제주지역 초·중학교 학생들의 끼니별 나트륨섭취 실태 조사

고양숙,김혜연 한국영양학회 2014 Journal of Nutrition and Health Vol.47 No.1

제주지역 초등학생 701명과 중학생 1,184명을 대상으로 끼니별, 식품군별, 음식군별 나트륨 섭취 실태를 파악하였으며 그 결과는 다음과 같다. 초등학교 조사대상자는 에너지 권장섭취량의 남, 여학생 각각 87.5%, 93.9%이었고, 중학생은 남·여학생 각각 86.1%, 91.7% 이었다. 나트륨 섭취량은 초등학교 남학생이 2,917.2 mg, 여학생 2,819.5 mg이었고, 중학생은 남학생이 3,336.6 mg, 여학생2,828.1 mg이었다. 초등학생은 하루 총 식품 섭취량의 39.1%를 간식에서 중학생은 점심에서 34.3%를 섭취하고 있었다. 초등학생의 총 열량섭취량에 대한 아침, 점심, 저녁, 간식의 열량 섭취 비율은 19.8%, 26.8%, 29.8%, 23.6%이었고, 중학생의 경우 열량 섭취 비율은17.2%, 33.6%, 27.2%, 22.0%이었고, 이에 비해 각 끼니별 나트륨 섭취 비율은 초등학생의 경우 18.0%, 35.1%, 32.8%, 14.1% 이었고, 중학생은 15.3%, 40.2%, 29.1%, 15.5%이었다. 초등학생, 중학생 모두 학교급식으로 인하여 점심에서 얻어지는 열량 및 나트륨 섭취량이 가장 높음을 알 수 있었다. 나트륨 섭취량이 높은 식품군은 양념류 (초등학생 1,252.5 mg, 중학생 1,158.0 mg), 채소류 (초등학생 409.0 mg, 중학생495.6 mg), 곡류 (초등학생 322.4 mg, 중학생 647.8 mg), 어패류 (초등학생 255.3 mg, 중학생 336.6 mg)이었으며, 곡류군을제외한 이들 식품군은 점심과 저녁에서 그 사용량이 더 높았고 이는 학교급식이나 저녁에 먹는 부식의 다양성을 보여주고있었다. 이에 비해 간식에서 나트륨 섭취비율이 높은 식품군은곡류군으로 초등학생은 하루 총 나트륨 섭취량의 5.9%를 중학생은 9.8%를 섭취하는 것으로 나타나 이와 관련된 간식 음식 선택에 대한 교육이 필요하다고 본다. 음식군별 나트륨 섭취 비율은 초등학생 중학생 모두 국류와 찌개류에서 나트륨 섭취량의 19.8%와 25.4%를 섭취하는것으로 나타났다. 이어 나트륨 섭취비율이 높은 음식은 김치류이었다. 전체적으로 무침류, 국류, 김치류, 구이류, 볶음류, 일품요리 등에서 나트륨 섭취 비율이 높았다. 끼니에 따른 나트륨섭취비율을 보면 점심에서 국, 김치, 찌개, 튀김, 볶음 등 다양한 부식에서 얻어지고 있었고, 저녁에는 면류, 구이, 일품요리등에서 간식에서는 빵·과자류, 면류에서 나트륨 섭취가 높은것으로 나타났다. 이상의 결과를 종합해 볼 때 제주지역 초·중학교 학생들의나트륨 섭취 실태는 점심식사에서 다양한 부식을 통한 나트륨섭취량이 높은 것으로 나타났다. 단백질 급원 식품이나 미량영양소의 공급을 고려하면, 채소와 어패류, 해조류, 육류 등으로다양한 조리방법을 사용하는 음식군의 배제보다는 짠맛을 조절할 수 있는 미각교육이 필요하다고 여겨지며, 아울러 나트륨섭취비율이 가장 높은 국물 섭취에 대한 영양교육과 또한 점심에서 얻어지는 나트륨 섭취 비율이 높으므로 학교급식 조리종사자 및 영양사를 대상으로도 나트륨 저감화를 위한 교육이 필요하다. 부식보다는 나트륨 섭취 비율이 낮지만 간식에서 섭취되는면류인 라면이나. 빵·과자류, 음료 는 나트륨 섭취도 높일 뿐아니라 열량 섭취도 높이므로 과일과 우유 및 유제품 등의 올바른 간식 음식 선택에 대한 교육도 나트륨 섭취를 줄일 수있는 방법이다. Purpose: The objective of this study was to investigate the differences of sodium intake in the diet according to the kind of meal, food group, and dish group. Methods: A dietary survey was conducted using the 24-hour recall method from April to May, 2009. The study subjects consisted of 701 elementary and 1,184 middle school students in the Jeju area. Mean sodium intake and the percentage contribution of meals and each dish and food group to daily sodium intake were calculated. Results: The daily sodium intake was 2,868.4 mg and 3,032.5 mg in elementary and middle school students. For elementary school students, breakfast, lunch, dinner, and snack provided approximately 18.0%, 35.1%, 32.8%, and 14.1% of total daily sodium intake, and for middle school students, 15.3%, 40.2%, 29.1%, and 15.5%, respectively. Major food groups for sodium intake were spices (1,252.5 mg in elementary, 1158.0 mg in middle school students), vegetables and their products (409.0 mg, 495.6 mg), cereal and grain products (322.4 mg, 647.8 mg), and fish and shellfish (255.3 mg, 336.6 mg). Except cereal and grain products, sodium intake of the food groups mentioned above was greater at lunch and dinner than at breakfast and snack. And, the elementary and middle school students obtained 5.9% and 9.8% of total daily sodium intake from cereal and grain products at snack. Among the 29 dish groups, the highest dish groups contributing to dietary sodium intake were soup and stew and tang/jeongol, consuming 19.8% (elementary school stu-dents) and 25.4% (middle school students) of daily sodium intake. The following major dish groups contributing to dietary sodium intake, in order, were kimchi, seasoned vegetables, grilled dish, stir-fried dish, and a` la carte. By meals, the per-centage of sodium intake from soup, kimchi, stew, fried dish, and stir-fried dish at school lunch was high, from noodles, grilled dish, and a` la carte at dinner, and from bakery/snacks and noodles at snack. Conclusion: Sodium intake from the various side dishes at school lunch was high and noodles and bakery/snacks were popular snack foods in elementary and middle school students in Jeju area. In order to lower the intake of sodium, students need to be educated about eat-ing less soup and choosing better snacks.

