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

J Nutr Health. 2017 Feb;50(1):64-73. Korean.
Published online February 28, 2017.  https://doi.org/10.4163/jnh.2017.50.1.64
© 2017 The Korean Nutrition Society
Relationship of sodium consumption with obesity in Korean adults based on Korea National Health and Nutrition Examination Survey 2010~2014
Se Young Cheon, Hye Won Wang, Hwa Jung Lee, Kyung Mi Hwang, Hae Seong Yoon and Yoon Jung Kang
Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju 28159, Korea.

To whom correspondence should be addressed. tel: +82-43-719-4413, Email: kangyj2000@korea.kr
Received December 26, 2016; Revised January 19, 2017; Accepted February 03, 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.

Keywords: sodium intake; energy intake; obesity; body mass index

Figures


Fig. 1
Flow chart of subject's selection
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Tables


Table 1
General characteristics according to gender
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Table 2
Anthropometrics and health-related variables according to daily sodium intake
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Table 3
Anthropometrics and health-related variables according to daily sodium intake in men
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Table 4
Anthropometrics and health-related variables according to daily sodium intake in women
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Table 5
Risk for obesity according to daily sodium intake
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Notes

This research was supported by a grant (16161MFDS081) from Ministry of Food and Drug Safety in 2016.

References
1. Mundstock E, Sarria EE, Zatti H, Mattos Louzada F, Kich Grun L, Herbert Jones M, Guma FT, Mazzola In, Epifanio M, Stein RT, Barb-Tuana FM, Mattiello R. Effect of obesity on telomere length: systematic review and meta-analysis. Obesity (Silver Spring) 2015;23(11):2165–2174.
2. Kopelman PG. Obesity as a medical problem. Nature 2000;404(6778):635–643.
3. Bibbins-Domingo K, Chertow GM, Coxson PG, Moran A, Lightwood JM, Pletcher MJ, Goldman L. Projected effect of dietary salt reductions on future cardiovascular disease. N Engl J Med 2010;362(7):590–599.
4. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev 2012;70(1):3–21.
5. Khang YH, Park MJ. Trends in obesity among Korean children using four different criteria. Int J Pediatr Obes 2011;6(3-4):206–214.
6. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. 2013-2014 National Health Nutrition Examination Survey Report [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2014 [cited 2015 Dec 1].
7. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA 2016;315(21):2284–2291.
8. Comuzzie AG, Allison DB. The search for human obesity genes. Science 1998;280(5368):1374–1377.
9. Lee JH, Reed DR, Price RA. Familial risk ratios for extreme obesity: implications for mapping human obesity genes. Int J Obes Relat Metab Disord 1997;21(10):935–940.
10. Slochower J, Kaplan SP, Mann L. The effects of life stress and weight on mood and eating. Appetite 1981;2(2):115–125.
11. Lahti-Koski M, Pietinen P, Heliövaara M, Vartiainen E. Associations of body mass index and obesity with physical activity, food choices, alcohol intake, and smoking in the 1982-1997 FINRISK Studies. Am J Clin Nutr 2002;75(5):809–817.
12. Powles J, Fahimi S, Micha R, Khatibzadeh S, Shi P, Ezzati M, Engell RE, Lim SS, Danaei G, Mozaffarian D. Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (Nutri-CoDE). Global, regional and national sodium intakes in 1990 and 2010: a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide. BMJ Open 2013;3(12):e003733.
13. Song DY, Park JE, Shim JE, Lee JE. 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 2013;46(1):72–85.
14. Bray GA, Popkin BM. Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes?: health be damned! Pour on the sugar. Diabetes Care 2014;37(4):950–956.
