Journal List > J Nutr Health > v.50(1) > 1081538

Cheon, Wang, Lee, Hwang, Yoon, and Kang: Relationship of sodium consumption with obesity in Korean adults based on Korea National Health and Nutrition Examination Survey 2010∼2014∗

Abstract

Purpose

Excess sodium intake may contribute to the etiology of hypertension and cardiovascular disease risk. World Health Organization (WHO) recommends a daily sodium intake of less than 2 g. The aim of this study was to estimate the association of sodium intake with obesity in Korean adults. Methods: This study used Dietary intake and Health data on 22,321 subjects aged 30 years and over from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010∼2014. Information on dietary intake was obtained by the one day 24-hour recall method in KNHANES, and sodium intake was classified into five groups (< 2,000 mg, 2,000∼4,000 mg, 4,000∼6,000 mg, 6,000∼8,000 mg, ≥ 8,000 mg). Obesity was defined as having a body mass index (BMI) higher than 25 kg/m2. Intake of sodium and obesity status were analyzed by logistic regression with SPSS Statistics 23. Results: Men tended to have a higher sodium intake than women (p < 0.001). After adjusting for age, sex, year, daily energy intake, education level, smoking status, drinking status, physical activity, and chronic diseases and comparing the highest sodium intake group (≥ 8,000 mg) with the lowest intake group (< 2,000 mg), the OR of obesity was 1.351 (95% CI: 1.032∼1.767) in men. The OR of obesity in the sodium intake group (4,000∼6,000 mg) was 1.232 (95% CI: 1.063∼1.427) in women. Conclusion: Our findings suggest an independent relationship between sodium intake and as increased risk of obesity in Korean adults, implying the necessity for future research on low-sodium diet intervention in relation to obesity.

References

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Fig. 1.
Flow chart of subject's selection
jnh-50-64f1.tif
Table 1.
General characteristics according to gender
Variables Total (n = 22,016) Men (n = 8,792) Women (n = 13,224) p-value∗∗
Age (yr) 50.76 ± 0.14 49.81 ± 0.19 51.65 ± 0.19 < 0.001
Height (cm) 162.97 ± 0.09 169.96 ± 0.09 156.41 ± 0.08 < 0.001
Weight (kg) 63.80 ± 0.11 70.25 ± 0.15 57.74 ± 0.10 < 0.001
BMI (kg/m2) 23.92 ± 0.03 24.26 ± 0.04 23.61 ± 0.04 < 0.001
Energy (kcal/day) 2,025.56 ± 7.95 2,464.48 ± 11.96 1,707.33 ± 7.92 < 0.001
Sodium (mg/day) 4,680.38 ± 29.15 5,502.59 ± 56.14 3,908.35 ± 32.43 < 0.001
Obesity prevalence (%) 34.3 38.6 30.2 < 0.001
Chronic disease (%)        
Hypertension 29.2 31.9 26.8 < 0.001
Diabetes mellitus 9.6 11.3 8.0 < 0.001
Stroke 1.3 1.5 1.1 0.014
Myocardial infarction & angina pectoris 2.0 2.2 1.9 0.065
Hypercholesterolemia 13.4 12.2 14.6 < 0.001
Hypertriglyceridemia 12.7 17.3 8.4 < 0.001
Education level (%)       < 0.001
Graduated elementary: ≤ 6 22.0 14.4 29.2  
Graduated middle: 7 ∼ 9 11.5 11.6 11.3  
Graduated high: 10 ∼ 12 33.9 34.7 33.1  
Graduated university: ≥ 13 32.7 39.3 26.4  
Pysical activity (%)       < 0.001
No 55.3 54.2 56.3  
Yes 41.6 43.1 40.3  
Smoking status (%)       < 0.001
Non-smoker 53.1 16.8 87.2  
Ex-smoker 20.9 37.7 5.2  
Current smoker 23.8 43.8 5.0  
Drinking status(%)       < 0.001
Non-drinker 11.7 4.6 18.4  
Past drinker 14.2 10.6 17.5  
Current drinker 71.8 82.8 61.4  

Data were represented means ± SE or % about representative of the entire korean population.