지자체의 나트륨 섭취 감소 계획 평가 및 근거 기반 목표 재설정 : 서울시 사례를 중심으로

임아현,황지윤,김기랑 한국영양학회 2017 Journal of Nutrition and Health Vol.50 No.6

Purpose: To identify the effectiveness of policy evaluation, consistent monitoring is necessary. This study aimed to carry out mid-term evaluation of objectives and programs related to comprehensive plans for sodium intake reduction by 2020 for Seoul city and then reestablish the objectives of the sodium intake reduction plans. Methods: Literature reviews, data analysis, and reviews of expert focus-groups were performed to evaluate objectives, to develop a new goal, and to identify the priority subjects of the sodium intake reduction programs. In order to examine target populations for the programs, awareness and behaviors related to sodium intakes among Seoul citizens were examined by sex, age, and income level using the 2008~2013 Korea National Health and Nutrition Examination Survey data. Results: Current objectives of the sodium intake reduction plan by 2020 for Seoul city were not appropriate, so objectives were reset to 3,600 mg of sodium intake by 2020 among Seoul citizens with 2% reduction per year. Although sodium intake showed a decreasing trend by year, it was still high, especially in men. The sodium intake reduction programs currently in progress have not been assessed at multiple levels across multiple sectors and have only been assessed fragmentarily. For dietary behavior related to sodium intakes by sex, age, and income level, sodium intake was higher in the group with less than 100 g of fruit intake compared to the group with 100 g or more. Subjects aged 30~59 years and the low household income group showed relatively higher sodium intakes. Based on the data analysis and the expert review, the priority subject of the sodium intake reduction programs was determined to be adult men. In terms of a program strategy for sodium intake reduction, multi-level and setting approaches, including work sites, home, and restaurants, were suggested to reduce sodium intakes of the target subject. Conclusion: The suggested objectives should be consistently monitored by data analysis, and the determined programs need to be phased in over 5 years.

