본문 바로가기
KERD
논문KCI 등재

The association between dietary sodium intake and obesity in adults by sodium intake assessment methods: a review of systematic reviews and re-meta-analysis

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

BACKGROUND/OBJECTIVES: The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults. SUBJECTS/METHODS: A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool. RESULTS: This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m2 ; 95% confidence interval [CI], 1.59–2.51; P < 0.001; I2 = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m2 ; 95% CI, 1.13–1.55; P < 0.001; I2 = 95%) and dietary methods (mean difference = 0.85 kg/m2 ; 95% CI, 0.1–1.51; P < 0.05; I2 = 95%). CONCLUSIONS: Quantitative synthesis of the systematic reviews has shown that crosssectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.

Abstract

BACKGROUND/OBJECTIVES: The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults. SUBJECTS/METHODS: A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool. RESULTS: This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m2 ; 95% confidence interval [CI], 1.59–2.51; P < 0.001; I2 = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m2 ; 95% CI, 1.13–1.55; P < 0.001; I2 = 95%) and dietary methods (mean difference = 0.85 kg/m2 ; 95% CI, 0.1–1.51; P < 0.05; I2 = 95%). CONCLUSIONS: Quantitative synthesis of the systematic reviews has shown that crosssectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.

참고문헌 (77)

