishes) in middle school students. Two hundred fifty two middle school students in Seoul were asked about awareness towards reducing sodium intake and soup/stew intake provided in school lunch in September 2015. Only 68% of students were aware of the 'Day without soup/stew' event and why those events were held. Girls tend to consume more all solid and liquid parts of soups than boys in Miso soup (50.0% vs 36.2%), Bean sprout soup (56.6% vs 44.8%), Seaweed soup (61.8% vs 45.7%), Beef Radish soup (61.8% vs 59.5%), and Korean pasta soup with Kimchi (58.1% vs 46.6%). Average sodium intake from soup/stew/noodle dishes in school lunch was $379.6{\pm}183.9mg$ if behaviors of eating solid or liquid parts were considered and $556.8{\pm}190.6mg$ if behaviors of eating solid or liquid parts were not considered. Based on the results, the difference of sodium intake depends on the consuming behaviors of liquid parts of soup and stew dishes. It is necessary to establish and use a sodium database for each solid part and liquid part separately in soup, stew and noodle dishes to assess more accurate sodium intake. Education on the reduction of sodium intake through proper behaviors is salient in the achievement of a healthy diet.

• Korean Journal of Community Nutrition
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• v.27 no.1
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• pp.27-35
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• 2022

Objectives: The purposes of this study were to compare the degree of sodium reduction practice and estimate sodium intake by salty food preference. Methods: Sodium reduction practices, salty food preferences and estimated sodium intake were surveyed for restaurant owners (n = 80), employees (n = 82) and customers (n = 727) at the restaurants participating in the sodium reduction project in Daegu, Korea. Estimated sodium intake was performed by examining sex, age, body mass index (BMI), salty eating habit and dietary behaviors. Results: The degree of sodium reduction practice was significantly higher in salinity meter use (P < 0.001), low salt seasonings (P < 0.001) and efforts to make the foods as bland as possible overall (P < 0.001) in the restaurants participating in sodium reduction project than in homes (P < 0.001). The degree of sodium reduction practice appeared lower in the high salty food preference group than in the low-preference group in such items as efforts to make the foods as bland as possible overall (P < 0.05) and washing the salty taste and then cooking (P < 0.05). The high-preference group showed high-salt dietary behavior, including eating all the soup until nothing was left (P < 0.05) more than the low-preference group, but low-salt dietary behavior included checking the sodium content in processed foods (P < 0 .0 5) less than the low-preference group. The high-preference group was higher in the soup and stew intake frequency than the low-preference group (P < 0.05) and much lower in nuts (P < 0.05) and fruits (P < 0.05) intake frequency. The high-preference group had a higher salty eating habit (P < 0.05), salty taste assessment (P < 0.05) and estimated sodium intake (P < 0.05) than the low-preference group. Conclusions: The present study showed that the salty food preference was strongly associated with lower sodium reduction practice and higher estimated sodium intake.

• Korean Journal of Community Nutrition
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• v.13 no.1
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• pp.1-12
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• 2008

This study was performed to understand recognition and behaviors related to sodium intake of Korean adults. The data were collected from subjects including 267 male and 285 female adults in nationwide and compared by gender and by age. We found that the male group showed significantly higher smoking, alcohol drinking, and exercise does the female group. The older group (40 to 59 years) revealed significantly higher exercise and lower alcohol drinking; however general disease and hypertension prevalence, diet therapy practice, and meditation for hypertension were higher. Recognizing sodium levels of foods containing high-sodium, and sodium-nutriture labels when purchasing foods, and knowing differences between salt and sodium of the male group or recognizing sodium levels of foods containing high-sodium of the older group was worse than the other. Among the 32 food behaviors, only 12 were identified as significantly correlated to sodium intake levels including behaviors of preferring Chinese and Japanese foods to Western foods, preferring kimchi to raw vegetables, completely consuming soup, stew, noodle liquid, liking of dried fish and salted mackerel, frequent eat-outs or delivered foods, and so forth. There were significant differences between gender or age groups in terms of sodium intake-increasing behaviors; the male group showed higher behaviors of preferring salty taste and eating all broths. And the older group revealed higher behavior of adding table salt as well as the previous two, however, the younger group showed more behaviors of eat-outs or delivered foods and not the liquid of kimchi.

• Korean Journal of Community Nutrition
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• v.17 no.6
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• pp.737-751
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• 2012

