영양표시 관심 영양소 군과 Low Density Lipoprotein 콜레스테롤 조절 정도의 연관성: 국민건강영양자료 2008–2011 = Relationship of Low Density Lipoprotein Cholesterol Level and Interest Nutrition on Nutrition Label in Korean Adults: 2008–2011 Korea National Health and Nutrition Examination Survey

다국어 초록 (Multilingual Abstract)

Background: Low density lipoprotein (LDL) cholesterol is an important metabolic marker, and it is suggested to be closely related with dietary habits.
The use of nutrition labels is beneficial for making healthier food choices. In addition, dietary habits and nutrients of interest vary among nutrientlabel users. This study investigated the association between different nutrients of interest and LDL cholesterol levels in Korean adults.
Methods: This cross-sectional study included 21,870 adults from the 2008–2011 Korea National Health and Nutrition Examination Survey (KNHANES).
Participants were divided into five groups according to the nutrients they were most interested in: 1) total calories, 2) carbohydrates, 3) protein, 4)fat, and 5) non-users of nutrition label. LDL cholesterol target level was set according to individual cardiovascular risk level. Multivariate logisticregression analysis was used to verify which nutrient of interest is related to the achievement of LDL cholesterol target level.
Results: Participants who were interested in total calories consumed lesser total calories and carbohydrates daily than those in the other groups did.
Moreover, compared with the “not reading nutrition label” group, the odds ratios (95% confidence intervals) for achieving LDL cholesterol targetlevel was 1.29 (1.05–1.58, P=0.015) in the “total calories” group after adjusting for confounding variables.
Conclusion: Participants who were interested in total calories were more likely to achieve optimal LDL cholesterol levels than those who did not readnutrition labels. Therefore, reading nutrition labels, especially focusing on total calories, can be helpful for reducing cardiovascular risk.

국문 초록 (Abstract)

연구배경: Low density lipoprotein (LDL) 콜레스테롤은 조절 가능한심혈관 질환의 위험인자이다. 식이 조절은 LDL 콜레스테롤 조절에중요한 요인이고 영양표시의 사용은 건전한 식이 조절에 영향을 미친다. 이에 본 연구에서는 2008–2011년 국민건강영양조사(KoreaNational Health and Nutrition Examination Survey, KNHANES)를 이용하여 개개인의 관심이 있는 영양 표기 확인에 따라 적절한 LDL콜레스테롤의 목표치 달성 정도에 차이가 있는지 확인해보고자 하였다.
방법: 2008–2011년 국민건강영양조사(KNHANES)를 이용하여 총21,870명을 연구에 포함시켰으며, 대상자는 탄수화물, 단백질, 지방,총 열량, 영양표시를 이용하는 군과 영양표시를 읽지 않는 군으로나누었다. 영양표시 사용과 관심군에 대한 질문은 KNHANES에 포함된 설문지를 사용하였으며 관심 있는 영양표시 이용여부에 따라목표 LDL 콜레스테롤 조절에 차이가 나는지 다중회귀분석을 시행하였다. SPSS 프로그램을 사용하였다.
결과: 총 열량에 관심을 가진 군은 실제 총 열량과, 탄수화물을 적게 섭취하는 식이 행태를 보였으며 연령, 성별, 소득수준, 건강행태를 보정한 후 총 열량 영양정보를 확인하는 군은 목표 LDL 콜레스테롤에 도달할 비율(OR, 1.29; 95% CI, 1.05–1.58; P=0.015)이 높았다.
탄수화물, 단백질, 지방 영양정보 확인군에서는 유의한 차이를 나타내지 않았다.
결론: 영양 표시 중 총 열량을 확인하는 경우 LDL 콜레스테롤이 잘조절되는 것을 확인하였으며 이는 총 칼로리를 이용한 영양 정보에관심을 가지는 습관이 심혈관 질환 발생의 위험을 줄이기 위한 전략의 하나로 이용될 수 있음을 의미한다.

