Epidemiology and Health

Editorial

Methodological issues in estimating sodium intake in the Korea National Health and Nutrition Examination Survey: Hyun Ja Kim, Kyungwon Oh; Epidemiol Health. 2014;36:e2014033. Published online November 28, 2014; DOI: https://doi.org/10.4178/epih/e2014033

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Abstract

For policy goal setting, efficacy evaluations, and the development of related programs for reducing sodium intake, it is essential to accurately identify the amount of sodium intake in South Korea and constantly monitor its trends. The present study aimed to identify the status of sodium intake in South Korea and to review the methods and their validity for estimating sodium intake in each country; through this, we aim to determine more accurate methods for determining sodium intake and to monitor the trend in sodium intake for Korean citizens in the future. Using 24-hour dietary recall data from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES) to estimate daily sodium intake, the average daily sodium intake among Koreans was 4,546 mg (men, 5,212 mg; women, 3,868 mg). In addition to the nutrition survey that uses the 24-hour dietary recall method, sodium intake can also be calculated from the amount of sodium excreted in 24-hour urine, 8-hour overnight urine, and spot urine samples. Although KNHANES uses the 24-hour dietary recall method to estimate the sodium intake, the 24-hour dietary recall method has the disadvantage of not being able to accurately determine the amount of sodium intake owing to its unique characteristics of the research method and in the processing of data. Although measuring the amount of sodium excreted in 24-hour urine is known to be the most accurate method, because collecting 24-hour urine from the general population is difficult, using spot urine samples to estimate sodium intake has been suggested to be useful for examining the trend of sodium intake in the general population. Therefore, we planned to conduct a study for estimating of 24-hour sodium excretion from spot urine and 8-hour overnight urine samples and testing the validity among subsamples in the KNHANES. Based on this result, we will adopt the most appropriate urine collection method for estimating population sodium intake in South Korea.

Summary

Korean summary
이 연구에서는 나트륨 섭취량 조사방법과 각 조사방법의 타당성을 고찰하여 나트륨 섭취량과 추이를 보다 정확하게 파악할 수 있는 방법을 모색해보고자 하였다. 국민건강영양조사에서는 24시간 회상법을 이용하여 우리나라 국민의 나트륨 섭취량을 산출하고 있으나, 정확성과 추이 비교에 제한점을 가지므로 소변을 이용하여 나트륨 섭취량을 추정하는 방법에 대한 검토가 필요하다. 이에, 국민건강영양조사의 일부 대상자에서 단회뇨, 야간뇨, 24시간 소변을 수집∙이용하여 24시간 소변 나트륨 배설량을 추정하는 식을 개발하고 그 타당도를 검증하는 연구를 수행하여 가장 적절한 소변 수집 방법을 국민건강영양조사에 도입할 계획이다.

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Original Article

Factors Associated with a Low-sodium Diet: The Fourth Korean National Health and Nutrition Examination Survey: Won Joon Lee, Hyeon Chang Kim, Sun Min Oh, Dong Phil Choi, Jaelim Cho, Il Suh; Epidemiol Health. 2013;35:e2013005. Published online June 20, 2013; DOI: https://doi.org/10.4178/epih/e2013005

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Abstract

<sec><title>OBJECTIVES</title>The low-sodium diet is a known preventive factor for hypertension and cardiovascular disease. Factors associated with low-sodium diets should be identified to reduce sodium intake effectively. This study was conducted to identify factors correlated with a low-sodium diet.</sec><sec><title>METHODS</title>This cross-sectional study analyzed data from a total of 14,539 Koreans aged 20 years or older, who participated in the Fourth (2007-2009) Korean National Health and Nutrition Examination Survey. A low-sodium diet was defined as having ≤2,000 mg/day based on 24-hour recalls. Multiple logistic regression models were used to assess sex, age, education, number of family members, household income, occupation, alcohol drinking, total energy intake, frequency of eating out, and hypertension management status for their associations with low-sodium diets.</sec><sec><title>RESULTS</title>Among all participants, only 13.9% (n=2,016) had low-sodium diets. In the multivariate analysis, 40-49 years of age, clerical work jobs, higher total energy intake, and frequent eating out were inversely associated with low-sodium diets. And female sex and living-alone were associated with low-sodium diets. Lower frequency of eating out was significantly associated with low-sodium diets, even after adjusting for total energy intake and other potential confounders. Adjusted odds ratios (95% confidence interval) for a low-sodium diet were 1.97 (1.49-2.61), 1.47 (1.13-1.91), 1.24 (0.96-1.61), and 1.00 (reference) in people who eat out <1 time/month, 1-3 times/month, 1-6 times/week, and ≥1 time/day, respectively.</sec><sec><title>CONCLUSIONS</title>Our study suggests that sex, age, number of family members, occupation, total energy intake, and lower frequency of eating out were associated with a low-sodium diet in Korean adults.</sec>

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