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2020 한국인 영양소 섭취기준 개정: 탄수화물

The development of the 2020 Dietary Reference Intakes for Koreans: carbohydrate

  • Kim, Wookyoung (Department of Food Science and Nutrition, Dankook University)
  • 투고 : 2021.11.18
  • 심사 : 2021.12.13
  • 발행 : 2021.12.31

초록

2020 한국인 영양소 섭취기준에서 탄수화물은 만성질환 예방을 위한 섭취기준으로 총 에너지 섭취량에 대한 탄수화물로부터의 에너지 섭취비율인 에너지적정비율을 1세 이후 모든 연령에서 55-65%로설정하였다. 그리고 2020년에 처음으로 탄수화물의 평균필요량과 권장섭취량을 설정하였다. 인체의 탄수화물 필요량은 뇌에서 하루에 소비되는 포도당량과 케톤체 생성이 나타나지 않는 양을 기준으로 1세 이후 모든 연령에서 1일 100 g을 설정하고, 권장섭취량은 15% 변이계수를 사용하여 두 배의 변이계수를 더한 130 g/일로 설정하였다. 탄수화물의 평균필요량은 최소필요량의 개념이지 에너지원으로서 적절한 섭취량에 대한 개념은 아니므로 탄수화물의 영양소섭취상태를 평가할 경우에는 평균필요량이나 권장섭취량에 비교하는 것은 적절하지 않고, 에너지적정비율을 활용하여 탄수화물로부터의 에너지 섭취비율의 적절성을 평가하는 것이 적절하다. 탄수화물은 에너지 적정비율범위에서 섭취할 때 만성질환의 위험을 낮출 수 있으며, 이를 탄수화물의 양뿐만 아니라 급원도 고려하는 식생활에 활용해야 할 것이다.

In the 2020 Dietary Reference Intakes for Koreans, an acceptable macronutrient distribution range (AMDR), similar to the one established in 2015, was determined for carbohydrates. AMDR is the ratio that signifies energy intake from carbohydrates to the total energy intake, and is a reference that indicates a decreasing risk of chronic diseases. The AMDR of carbohydrate was determined to be optimal at 55-65% for all ages above 1 year. For the first time, in the year 2020, the estimated average requirement (EAR) and recommended nutrient intake (RNI) for carbohydrates were established. The EAR was based on the amount of glucose used per day in the brain, and was set at 100 g/day for all ages above 1 year. The RNI was set at 130 g/day, by adding a double coefficient of variation using a 15% coefficient of variation, for all ages above 1 year. In pregnant women, the amount of glucose utilized by the fetus brain was considered additionally, and for lactating women the amount of lactose secreted into maternal milk was additionally taken into consideration. Since the EAR of carbohydrate indicates the minimum amount of glucose required by the brain and is not an appropriate intake amount as an energy source, it is incorrect to compare the carbohydrate intake with the EAR or RNI. To evaluate the nutritional status of carbohydrate, it is appropriate to use the AMDR. Carbohydrate intakes within the AMDR range has the possibility in reducing the risk of chronic diseases. Hence, it is important to consider the quality as well as quantity of carbohydrates consumed.

