Salt Preference and Sodium Intake among Pregnant Women

Mi Jeung Im; Dong Sook Cho

doi:10.4069/kjwhn.2016.22.4.297

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Im and Cho: Salt Preference and Sodium Intake among Pregnant Women

Original Article

Korean Journal of Women Health Nursing 2016; 22(4): 297-307.

Published online: 27 December 2016

DOI: https://doi.org/10.4069/kjwhn.2016.22.4.297

Salt Preference and Sodium Intake among Pregnant Women

Mi Jeung Im¹, Dong Sook Cho²

¹Nowon Eulji Medical Center, Eulji University, Seoul, Korea.

²College of Nursing, Eulji University, Seongnam, Korea.

Corresponding author: Cho, Dong Sook. College of Nursing, Eulji University, 553 Sanseong-daero, Sujeong-gu, Seongnam 13135, Korea. Tel: +82-31-740-7157, Fax: +82-31-740-7359, chds@eulji.ac.kr

Received 31 October 2016 Revised 3 December 2016 Accepted 14 December 2016

(open-access):

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

This study was to estimate salt preference and sodium intake of pregnant women, and identify the relationship between salt preference and sodium intake.

Methods

Research design was a cross sectional correlational survey with 197 pregnant women who visited outpatient clinics for antenatal care. The sodium intake levels were estimated by the amounts of sodium intake using the 24-hour recall method and sodium concentration in spot urine. The data were analyzed using descriptive statistics, t-test, ANOVA and Pearson's correlation.

Results

Sodium intake using 24-hour recall method was 3,504±1,359 mg. Sodium intake levels had statistically significant differences depending on income. The average amount of sodium in spot urine was 2,882±878mg/day. Sodium excretion levels had statistically significant differences depending on whether participants had preexisting hypertension in their family history and Body Mass Index (BMI) pre-conception. Salt preference was 62.61±20.96 out of 180 points. Salt preference had significant differences depending on income, parity, gestational age, BMI pre-conception and showed negative correlation with sodium quantity in spot urine.

Conclusion

Sodium intake in pregnant women recommended by World Health Organization recommended is 175%. Salt preference was not significantly different between sodium intake levels, however it was negatively correlated with sodium quantity in spot urine among pregnant women.

Keywords: Pregnant women, Sodium, Urine

Figures and Tables

Table 1

Nutrient Intakes of Pregnant Women (N=197)

Intakes	1st trimester (n=25)	2nd trimester (n=112)	3rd trimester (n=60)	Total	x^2‡	p
Intakes	M±SD	M±SD	M±SD	M±SD	x^2‡	p
Energy (kcal)	1,635±428	1,745±582	1,830±578	1,757±564	2.97	.227
Protein (g)^† (% Energy)	67±25	75±60	71±27	73±49	0.36	.836
Protein (g)^† (% Energy)	16±3	16±5	15±3	16±4	0.36	.836
Fat (g)^† (% Energy)	56±29	63±40	57±30	60±36	0.34	.845
Fat (g)^† (% Energy)	30±24	30±21	27±16	29±20	0.34	.845
Carbohydrate (g)^† (% Energy)	221±58	237±67	263±91	243±75	5.25	.073
Carbohydrate (g)^† (% Energy)	54±1	55±1	57±1	55±1	5.25	.073
Calcium (mg)	483±258	629±304	579±286	595±296	5.59	.061
Iron (mg)	11±4	12±4	13±7	12±5	3.45	.178
Folate (㎍)	188±57	215±103	228±135	216±110	0.64	.725
Sodium intake (mg)	3,211±1,072	3,580±1,474	3,485±1,237	3,504±1,359	1.26	.532
Sodium excretion (mg)	2,673±882	2,912±925	2,912±783	2,882±878	0.96	.620

^†Acceptable macronutrient distribution ranges (AMDR); ^‡Kruskal-Wallis test.

