• Nutrition Research and Practice
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• 제14권5호
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• pp.501-518
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• 2020

BACKGROUND/OBJECTIVES: Sodium intake is positively associated with blood pressure, which may increase the risk for cardiovascular disease (CVD). Therefore, we assessed the disease burden of CVD attributable to sodium intakes above 2,000 mg/day and prospectively investigated the association between dietary/urinary sodium levels and the risk of all-cause and CVD-mortality using the Korea National Health and Nutrition Examination Survey (KNHNES). SUBJECTS/METHODS: A total of 68,578 and 33,113 participants were included for comparative risk assessment (CRA) analysis and mortality analysis, respectively, and mean follow-up time for mortality was 5.4 years. CRA analysis was used to quantify attributable incidences of stroke, ischemic heart disease (IHD), and deaths attributable to sodium intake between 1998 and 2016. Cox proportional hazard regression model was used to determine the association between sodium intake and all-cause and CVD-mortality. RESULTS: Mean dietary sodium intake decreased over time, reaching 3,647 mg/day in 2016. Similarly, the population attributable fractions of stroke and IHD, and the number of CVD-associated deaths attributable to high sodium intake/excretion also decreased. In terms of association with mortality, when participants were grouped into quartiles (Q) by energy-adjusted sodium intake, those in Q2 had a lower risk of all-cause mortality than those in Q1 with lower intakes. The risk of CVD-associated mortality was higher only in females with high sodium intake in Q4 than those in Q1. CONCLUSIONS: This nationwide data indicates that, in line with previous studies of multiple cohorts, both low and high sodium intakes may be associated with an increased risk of mortality; therefore, the optimal sodium intake for Koreans needs to be revised.

• 대한지역사회영양학회지
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• 제10권5호
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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.

• 한국식품영양학회지
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• 제30권1호
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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.

• 동아시아식생활학회지
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• 제25권6호
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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.

• 한국산학기술학회논문지
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• 제19권7호
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• pp.453-462
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• 2018

본 연구는 부모의 나트륨 섭취량과 청소년 자녀의 나트륨 섭취량이 일치하는지에 대해 파악하고, 청소년 자녀의 나트륨 섭취량에 영향을 미치는 요인을 파악하고자 하며, 그 결과에 따라 가정에서의 나트륨 섭취량을 조절할 수 있는 방안을 제시하는 것에 목적이 있다. 2015년 국민건강영양조사 자료에서 연구대상자를 영양섭취량 중에서도 나트륨 섭취량이 측정된 만 7세에서 만 18세까지의 초등학생, 중학생, 고등학생을 추출하고, 결측값을 제외하여 최종분석대상자는 405명이었다. 그리고 청소년 ID에 아버지 ID와 어머니 ID로 데이터를 매칭하여 생성하였다. 연구결과 청소년은 여자 청소년보단 남자 청소년이 ${\beta}=-.187$, 청소년의 연령이 높을수록 ${\beta}=.192$, 외식빈도가 많을수록 ${\beta}=.153$, 나트륨 섭취량이 높아졌다. 그리고 아버지보다는 어머니의 연령이 높을수록 ${\beta}=.171$, 나트륨 섭취량이 높을수록 ${\beta}=.136$으로 청소년의 나트륨 섭취량이 높았다. 이 점은 우리나라는 어머니가 주로 식사준비를 하는 경우가 많기 때문이다. 그러나 한편으로는 맞벌이 부부의 증가로 부모가 자녀의 질적인 식사를 고려하지 못하게 되어 자녀의 식사를 외식에 의존하는 경우도 적지 않을 것으로 예측되어 그러한 관점에서의 실태조사가 추후 필요하다.

• Journal of Nutrition and Health
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• 제20권4호
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• pp.246-257
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• 1987

The present study was conducted to examine the effect of an increased level of dietary sodium on calcium excretion in 8 health young adult Korean women on a controlled diet. After adaptation period of 2 days, each subject received 2811.8$\pm$68.1 mgNa(day during the initial period of 5 days (low sodium period) and 6417.1$\pm$248.6mgNa(day during the following period of 5 days (high sodium period). Calcium intake was 593.7$\pm$15.7 mg Ca/day during the low sodium period of 596.1$\pm$25.1 Ca/day duing the high sodium period. When the low sodium period is compared with the high soidum period, the results were as following. 1) Mean urinary sodium excretion was significantly higher during the high sodium period (5760.1$\pm$156.5mg0 than during the low sodium period (2272.2$\pm$108.6mg)(P<0.001). Fecal sodium excretion of the high sodium period was also significantly higher than that of the low sodium period(P<0.001). Mean value of sodium balance during the high sodium period was higher than that of the low sodium period . However, the difference was not significant. 2) Mean urinary calcium excretion was significantly higher during the high sodium period than during the low sodium period ; mean value of the low sodium period was 124.7$\pm$11.3mg and that of the high sodium period was 202.6$\pm$17.2mg)P<0.001). Fecal calcium excretion was higher during the high sodium period (284.9$\pm$31.0mg) than during the low sodium period (253.9$\pm$15.3mg0, but there was no significance. Mean value of calcium balance during the high sodium period was significantly lower than that of the low sodium period(P<0.001). The above results show that high sodium intake increases calcium excretion as well as sodium excretion.