  1. NCD Risk Factor Collaboration(NCD-RisC), "Trends in adult body-mass index in 200 countries from 1975to 2014 : a pooled analysis of 1698 population-based measurement studies with 19·2 million participants", Lancet, 387, pp.1377~1396 (2016)
  2. Ansari S, "Adult obesity complications : challenges and clinical impact", Ther Adv Endocrinol Metab, 11, pp.2042018820934955~ (2020)
  3. Hruby A, "The epidemiology of obesity : a big picture", Pharmacoeconomics, 33, pp.673~689 (2015)
  4. Larsen SC, "24h urinary sodium excretion and subsequent change in weight, waist circumference and body composition", PLoS One, 8, pp.e69689~ (2013)
  5. Yi SS, "Independent associations of sodium intake with measures of body size and predictive body fatness", Obesity(Silver Spring), 23, pp.20~23 (2015)
  6. Yoon YS, "Sodium density and obesity; the Korea National Health and Nutrition Examination Survey 2007-2010", Eur J Clin Nutr, 67, pp.141~146 (2013)
  7. McLean RM, "Measuring population sodium intake : a review of methods", Nutrients, 6, pp.4651~4662 (2014)
  8. Grimes CA, "Dietary sodium intake and overweight and obesity in children and adults : a protocol for a systematic review and meta-analysis", Syst Rev, 5, pp.7~ (2016)
  9. Whiting P, "ROBIS : a new tool to assess risk of bias in systematic reviews was developed", J Clin Epidemiol, 69, pp.225~234 (2016)
  10. Higgins JP, "Measuring inconsistency in meta-analyses", BMJ, 327, pp.557~560 (2003)
  11. Grimes CA, "The association between dietary sodium intake, adiposity and sugar-sweetened beverages in children and adults : a systematic review and meta-analysis", Br J Nutr, 126, pp.409~427 (2021)
  12. Moosavian SP, "Salt and obesity : a systematic review and metaanalysis of observational studies", Int J Food Sci Nutr, 68, pp.265~277 (2017)
  13. Yoon Jung Kang, "Associations of Obesity and Dyslipidemia with Intake of Sodium, Fat, and Sugar among Koreans: a Qualitative Systematic Review", Clinical Nutrition Research, 5(4), pp.290~304 (2016), 한국임상영양학회
  14. Baudrand R, "High sodium intake is associated with increased glucocorticoid production, insulin resistance and metabolic syndrome", Clin Endocrinol(Oxf), 80, pp.677~684 (2014)
  15. Hoffmann IS, "Salt and the metabolic syndrome", Nutr Metab Cardiovasc Dis, 19, pp.123~128 (2009)
  16. Hulthén L, "Salt intake in young Swedish men", Public Health Nutr, 13, pp.601~605 (2010)
  17. Ma Y, "High salt intake : independent risk factor for obesity?", Hypertension, 66, pp.843~849 (2015)
  18. Madhavan S, "Ethnicity and the relationship of sodium intake to blood pressure", J Hypertens, 12, pp.97~103 (1994)
  19. Nam GE, "Association between 24-h urinary sodium excretion and obesity in Korean adults : a multicenter study", Nutrition, 41, pp.113~119 (2017)
  20. Polonia JJ, "Association of 24-h urinary salt excretion with central haemodynamics and assessment of food categories contributing to salt consumption in Portuguese patients with hypertension", Blood Press Monit, 18, pp.303~310 (2013)
  21. Vega-Vega O, "Contemporary dietary intake : too much sodium, not enough potassium, yet sufficient iodine : the SALMEX Cohort results", Nutrients, 10, pp.816~ (2018)
  22. Verhave JC, "Sodium intake affects urinary albumin excretion especially in overweight subjects", J Intern Med, 256, pp.324~330 (2004)
  23. Yan L, "Population-based association between urinary excretion of sodium, potassium and its ratio with albuminuria in Chinese", Asia Pac J Clin Nutr, 25, pp.785~797 (2016)
  24. 이무용, "High Sodium Intake in Women with Metabolic Syndrome", Korean Circulation Journal, 44(1), pp.30~36 (2014), 대한심장학회
  25. Han SY, "Association of the estimated 24-h urinary sodium excretion with albuminuria in adult Koreans : the 2011 Korea National Health and Nutrition Examination Survey", PLoS One, 9, pp.e109073~ (2014)
  26. Han W, "Relationship between urinary sodium with blood pressure and hypertension among a Kazakh community population in Xinjiang, China", J Hum Hypertens, 31, pp.333~340 (2017)
  27. Huh JH, "Gender-specific association between urinary sodium excretion and body composition : analysis of the 2008-2010 Korean National Health and Nutrition Examination Surveys", Metabolism, 64, pp.837~844 (2015)
  28. Lee SK, "Sodium excretion and cardiovascular structure and function in the nonhypertensive population: the Korean Genome and Epidemiology Study", Am J Hypertens, 28, pp.1010~1016 (2015)
  29. Oh SW, "Association of sodium excretion with metabolic syndrome, insulin resistance, and body fat", Medicine (Baltimore), 94, pp.e1650~ (2015)
  30. Petermann-Rocha F, "Sociodemographic patterns of urine sodium excretion and its association with hypertension in Chile : a cross-sectional analysis", Public Health Nutr, 22, pp.2012~2021 (2019)
  31. Watanabe S, "The association between urinary sodium excretion and blood pressure in a community-based population : the Yamagata(Takahata)study", Clin Exp Nephrol, 23, pp.380~386 (2019)
  32. Pfister R, "Estimated urinary sodium excretion and risk of heart failure in men and women in the EPIC-Norfolk study", Eur J Heart Fail, 16, pp.394~402 (2014)
  33. Welsh CE, "Urinary sodium excretion, blood pressure, and risk of future cardiovascular disease and mortality in subjects without prior cardiovascular disease", Hypertension, 73, pp.1202~1209 (2019)
  34. Eufinger SC, "Habitual dietary sodium intake is inversely associated with coronary flow reserve in middle-aged male twins", Am J Clin Nutr, 95, pp.572~579 (2012)
  35. Jablonski KL, "Low dietary sodium intake is associated with enhanced vascular endothelial function in middle-aged and older adults with elevated systolic blood pressure", Ther Adv Cardiovasc Dis, 3, pp.347~356 (2009)
  36. Murata A, "Prospective cohort study evaluating the relationship between salted food intake and gastrointestinal tract cancer mortality in Japan", Asia Pac J Clin Nutr, 19, pp.564~571 (2010)
  37. "J Assoc Physicians India", 2007, 405~411
  38. Sharma S, "Dietary sodium and potassium intake is not associated with elevated blood pressure in US adults with no prior history of hypertension", J Clin Hypertens(Greenwich), 16, pp.418~423 (2014)
  39. Shikata K, "A prospective study of dietary salt intake and gastric cancer incidence in a defined Japanese population : the Hisayama study", Int J Cancer, 119, pp.196~201 (2006)
  40. Zhao X, "Using a low-sodium, highpotassium salt substitute to reduce blood pressure among Tibetans with high blood pressure : a patientblinded randomized controlled trial", PLoS One, 9, pp.e110131~ (2014)