15. Ma Y, He FJ, MacGregor GA. High salt intake: independent risk factor for obesity. Hypertension 2015;66(4):843–849.
16. Yang Q, Zhang Z, Kuklina EV, Fang J, Ayala C, Hong Y, Loustalot F, Dai S, Gunn JP, Tian N, Cogswell ME, Merritt R. Sodium intake and blood pressure among US children and adolescents. Pediatrics 2012;130(4):611–619.
17. Larsen SC, Ängquist L, Sørensen TI, Heitmann BL. 24h urinary sodium excretion and subsequent change in weight, waist circumference and body composition. PLoS One 2013;8(7):e69689.
18. Navia B, Aparicio A, Perea JM, Pérez-Farinós N, Villar-Villalba C, Labrado E, Ortega RM. Sodium intake may promote weight gain; results of the FANPE study in a representative sample of the adult Spanish population. Nutr Hosp 2014;29(6):1283–1289.
19. Song HJ, Cho YG, Lee HJ. Dietary sodium intake and prevalence of overweight in adults. Metabolism 2013;62(5):703–708.
20. Oh HW, Kim HJ, Jun DW, Lee SM. Associations between 24-hour urine sodium excretion level and obesity-related metabolic risk factors. Korean J Community Nutr 2015;20(6):460–467.
21. Oh SW, Han KH, Han SY, Koo HS, Kim S, Chin HJ. Association of sodium excretion with metabolic syndrome, insulin resistance, and body fat. Medicine (Baltimore) 2015;94(39):e1650.
22. Kim JH, Lim GE, Kang S, Lee K, Park TJ, Kim J. The relationship between daily sodium intake and obesity in Korean adults. Korean J Health Promot 2015;15(4):175–184.
23. World Health Organization Western Pacific Region. International Association for the Study of Obesity. International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia Pty Limited; 2000.
24. Chobanian AV, Hill M. National Heart, Lung, and Blood Institute Workshop on sodium and blood pressure: a critical review of current scientific evidence. Hypertension 2000;35(4):858–863.
25. Blaustein MP, Hamlyn JM. Role of a natriuretic factor in essential hypertension: an hypothesis. Ann Intern Med 1983;98(5 Pt 2):785–792.
26. Wang XQ, Terry PD, Yan H. Review of salt consumption and stomach cancer risk: epidemiological and biological evidence. World J Gastroenterol 2009;15(18):2204–2213.
27. Park B, Shin A, Park SK, Ko KP, Ma SH, Lee EH, Gwack J, Jung EJ, Cho LY, Yang JJ, Yoo KY. Ecological study for refrigerator use, salt, vegetable, and fruit intakes, and gastric cancer. Cancer Causes Control 2011;22(11):1497–1502.
28. World Health Organization. Guideline. Sodium intake for adults and children. Geneva: World Health Organization; 2012.
29. Cocores JA, Gold MS. The salted food addiction hypothesis may explain overeating and the obesity epidemic. Med Hypotheses 2009;73(6):892–899.
30. Fonseca-Alaniz MH, Brito LC, Borges-Silva CN, Takada J, Andreotti S, Lima FB. High dietary sodium intake increases white adipose tissue mass and plasma leptin in rats. Obesity (Silver Spring) 2007;15(9):2200–2208.
31. Fonseca-Alaniz MH, Takada J, Andreotti S, de Campos TB, Campaña AB, Borges-Silva CN, Lima FB. High sodium intake enhances insulin-stimulated glucose uptake in rat epididymal adipose tissue. Obesity (Silver Spring) 2008;16(6):1186–1192.
32. Grimes CA, Riddell LJ, Campbell KJ, Nowson CA. Dietary salt intake, sugar-sweetened beverage consumption, and obesity risk. Pediatrics 2013;131(1):14–21.
33. Libuda L, Kersting M, Alexy U. Consumption of dietary salt measured by urinary sodium excretion and its association with body weight status in healthy children and adolescents. Public Health Nutr 2012;15(3):433–441.
34. Yoon YS, Oh SW. Sodium density and obesity; the Korea National Health and Nutrition Examination Survey 2007-2010. Eur J Clin Nutr 2013;67(2):141–146.
35. Park YS, Son SM, Lim WJ, Kim SB, Chung YS. Comparison of dietary behaviors related to sodium intake by gender and age. Korean J Community Nutr 2008;13(1):1–12.
36. Jeong YS, Lim HJ, Kim SB, Kim HJ, Son SM. Blood pressure and dietary related risk factors associated with high sodium intake assessed with 24-hour urine analysis for Korean adults. Korean J Community Nutr 2014;19(6):537–549.