회상법과 식품섭취빈도조사법을 이용한 제주지역 노인들의 영양소섭취 조사 비교

Abstract

본 연구는 제주시 영평상동, 서귀포시 대천동 강정마을, 제주시 한경면 조수1리, 서귀포시 남원읍 신례1리에서 거동이 가능한 65세 이상 노인 225명을 대상으로 24시간 회상법과 식품섭취빈도조사법에 따른 영양소 섭취량 및 식품군별 섭취량을 비교하고, 조사방법에 따른 영양소 및 식품군의 섭취량간의 일치도를 검토하여 앞으로 노인들의 식이섭취 조사에 도움이 되는 기초자료를 제공하고자 한다. 본 연구의 결과를 요약하면 다음과 같다.

1. 조사대상자의 평균연령은 남자노인 71.9±5.0세, 여자노인 75.6±6.7세이었으며 남자노인이 여자노인에 비해 교육수준 및 배우자와의 동거비율이 높은 반면 여자노인은 독거노인의 비율이 41.1%나 되었고 전체노인 중 56.9%가 직업을 가지고 있는 것으로 나타났다.

2. 24시간 회상법과 식품섭취빈도 조사법에 따른 평균 섭취열량은 1,405.2±405.7 Kcal, 1,717.9 ± 567.0Kcal로 두 방법 간의 열량 차이는 -312.7Kcal 로 나타났고, 모든 영양소에서 유의적인 차이가 있었다. 섭취량의 차이에 대한 비율은 단백질, 지방, 비타민 A, 비타민 B1, 엽산에서 2.8～5.7로 차이가 적은 반면 비타민 B2, 비타민 C, 콜레스테롤은 20.7～30.0으로 차이가 크게 나타났다. 열량 1,000Kcal 당 섭취량으로 보정하였을 때 섭취량의 차이는 단백질, 칼슘, 철분, 나트륨, 칼륨, 비타민 A, 비타민 B1, 비타민 B2, 나이아신에서 유의적이었고, 섭취량의 차이에 대한 비율은 단백질, 탄수화물, 칼슘, 인, 철분, 나트륨, 칼륨, 나이아신에서 0.6～7.7로 적었으나 비타민 C, 콜레스테롤에서 34.4, 31.2로 차이가 크게 나타났다.

3. 24시간 회상법과 식품섭취빈도 조사법에서 Pearson 상관계수는 열량, 단백질, 지방, 탄수화물로 비타민 B2를 제외한 대부분의 영양소에서 0.21～0.59로 유의적이었다. Spearman 순위 상관계수는 모든 영양소에서 0.21～0.54로 유의적으로 나타났다. 열량 1,000Kcal 당 섭취량으로 보정하였을 때 Pearson 상관계수는 보정 전 보다 낮게 나타났다. Spearman 상관계수도 0.16～0.41로 칼슘과 비타민 B1을 제외한 모든 영양소에서 유의적으로 나타났다.

4. 24시간 회상법과 식품섭취빈도조사법에 따른 식품군 섭취량은 육류, 과일류, 해조류를 제외한 모든 식품군에서 유의적인 차이를 보였다. 섭취량의 차이에 대한 비율은 감자류, 육류, 어패류, 해조류, 우유 및 유제품, 음료 및 주류, 양념류에서 유의적인 차이를 보였다. Pearson 상관계수는 곡류, 당류, 콩류, 채소류 및 버섯류, 육류, 어패류, 우유 및 유제품, 양념류에서 유의적이었고, 섭취량을 보정하였을 때 Pearson 상관계수와 Spearman 상관계수는 낮아졌다. 중량 보정 후에 24시간 회상법에서 더 높게 섭취된 것은 감자류, 육류, 어패류, 음료 및 주류였다. 계절별, 지역별 생산물에 따라 식품군의 섭취량이 차이가 발생하였다.

5. 24시간 회상법과 식품섭취빈도조사법에 따른 영양소섭취량의 상대적 순위로 대상자를 4분위와 5분위로 교차 분류한 결과 각각 82.2%, 65.5%의 일치율을 보였으며, 정반대로 낮게 분류될 확률은 약 11.0%와 6.7%, 정반대로 높게 분류될 확률은 9.6%, 6.7%로 나타났다. 4분위와 5분위 교차분류에 따른 Weighted Kappa 값은 각각 평균 0.26으로 나타나 분류방법에 따른 Weighted Kappa 차이는 없었다.

본 연구에서 24시간회상법과 식품섭취빈도 조사법에 따른 영양소 섭취량을 비교하였을 때 유의적인 차이가 있었고, 영양소섭취량과 섭취 순위에 따른 유의성도 나타났다. 24시간 회상법과 식품섭취빈도 조사법에 따른 일치율은 다른 연구들과 비슷하게 나타나 식이섭취 조사 자료로 활용할 만하다고 할 수 있다. 두 방법 간의 일치 정도를 4분위 분류(Quartile)와 5분위 분류(Quintile)로 보았을 때 4분위 분류 보다 5분위 분류에서 정반대로 분류될 확률이 낮아졌다. 본 연구 결과 24시간 회상법에서는 계절적인 요인을 고려하고, 식품섭취빈도조사에서는 적정한 식품항목의 개수를 확인하여 적용시켜 제주지역에 맞는 식이조사를 위한 기초자료를 제시하고자 한다.