  41. Yokokawa H, "Daily salt intake estimated by overnight urine collections indicates a high cardiovascular disease risk in Thailand", Asia Pac J Clin Nutr, 25, pp.39~45 (2016)
  42. Zhao L, "Association of usual 24-h sodium excretion with measures of adiposity among adults in the United States : NHANES, 2014", Am J Clin Nutr, 109, pp.139~147 (2019)
  43. Song HJ, "Dietary sodium intake and prevalence of overweight in adults", Metabolism, 62, pp.703~708 (2013)
  44. Ge Z, "Association between 24 h urinary sodium and potassium excretion and the metabolic syndrome in Chinese adults : the Shandong and Ministry of Health Action on Salt and Hypertension(SMASH)study", Br J Nutr, 113, pp.996~1002 (2015)
  45. Zhang X, "A positive association between dietary sodium intake and obesity and central obesity : results from the National Health and Nutrition Examination Survey 1999-2006", Nutr Res, 55, pp.33~44 (2018)
  46. Appel LJ, "Effects of reduced sodium intake on hypertension control in older individuals : results from the Trial of Nonpharmacologic Interventions in the Elderly(TONE)", Arch Intern Med, 161, pp.685~693 (2001)
  47. Bulpitt CJ, "Is low salt dietary advice a useful therapy in hypertensive patients with poorly controlled blood pressure?", Ann Clin Res, 16(Suppl 43), pp.143~149 (1984)
  48. Geleijnse JM, "Reduction in blood pressure with a low sodium, high potassium, high magnesium salt in older subjects with mild to moderate hypertension", BMJ, 309, pp.436~440 (1994)
  49. Kumanyika SK, "Feasibility and efficacy of sodium reduction in the Trials of Hypertension Prevention, phase I", Hypertension, 22, pp.502~512 (1993)
  50. Nowson CA, "Low-sodium dietary approaches to stop hypertension-type diet including lean red meat lowers blood pressure in postmenopausal women", Nutr Res, 29, pp.8~18 (2009)
  51. Petersen KS, "Food label education does not reduce sodium intake in people with type 2 diabetes mellitus. A randomised controlled trial", Appetite, 68, pp.147~151 (2013)
  52. Beard TC, "Randomised controlled trial of a no-added-sodium diet for mild hypertension", Lancet, 2, pp.455~458 (1982)
  53. Dodson PM, "Sodium restriction and blood pressure in hypertensive type II diabetics : randomised blind controlled and crossover studies of moderate sodium restriction and sodium supplementation", BMJ, 298, pp.227~230 (1989)
  54. Gilleran G, "Effects of dietary sodium substitution with potassium and magnesium in hypertensive type II diabetics : a randomised blind controlled parallel study", J Hum Hypertens, 10, pp.517~521 (1996)
  55. He FJ, "School based education programme to reduce salt intake in children and their families(School-EduSalt) : cluster randomised controlled trial", BMJ, 350, pp.h770~ (2015)
  56. Nouvenne A, "Effects of a low-salt diet on idiopathic hypercalciuria in calcium-oxalate stone formers : a 3-mo randomized controlled trial", Am J Clin Nutr, 91, pp.565~570 (2010)
  57. Hypertension Prevention Trial Research Group, "The Hypertension Prevention Trial : three-year effects of dietary changes on blood pressure", Arch Intern Med, 150, pp.153~162 (1990)
  58. Staessen J, "Salt intake and blood pressure in the general population : a controlled intervention trial in two towns", J Hypertens, 6, pp.965~973 (1988)
  59. Takahashi Y, "Blood pressure change in a free-living populationbased dietary modification study in Japan", J Hypertens, 24, pp.451~458 (2006)
  60. The Trials of Hypertension Prevention Collaborative Research Group, "Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with highnormal blood pressure. The Trials of Hypertension Prevention, phase II", Arch Intern Med, 157, pp.657~667 (1997)
  61. Ard JD, "One-year follow-up study of blood pressure and dietary patterns in dietary approaches to stop hypertension(DASH)-sodium participants", Am J Hypertens, 17, pp.1156~1162 (2004)
  62. Sakaki M, "Characteristics of the hypertensive patients with good and poor compliance to long-term salt restriction", Clin Exp Hypertens, 36, pp.92~96 (2014)
  63. Takahashi Y, "Maintenance of a low-sodium, high-carotene and-vitamin C diet after a 1-year dietary intervention : the Hiraka dietary intervention follow-up study", Prev Med, 43, pp.14~19 (2006)
  64. 김정훈, "한국 성인의 하루 나트륨 섭취량과 비만의 연관성", Korean Journal of Health Promotion, 15(4), pp.175~184 (2015), 대한임상건강증진학회[DOI]
  65. 임소영, "전당뇨병 성인에서 나트륨 섭취와 복부비만과의 상관관계", 한국식품영양과학회지, 43(5), pp.763~771 (2014), 한국식품영양과학회
  66. 오현우, "비만인과 정상인에서 24시간 소변 내 나트륨 배출량과 비만관련 대사위험지표의 관련성", 대한지역사회영양학회지, 20(6), pp.460~467 (2015), 대한지역사회영양학회
  67. Lee M, "Salt induces adipogenesis", lipogenesis and inflammatory adipocytokines secretion in adipocytes, 2019, pp.20, 160~
  68. Lanaspa MA, "High salt intake causes leptin resistance and obesity in mice by stimulating endogenous fructose production and metabolism", Proc Natl Acad Sci U S A, 115, pp.3138~3143 (2018)
  69. Fonseca-Alaniz MH, "High sodium intake enhances insulin-stimulated glucose uptake in rat epididymal adipose tissue", Obesity(Silver Spring), 16, pp.1186~1192 (2008)
  70. Fonseca-Alaniz MH, "High dietary sodium intake increases white adipose tissue mass and plasma leptin in rats", Obesity(Silver Spring), 15, pp.2200~2208 (2007)
  71. Zhang Y, "Elevation of fasting ghrelin in healthy human subjects consuming a high-salt diet : a novel mechanism of obesity?", Nutrients, 8, pp.323~ (2016)
  72. Mähler A, "Increased salt intake decreases diet-induced thermogenesis in healthy volunteers : a randomized placebo-controlled study", Nutrients, 14, pp.253~ (2022)
  73. Cogswell ME, "Use of urine biomarkers to assess sodium intake : challenges and opportunities", Annu Rev Nutr, 35, pp.349~387 (2015)
  74. Campbell NR, "The International Consortium for Quality Research on Dietary Sodium", Salt(TRUE)position statement on the use of 24-hour, spot, and short duration(<24 hours)timed urine collections to assess dietary sodium intake, 2019, pp.21, 700~709
  75. Bie P, "Mechanisms of sodium balance : total body sodium, surrogate variables, and renal sodium excretion", Am J Physiol Regul Integr Comp Physiol, 315, pp.R945~62 (2018)
  76. Huang L, "Mean population salt intake estimated from 24-h urine samples and spot urine samples : a systematic review and meta-analysis", Int J Epidemiol, 45, pp.239~250 (2016)
  77. Ji C, "Systematic review of studies comparing 24-hour and spot urine collections for estimating population salt intake", Rev Panam Salud Publica, 32, pp.307~315 (2012)

