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2 "Hee Ju Jun"
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Original article
Age-period-cohort analysis of dietary sodium, potassium, and sodium-to-potassium ratio in Korea
Hee Ju Jun, Shieon Kim, Garam Jo
Epidemiol Health. 2025;47:e2025062.   Published online November 4, 2025
DOI: https://doi.org/10.4178/epih.e2025062
  • 1,076 View
  • 66 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Excessive sodium and insufficient potassium consumption are major dietary contributors to hypertension (HTN) and cardiovascular diseases. The sodium-to-potassium ratio is a known predictor of blood pressure (BP) and HTN. This study evaluated 16-year-trends in dietary sodium, potassium, and the sodium-to-potassium ratio, and their associations with BP and HTN in Korea.
METHODS
Data from 76,484 participants aged 19-79 years were obtained from the Korea National Health and Nutrition Examination Survey conducted in 2007-2022. Sodium and potassium intake were assessed using 24-hour recalls, and the sodium- to-potassium ratio was calculated. All values were energy-adjusted using the residual method. Age-period-cohort (APC) models were used to analyze temporal trends. Associations with BP and HTN were examined using multivariate linear and logistic regression models, adjusting for confounders.
RESULTS
Energy-adjusted sodium intake decreased across all age groups, and potassium slightly increased in the recent 5 years, though both remained suboptimal relative to recommendations. APC analyses showed increasing potassium intake with age and a reversed U-shape cohort pattern. The sodium-to-potassium ratio decreased with age and calendar year but increased in recent cohorts. A higher sodium-to-potassium ratio was strongly associated with elevated systolic (β=0.028, p<0.001) and diastolic BP (β=0.036, p<0.001), and increased odds of HTN (odds ratio, 1.19; 95% confidence interval, 1.07 to 1.33). A linear association appeared when the sodium-to-potassium ratio exceeded 1.00 in the spline model.
CONCLUSIONS
Despite improvements, sodium intake remains excessive, and potassium insufficient, particularly in younger adults and recent cohorts. Public health interventions should prioritize reducing sodium and promoting potassium-rich foods to reduce cardiovascular risk.
Summary
Korean summary
한국 성인의 나트륨 섭취는 지난 16년간 감소했지만 여전히 과도한 수준이고, 칼륨 섭취는 최근 증가했으나 권장량에 미치지 못했습니다. 연령·기간·코호트(APC) 분석 결과, 나트륨-칼륨 비율이 최근 출생 코호트에서 높아지는 경향을 보였습니다. 나트륨-칼륨 비율이 높을수록 혈압 상승과 고혈압 위험 증가가 유의하게 연관되는 만큼, 공중보건적 관리가 필요합니다.
Key Message
Over the past 16 years, sodium intake among Korean adults has decreased but remains high, while potassium intake has recently increased yet still falls below recommended levels. Age-period-cohort (APC) analyses showed that the sodium-to-potassium ratio has tended to increase in more recent cohorts. Because a higher sodium-to-potassium ratio is significantly associated with elevated blood pressure and a higher risk of hypertension, targeted public health efforts are needed.
Original Article
Association of dietary inflammatory index with mortality risk: a prospective analysis of the Korea National Health and Nutrition Examination Survey
Dahyun Park, Hee Ju Jun, Garam Jo, Soyoung Kwak, Min-Jeong Shin
Epidemiol Health. 2025;47:e2025017.   Published online April 9, 2025
DOI: https://doi.org/10.4178/epih.e2025017
  • 6,665 View
  • 102 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The energy-adjusted dietary inflammatory index (E-DII), a tool developed based on comprehensive research and literature reviews, is used to assess the inflammatory potential of specific diets. Although previous research has demonstrated an association between E-DII and mortality, longitudinal studies investigating a causal relationship in Asian populations are lacking. This study aimed to explore the prospective association between E-DII and the risk of all-cause, cancer, and cardiovascular disease (CVD) mortality using a population-based Korean cohort.
METHODS
The analysis included data from 40,596 individuals who participated in the Korea National Health and Nutrition Examination Survey between 2007 and 2015. The exclusion criteria encompassed the diagnosis of cancer or CVD at baseline, pregnancy at baseline, and death within the first 2 years after baseline. The E-DII was calculated using data from 24-hour dietary recall interviews. Cox proportional hazard regression models were employed to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for mortality risk across E-DII tertiles.
RESULTS
Over an 8.2-year follow-up period, 2,070 deaths were recorded. Compared with the lowest E-DII, a higher index was associated with an increased risk of mortality from all causes (HR, 1.45; 95% CI, 1.25 to 1.69), cancer (HR, 1.41; 95% CI, 1.09 to 1.81), and CVD (HR, 1.53; 95% CI, 1.07 to 2.18). The association between E-DII and all-cause mortality was particularly pronounced among individuals with metabolic conditions.
CONCLUSIONS
Our findings suggest a strong positive association between high E-DII and increased mortality in Korean adults, especially those with metabolic disorders.
Summary
Korean summary
본 연구는 2007–2015년 국민건강영양조사-사망원인통계 연계 데이터를 바탕으로 한국 성인을 대상으로 식이염증지수(E-DII)와 전체, 암, 심혈관질환 사망률 간의 연관성을 분석하였음. 높은 식이염증지수는 전체 사망(HR, 1.45; 95% CI, 1.25–1.69), 암 사망(HR, 1.41; 95% CI, 1.09–1.81), 심혈관질환 사망(HR, 1.53; 95% CI, 1.07–2.18) 위험 증가와 유의하게 관련되었으며, 특히 대사질환 보유자에서 그 연관성이 두드러졌음.
Key Message
This prospective cohort study analyzed nationally representative data from the Korea National Health and Nutrition Examination Survey (2007–2015) to examine the association between the energy-adjusted Dietary Inflammatory Index (E-DII) and mortality risk. A higher E-DII was significantly associated with increased risks of all-cause (HR, 1.45; 95% CI, 1.25–1.69), cancer mortality (HR, 1.41; 95% CI, 1.09–1.81), and cardiovascular mortality (HR, 1.53; 95% CI, 1.07–2.18), particularly among individuals with metabolic disorders.

Citations

Citations to this article as recorded by  
  • Dietary Inflammatory Index and the Risk of Gastric Precancerous Lesions Among Korean Adults in a Rural Area
    Yewon Cho, Dongkyu Lee, Chang Soo Eun, Dong Soo Han, Hyun Ja Kim
    Nutrients.2025; 17(22): 3502.     CrossRef
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