참고문헌 (Reference)

1 박승국, "한국의 만성질환자에서 영양표시 이용실태와 유용성" 대한임상건강증진학회 14 (14): 131-140, 2014

2 김성용, "소비자의 식품선택에 대한 영양표시 이용의 효과 분석" 한국소비자학회 21 (21): 107-128, 2010

3 Risérus U, "Trans fatty acids and insulin resistance" 7 : 37-39, 2006

4 Kelley DE, "Relative effects of calorie restriction and weight loss in noninsulin-dependent diabetes mellitus" 77 : 1287-1293, 1993

5 Kang HT, "Reading nutrition labels is associated with a lower risk of metabolic syndrome in Korean adults : the 2007-2008 Korean NHANES" 23 : 876-882, 2013

6 Freedman MR, "Popular diets: a scientific review" 9 (9): 1S-40S, 2001

7 Temple JL, "Nutrition labels decrease energy intake in adults consuming lunch in the laboratory" 110 : 1094-1097, 2010

8 Fernandez ML, "Mechanisms by which dietary fatty acids modulate plasma lipids" 135 : 2075-2078, 2005

9 Wolever TM, "Long-term effect of varying the source or amount of dietary carbohydrate on postprandial plasma glucose, insulin, triacylglycerol, and free fatty acid concentrations in subjects with impaired glucose tolerance" 77 : 612-621, 2003

10 Howard BV, "LDL cholesterol as a strong predictor of coronary heart disease in diabetic individuals with insulin resistance and low LDL: the Strong Heart Study" 20 : 830-835, 2000

11 김순희, "Korean diet: Characteristics and historical background" 한국식품연구원 3 (3): 26-31, 2016

12 Roberto CA, "Improving the design of nutrition labels to promote healthier food choices and reasonable portion sizes" 38 (38): S25-S33, 2014

13 Vyth EL, "Front-of-pack nutrition label stimulates healthier product development : a quantitative analysis" 7 : 65-, 2010

14 "Food labeling regulations" Ministry of Health and Welfare

15 Ollberding NJ, "Food label use and its relation to dietary intake among US adults" 111 (111): S47-S51, 2011

16 Graham DJ, "Eye tracking and nutrition label use : a review of the literature and recommendations for label enhancement" 37 : 378-382, 2012

17 Baigent C, "Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials" 376 : 1670-1681, 2010

18 Larson-Meyer DE, "Effect of calorie restriction with or without exercise on insulin sensitivity, beta-cell function, fat cell size, and ectopic lipid in overweight subjects" 29 : 1337-1344, 2006

19 Heilbronn LK, "Effect of 6-month calorie restriction on biomarkers of longevity, metabolic adaptation, and oxidative stress in overweight individuals: a randomized controlled trial" 95 : 1539-1548, 2006

20 Reiner Z, "ESC/EAS Guidelines for the management of dyslipidaemias : the Task Force for the management of dyslipidaemias of the European Society of Cardiology(ESC)and the European Atherosclerosis Society(EAS)" 32 : 1769-1818, 2011

21 Martinez-Gonzalez MA, "Dietary patterns, Mediterranean diet, and cardiovascular disease" 25 : 20-26, 2014

22 Grundy SM, "Dietary influences on serum lipids and lipoproteins" 31 : 1149-1172, 1990

23 Liese AD, "Dietary glycemic index and glycemic load, carbohydrate and fiber intake, and measures of insulin sensitivity, secretion, and adiposity in the Insulin Resistance Atherosclerosis Study" 28 : 2832-2838, 2005

24 Bray GA, "Dietary fat intake does affect obesity!" 68 : 1157-1173, 1998

25 Ma Y, "Association between carbohydrate intake and serum lipids" 25 : 155-163, 2006

26 Holt SH, "An insulin index of foods : the insulin demand generated by 1000-kJ portions of common foods" 66 : 1264-1276, 1997

27 Drichoutis AC, "A theoretical and empirical investigation of nutritional label use" 9 : 293-304, 2008

28 이은정, "2018 Guidelines for the Management of Dyslipidemia in Korea" 한국지질동맥경화학회 8 (8): 78-131, 2019

29 Grundy SM, "2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines" 73 : e285-e350, 2019