Simple Method to Estimate Daily Sodium Intake in Peritoneal Dialysis Patients

김소미,이은경,조종태,강기수,송현주,강민숙,이은주,한수민,김순배 한국정맥경장영양학회 2016 한국정맥경장영양학회 학술대회집 Vol.2016 No.-

Background: Restriction of dietary sodium intake for peritoneal dialysis (PD) patients is recommended, but there is limited information on the measurement and monitoring of sodium intake. We have developed a simple method to estimate daily sodium intake during the measurement of dialysis adequacy in PD patients. Methods: A total of 83 PD patients from the Asan Medical Center were enrolled into the study. The patients were divided into two groups based on residual renal function (RRF). We measured total sodium removal and estimated daily sodium intake using dietary recall for 1 day, during the assessment of dialysis adequacy. Results: There were 39 patients in the RRF(-) group and 44 in the RRF(+) group. In both groups, and all patients, there were significant positive correlations between sodium intake and total sodium removal: RRF(-) group, r = 0.598; RRF(+) group, r = 0.577; total patients, r = 0.595. There were linear relationships between dietary sodium intake and total sodium removal in both groups: RRF(-) group, sodium intake (mg/d) = 19.28 × peritoneal sodium removal (mEq/d) + 211; RRF(+) group, sodium intake (mg/d) = 15.40 × total sodium removal (mEq/d) + 609. All PD patients, sodium intake (mg/d) = 15.64 × total sodium removal (mEq/d) + 646. Conclusions: The measurement of total sodium removal during the assessment of dialysis adequacy could be an effective and simple method to estimate dietary sodium intake in PD patients. A dietary intake of 2,000 mg of sodium corresponds to a total sodium removal of approximately 87 mEq/d.

방문건강관리사업 영양사의 나트륨 관련 인식도, 식태도, 저감화 교육 요구도

모윤정(Yun Jeong Mo),김숙배(Sook Bae Kim) 대한지역사회영양학회 2014 대한지역사회영양학회지 Vol.19 No.6

The purpose of this study was to investigate recognition, dietary attitude and education needs for reducing sodium intakes of dietitian at customized home visiting health service (CHVHS). Methods: The subjects were 75 dietitian at CHVHS. We investigated several variables (recognition, dietary attitude, education needs for reducing sodium intakes) and determined sodium intakes level of subjects as ‘low’, ‘middle’ and ‘high’ by Dish Frequency Questionnaire 25 (DFQ 25). Also, we assessed the differences in recognition, dietary attitude, sodium intake level and education needs by dietitian career period (under 3 yrs vs. over 3 yrs) at CHVHS. Results: In recognition related reducing sodium intake, they showed ‘checking a sodium content in nutrition labeling’ score 2.5/4.0 and ‘perception difference between sodium and salt’ score 3.1/4.0. There was no difference in the recognition between under 3yrs’ group and over 3yrs’ group. In dietary attitude related reducing sodium intake, they showed ‘palatability for salty taste’ score 0.8/1.0, ‘attitude in related soups’ 0.7/1.0, ‘attitude in related using natural spice’ 0.6/1.0. There was a difference in ‘attitude in related soups’ between under 3yrs’ group and over 3yrs’ group (0.6 vs. 0.7). In sodium intake level by DFQ 25, they showed ‘low group’ 41.3%, ‘middle group’ 41.3% and ‘high group’ 17.3%. There was no difference in the distribution of sodium intake level by the career. In education needs related reducing sodium intakes, there were ‘teaching experience’ 93.3%, ‘have a difficulty in teaching about reducing sodium intakes’ 86.6%, and ‘necessity of education for CHVHS dietitians’ 100.0%. ‘Needed education contents for CHVHS dietitians’ were ranked as ‘cooking way to reduce sodium intake’ 58.7%, ‘relation between hypertension and sodium’ 17.3%, ‘composing way to reduce sodium intake’ 17.3%. There was a difference in needed education contents ‘relationship between hypertension and sodium’ (33.3% vs. 2.6%) and ‘The cooking way to reduce sodium intake’ (38.9% vs. 76.9%) by the career. Conclusions: The results suggested that a capacity training program for reducing sodium intake may be needed for dietitians at CHVHS to improve health of the community elderly. For effective training program related reducing sodium intake for dietitians at CHVHS, it may be necessary to consider the career period as dietitians at CHVHS.

성인 여성의 나트륨 섭취수준과 칼슘 영양상태 및 골밀도

윤진숙(Jin Sook Yoon),이미정(Mi Jung Lee) 대한지역사회영양학회 2013 대한지역사회영양학회지 Vol.18 No.2

Previous studies have shown that sodium excretion is positively related to calcium excretion in the urine. As excessive sodium intake is a common nutritional problem in Korea, we intended to investigate associations among sodium intake levels and calcium status, evaluated by 24 hour recall method and urinary excretion, and bone status. We collected dietary information for non-consecutive three days from 139 young adult women 19~29 years. After classifying the subjects into 4 groups based on the dietary sodium levels by daily total sodium intake (mg) and sodium density (sodium intake per 1000 kcal energy intake), we compared the bone status, nutrient intakes, urinary calcium and sodium excretions. The results showed a positive association between total daily sodium intake and intake of other nutrients. However, no significant differences in nutrients intakes were observed among subject groups classified by sodium density levels. There were no significant differences of bone density among groups by total daily sodium intake as well as by sodium density. While total daily sodium intake showed significantly positive relationship with urinary sodium (p < 0.05) and calcium (p < 0.05), sodium density was not related to urinary excretion of calcium and sodium. Our results suggested that promoting balanced meals providing appropriate amounts of energy intake is the essential component of nutrition education for improving calcium status of young Korean women with excessive sodium intake. (Korean J Community Nutr 18(2) : 125~133, 2013)