∗∗ p-value were obtained by t-test or chi-square test.

Table 2.
Anthropometrics and health-related variables according to daily sodium intake
Variables < 2,000 mg∗∗∗ (n = 3,726) 2,000 ∼ 4,000 mg (n = 8,246) 4,000 ∼ 6,000 mg (n = 5,223) 6,000 ∼ 8,000 mg (n = 2,602) ≥ 8,000 mg (n = 2,219) p-value∗∗∗∗
Age (year) 57.20 ± 0.35 51.49 ± 0.22 49.00 ± 0.24 48.11 ± 0.27 47.16 ± 0.32 < 0.001
Height (cm) 157.84 ± 0.18 161.62 ± 0.13 164.48 ± 0.15 165.93 ± 0.21 167.13 ± 0.21 < 0.001
Weight (kg) 59.24 ± 0.23 62.24 ± 0.16 65.19 ± 0.20 66.43 ± 0.30 68.45 ± 0.35 < 0.001
BMI (kg/m2) 23.73 ± 0.07 23.75 ± 0.05 24.01 ± 0.06 24.04 ± 0.08 24.40 ± 0.10 < 0.001
Energy (kcal/day) 1,305.62 ± 10.41 1,748.64 ± 8.38 2,180.41 ± 11.69 2,540.23 ± 19.47 2,891.20 ± 22.45 < 0.001
Obesity prevalence (%) 32.2 31.4 35.7 35.7 41.0 < 0.001
Chronic disease (%)            
Hypertension 36.2 28.6 28.7 26.0 27.1 < 0.001
Hypertension (at exam)∗∗ 11.3 11.7 14.2 13.9 14.7 0.003
Diabetes mellitus 12.1 9.9 8.5 8.4 8.9 < 0.001
Stroke 2.2 1.6 0.9 0.8 0.6 < 0.001
Myocardial infarction & angina pectoris 3.2 2.1 1.7 1.7 1.4 < 0.001
Hypercholesterolemia 16.9 13.4 12.7 12.1 12.4 < 0.001
Hypertriglyceridemia 10.9 10.9 14.3 13.5 16.1 < 0.001
Education level (%)           < 0.001
Graduated elementary: ≤ 6 39.7 24.0 17.4 14.1 12.5  
Graduated middle: 7 ∼ 9 12.8 11.4 11.5 11.3 10.3  
Graduated high: 10 ∼ 12 27.2 33.7 34.8 37.0 37.1  
Graduated university: ≥ 13 20.4 30.8 36.3 37.5 40.2  
Pysical activity (%)           < 0.001
No 55.8 54.9 56.4 54.9 53.9  
Yes 39.4 41.8 40.9 43.0 44.0  
Smoking status (%)           < 0.001
Non-smoker 69.0 60.1 47.6 41.1 36.7  
Ex-smoker 13.4 18.4 22.7 25.4 29.5  
Current smoker 13.5 19.3 28.1 32.0 32.4  
Drinking status (%)           < 0.001
Non-drinker 19.9 13.1 8.9 8.3 7.2  
Past drinker 18.9 15.8 12.7 11.1 9.9  
Current drinker 57.0 68.8 76.5 78.9 81.2  

Data were represented means ± SE or % about representative of the entire korean population.

∗∗ Hypertension at the exam: Hypertension diagnosed at the health exam for the first time

∗∗∗ Daily sodium intake

∗∗∗∗ p-value were obtained by t-test or chi-square test.

