Korean J Fam Pract. 2018; 8(5): 741-746  https://doi.org/10.21215/kjfp.2018.8.5.741
Trends of Urinary Excretion of Sodium in Korean Adults: Based on the Korea National Health and Nutrition Examination Survey 2009-2015
Yun Jae Han, Hyun Woo Kim*, Jung Hyun Kim, Dong Won Lee, Ji Hoon Jung, Sang Hyun Cho, Sun Whan Kim, Seung Jin Jung, Byung Shik Cho, Jae Hyun Youn
Department of Family Medicine, Hana General Hospital, Cheongju, Korea
Hyun Woo Kim
Tel: +82-43-230-6555, Fax: +82-43-230-5300
E-mail: jamesinfm@gmail.com
ORCID: http://orcid.org/0000-0002-9664-8324
Received: July 21, 2017; Revised: October 18, 2017; Accepted: October 24, 2017; Published online: October 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Although the association between sodium intake and disease has been reported, no studies have assessed the trend of sodium excretion in urine in Koreans. We estimated daily urinary sodium excretion in Koreans and analyzed annual trends over time.
Methods: The 4th (2009), 5th (2010–2011), and 6th (2013–2014) National Health and Nutrition Examination Survey were used to extract data on adult subjects aged ＞20 years who did not take blood pressure medicine. The daily urinary sodium excretion was calculated using the E24UNA_K formula. The chi-square test was used to compare annual differences in analysis variables. Independent two-sample t-tests and analysis of variance were used to compare differences in 24-hour average urinary sodium excretion. Linear regression analysis was used to examine the increase according to year.
Results: The daily average urinary sodium excretion in Korean adults was 170.8±35.6 meq/day from 2009 to 2015. The daily average sodium excretion was 177.3±35.0 meq/day in 2009, 168.9±37.7 meq/day in 2010–2011, and 170.4±34.8 meq/day in 2014–2015. There were no significant increases between these periods (P-trend=0.459).
Conclusion: Although there were no increases in daily average sodium excretion, Koreans should try to reduce sodium intake because the daily average sodium consumption by Koreans is more than double the recommended allowance.
Keywords: Urinalysis; Creatinine; Nutrition Surveys
References
  1. Korea Centers for Disease Control and Prevention. Korea National Health and Nutrition Examination Survey (KNHANES V-1). Cheongju: Korea Centers for Disease Control and Prevention; 2011.
  2. Rhee MY, Lee SY, Oh SW, Shin SJ, Yim JY, Kim JH, et al. Study for the effect of Natrium intake on the prevalence of cardiovascular disease. Seoul: Ministry of Food and Drug Safety; 2013 Nov. Report No. 1475007349.
  3. Lim HJ. A study on the food intake, sodium and potassium intakes and urinary excretion of preschool children in Pusan. Korean J Nutr 2000; 33: 64759.
  4. Statistics Korea. Annual report on the cause of death statistics. Daejeon: Statistics Korea; 2008.
  5. HE FJ, MacGregor GA. Salt, blood pressure and cardiovascular disease. Curr Opin Cardiol 2007; 22: 298-305.
    Pubmed CrossRef
  6. Adrogué HJ, Madias NE. Sodium and potassium in the pathogenesis of hypertension. N Engl J Med 2007; 356: 1966-78.
    Pubmed CrossRef
  7. Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ 2007; 334: 885-8.
    Pubmed KoreaMed CrossRef
  8. Tuomilehto J, Jousilahti P, Rastenyte D, Moltchanov V, Tanskanen A, Pietinen P, et al. Urinary sodium excretion and cardiovascular mortality in Finland: a prospective study. Lancet 2001; 357: 848-51.
    CrossRef
  9. He FJ, Marrero NM, MacGregor GA. Salt intake is related to soft drink consumption in children and adolescents: a link to obesity? Hypertension 2008;51: 629-34.
    Pubmed CrossRef
  10. Hoffmann IS, Cubeddu LX. Salt and the metabolic syndrome. Nutr Metab Cardiovasc Dis 2009; 19: 123-8.
    Pubmed CrossRef
  11. Law MR, Frost CD, Wald NJ. By how much does dietary salt reduction lower blood pressure? I--analysis of observational data among populations. BMJ 1991; 302: 811-5.
