Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Evaluation of the sodium intake reduction plan for a local government and evidence-based reestablishment of objectives: Case of the Seoul Metropolitan Government

지자체의 나트륨 섭취 감소 계획 평가 및 근거 기반 목표 재설정 : 서울시 사례를 중심으로

  • Lim, A-Hyun (Seoul Food Life Support Center, Seoul Metropolitan Government) ;
  • Hwang, Ji-Yun (Department of Foodservice Management and Nutrition, Sangmyung University) ;
  • Kim, Kirang (Department of Food Science and Nutrition, Dankook University)
  • 임아현 (서울특별시 식생활종합지원센터) ;
  • 황지윤 (상명대학교 외식영양학과) ;
  • 김기랑 (단국대학교 식품영양학과)
  • Received : 2017.09.18
  • Accepted : 2017.11.15
  • Published : 2017.12.31
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Abstract

Purpose: To identify the effectiveness of policy evaluation, consistent monitoring is necessary. This study aimed to carry out mid-term evaluation of objectives and programs related to comprehensive plans for sodium intake reduction by 2020 for Seoul city and then reestablish the objectives of the sodium intake reduction plans. Methods: Literature reviews, data analysis, and reviews of expert focus-groups were performed to evaluate objectives, to develop a new goal, and to identify the priority subjects of the sodium intake reduction programs. In order to examine target populations for the programs, awareness and behaviors related to sodium intakes among Seoul citizens were examined by sex, age, and income level using the 2008~2013 Korea National Health and Nutrition Examination Survey data. Results: Current objectives of the sodium intake reduction plan by 2020 for Seoul city were not appropriate, so objectives were reset to 3,600 mg of sodium intake by 2020 among Seoul citizens with 2% reduction per year. Although sodium intake showed a decreasing trend by year, it was still high, especially in men. The sodium intake reduction programs currently in progress have not been assessed at multiple levels across multiple sectors and have only been assessed fragmentarily. For dietary behavior related to sodium intakes by sex, age, and income level, sodium intake was higher in the group with less than 100 g of fruit intake compared to the group with 100 g or more. Subjects aged 30~59 years and the low household income group showed relatively higher sodium intakes. Based on the data analysis and the expert review, the priority subject of the sodium intake reduction programs was determined to be adult men. In terms of a program strategy for sodium intake reduction, multi-level and setting approaches, including work sites, home, and restaurants, were suggested to reduce sodium intakes of the target subject. Conclusion: The suggested objectives should be consistently monitored by data analysis, and the determined programs need to be phased in over 5 years.

문헌 고찰을 통한 국내외 나트륨 정책 현황 및 나트륨 섭취량, 서울시에서 진행되고 있는 나트륨 섭취 감소 프로그램의 분석, 국민건강영양조사에서의 서울 시민을 대상으로 한 나트륨 섭취 추이, 인구학 사회경제적 특성 및 나트륨 섭취와 관련된 식행동에 따른 나트륨 섭취량 자료분석, 전문가 안면 타당도 평가 결과를 통한 서울시 나트륨 섭취 저감화 계획 목표 재설정 및 프로그램 우선 순위와 대상자 선정은 다음과 같다. 나트륨 저감화 전략에 따른 각 국가의 나트륨 섭취 감소율을 분석한 결과 전년도 대비 약 1.0 ~ 2.0%씩 감소하였고 우리나라의 경우 5.3%의 감소율을 보였다. 따라서 본 연구에서 제시하는 서울시 나트륨 섭취 저감화 정책 목표는 연간 나트륨 섭취량 감소율 2.7%와 서울시 나트륨 저감화 사업의 확대 계획을 고려하여 2.0%로 연간 감소율을 적용하는 것으로 하여 2020년에는 약 3,600 mg의 나트륨 섭취량을 목표로 재설정하였다. 서울시에서 수행하고 있는 나트륨 감소를 위한 프로그램을 생태학적 프레임에 적용하여 분석한 결과, 전반적으로 생태학적 프레임에서 제안하고 있는 개인적, 사회적 환경, 물리적 환경, 거시적 환경 수준들이 프로그램에 포함되고 있었으나 각 프로그램들은 대상자에 따라 수준별로 연계가 되어 있지 못하였고, 주로 단편적이고 산발적으로 진행되고 있었다. 또한 각 자치구별로 공통되고 표준화된 프로그램은 없었다. 따라서 선택과 집중을 기반으로 하여 대상자별로 각 수준들이 연계되어 표준화된 프로그램이 필요한 것으로 나타났다. 프로그램 우선순위 대상자는 성별에서는 여자보다 남자에서, 연령대에서는 30 ~ 50대 성인, 소득수준에서는 저소득층이었고, 나트륨 섭취와 관련된 식행동 중에서는 과일 섭취량이 적은 군이 전반적으로 나트륨 섭취량이 높은 특성을 가져 과일 섭취에 대한 식행동 변화가 중요한 것으로 나타났다. 나트륨 섭취 감소를 위한 프로그램 분석, 서울시 나트륨 섭취 현황 및 고 나트륨 섭취 대상자 특성 분석, 전문가 대상 안면 타당도 평가 결과를 바탕으로 서울시 나트륨 감소를 위한 프로그램 우선순위 대상자는 성인 남성으로서 프로그램의 전략 방향은 생태학적 프레임을 적용하여 이들이 주로 생활하는 생활 터인 직장, 가정, 음식점에서의 나트륨 섭취 환경 개선을 위한 프로그램들을 수준별로 연계하여 진행하는 것으로 제안하였다. 따라서 가정과 음식점에서는 성인 남성의 나트륨 섭취에 영향을 줄 수 있는 주부와 조리 종사자도 프로그램 주요 대상자로 선정 되었다. 본 연구에서는 제안된 나트륨 섭취량의 목표치와 중재 프로그램에 대한 우선순위는 지속적인 모니터링과 효과평가를 통하여 업데이트가 되어야 할 것이다. 향후 생태학적 프레임에 적용된 나트륨 섭취 감소 프로그램의 효과에 대한 전반적인 평가가 필요할 것으로 사료되며 나트륨 섭취 저감화 정책 및 프로그램의 지속성과 효과적인 수행을 위해서는 타 기관 및 부서에서 수행되고 있는 관련 프로그램과의 연계와 협의 체계가 마련되어야 할 것이다.

Keywords

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