Korean Journal of Community Nutrition (대한지역사회영양학회지)

The Korean Society of Community Nutrition (대한지역사회영양학회)
권호 표지
DOI QR코드

DOI QR Code

Blood Pressure and Dietary Related Risk Factors Associated with High Sodium Intake Assessed with 24-hour Urine Analysis for Korean Adults

한국 성인들의 24시간 소변 분석법에 근거한 고나트륨군의 혈압과 고나트륨 섭취관련 위험인자에 관한 연구

  • Jeong, Yeon-Seon (Department of Food Science and Nutrition, The Catholic University) ;
  • Lim, Hwa-Jae (Department of Food Science and Nutrition, Dong-eui University) ;
  • Kim, Sook-Bae (Department of Food Science and Human Nutrition, Chonbok National University) ;
  • Kim, Hee Jun (Department of Food Science and Nutrition, The Catholic University) ;
  • Son, Sook Mee (Department of Food Science and Nutrition, The Catholic University)
  • 정연선 (가톨릭대학교 식품영양학과) ;
  • 임화재 (동의대학교 식품영양학과) ;
  • 김숙배 (전북대학교 식품영양학과) ;
  • 김희준 (가톨릭대학교 식품영양학과) ;
  • 손숙미 (가톨릭대학교 식품영양학과)
  • Received : 2014.11.07
  • Accepted : 2014.12.12
  • Published : 2014.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study was conducted to examine blood pressure and other characteristics of a high sodium intake group assessed with 24-hr urine analysis and the dietary factors related to the risk of high sodium intake among Korean adults. Methods: A cross-sectional study was conducted with adults aged 20-59 years. Subjects who completed 24-hr urine collection (N = 205) were divided into 3 groups (tertile) according to the sodium intake estimated with 24-hour urine analysis. We compared the blood pressure, BMI and dietary related factors of the 3 groups (low, medium, high sodium intake group) with General Linear Model (GLM) and Duncan's multiple range test (p < 0.05). The risk factors related to high sodium intake were assessed with odds ratio (p < 0.05). Results: The sodium intake (mg/day) of the 3 groups were $3359.8{\pm}627.9$, $4900.3{\pm}395.1$ and $6770.6{\pm}873.9$, respectively, corresponding to daily salt intake (g/day) 8.5, 12.4 and 17.2, respectively. High sodium group showed significantly elevated age, BMI and systolic/diastolic blood pressure. Being male gender was associated with significantly increased risk of sodium intake (OR = 1.972; 95%CI: 1.083-3.593). The other factors related to high sodium intake were higher BMI (${\leq}25$) (OR = 2.619; 95% CI: 1.368-5.015), current alcohol consumption (OR = 1.943; 95%CI: 1.060-3.564), and having salty soybean paste with salt percentage > 14% (OR = 3.99; 95% CI: 1.404-6.841). The dietary attitude related to increased risk of high sodium intake included 'enjoy dried fish and salted mackerel' (p < 0.001) and 'eat all broth of soup, stew or noodle' (p < 0.001). Conclusions: Because high sodium intake was associated with higher blood pressure, nutrition education should focus on alcohol consumption, emphasis on related dietary factors such as using low salt soybean paste, improvements in the habit of eating dried fish and salted mackerel or eating all broth of soup, stew or noodle.