젊은 여성에서 짠맛 역치 및 자기 평가 짠맛 선호도와 나트륨 섭취 간의 상호 관련성

심유진(Shim, Eugene),양윤정(Yang, Yoon Jung),양윤경(Yang, Yoon Kyoung) 한국영양학회 2016 Journal of Nutrition and Health Vol.49 No.2

본 연구에서는 20대 초반 한국 여성의 짠맛 역치 및 선호도를 측정하여 음식섭취빈도법을 통해 추정한 나트륨 섭취량과의 연관성을 분석하고, 자기 평가 짠맛 선호도와 관련되어 있는 나트륨 섭취 관련 식행동과 나트륨 섭취 기여음식을 조사하였다. 자기 평가 짠맛 선호도는 음식섭취빈도법을 이용하여 추정한 나트륨 섭취량과 유의한 양의 상관관계에 있었으며, 나트륨 증가 식행동과 양의 상관관계에 있었고, 나트륨 감소 식행동과 음의 상관관계에 있었다. 나트륨 섭취와 관련된 식행동 중에는 식탁에서 소금과 양념간장의 사용, 외식과 배달음식의 빈도, 국, 찌개, 국수류의 국물 섭취, 레토르트나 가공 식품의 이용, 생채소의 섭취, 싱거운 맛에 대한 수용태도 등의 항목이 자기 평가 짠맛 선호도와 유의한 관련성이 있었으며 나트륨 섭취 기여 음식 중에는 라면, 순두부찌개, 총각김치 및 김치를 이용한 음식 등이 자기 평가 짠맛 선호도와 유의하게 관련되어 있어, 짠맛 선호도가 이들 식행동 및 음식을 통해 높은 나트륨 섭취와 관련되어 있는 것으로 생각된다. 예상과는 달리 짠맛 검출 및 인식 역치는 자기 평가 짠맛 선호도, 나트륨 섭취량, 나트륨 증가 및 감소 식행동과 유의한 상관관계를 보이지 않아 식품체계가 아닌 염화나트륨 수용액을 이용한 짠맛 역치보다는 자기 평가된 짠맛 선호도가 개인의 평상시 나트륨 섭취량을 간접적으로 평가할 수 있는 더 좋은 지표로서 생각된다. 결론적으로, 자기 평가 짠맛 선호도는 나트륨 섭취와 관련된 식행동과의 연관성으로 인하여 평상시 나트륨 섭취 정도를 잘 반영하는 것으로 나타났으며, 개인의 나트륨 섭취 수준을 평가하는 간단하고 효과적인 도구로서 활용될 수 있을 것이다. 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.

24시간 소변 분석, 식사기록법 및 음식섭취빈도조사에 의한 여자 성인의 나트륨 섭취량 조사

신은경(Shin Eun-Kyung),이혜진(Lee Hye-Jin),이중정(Lee Jung-Jeung),안문영(Ann Moon-Young),손숙미(Son Sook-Me),이연경(Lee Yeon-Kyung) 韓國營養學會 2010 Journal of Nutrition and Health Vol.43 No.1

This study assesses the sodium intake of adults by 24-hour urine analysis, dietary records review and a food intake questionnaire. Subjects were 236 adult female in Daegu. The results are summarized as follows: Sodium intake as indicated by the 24-hour urine analysis was 5,805.4 ± 3836.8 ㎎. This was significantly higher than intake indicated by dietary records (4415.4 ± 1935.1 ㎎) and the dish frequency questionnaire (DFQ 55)(4293.5 ± 1526.5 ㎎). The results of the 24-hour urine analysis and DFQ 55 showed that sodium intake was higher for the 65-to-74-year-old age group than for other age groups (p < 0.05, p < 0.05). Review of dietary records to examine typical sodium intake by food groups showed that 53.7% of the sodium consumed by subjects in all age groups came from seasonings and spices (2399.0 ± 1526.5 ㎎). The analysis of sodium intake by food groups using DFQ 55 showed 34.2% of their sodium came from consumption of kimchi (p < 0.001) and kimch, soup, stew and fish jorim accounted for 57.8% of total sodium intake. The results indicate positive correlation between age and sodium intake, as shown by the 24-hour urine analysis and food intake questionnaire (p < 0.05). Therefore, these results would be valuable as basic data for planning nutrition education for sodium intake reduction.