관련 논문AI추천

The Association between Urinary Sodium Excretion and Metabolic Syndrome in Korean Adults from the 2010–2011 Korean National Health and Nutrition Examination Survey김정화, 서정은, 심경원, 안희정, 이상화, 이홍수, 전혜진, A Ri Byun대한가정의학회 · Korean Journal of Family Medicine2017 · 제38권 제4호Comparison between 24-hour diet recall and 24-hour urine collection for estimating sodium and potassium intakes and their ratio among Korean adults노희경, 한영희, 허영란, 현태선, Choi Mi-Kyeong, Lee Yeon-Kyung한국영양학회 · Nutrition Research and Practice2023 · 제17권 제2호The association between urine-estimated salt intake and hypertension: findings of a population-based studyAzizi Fereidoun, Bahadoran Zahra, Ghasemi Asghar, Mirmiran Parvin대한고혈압학회 · Clinical Hypertension2025 · 제31권 Effects of dietary salt intake restriction on blood glucose levels: a meta-analysis of crossover studyCui Jiajing, He Haitao, Ren Shuping, Shen Yong, Shi Yujie한국영양학회 · Nutrition Research and Practice2023 · 제17권 제3호Association between dietary sodium intake and disease burden and mortality in Koreans between 1998 and 2016: The Korea National Health and Nutrition Examination Survey조가람, Gitanjali M. Singh, Lee Jong-Tae, Lee Juhee, Park Clara Yongjoo, Shin Min-Jeong한국영양학회 · Nutrition Research and Practice2020 · 제14권 제5호Development of objective indicators for quantitative analysis of sodium intake: the sodium to potassium ratio of second-void urine is correlated with 24-hour urinary sodium excretion한상엽, HyeongCheonPark, Joo-Hark Yi, Jung Gon Kim, Sang-Woong Han한국영양학회 · Nutrition Research and Practice2020 · 제14권 제1호

이 간행물의 다른 논문 (15건)