Keywords

References

  1. Adrogue HJ, Madias NE (2007): Sodium and potassium in the pathogenesis of hypertension. N Engl J Med 356(19): 1966-1978 https://doi.org/10.1056/NEJMra064486
  2. Antonios TF, MacGregor GA (1995): Deleterious effects of salt intake other than effects on blood pressure. Clin Exp Pharmacol Physiol 22(3):180-184 https://doi.org/10.1111/j.1440-1681.1995.tb01976.x
  3. Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM; American Heart Association (2006): Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 47(2): 296-308 https://doi.org/10.1161/01.HYP.0000202568.01167.B6
  4. Carvalho JJ, Baruzzi RG, Howard PF, Poulter N, Alpers MP, Franco LJ, Marcopito LF, Spooner VJ, Dyer AR, Elliott P, Stamler J, Stamler R (1989): Blood pressure in four remote populations in the INTERSALT Study. Hypertension 14(3): 238-246 https://doi.org/10.1161/01.HYP.14.3.238
  5. Chang SO (2010): Effect of a 6-month low sodium diet on the salt taste perception and pleasantness, blood pressure and the urinary sodium excretion in female college students. Korean J Nutr 43(5): 433-442 https://doi.org/10.4163/kjn.2010.43.5.433
  6. Cho YY (2002): Practice guidelines for reducing salt intake. Korean J Community Nutr 7(3): 394-400
  7. Cocores JA, Gold MS (2009): The Salted Food Addiction Hypothesis may explain overeating and the obesity epidemic. Med Hypotheses 73(6): 892-899 https://doi.org/10.1016/j.mehy.2009.06.049
  8. Contreras RJ (1978): Salt taste and disease. Am J Clin Nutr 31(6): 1088-1097 https://doi.org/10.1093/ajcn/31.6.1088
  9. Wilson DK, Sica DA, Miller SB (1999): Effects of potassium on blood pressure in salt-sensitive and salt-resistant black adolescents. Hypertension 34(2):181-186 https://doi.org/10.1161/01.HYP.34.2.181
  10. de Wardener HE, MacGregor GA (2002): Harmful effects of dietary salt in addition to hypertension. J Hum Hypertens 16(4): 213-223 https://doi.org/10.1038/sj.jhh.1001374
  11. Golledge J, Hankey GJ, Yeap BB, Almeida OP, Flicker L, Norman PE (2014): Reported high salt intake is associated with increased prevalence of abdominal aortic aneurysm and larger aortic diameter in older men. PLoS One 9(7): e102578 https://doi.org/10.1371/journal.pone.0102578
  12. He FJ, Marrero NM, MacGregor GA (2008): Salt intake is related to soft drink consumption in children and adolescents: a link to obesity? Hypertension 51(3): 629-634 https://doi.org/10.1161/HYPERTENSIONAHA.107.100990
  13. Holbrook JT, Patterson KY, Bodner JE, Douglas LW, Veillon C, Kelsay J, Mertz W, Smith JC (1984): Sodium and potassium intake and balance in adults consuming self selected diets. Am J Clin Nutr 40: 786-793 https://doi.org/10.1093/ajcn/40.4.786
  14. Hu G, Jousilahti P, Peltonen M, Lindstrom J, Tuomilehto J (2005): Urinary sodium and potassium excretion and the risk of type 2 diabetes: a prospective study in Finland. Diabetologia 48(8): 1477-1483 https://doi.org/10.1007/s00125-005-1824-1
  15. Intersalt Cooperative Research Group (1988): Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. BMJ 297(6644): 319-328 https://doi.org/10.1136/bmj.297.6644.319
  16. Itoh R, Suyama Y, Oguma Y, Yokota F (1999): Dietary sodium, an independent determinant for urinary deoxypyridinoline in elderly women. A cross-sectional study on the effect of dietary factors on deoxypyridinoline excretion in 24-h urine specimens from 763 free-living healthy Japanese. Eur J Clin Nutr 53(11): 886-890 https://doi.org/10.1038/sj.ejcn.1600871
  17. Khaw KT, Barrett-Connor E (1988): The association between blood pressure, age, and dietary sodium and potassium: a population study. Circulation 77(1): 53-61 https://doi.org/10.1161/01.CIR.77.1.53
  18. Kim HH, Lee YK (2013): Analysis of presumed sodium intake of office workers using 24-hour urine analysis and correlation matrix between variables. Korean J Nutr 46(1): 26-33 https://doi.org/10.4163/kjn.2013.46.1.26
  19. Kirkendall AM, Connor WE, Abboud F, Rastogi SP, Anderson TA, Fry M (1976): The effect of dietary sodium chloride on blood pressure, body fluids, electrolytes, renal function, and serum lipids of normotensive man. J Lab Clin Med 87(3): 411-434
  20. Koo JO, Kim YK, Seo JS, Son SM, Lee YS (2007): Diet therapy principle and practice, Paju, Kyomunsa
  21. Lee YK, Sung CJ, Choi MK, Lee YS (2002): Effects of sodium intakes on blood pressure and blood parameters in Korean normal adult women. Korean J Nutr 35(7): 754-762
  22. Liu K, Dyer AR, Cooper RS, Stamler R, Stamler J (1979): Can overnight urine replace 24-hour urine collection to asses salt intake? Hypertension 1(5): 529-536 https://doi.org/10.1161/01.HYP.1.5.529
  23. Ministry of Health and Welfare; Korea Institute for Health and Social Affairs (2006): The Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005, Seoul, Korea Institute for Health and Social Affairs
  24. Morris RC Jr, Sebastian A, Forman A, Tanaka M, Schmidlin O (1999): Normotensive salt sensitivity: effects of race and dietary potassium. Hypertension 33(1):18-23 https://doi.org/10.1161/01.HYP.33.1.18
  25. Navia B, Aparicio A, Perea JM, Perez-Farinos N, Villar-Villalba C, Labrado E, Ortega RM (2014): Sodium intake may promote weight gain; results of the FANPE study in a representative sample of the adult Spanish population. Nutr Hosp 29(6): 1283-1289
  26. Nicoll R, McLaren Howard J (2014): The acid-ash hypothesis revisited: a reassessment of the impact of dietary acidity on bone. J Bone Miner Metab 32(5): 469-475 https://doi.org/10.1007/s00774-014-0571-0
  27. Ortega RM, Lopez-Sobaler AM, Requejo AM, Andres P (2004): Food composition. A basic tool for assessing nutritional status, Madrid, Complutense
  28. Pangborn RM, Pecore SD (1982): Taste perception of sodium chloride in relation to dietary intake of salt. Am J Clin Nutr 35(3): 510-520 https://doi.org/10.1093/ajcn/35.3.510
  29. Park YS, Son SM, Lim WJ, Kim SB, Chung YS (2008): Comparison of dietary behaviors related to sodium intake by gender and age. Korean J Community Nutr Feb 13(1): 1-12
  30. Rhee MY, Yang SJ, Oh SW, Park Y, Kim CI, Park HK, Park SW, Park CY (2011): Novel genetic variations associated with salt sensitivity in the Korean population. Hypertens Res 34(5): 606-611 https://doi.org/10.1038/hr.2010.278
  31. Sariae M, Piasek M, Blanusa M, Kostial K, Ilich JZ (2005): Sodium and calcium intakes and bone mass in rats revisited. Nutrition 21(5):609-614 https://doi.org/10.1016/j.nut.2004.10.009
  32. Son SM, Huh GY (2006): Dietary risk factors associated with hypertension in patients. Korean J Community Nutr 11(5): 661-672
  33. Son SM, Park YS, Lim HJ, Kim SB, Jeong YS (2007): Sodium intakes of Korean adults with 24-hour urine analysis and dish frequency questionnaire and comparison of sodium intakes according to the regional area and dish group. Korean J Community Nutr 12(5): 545-558
  34. Song DY, Park JE, Shim JE, Lee JE (2013): Trends in the major dish groups and food groups contributing to sodium intake in the Korea National Health and Nutrition Examination Survey 1998-2010. Korean J Nutr 46(1):72-85 https://doi.org/10.4163/kjn.2013.46.1.72
  35. Sun N, Han W, Zhao L, Liu X, Chen Y, Wang H (2014): P257 Relationship between 24h urinary sodium with blood pressure, arterial elasticity and urine protein in hypertensive patients. Cardiovasc Res 103(Suppl 1): S9-S46
  36. The Korean Nutrition Information Center (1998): Food values of portions commonly used, Seoul, Jungang Co
  37. Tobian L (1983): Human essential hypertension: implications of animal studies. Ann Intern Med 98(5 Pt 2): 729-734 https://doi.org/10.7326/0003-4819-98-5-729
  38. Tsugane S (2005): Salt, salted food intake, and risk of gastric cancer: epidemiologic evidence. Cancer Sci 96(1): 1-6 https://doi.org/10.1111/j.1349-7006.2005.00006.x
  39. Whelton PK, He J, Cutler JA, Brancati FL, Appel LJ, Follmann D, Klag MJ (1997): Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 277(20): 1624-1632 https://doi.org/10.1001/jama.1997.03540440058033
  40. Woo KJ, Koh KH (1989): A study on the texture and taste of Kimchi in various saltings. Korean J Soc Food Sci 5(1): 31-41
  41. Yon M, Lee Y, Kim D, Lee J, Koh E, Nam E, Shin H, Kang BW, Kim JW, Heo S, Cho HY, Kim CI (2011): Major sources of sodium intake of the Korean population at prepared dish level: based on the KNHANES 2008 & 2009. Korean J Community Nutr 16(4): 473-487 https://doi.org/10.5720/kjcn.2011.16.4.473
  42. Yoon YO, Kim ES, Ro HK (1991): Potassium intakes of some industrial workers. Korean J Nutr 24(4): 344-349
  43. Zhang Z, Cogswell ME, Gillespie C, Fang J, Loustalot F, Dai S, Carriquiry AL, Kuklina EV, Hong Y, Merritt R, Yang Q (2013): Association between usual sodium and potassium intake and blood pressure and hypertension among U.S. adults: NHANES 2005-2010. PLoS One 8(10): e75289 https://doi.org/10.1371/journal.pone.0075289
  44. Zhao X, Yang X, Zhang X, Li Y, Zhao X, Ren L, Wang L, Gu C, Zhu Z, Han Y (2014): Dietary salt intake and coronary atherosclerosis in patients with prehypertension. J Clin Hypertens (Greenwich) 16(8): 575-580 https://doi.org/10.1111/jch.12362