    Pubmed KoreaMed CrossRef
  12. He FJ, Markandu ND, MacGregor GA. Modest salt reduction lowers blood pressure in isolated systolic hypertension and combined hypertension. Hypertension 2005; 46: 66-70.
    Pubmed CrossRef
  13. Song HJ, Cho YG, Lee HJ. Dietary sodium intake and prevalence of overweight in adults. Metabolism 2013; 62: 703-8.
    Pubmed CrossRef
  14. Yoon YS, Oh SW. Sodium density and obesity; the Korea National Health and Nutrition Examination Survey 2007-2010. Eur J Clin Nutr 2013; 67:141-6.
    Pubmed CrossRef
  15. Grimes CA, Riddell LJ, Campbell KJ, Nowson CA. Dietary salt intake, sugarsweetened beverage consumption, and obesity risk. Pediatrics 2013; 131: 1421.
    Pubmed CrossRef
  16. Jain N, Minhajuddin AT, Neeland IJ, Elsayed EF, Vega GL, Hedayati SS. Association of urinary sodium-to-potassium ratio with obesity in a multiethnic cohort. Am J Clin Nutr 2014; 99: 992-8.
    Pubmed KoreaMed CrossRef
  17. Yi SS, Firestone MJ, Beasley JM. Independent associations of sodium intake with measures of body size and predictive body fatness. Obesity (Silver Spring) 2015; 23: 20-3.
    Pubmed CrossRef
  18. He FJ, Jenner KH, Macgregor GA. WASH-world action on salt and health. Kidney Int 2010; 78: 745-53.
    Pubmed CrossRef
  19. Kim HN. Sodium reduction policy of foreign nations and perception of institutional foodservice customers on low sodium diet [dissertation]. Seoul:Chung-Ang Univ.; 2012. Korean.
  20. Korea Centers for Disease Control and Prevention. Korea National Health and Nutrition Examination Survey (KNHANES VI-3). Cheongju: Korea Centers for Disease Control and Prevention; 2016.
  21. National Centre for Social Research. An assessment of dietary sodium levels among adults (aged 19-64) in the general population in Wales based on analysis of dietary sodium in 24 hour urine samples. London: Joint Health Surveys Unit; 2007.
  22. Scottish Centre for Social Research. A survey of 24 hour urinary sodium excretion in a representative sample of the Scottish population as a measure of salt intake. Edinburgh: Scottish Centre for Social Research; 2011.
  23. Ortega RM, López-Sobaler AM, Ballesteros JM, Pérez-Farinós N, RodríguezRodríguez E, Aparicio A, et al. Estimation of salt intake by 24 h urinary sodium excretion in a representative sample of Spanish adults. Br J Nutr 2011; 105: 787-94.
    Pubmed CrossRef
  24. Park JH, Kim YC, Koo HS, Oh SW, Kim S, Chin HJ. Estimated amount of 24-hour urine sodium excretion is positively correlated with stomach and breast cancer prevalence in Korea. J Korean Med Sci 2014; 29 Suppl 2: S1318.
    Pubmed KoreaMed CrossRef
  25. Dahl LK. Salt and hypertension. Am J Clin Nutr 1972; 25: 231-44.
    Pubmed CrossRef
  26. Pramono A, Noriko N, S B Komara. Natrium dischargement from peripheral blood as a predominant factor influenced by the administration of banana (Musa paradisiaca) on elderly female hypertensive patient. IOP Conf Ser Mater Sci Eng 2017: 193.
    CrossRef
  27. 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: 53749.
    CrossRef
  28. Pfeiffer CM, Hughes JP, Cogswell ME, Burt VL, Lacher DA, Lavoie DJ, et al. Urine sodium excretion increased slightly among U.S. adults between 1988 and 2010. J Nutr 2014; 144: 698-705.
    Pubmed KoreaMed CrossRef
  29. Stolarz-Skrzypek K, Kuznetsova T, Thijs L, Tikhonoff V, Seidlerová J, Richart T, et al. Fatal and nonfatal outcomes, incidence of hypertension, and blood pressure changes in relation to urinary sodium excretion. JAMA 2011; 305:1777-85.
    Pubmed CrossRef
  30. Lelong H, Galan P, Kesse-Guyot E, Fezeu L, Hercberg S, Blacher J. Relationship between nutrition and blood pressure: a cross-sectional analysis from the NutriNet-Santé Study, a French web-based cohort study. Am J Hypertens 2015; 28: 362-71.
    Pubmed CrossRef

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