본 연구는 2007~2015 국민건강영양조사 자료를 이용하여 고등학생(만 15~18세, 2,377명)의 가당음료 섭취 수준에 따른 식품군 및 영양소 섭취 실태를 파악하고자 실시하였다. 연도별 음료 섭취량의 변화 추이, 2007~2015 국민건강영양조사의 대상자를 통합하여 가당음료 섭취 수준에 따른 식품군 및 영양소 섭취량, 영양소 섭취 적정도 및 영양불량의 차이를 다중회귀분석이나 𝛘2-test로 검증하였다. 가공 과정에 당류를 넣는 탄산음료(콜라, 사이다, 기타 탄산음료 포함), 스포츠음료, 카페인음료(커피, 에너지 음료, 홍차, 코코아류)를 합하여 가당음료(sugar-sweetened beverage, SSB)로 분류하였다. 24시간 회상법으로 1일간 실시한 1일 가당음료 섭취량에 따라 대상자를 가당음료 1군(SSB 1, 가당음료 섭취량 0 g/d), 가당음료 2군(SSB 2, 0 g/d < 가당음료 섭취량 < 50 백분위수), 가당음료 3군(SSB 3, 가당음료 섭취량 ≥ 50 백분위수)으로 구분하였다. 연구 결과, 연도에 따라 1일 가당음료 섭취량은 남자(p<0.0001), 여자(p=0.0280) 모두 증가하는 추세이었으며, 2007년에 비해 2015년의 증가 정도는 남자 3.3배, 여자 2.1배로 남자가 여자보다 컸다. 음료 종류별로는 탄산음료 섭취량이 가장 많았으며 2007년에 비해 2015년에 남자 2.7배(p<0.0001), 여자 1.6배로 크게 증가하였다. 식품군별 1일 섭취량에서 채소류 섭취량은 남자와 여자 모두 가당음료 1군~가당음료 3군 중 가당음료 3군이 유의적으로 가장 적었으며(p<0.0001), 우유 및 그제품 섭취량은 남자(p<0.0001)에서는 가당음료 3군으로 갈수록 유의적으로 감소하였으나 여자에서는 가당음료 3군이 다른 군에 비해 적은 경향이었다. 1일 영양소 섭취량의 섭취기준에 대한 비율은 남녀의 가당음료 1군~가당음료 3군에서 식이섬유가 전체 영양소 중 가장 낮아 21.3±1.1~25.3±1.8% 밖에 되지 않았으며, 칼슘이 49.6±2.5~59.8±3.2%로 두번째로 낮았다. 에너지는 남녀 모두 가당음료 3군으로 갈수록 증가하였으며(p<0.0001), 비타민 C는 남자(p<0.0001), 여자(p=0.0382) 모두 가당음료 3군으로 갈수록 낮아졌다. 칼슘은 남자(p<0.0001), 여자(p=0.0008) 모두 가당음료 3군이 다른 군보다 낮았다. 에너지/지방과잉섭취자 비율은 남녀에서 모두 가당음료 3군으로 갈수록 증가하였으며(p=0.0002), 나트륨 목표섭취량 이상 섭취자 비율은 남자에서 가당음료 3군으로 갈수록 증가하였다(p=0.0429). 칼슘부족섭취자 비율은 남녀에서 가당음료 섭취 수준에 따른 차이가 없었으나 가당음료 1군~가당음료 3군에서 85% 이상으로 나타나 매우 높았다. 따라서 고등학생에서 가당음료 섭취가 높아질수록 식품군의 고른 섭취와 영양균형이 결여되는 경향이어서 식품 섭취 다양성 및 영양균형을 위해 가당음료 섭취를 줄이도록 관련 식생활교육과 사회적 지원을 강화하는 것이 필요하다고 하겠다.
This study examined the food group and dietary nutrient intakes by sugar-sweetened beverage(SSB) intake level in high school students aged 15~18 years(n=2,377) using the 2007~2015 Korea National Health and Nutrition Examination Survey. Subjects were classified into three groups by SSB(included carbonated drinks, sports drinks, and caffeinated drinks that contained added sugars) intake level obtained from 24-hour recall method: SSB 1(SSB intake 0 g/d), SSB 2(0 g/d < SSB intake < 50th percentile) and SSB 3(SSB intake ≥ 50th percentile). Result of daily intakes of SSB were 160.6±10.5 g/d for boys and 98.6±7.1 g/d for girls and it increased for boys(p<0.0001) and girls(p=0.0280) by year. The highest intakes were carbonated drinks followed by fruit juices for boys and girls. Intakes of carbonated drinks increased as 2.7 times for boys(p<0.0001) and 1.6 times for girls between 2007 and 2015 year. Daily intakes of vegetables were the lowest in SSB 3 of three groups for boys and girls(p<0.0001), and those of fruits were lower in SSB 2 and SSB 3 than SSB 1 for boys(p=0.0013). Daily intakes of milk & milk products decreased toward SSB 3 group for boys(p<0.0001) while those were the lowest in SSB 3 of three groups for girls. Daily intakes of dietary fiber(21.3~25.3%) and calcium(49.6~59.8%) were very low compared to the dietary reference intakes. Percentage of daily intakes compared to the dietary reference intakes increased for energy for boys and girls(p<0.0001) while decreased for vitamin C toward SSB 3 group for boys(p<0.0001) and girls(p=0.0382). Those of calcium were the lowest in SSB 3 of three groups for boys(p<0.0001) and girls(p=0.0008). Ratio of excess intakes of energy/fat increased toward SSB 3 group for boys and girls(p=0.0002). Ratio of calcium deficiency was not different among groups but that was very high(85.9~92.5%). Therefore, it should be emphasized to reduce SSB intakes in order to improve diversity in food group and dietary nutrient intakes among high school students through dietary education and government support.
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1. 김길례, 이연경 2021. "대구지역 성인의 가당음료 섭취와 영양지수를 활용한 식사의 질과의 관련성" 대한지역사회영양학회지 = Korean journal of community nutrition, 26(5): 350~362