Table 3.
Anthropometrics and health-related variables according to daily sodium intake in men
Variables < 2,000 mg∗∗∗ 2,000 ∼ 4,000 mg 4,000 ∼ 6,000 mg 6,000 ∼ 8,000 mg ≥ 8,000 mg p-value∗∗∗∗
(n = 791) (n = 2,720) (n = 2,485) (n = 1,415) (n = 1,381)
Age (year) 57.62 ± 0.69 51.94 ± 0.32 48.53 ± 0.29 47.75 ± 0.34 46.97 ± 0.37 < 0.001
Height (cm) 167.14 ± 0.03 169.34 ± 0.16 170.37 ± 0.16 170.68 ± 0.21 170.87 ± 0.20 < 0.001
Weight (kg) 66.65 ± 0.50 69.14 ± 0.26 70.60 ± 0.25 71.09 ± 0.36 72.33 ± 0.38 < 0.001
BMI (kg/m2) 23.78 ± 0.14 24.05 ± 0.08 24.28 ± 0.07 24.36 ± 0.10 24.71 ± 0.10 < 0.001
Energy (kcal/day) 1,220.20 ± 23.66 1,460.19 ± 13.98 2,750.06 ± 16.51 2,210.41 ± 25.26 3,850.13 ± 25.93 < 0.001
Obesity prevalence (%) 33.5 34.9 39.3 39.2 45.4 < 0.001
Chronic disease (%)            
Hypertension 35.6 32.7 32.7 28.7 30.5 0.009
Hypertension (at exam)∗∗ 12.8 16.4 19.1 17.5 18.2 0.078
Diabetes mellitus 16.4 13.4 9.9 9.8 9.2 < 0.001
Stroke 3.8 2.1 1.2 0.8 0.6 < 0.001
Myocardial infarction & angina pectoris 3.8 2.4 1.9 1.9 1.7 0.002
Hypercholesterolemia 13.7 11.5 12.6 12.1 12.3 < 0.001
Hypertriglyceridemia 15.3 14.9 19.3 17.1 19.3 0.015
Education level (%)           < 0.001
Graduated elementary: ≤ 6 28.2 18.9 11.8 9.6 9.9  
Graduated middle: 7 ∼ 9 15.0 11.6 11.9 11.6 9.8  
Graduated high: 10 ∼ 12 30.0 31.7 35.6 38.5 36.6  
Graduated university: ≥ 13 26.8 37.8 40.7 40.3 43.7  
Pysical activity (%)           0.001
No 53.5 53.0 56.3 54.3 53.1  
Yes 41.2 43.45 41.5 44.1 45.0  
Smoking status (%)           < 0.001
Non-smoker 16.9 17.7 16.8 15.2 16.8  
Ex-smoker 38.4 39.0 36.0 36.7 38.9  
Current smoker 39.9 41.0 46.0 47.1 43.1  
Drinking status (%)           < 0.001
Non-drinker 7.7 5.4 3.6 4.4 3.9  
Past drinker 16.3 12.8 9.7 9.2 7.5  
Current drinker 70.9 79.7 85.3 85.0 87.1  

Data were represented means ± SE or % about representative of the entire korean population.

∗∗ Hypertension at the exam: Hypertension diagnosed at the health exam for the first time

∗∗∗ Daily sodium intake

∗∗∗∗ p-value were obtained by t-test or chi-square test.