Table 2

Responses of Salt Preference Questionnaire Items by Gestational Age (N=197)

Items	1st trimester (n=25)	2nd trimester (n=112)	3rd trimester (n=60)	Total	x^2‡	p
Items	M±SD	M±SD	M±SD	M±SD	x^2‡	p
Behavior items	22.08±11.32	20.68±10.39	29.92±14.71	23.67±12.62	18.34	<.001
1. Usually eat salty	5.88±1.83	6.03±1.37	6.70±1.94	6.21±1.65	6.14	.046
2. Add salt or soy sauce on cooked dishes	2.56±3.24	2.50±2.85	4.33±3.92	3.07±3.35	9.72	.008
3. Add salt on food before tasting	1.76±2.33	1.46±2.40	3.33±4.05	2.07±3.09	9.30	.010
4. How much salt use on thick brothor soup made of beef	6.36±2.50	6.08±1.95	6.45±2.70	6.23±2.27	3.13	.209
5. Eat pan-fried or deep-fried food with soy sauce	3.36±4.27	2.95±3.51	4.90±4.49	3.59±4.01	7.82	.020
6. Eat broiled meat or fish with salt, soy sauce or red pepper sauce	2.16±3.41	1.66±3.14	4.20±4.46	2.50±3.78	16.75	<.001
High salt food items	36.72±9.14	36.78±11.96	44.15±13.93	39.02±12.70	12.79	.002
7. How frequently eat kimchi (including kimchi pot stew and fried rice with kimchi)	9.36±3.04	10.26±2.00	9.50±2.98	9.91±2.50	2.43	.297
8. How frequently eat soup or pot stew?	8.28±2.64	9.24±2.21	8.80±2.92	8.98±2.51	3.27	.195
9. How frequently eat vegetables cooked or salad	5.76±2.59	6.46±2.36	7.25±2.49	6.61±2.46	8.31	.016
10. How frequently eat food that stir-fried, hard-broiled or pickled with soy sauce, soy bean paste or red pepper paste	4.44±2.47	4.47±2.58	6.15±2.95	4.98±2.78	15.74	<.001
11. How frequently eat processed meat food such as ham, sausage or bacon	2.52±2.24	2.25±2.63	3.45±3.12	2.65±2.78	6.30	.043
12. How frequently eat semi-cooked, instant or canned food	2.04±2.84	1.34±2.34	2.45±2.84	1.77±2.60	8.02	.018
13. How frequently eat salted nuts, dried seafood, potato chip or popcorn	1.44±2.47	0.99±2.43	2.60±3.05	1.54±2.72	18.21	<.001
14. How frequently eat rice or noodles with black bean sauce	0.72±1.31	0.70±1.89	1.55±2.17	0.96±1.95	12.44	.002
15. Which one prefer between animal food or vegetable food	2.16±4.54	1.07±3.14	2.40±4.45	1.61±3.80	5.35	.069
Total	58.52±17.41	57.46±18.84	73.95±21.92	62.61±20.96	24.78	<.001

^†Kruskal-Wallis test.

Table 3

Salt Preference, Sodium Intake, Sodium Excretion according to Characteristics of Pregnant Women (N=197)