The purpose of this study was to assess sodium and potassium intakes and urinary excretion of adults in Busan and to evaluate the relationship of urinary sodium/potassium excretion (UNa/UK) to the status of anthropometric, blood pressure, urine analysis, and nutrient intake of subjects. Nutrient intake by 24-h recall, 24-h UNa/UK were measured with 87 adults aged 20-59 yrs (42 men and 45 women). The mean intakes of sodium and potassium were 3915.4 mg and 3093.9 mg, respectively. The mean 24-h UNa/UK was 3457.0/1680.4 mg. UNa showed significant positive correlations with sodium intake (p < 0.001, p < 0.001), sodium/potassium ratio (p < 0.001, p < 0.01), UK (p < 0.001, p < 0.001), and UNa/UK ratio (p < 0.05, p < 0.01) in men and women and with age, BMI, systolic blood pressure (SBP) and diastolic blood pressure in women (p < 0.05, p < 0.05, p < 0.05, p < 0.05). The UK showed significant positive correlations sodium intake (p < 0.001, p < 0.001), UNa (p < 0.001, p < 0.001) in men and women and with sodium density in men (p < 0.001) and with age, intakes of protein and potassium in women (p < 0.01, p < 0.05, p < 0.05). Mean SBP was lowest in the second quartile and highest in the fourth quartile of UNa. Mean UNa in the second, third, and fourth quartiles were 2821.1 mg, 3621.3 mg, and 5456.4 mg, respectively. Mean SBP in the second, third, and fourth quartiles were 115.8 mmHg, 120.7 mmHg, and 125.9 mmHg, respectively. Based on the results, UNa was related to sodium intake, UK, and SBP. We conclude that nutritional education for the reduction of high sodium intake is needed in the general population to prevent and control adverse blood pressure levels.

• Korean Journal of Community Nutrition
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• v.10 no.5
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• pp.677-692
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• 2005

The assessment of sodium intake is complex because of the variety and nature of dietary sodium. This study intended to develop a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and a short DFQ for screening subjects with high or low sodium intake. For DFQ112, one hundred and twelve dish items were selected based on the information of sodium content of the one serving size and consumption frequency. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. One hundred seventy one adults (male: 78, female: 93) who visited hypertension or health examination clinic participated in the validation study. DFQ55 was developed from DFQ112 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. To develop a short DFQs for classifying subjects with low or high sodium intakes, the weighed score according to the sodium content of one protion size was given to each dish item of DFQ25 or DFQ14 and multiplied with the consumption frequency score. A sum index of all the dish items was formed and called sodium index (Na index). For validation study the DFQ112, 2-day diet record and one 24-hour urine collection were analyzed to estimate sodium intakes. The sodium intakes estimated with DFQ112 and 24-h urine analysis showed $65\%$ agreement to be classified into the same quartile and showed significant correlation (r=0.563 p<0.05). However, the actual amount of sodium intake estimated with DFQ112 (male: 6221.9mg, female: 6127.6mg) showed substantial difference with that of 24-h urine analysis (male: 4556.9mg, female: 5107.4mg). The sodium intake estimated with DFQ55 (male: 4848.5mg, female: 4884.3mg) showed small difference from that estimated with 24-h urine analysis, higher proportion to be classfied into the same quartile and higher correlation with the sodium intakes estimated with 24-h urine analysis and systolic blood pressure. It seems DFQ55 can be used as a tool for quantitative estimation of sodium intake. Na index25 or Na index14 showed $39\~50\%$ agreement to be classified into the same quartile, substantial correlations with the sodium intake estimated with DFQ55 and significant correlations with the sodium intake estimated with 24-h urine analysis. When point 119 for Na index25 was used as a criterion of low sodium intake, sensitivity, specificity and positive predictive value was $62.5\%,\;81.8\%\;and\;53.2\%$, respectively. When point 102 for Na index14 was used as a criterion of high sodium intake, sensitivity, specificity and positive predictive value were $73.8\%,\;84.0\%,\;62.0\%$, respectively. It seems the short DFQs using Na index 14 or Na index25 are simple, easy and proper instruments to classify the low or high sodium intake group.

• Nutrition Research and Practice
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• v.9 no.6
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• pp.644-649
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• 2015

BACKGROUND/OBJECTIVES: Targeting consumers who consume lunches at their worksite cafeterias would be a valuable approach to reduce sodium intake in South Korea. To assess the relationships between socio-demographic factors, consumer satisfaction, attitudes, barriers and the frequency of sodium-reduced meal intake. SUBJECTS/METHODS: We implemented a cross-sectional research, analyzing data from 738 consumers aged 18 years or older (327 males and 411 females) at 17 worksite cafeterias in South Korea. We used the ordinary least squares regression analysis to determine the factors related to overall satisfaction with sodium-reduced meal. General linear models with LSD tests were employed to examine the variables that differed by the frequency of sodium-reduced meal intake. RESULTS: Most subjects always or usually consumed the sodium-reduced meal (49%), followed by sometimes (34%) and rarely or never (18%). Diverse menus, taste and belief in the helpfulness of the sodium-reduced meal significantly increased overall satisfaction with the sodium-reduced diet (P < 0.05). We found importance of needs in the following order: 1) 'menu diversity' (4.01 points), 2) 'active promotion' (3.97 points), 3) 'display of nutrition labels in a visible location' (3.96 points), 4) 'improvement of taste' (3.88 points), and 5) 'education of sodium-reduction self-care behaviors' (3.82 points). CONCLUSION: Dietitians could lead consumers to choose sodium-reduced meals by improving their taste and providing diverse menus for the sodium-reduced meals at worksite cafeterias.