제주지역 뇌졸중 환자-대조군의 식습관 및 식품섭취실태 비교 연구

Abstract

본 조사는 제주지역 뇌졸중 환자들의 건강습관, 식습관 및 식품섭취를 알아보고 뇌졸중을 일으키는 식습관, 건강습관 관련 위험요인 및 식품의 섭취를 파악하여 뇌졸중 예방을 위한 기초 자료를 얻고자 수행되었다. 조사대상자는 2006년 5월부터 2008년 4월까지 제주대학교병원에서 뇌졸중으로 진단을 받은 130명을 환자군으로 하였고, 대조군 환자는 같은 병원 내에 입원한 정형외과 환자를 중심으로 하여 뇌졸중 병력과 소화기적으로 문제가 없는 환자 중 환자군과 성별이 같고 연령차이가 5세 내외인 환자를 대상으로 하여 130명을 선정하였다. 설문지를 통하여 일반사항, 신체계측 및 건강습관, 식생활 및 태도, 식품섭취빈도가 조사되었으며, 식품섭취빈도결과를 분석하여 하여 영양소 섭취량을 산출하였다. 본 연구의 결과를 요약하면 다음과 같다.

1. 환자군의 평균연령, 평균 신장, 평균 체중, 평균 체질량지수(BMI)는 대조군과 비슷하였으며 혈압과 과거병력은 환자군이 대조군에 비해 높았으며 유의적인 차이를 보였다.

2. 환자군의 음주율과 흡연율은 대조군에 비해 높았고 유의하였으며. 규칙적인 운동의 비율은 낮았고 유의하였다.

3. 환자군의 식사시간의 규칙성, 식사량의 일정성은 대조군에 비해 유의하게 낮고, 식사속도와 과식을 하는 비율은 높았고 유의적인 차이를 보였다.

4. 식생활 진단결과, 환자군의 총 점수는 23.1±2.8점, 대조군은 34.1±9.2점으로 환자군은 대조군에 비해 나쁜 식습관을 가진 것으로 조사되었다.

5. 1일 에너지 섭취량은 환자군과 대조군 각각 2159.8±4446.02㎉, 1948.9±410.5㎉로 환자군의 에너지 섭취량이 높고 유의하였다. 환자군은 대조군에 비해 단백질, 지방, 탄수화물, 비타민 B1, 비타민 B2, 비타민 B6, 비타민 E, 나이아신, 칼슘, 인, 철, 나트륨, 칼륨, 아연, 콜레스테롤의 섭취량이 높았고 유의하였다.

6. 단백질: 지방: 탄수화물의 열량 구성 비율은 환자군과 대조군이 각각 16.5: 21.9: 61.6, 16.1: 20.4: 63.4로 나타나 환자군은 전체 열량에 대하여 지방 에너지가 차지하는 비율이 대조군에 비해 높고, 탄수화물 에너지가 차지하는 비율은 낮았고 유의하였다.

7. 총 식품 섭취량은 환자군과 대조군 각각 1605.1±454.4g, 1435.2±485.6g으로 환자군이 대조군에 비해 높고 유의하였다. 식물성 식품 섭취량은 환자군이 대조군에 비해 높았고 유의하였다.

8. 환자군이 대조군에 비해 섭취량이 많았던 음식은 수박, 된장국/된장·청국장찌개, 배추/배추국, 계란/메추리알, 맥주, 두유, 라면, 소주, 칼국수/수제비/우동/냉면, 멸치/멸치볶음, 삼겹살, 젓갈류, 마늘/마늘장아찌, 복숭아/자두, 참외/멜론, 커피, 프림, 설탕, 쿠키/크래커/스낵, 햄/소시지/스팸, 마요네즈/샐러드드레싱, 버터/마가린 등이었고 유의적인 차이를 보였다.

9. 환자군은 계란/메추리알, 라면, 밥류, 된장국/된장·청국장찌개, 불고기/볶음/탕수육/돈까스/갈비, 등푸른생선조림/찌개, 배추/배추국, 프림 등이 대조군에 비해 지방 섭취량 및 기여비율이 높은 것으로 나타났다.

10. 환자군은 계란/메추리알, 멸치/멸치볶음, 된장국/된장·청국장찌개, 라면, 등푸른생선조림/찌개, 흰살생선조림/찌개, 불고기/볶음/탕수육/돈까스/갈비, 젓갈류, 프림 등이 대조군에 비해 콜레스테롤 섭취량 및 기여비율이 높은 것으로 나타났다.

11. 철분, 아연, 식이섬유의 섭취 증가는 뇌졸중의 발생 위험도를 유의하게 낮추는 보호인자로 나타났고, 에너지 및 콜레스테롤의 섭취 증가가 뇌졸중의 발생 위험도를 유의하게 높이는 위험인자인 것으로 나타났다.