Table 4.
Anthropometrics and health-related variables according to daily sodium intake in women
Variables < 2,000 mg∗∗∗ 2,000 ∼ 4,000 mg 4,000 ∼ 6,000 mg 6,000 ∼ 8,000 mg ≥ 8,000 mg ∗∗∗∗
(n = 2,935) (n = 5,526) (n = 2,738) (n = 1,187) (n = 838) p-value
Age (yr) 57.07 ± 0.36 51.19 ± 0.24 49.60 ± 0.31 48.76 ± 0.40 47.64 ± 0.49 < 0.001
Height (cm) 154.78 ± 0.15 156.54 ± 0.11 156.91 ± 0.15 157.59 ± 0.22 157.64 ± 0.23 < 0.001
Weight (kg) 56.80 ± 0.20 57.71 ± 0.15 58.26 ± 0.21 58.23 ± 0.33 58.61 ± 0.51 < 0.001
BMI (kg/m2) 23.71 ± 0.08 23.56 ± 0.06 23.67 ± 0.08 23.46 ± 0.13 23.59 ± 0.20 0.344
Energy (kcal/day) 1,234.29 ± 9.56 1,618.92 ± 8.65 1,930.36 ± 13.19 2,221.88 ± 23.09 2,398.68 ± 30.38 < 0.001
Obesity prevalence (%) 31.8 29.2 31.1 29.7 29.9 0.268
Chronic disease (%)            
Hypertension 36.4 25.9 23.6 21.2 18.6 < 0.001
Hypertension (at exam)∗∗ 10.8 8.7 7.8 7.4 6.0 0.002
Diabetes mellitus 10.7 7.7 6.8 6.1 8.3 < 0.001
Stroke 1.7 1.2 0.5 0.8 0.5 < 0.001
Myocardial infarction & angina pectoris 3.1 1.9 1.6 1.3 0.7 0.002
Hypercholesterolemia 17.9 14.7 12.7 12.1 12.7 < 0.001
Hypertriglyceridemia 9.5 8.3 8.0 7.2 8.0 0.029
Education level(%)           < 0.001
Graduated elementary: ≤ 6 43.4 27.4 24.6 2.3 19.1  
Graduated middle: 7 ∼ 9 12.0 11.3 11.0 10.8 11.5  
Graduated high: 10 ∼ 12 26.3 35.1 33.8 34.4 38.3  
Graduated university: ≥ 13 18.3 26.3 30.6 32.5 31.1  
Pysical activity (%)           0.173
No 56.5 56.1 56.6 56.1 56.1  
Yes 38.8 40.7 40.3 40.9 41.4  
Smoking status (%)           0.091
Non-smoker 86.2 87.9 87.1 86.5 87.2  
Ex-smoker 5.2 4.9 5.6 5.5 5.7  
Current smoker 4.8 5.0 5.1 5.6 5.3  
Drinking status (%)           < 0.001
Non-drinker 23.9 18.1 15.8 15.1 15.5  
Past drinker 19.7 17.8 16.6 14.5 16.2  
Current drinker 52.5 61.8 65.1 68.2 66.2  

Data were represented means ± SE or % about representative of the entire korean population.

∗∗ Hypertension at the exam: Hypertension diagnosed at the health exam for the first time

∗∗∗ Daily sodium intake

∗∗∗∗ p-value were obtained by t-test or chi-square test.

Table 5.
Risk for obesity according to daily sodium intake
  Sodium intake (mg/day) Unadjusted OR (95% CI) Adjusted OR (95% CI)∗∗
Obesity      
Total < 2,000 mg 1 1
  2,000 ∼ 4,000 mg 0.965 (0.875 ∼ 1.064) 0.993 (0.891 ∼ 1.107)
  4,000 ∼ 6,000 mg 1.169 (1.052 ∼ 1.300) 1.126 (1.994 ∼ 1.276)
  6,000 ∼ 8,000 mg 1.170 (1.032 ∼ 1.327) 1.112 (0.959 ∼ 1.291)
  ≥ 8,000 mg 1.462 (1.283 ∼ 1.667) 1.358 (1.156 ∼ 1.595)
Men < 2,000 mg 1 1
  2,000 ∼ 4,000 mg 1.063 (0.856 ∼ 1.319) 0.961 (0.765 ∼ 1.208)
  4,000 ∼ 6,000 mg 1.286 (1.037 ∼ 1.595) 1.066 (0.839 ∼ 1.354)
  6,000 ∼ 8,000 mg 1.279 (1.018 ∼ 1.607) 1.066 (0.824 ∼ 1.380)
  ≥8,000 mg 1.648 (1.312 ∼ 2.070) 1.351 (1.032 ∼ 1.767)
Women < 2,000 mg 1 1
  2,000 ∼ 4,000 mg 0.884 (0.794 ∼ 0.985) 1.066 (0.944 ∼ 1.203)
  4,000 ∼ 6,000 mg 0.967 (0.852 ∼ 1.099) 1.232 (1.063 ∼ 1.427)
  6,000 ∼ 8,000 mg 0.905 (0.763 ∼ 1.073) 1.198 (0.984 ∼ 1.459)
  ≥ 8,000 mg 0.914 (0.747 ∼ 1.120) 1.229 (0.977 ∼ 1.548)

Abbreviations: OR, odds ratio; CI, confidence interval; BMI, body mass index

Obesity was defined as BMI ≥ 25 kg/m2.

∗∗ Logistic regression for obesity with daily sodium intake after adjustment for age, sex, year, energy density, education level, smoking status, drinking status, physical activity, chronic disease

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