This research was carried out with 225 seniors over 65 years old who have mobility residing within the areas of Yeongpyeongsang-dong Jeju City, Daecheon-dong Kangjung Village Seogwipo City, Josu 1-li Hankyeong-myeon Jeju City and Sinrye 1-li Namwon-eup Seogwipo City as the target groups by using the 24 hour recall method and food frequency questionnaire. The amount of nutrient intake and amount of food group intake followed by the 24-hour recall method and the food frequency questionnaire method were compared first. Then, by investigating into the correspondence of the intake amount in nutrients and food groups according to the investigative method, the objective of this research was to provide basic data which will help in further investigations of dietary intake of seniors in the future. The following are a brief summary of the research findings.

1. The average age of the target group was 71.9±5.0 for males and 75.6±6.7 for females. The male seniors had higher education rate and higher percentage of living with a spouse. On the other hand, the female seniors had a percentage of up to 41.1% of who was living alone and 56.9% out of the whole group had jobs.

2. The average calorie intake followed by the 24 hour recall method and food frequency questionnaire method 1,405.2±405.7 Kcal and 1,717.9 ± 567.0Kcal respectively and the difference in calorie between them was -312.7Kcal. The results were significant in all nutrients. The ratio between the difference in intake for protein, fat, vitamin A, vitamin B1, and folic acid was 2.8～5.7 which showed not much difference. On the other hand, for vitamin B2, vitamin C, and cholesterol, the difference was shown to be 20.7～30.0 which showed a huge difference. When it was compensated to 1,000Kcal calorie per intake, the difference in intake for protein, calcium, iron, sodium, potassium, vitamin A, vitamin B1, vitamin B2, and niacin was quite significant. The ratio of difference in intake for protein, carbohydrates, calcium, phosphorus, iron, sodium, potassium, and niacin were 0.6～7.7 which was quite small but in vitamin C and cholesterol, the difference was 34.4 and 31.2 which was quite huge.

3. The Pearson correlation coefficient in the 24 hour recall method and food frequency questionnaire method excluded calories, protein, fats, carbohydrates, and vitamin B2 and so most of them were between 0.21～0.59 which was quite noteworthy. The Spearman rank correlation coefficient appeared quite significantly in all nutrients between 0.21～0.54. When it was compensated to 1,000Kcal calorie per intake, the Pearson correlation coefficient was shown to be lower than before the compensation. The Spearman correlation coefficient was between 0.16～0.41 and was quite significant excluding the calcium and vitamin B1.

4. The amount of food group intake followed by the food frequency questionnaire method and the 24 hour recall method showed a significant difference in all food groups except meat, fruits and shellfish. The intake ratio showed a significant difference in potatoes, meat, shellfish, seaweed, milk products, drinks, and seasoning. The Pearson correlation coefficient was very significant in grains, sugars, beans, vegetables and mushrooms, meat, shellfish, milk products and seasoning. When the intake amount was complemented, the Pearson correlation coefficient and the Spearman correlation coefficient became lower. The potatoes, meat, shellfish, drinks and alcohol areas showed a higher intake in the 24 hour recall method even after the weight complementation. There was also a difference in intake amount according to seasons and regional produce.

5. As a result of cross-sorting the target groups and ranking them according to nutrient intake amount in relation to each other into quartiles and quintiles, it showed a correspondence rate of 82.2% and 65.5% respectively. The percentage of being sorted in exactly the opposite way was shown to be about 11.0% and 6.7%, and the percentage of being sorted higher appeared to be 9.6% and 6.7%. The value of the weighted Kappa according to the quartile cross sorting was shown to be an average of 0.26 and the value of the weighted Kappa according to the quintile cross sorting was shown to be also 0.26 which showed no difference in weighted Kappa between the quartile and quintile sorting method.

In this research, there was a significant difference when comparing the nutrient intake followed by the 24 hour recall method and food frequency questionnaire method. There also appeared to be significance followed by the intake amount and the order of the food intake. The correspondence rate in the 24 hour recall method and the food frequency questionnaire method was shown to be about the same with other researches and can therefore be said to be suitable to be used as data in other dietary investigations. When we were to consider the correspondence rate between the two methods from the quartile and quintile sorting point of view, the quintile sorting had a lower possibility of being sorted into the exact opposite way rather than the quartile sorting so it is the opinion of this writer that this correspondence rate gets to be reformed between the two methods. In conclusion, I believe that there is a need to develop better surveys of food intake frequency for the investigation into the dietary habits of seniors in the Jeju region according to elements in seasonal difference in food intake, seasonal elements, as well as survey question items.