뇌졸중 발생 위험요인으로 지적되고 있는 과다음주, 흡연, 운동부족, 스트레스에 대한 예방이 필요하며, 규칙적인 식습관, 식사속도의 조절, 적당한 식사량, 짜게 먹지 않는 식습관, 지방 및 콜레스테롤이 높은 식품의 섭취조절 등은 뇌졸중 예방을 위한 좋은 방법이 될 수 있다. 특히 지방 및 콜레스테롤 기여 비율이 높은 상용 음식들에 대한 섭취조절을 위한 적극적인 예방교육이 필요하다고 보며 본 연구 결과는 뇌졸중의 예방에 있어 좋은 기초 자료로 활용될 수 있을 것이다.

The present study was performed to get the fundamental materials for prevention of stroke by researching the life styles, eating habits and food that stroke patients around the Jeju area take and understanding the dangerous factors of the above-mentioned disease. The case participants(n=130) were selected from patients diagnosed as stroke patients in Cheju National University Hospital from May 2006 to April 2008. The control group(n=130) was selected from patients in the hospital who have no stroke history or digestive troubles. Stroke patients were compared with those in the control group who are of similar age and of the same sex. The survey was conducted through individual interviews using questionnaires including questions about their lifestyles, eating habits, exercise and the frequency of food intakes. Nutrient intakes were calculated based on the frequency of food intakes. The results are summarized as follows:

1. The patient group's average age, height, weight, and average Body Mass Index(BMI) were similar to the control group. However, the blood pressure and past illness history were higher than the control group and showed a significant difference.

2. The drinking and smoking rate of the patient group were higher than the control group which was quite significant. The rate of regular exercise was lower which was quite significant as well.

3. The patient group's regularity of mealtimes and the consistency of the amount of the meal were significantly lower than the control group. Whereas the rate of eating speed and overeating were significantly higher than the control group.

4. After the diagnosis of their eating habits, the total score of the patient group was 23.1±2.8 points, and the control group's score was 34.1±9.2 points which showed that the patient group had the worse eating habits compared to the control group.

5. The amount of energy intake for one day for the patient group and the control group were 2159.8±4446.02㎉ and 1948.9±410.5㎉ respectively. The amount of energy intake for the patient group was higher and quite significant. The patient group compared to the control group was higher in the intake of protein, fats, carbohydrates, vitamin B1, vitamin B2, vitamin B6, vitamin E, nicotinic acid, calcium, phosphorus, iron, natrium, kalium, zinc and cholesterol which was quite significant.

6. The ratio of calories of protein: fats: carbohydrates for the patient group and the control group were shown to be 16.5: 21.9: 61.6, 16.1: 20.4: 63.4 respectively. The ratio occupied by the fat energy for the patient group regarding the whole calorie was found to be higher than the control group and the ratio occupied by the carbohydrate energy was lower. 7. The total amount of calorie intake for the patient group and the control group were 1605.1±454.4g and 1435.2±485.6g respectively. The patient group was found to be higher than the control group. The amount of animal food intake was higher for the patient group than the control group but was not that significant but the intake of plant food was high and quite significant.

8. The food that had more intake for the patient group than the control group were watermelon, bean paste soup/bean paste·fermented soy bean stew, bae chu(Korean kimchi cabbage)/bae chu soup, eggs/partridge eggs, beer, soy milk, ramen, soju, kalguksu(handcut noodles)/sujaebi(wheat dough soup/wu-dong(thick noodles)/naengmyeon (cold noodles), anchovies/broiled anchovies, samkyeopsal(meat from a certain part of the pig), fermented fish sauces, garlic/dried and soy sauce seasoned garlic, peaches/plums, Korean melons/melons, coffee, cream, sugar, cookies/crackers/snacks, hams/sausages/spam, mayonnaise/salad dressing, butter/margarine and showed a significant difference.

9. The patient group showed a higher fat intake and participatory ratio with eggs/partridge eggs, ramen, rice and other grains, bean paste soup/bean paste·fermented soy bean stews, bulgogi/broiled food/pork cutlet/ribs, boiled down blue-skinned fish/stews, bae chu/bae chu soup, and cream.

10. The patient group showed a higher cholesterol intake and participatory rate than the control group with eggs/partridge eggs, anchovies/broiled anchovies, bean paste soup/bean paste·fermented soy bean stew, ramen, boiled down oily fish/stews, boiled down white fish/stews, bulgogi/broiled food/pork cutlet/ribs, fermented fish sauces, and cream.

11. The increase in the intake of iron, zinc, and fibers were shown to be the only protective agents which significantly lowers the occurrence of strokes. The increase in calories and cholesterol were shown to be the dangerous element in significantly elevating the possibility of strokes.

There needs to be some kind of preventive measures against overdrinking, smoking, lack of exercise and stress which have been pointed out as dangerous elements in leading to strokes. A regular eating habit, controlling the eating speed, appropriate amount of meals, eating less salt, controlling the amount of intake of food that are high in cholesterol can all be good ways to prevent strokes. I believe it is necessary to carry out an active preventive education especially for controlling the amount of intake of food which are high in participatory ratio of fats and cholesterol and it is hoped that the results of this research may be used as a good basic data for preventing strokes.