• Nutrition Research and Practice
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• 제10권3호
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• pp.288-293
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• 2016

BACKGROUND/OBJECTIVES: We compared changes in heart-femoral pulse wave velocity (hfPWV) in response to low sodium and high sodium diet between individuals with sodium sensitivity (SS) and resistance (SR) to evaluate the influence of sodium intake on arterial stiffness. SUBJECTS/METHODS: Thirty-one hypertensive and 70 normotensive individuals were given 7 days of low sodium dietary approach to stop hypertension (DASH) diet (LSD, 100 mmol NaCl/day) followed by 7 days of high sodium DASH diet (HSD, 300 mmol NaCl/day) during 2 weeks of hospitalization. The hfPWV was measured and compared after the LSD and HSD. RESULTS: The hfPWV was significantly elevated from LSD to HSD in individuals with SS (P = 0.001) independently of changes in mean arterial pressure (P = 0.037). Conversely, there was no significant elevation of hfPWV from LSD to HSD in individuals with SR. The percent change in hfPWV from the LSD to the HSD in individuals with SS was higher than that in individuals with SR. Subgroup analysis revealed that individuals with both SS and hypertension showed significant elevation of hfPWV from LSD to HSD upon adjusted analysis using changes of the means arterial pressure (P = 0.040). However, there was no significant elevation of hfPWV in individuals with SS and normotension. CONCLUSION: High sodium intake elevated hfPWV in hypertensive individuals with SS, suggesting that high sodium intake increases aortic stiffness, and may contribute to enhanced cardiovascular risk in hypertensive individuals with SS.

• 한국식품영양학회지
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• 제31권1호
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• pp.143-148
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• 2018

The objective of this study is to provide direction in the improvement of sodium labeling in an effort to reduce consumption. We surveyed confirmation and importance of food labeling and nutrition information and we also analyzed the willingness to pay on new nutrients labeling. Consumers checked the sell-by-date, product name, method of intake, but not nutritional information. They also checked for calories and carbohydrates but they were not interested in sodium, sugar, and trans fat which are health hazard nutrients. It is necessary to improve nutrition labeling, because consumers are experiencing difficulties in obtaining sodium information under the nutrition labeling system. Consumers will pay about 0.66% more if new sodium labeling is introduced. In conclusion, food labeling system can be improved by smooth and efficient access of information. for health-hazard nutritional components, such as sodium, it is important to introduce policies that reduce their intake. This can be done by providing consumers with clear and concise information. The social costs of high sodium intake could be reduced, hence improving the national health.

• Nutrition Research and Practice
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• 제14권5호
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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.

• Journal of Community Nutrition
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• 제8권4호
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• pp.193-199
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• 2006

There have been many studies indicating increased salt intake is related to elevated blood pressure (BP). Hypertension and pre-hypertension are prevalent in Korea. A national survey showed that the Korean average daily salt consumption was 12.5g, which is more than twice the current recommendation in the UK or USA. This study was performed to understand which aspects of the Korean diet contributed to high salt intake and elevated BP in Korea. The subjects consisted of 1,110 Korean adult men aged 30 to 49 years who were selected from the data of 2001 Korean National Health and Nutrition Survey, a nationwide cross sectional survey. The relationship of BP with sodium and high sodium food intakes were analyzed. After categorizing subjects according to their BP, the socio-demographic information and food and nutrients intakes were analyzed. BP increased with a larger amounts of sodium intake and the trend was significant with diastolic BP. However, the trends of BP for sodium densities of the diet were not. People with hypertension significantly tended to be older, larger, and less educated than people with normal BP. And they consumed more foods from the fats, oils & sweets group and larger amounts of discretionary sodium than normal people. The current report advocates that public health intervention, which improves the awareness of the role of salt on elevated blood pressure for the public, should be implemented in Korea.