Cited by

  1. 나트륨 섭취량 추정을 위한 소변 중 Cl-의 간이적 측정방법의 유용성 검증 vol.29, pp.1, 2014, https://doi.org/10.9799/ksfan.2016.29.1.027
  2. 2010년~2014년 국민건강영양조사 자료를 이용한 성인의 나트륨 섭취와 비만과의 관련성 vol.50, pp.1, 2017, https://doi.org/10.4163/jnh.2017.50.1.64
  3. 전북지역 초등학교 교사의 나트륨에 대한 지식, 나트륨섭취 식행동, 저염식 태도 및 식생활지도와의 관계 연구 vol.50, pp.2, 2017, https://doi.org/10.4163/jnh.2017.50.2.180
  4. 광주·전남에 거주하는 일부 남성의 나트륨 저감화 행동변화단계에 따른 식행동 특성 및 나트륨 저감화 영양교육의 효과분석 연구 vol.50, pp.5, 2014, https://doi.org/10.4163/jnh.2017.50.5.472
  5. Comparison of Sodium-Related Dietary Behavior and Low-Salt Dietary Attitude Based on the Gender and Salty Taste Assessment of Chinese International Students in the Jeonbuk Area vol.31, pp.2, 2014, https://doi.org/10.17495/easdl.2021.4.31.2.91