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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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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 |
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 |
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 |
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 |
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) |
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