Associations of Obesity and Dyslipidemia with Intake of Sodium, Fat, and Sugar among Koreans: a Qualitative Systematic Review

( Yoon Jung Kang ),( Hye Won Wang ),( Se Young Cheon ),( Hwa Jung Lee ),( Kyung Mi Hwang ),( Hae Seong Yoon ) 한국임상영양학회 2016 Clinical Nutrition Research Vol.5 No.4

A qualitative systematic review was performed to identify associations of obesity and dyslipidemia with intake of sodium, fat, and sugar among Koreans. We reviewed 6 Korean research databases (KMbase, KoreaMed, NDSL, DBpia, RISS, KISS) with the keywords “sodium intake,” “fat intake,” and “sugar intake.” Total of 11 studies were investigated in this present study. Of these articles, 7 studies were related to sodium intake, 2 studies had a relation to fat intake, and 2 studies were associated with sugar intake. We indicated general characteristics, concentration of serum lipids, nutrition intake, and statistically significant results. High sodium intake contributed to increased etiology of hypertriglyceridemia, high-density lipoprotein (HDL) hypocholesterolemia, and a risk of being overweight. Fat intake was significantly associated with body fat, low-density lipoprotein (LDL) hypercholesterolemia, and HDL hypocholesterolemia. Sugar intake from coffee drinks and sugar-sweetened beverages contributed to increased HDL hypocholesterolemia and continuous metabolic syndrome score. This qualitative review among Koreans represented that intake of sodium, fat, and sugar has a positive relationship with cause of obesity-related diseases. Especially, this present study has a great significance in terms of considered study that intake of the potentially hazardous nutrients among Koreans has an association with obesity and dyslipidemia. However, further studies such as randomized controlled trials on associations between sodium, fat, and sugar and obesity and dyslipidemia need to be continuously required in order to conduct quantitative systematic reviews and a meta-analysis for Koreans.

한국인의 나트륨 섭취 급원 음식 및 섭취 양상

연미영(Mi Yong Yon),이윤나(Yoon Na Lee),김도희(Do Hee Kim),이지연(Jee Yeon Lee),고은미(Eun Mi Koh),남은정(Eun Jeong Nam),신혜형(Hye Hyung Shin),강백원(Baeg Won Kang),김종욱(Jong Wook Kim),허석(Seok Heo),조해영(Hea Young Cho),김초일(C) 대한지역사회영양학회 2011 대한지역사회영양학회지 Vol.16 No.4

We attempted to define the sources of sodium intake for the Korean population at prepared dish level to provide a basis for developing sustainable nutrition policies and feasible programs for sodium intake reduction. Dietary intake data from 2008 and 2009 Korea National Health and Nutrition Examination Survey was used in the analysis for sodium intake sources. Sodium intake from individual dish consumed by each subject was calculated and used in delineating major sodium sources at dish and dish group level for sub-populations of different sex and age. Also, sodium intake was compared between eaters and non-eaters of some specific dish groups with considerable contribution to total sodium intake. The number of subjects included in the analysis was 18,022 and mean sodium intake was 4,600 mg/capita/day. Major sources of sodium intake at dish group level were in the following order: kimchi (1125 mg, 24.5%), noodles (572 mg, 12.4%), soups (488 mg, 10.6%), stews (399 mg, 8.7%), and cooked rice (284 mg, 6.2%). The magnitude of contribution to total sodium intake by soups and stews was different by age group. Sodium intake difference between eaters and non-eaters was much larger for kimchi group (2,343 mg for male, 1,452 mg for female) than for soups or stews. Interaction between consumption of aforementioned specific dish groups and age was highly significant (p < 0.0005) for both sexes. This study revealed an importance of having not only the control over sodium content of foods/dishes, but also the customized approach for different groups of population to accomplish an appreciable reduction in sodium intake. (Korean J Community Nutr 16(4) : 473~487, 2011)

Dietary Reference Intakes of sodium for Koreans: focusing on a new DRI component for chronic disease risk reduction

Hyun Ja Kim,Yeon-Kyung Lee,Hoseok Koo,Min-Jeong Shin 한국영양학회 2022 Nutrition Research and Practice Vol.16 No.no.sup1

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.