키워드

참고문헌

  1. Ministry of Health and Welfare. 2019 National health statistics. Sejong: Ministry of Health and Welfare; 2020.
  2. Choi HM. 21st Nutrition. 6th ed. Paju: Kyomunsa; 2021. p.62-66.
  3. Astrup A, Meinert Larsen T, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet 2004; 364(9437): 897-899. https://doi.org/10.1016/S0140-6736(04)16986-9
  4. Oh HW, Jun DW. Association between a high-fat low-carbohydrate diet and non-alcoholic fatty liver disease: truth or myth? Korean J Med 2017; 92(2): 112-117. https://doi.org/10.3904/kjm.2017.92.2.112
  5. Han YH, Kim HJ, Chung RH, Baek WS. A Retrospective study of the relationship between sleep duration, carbohydrate intake and the atherosclerotic cardiovascular disease risk in Korean, based on the 2013-2015 Korean National Health and Nutrition Examination Survey. Korean J Fam Pract 2019; 9(1): 89-95. https://doi.org/10.21215/kjfp.2019.9.1.89
  6. Moon HK, Kong JE. Assessment of nutrient intake for middle aged with and without metabolic syndrome using 2005 and 2007 Korean National Health and Nutrition Survey. Korean J Nutr 2010; 43(1): 69-478. https://doi.org/10.4163/kjn.2010.43.1.69
  7. Song Y, Joung H. A traditional Korean dietary pattern and metabolic syndrome abnormalities. Nutr Metab Cardiovasc Dis 2012; 22(5): 456-462. https://doi.org/10.1016/j.numecd.2010.09.002
  8. Song SJ, Lee JE, Paik HY, Park MS, Song YJ. Dietary patterns based on carbohydrate nutrition are associated with the risk for diabetes and dyslipidemia. Nutr Res Pract 2012; 6(4): 349-356. https://doi.org/10.4162/nrp.2012.6.4.349
  9. Kim EK, Lee JS, Hong H, Yu CH. Association between glycemic index, glycemic load, dietary carbohydrates and diabetes from Korean National Health and Nutrition Examination Survey 2005. Korean J Nutr 2009; 42(7): 622-630. https://doi.org/10.4163/kjn.2009.42.7.622
  10. Ha K, Song Y. Low-carbohydrate diets in Korea: why does it matter, and what is next? J Obes Metab Syndr 2021; 30(3): 222-232. https://doi.org/10.7570/jomes21051
  11. Brouns F. Overweight and diabetes prevention: is a low-carbohydrate-high-fat diet recommendable? Eur J Nutr 2018; 57(4): 1301-1312. https://doi.org/10.1007/s00394-018-1636-y
  12. Sim YJ. A low-carbohydrate, high-fat diet. Korean J Obes 2016; 25(4): 188-189. https://doi.org/10.7570/kjo.2016.25.4.188
  13. Goodridge AG, Sul HS. Lipid metabolism synthesis and oxidation. In: Stipanuk MH, editor. Biochemical and Physiological Aspects of Human Nutrition. Philadelphia (PA): W.B. Saunders Company; 2000. p.305-350.
  14. Paoli A. Ketogenic diet for obesity: friend or foe? Int J Environ Res Public Health 2014; 11(2): 2092-2107. https://doi.org/10.3390/ijerph110202092
  15. Westman EC. Is dietary carbohydrate essential for human nutrition? Am J Clin Nutr 2002; 75(5): 951-953. https://doi.org/10.1093/ajcn/75.5.951a
  16. St Jeor ST, Howard BV, Prewitt TE, Bovee V, Bazzarre T, Eckel RH, et al. Dietary protein and weight reduction: a statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association. Circulation 2001;104(15): 1869-1874. https://doi.org/10.1161/hc4001.096152
  17. Naude CE, Schoonees A, Senekal M, Young T, Garner P, Volmink J. Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis. PLoS One 2014; 9(7): e100652. https://doi.org/10.1371/journal.pone.0100652
  18. Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, et al. Weight loss with a lowcarbohydrate, Mediterranean, or low-fat diet. N Engl J Med 2008; 359(3): 229-241. https://doi.org/10.1056/NEJMoa0708681
  19. Mansoor N, Vinknes KJ, Veierod MB, Retterstol K. Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Br J Nutr 2016; 115(3): 466-479. https://doi.org/10.1017/S0007114515004699
  20. Kim JH. Effects of a low-carbohydrate, high-fat diet. Korean J Obes 2016; 25(4): 176-183. https://doi.org/10.7570/kjo.2016.25.4.176
  21. Jenkins DJ, Wolever TM, Taylor RH, Barker H, Fielden H, Baldwin JM, et al. Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 1981; 34(3): 362-366. https://doi.org/10.1093/ajcn/34.3.362
  22. Korean Diabetes Association. Diabetes food exchange system guide, 3rd ed. Seoul: Korean Diabetes Association; 2010.
  23. Park MH, Nam KS, Chung SJ. Effects of a low glycemic load diet on body weight loss in overweight or obese young adults. J Nutr Health 2020; 53(5): 464-475. https://doi.org/10.4163/jnh.2020.53.5.464
  24. Choi Y, Chang Y, Ryu S, Cho J, Kim MK, Ahn Y, et al. Relation of dietary glycemic index and glycemic load to coronary artery calcium in asymptomatic Korean adults. Am J Cardiol 2015; 116(4): 520-526. https://doi.org/10.1016/j.amjcard.2015.05.005
  25. Lutsey PL, Steffen LM, Stevens J. Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study. Circulation 2008; 117(6): 754-761. https://doi.org/10.1161/CIRCULATIONAHA.107.716159
  26. Kwon O, Kim H, Kim J, Hwang JY, Lee J, Yoon MO. The development of the 2020 dietary reference intakes for Korean population: Lessons and challenges. J Nutr Health 2020; 54(5): 425-434.
  27. Choi H, Song S, Kim J, Chung J, Yoon J, Paik HY, et al. High carbohydrate intake was inversely associated with high-density lipoprotein cholesterol among Korean adults. Nutr Res 2012; 32(2): 100-106. https://doi.org/10.1016/j.nutres.2011.12.013
  28. Institute of Medicine. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Washington, D.C.: National Academy Press; 2005.
  29. Ministry of Health and Welfare, The Korean Nutrition Society. Dietary reference intakes for Koreans 2015. Sejong: Ministry of Health and Welfare; 2015.
  30. Ministry of Health and Welfare, The Korean Nutrition Society. Dietary reference intakes for Koreans 2020. Sejong: Ministry of Health and Welfare; 2020.
  31. Han MR, Lim JH, Song YJ. The effect of high-carbohydrate diet and low-fat diet for the risk factors of metabolic syndrome in Korean adolescents: Using the Korean National Health and Nutrition Examination Surveys (KNHANES) 1998-2009. J Nutr Health 2014; 47(3): 186-192. https://doi.org/10.4163/jnh.2014.47.3.186
  32. Lee LH. Bone health status of Korean elderly people and dietary factors related to bone mineral density. J Res Ins Korean Educ 2006; 24: 1-19.
  33. Jung HJ, Song WO, Paik HY, Joung H. Dietary characteristics of macronutrient intake and the status of metabolic syndrome among Koreans. Korean J Nutr 2011; 44(2): 119-130. https://doi.org/10.4163/kjn.2011.44.2.119