Characteristics		Categories	n	Sodium excretion		Sodium excretion		Sodium excretion
Characteristics		Categories	n	M±SD	x² or z or t(p)	M±SD	x² or z or t(p)	M±SD	x² or z or t(p)
Family history	Hypertension	Yes	97	60.95±19.95	−1.10 (.273)	3,396±1,231	−1.10 (.273)	3,017±858	2.14 (.033)
	Hypertension	No	100	64.23±21.88	−1.10 (.273)	3,609±1,471	−1.10 (.273)	2,751±881	2.14 (.033)
	Stroke^‡	Yes	25	60.88±17.35	−0.12 (.903)	3,264±1,276	−1.00 (.320)	3,060±839	−1.19 (.235)
	Stroke^‡	No	172	62.87±21.47	−0.12 (.903)	3,539±1,370	−1.00 (.320)	2,856±883	−1.19 (.235)
	Diabetes mellitus^‡	Yes	38	67.55±24.42	−1.31 (.192)	3,301±1,089	−0.99 (.325)	2,761±806	−0.77 (.441)
	Diabetes mellitus^‡	No	159	61.43±19.96	−1.31 (.192)	3,553±1,414	−0.99 (.325)	2,911±894	−0.77 (.441)
	Heart disease^‡	Yes	9	73.00±25.16	−1.41 (.158)	2,997±1,179	−0.97 (.332)	3,265±841	−1.25 (.212)
	Heart disease^‡	No	188	62.12±20.69	−1.41 (.158)	3,529±1,365	−0.97 (.332)	2,863±878	−1.25 (.212)
Income (10,000 won/monthly)		＜300	59	67.53±23.22	3.38 (.036) a>b, c	3,143±1,277	3.23 (.042) a, b＜c	2,816±927	0.24 (.789)
		300~400	79	62.68±19.35		3,598±1,426		2,914±838
		>400	59	57.61±19.81		3,740±1,294		2,905±892
Pregnancy experience^‡		≥Second	60	67.83±20.78	−2.48 (.013)	3,244±1,293	−1.67 (.095)	2,754±932	−1.23 (.220)
Pregnancy experience^‡		First	137	60.33±20.71	−2.48 (.013)	3,619±1,376	−1.67 (.095)	2,938±851	−1.23 (.220)
Gestational age^†		1st trimester	25	58.52±17.41	24.78 (＜.001) a, b＜c	3,211±1,072	1.26 (.532)	2,673±882	0.96 (.620)
		2nd trimester	112	57.46±18.84		3,580±1,474		2,912±925
		3rd trimester	60	73.95±21.92		3,485±1,238		2,912±783
SBP (mmHg)^‡		≤120	190	62.54±21.18	−0.62 (.534)	3,499±1,369	−0.46 (.646)	2,906±874	−1.92 (.055)
SBP (mmHg)^‡		>120	7	64.71±14.85	−0.62 (.534)	3,786±723	−0.46 (.646)	2,220±776	−1.92 (.055)
DBP (mmHg)^‡		≤80	193	62.21±20.89	−2.03 (.043)	3,499±1,369	−0.82 (.415)	2,882±877	−0.06 (.951)
DBP (mmHg)^‡		>80	4	82.25±16.46	−2.03 (.043)	3,786±723	−0.82 (.415)	2,864±1,071	−0.06 (.951)
BMI (pre-conception) (kg/m²)^†		Underweight	70	57.29±20.43	12.47 (.002) a, b＜c	3,754±1,470	3.41 (.182)	2,835±869	8.72 (.013) a, b>c
		Normal	114	64.61±21.02		3,372±1,314		2,981±862
		Obese	13	73.77±16.77		3,324±948		2,262±850

a,b,c: Scheffé test; SBP=systolic blood pressure; DBP=diastolic blood pressure; BMI=body mass index; ^†Kruskal-Wallis test; ^‡Mann-Whitney test.

Table 4

Relationships among Salt Preference, Sodium Intake and Excretion of Pregnant Women (N=197)

Variables	Salt preference	Sodium intake	Sodium excretion
Variables	r (p)	r (p)	r (p)
Salt preference	1
Sodium intake	−.03 (.696)	1
Sodium excretion	−.22 (.002)	.05 (.461)	1

Notes

This manuscript is a condensed from of the first author's master's thesis from Eulji University.

Summary Statement

▪ What is already known about this topic?

The amount of nutritional knowledge and eating habits among pregnant women. The dietary quality evaluation of pregnant women and the evaluation of dietary information, efficacy of folic acid and iron levels of pregnant women.

▪ What this paper adds?

Pregnant womens'sodium intake from foods eaten and sodium excretion in spot urine were 1.7-fold and 1.4-fold, respectively, compared to WHO salt intake recommendation.

▪ Implications for practice, education and/or policy

As pregnancy progressed salt preference scores were elevated. Education for limited salt intake is necessary for pregnant women.

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