651
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Toft U, Cerqueira C, Andreasen AH, Thuesen BH, Laurberg P, Ovesen L, Perrild H, Jørgensen T. Estimating salt intake in a Caucasian population: can spot urine substitute 24-hour urine samples? Eur J Prev Cardiol 2013; 21:1300-7. [DOI: 10.1177/2047487313485517] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ulla Toft
- Glostrup University Hospital, Glostrup, Denmark
| | | | | | | | | | | | - Hans Perrild
- Bispebjerg University Hospital, Bispebjerg, Denmark
| | - Torben Jørgensen
- Glostrup University Hospital, Glostrup, Denmark
- University of Copenhagen, Copenhagen, Denmark
- University of Aalborg, Aalborg, Denmark
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652
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Spohrer R, Garrett GS, Timmer A, Sankar R, Kar B, Rasool F, Locatelli-Rossi L. Processed foods as an integral part of universal salt iodization programs: a review of global experience and analyses of Bangladesh and Pakistan. Food Nutr Bull 2013; 33:S272-80. [PMID: 23444708 DOI: 10.1177/15648265120334s303] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite the reference to salt for food processing in the original definition of universal salt iodization (USI), national USI programs often do not explicitly address food industry salt. This may affect program impact and sustainability, given the increasing consumption of processed foods in developing countries. OBJECTIVE To review experience of the use of iodized salt in the food industry globally, and analyze the market context in Bangladesh and Pakistan to test whether this experience may be applicable to inform improved national USI programming in developing countries. METHODS A review of relevant international experience was undertaken. In Bangladesh and Pakistan, local rural market surveys were carried out. In Bangladesh, structured face-to-face interviews with bakers and indepth interviews with processed food wholesalers and retailers were conducted. In Pakistan, face-to-face structured interviews were conducted with food retailers and food labels were checked. RESULTS Experience from industrialized countries reveals impact resulting from the use of iodized salt in the food industry. In Bangladesh and Pakistan, bread, biscuits, and snacks containing salt are increasingly available in rural areas. In Bangladesh, the majority of bakers surveyed claimed to use iodized salt. In Pakistan, 6 of 362 unique product labels listed iodized salt. CONCLUSIONS Successful experience from developed countries needs to be adapted to the developing country context. The increasing availability of processed foods in rural Bangladesh and Pakistan provides an opportunity to increase iodine intake. However, the impact of this intervention remains to be quantified. To develop better national USI programs, further data are required on processed food consumption across population groups, iodine contents of food products, and the contribution of processed foods to iodine nutrition.
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Affiliation(s)
- Rebecca Spohrer
- Global Alliance for Improved Nutrition (GAIN), P.O. Box 55, Geneva 1211, Switzerland.
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653
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Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ 2013; 346:f1378. [PMID: 23558164 PMCID: PMC4816263 DOI: 10.1136/bmj.f1378] [Citation(s) in RCA: 542] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To conduct a systematic review of the literature and meta-analyses to fill the gaps in knowledge on potassium intake and health. DATA SOURCES Cochrane Central Register of Controlled Trials, Medline, Embase, WHO International Clinical Trials Registry Platform, Latin American and Caribbean Health Science Literature Database, and the reference lists of previous reviews. STUDY SELECTION Randomised controlled trials and cohort studies reporting the effects of potassium intake on blood pressure, renal function, blood lipids, catecholamine concentrations, all cause mortality, cardiovascular disease, stroke, and coronary heart disease were included. DATA EXTRACTION AND SYNTHESIS Potential studies were independently screened in duplicate, and their characteristics and outcomes were extracted. When possible, meta-analysis was done to estimate the effects (mean difference or risk ratio with 95% confidence interval) of higher potassium intake by using the inverse variance method and a random effect model. RESULTS 22 randomised controlled trials (including 1606 participants) reporting blood pressure, blood lipids, catecholamine concentrations, and renal function and 11 cohort studies (127,038 participants) reporting all cause mortality, cardiovascular disease, stroke, or coronary heart disease in adults were included in the meta-analyses. Increased potassium intake reduced systolic blood pressure by 3.49 (95% confidence interval 1.82 to 5.15) mm Hg and diastolic blood pressure by 1.96 (0.86 to 3.06) mm Hg in adults, an effect seen in people with hypertension but not in those without hypertension. Systolic blood pressure was reduced by 7.16 (1.91 to 12.41) mm Hg when the higher potassium intake was 90-120 mmol/day, without any dose response. Increased potassium intake had no significant adverse effect on renal function, blood lipids, or catecholamine concentrations in adults. An inverse statistically significant association was seen between potassium intake and risk of incident stroke (risk ratio 0.76, 0.66 to 0.89). Associations between potassium intake and incident cardiovascular disease (risk ratio 0.88, 0.70 to 1.11) or coronary heart disease (0.96, 0.78 to 1.19) were not statistically significant. In children, three controlled trials and one cohort study suggested that increased potassium intake reduced systolic blood pressure by a non-significant 0.28 (-0.49 to 1.05) mm Hg. CONCLUSIONS High quality evidence shows that increased potassium intake reduces blood pressure in people with hypertension and has no adverse effect on blood lipid concentrations, catecholamine concentrations, or renal function in adults. Higher potassium intake was associated with a 24% lower risk of stroke (moderate quality evidence). These results suggest that increased potassium intake is potentially beneficial to most people without impaired renal handling of potassium for the prevention and control of elevated blood pressure and stroke.
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Affiliation(s)
- Nancy J Aburto
- Nutrition Policy and Scientific Advice Unit, Department of Nutrition for Health and Development, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
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654
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Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl JJ. Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ 2013; 346:f1326. [PMID: 23558163 PMCID: PMC4816261 DOI: 10.1136/bmj.f1326] [Citation(s) in RCA: 814] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/18/2013] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the effect of decreased sodium intake on blood pressure, related cardiovascular diseases, and potential adverse effects such as changes in blood lipids, catecholamine levels, and renal function. DESIGN Systematic review and meta-analysis. DATA SOURCES Cochrane Central Register of Controlled Trials, Medline, Embase, WHO International Clinical Trials Registry Platform, the Latin American and Caribbean health science literature database, and the reference lists of previous reviews. STUDY SELECTION Randomised controlled trials and prospective cohort studies in non-acutely ill adults and children assessing the relations between sodium intake and blood pressure, renal function, blood lipids, and catecholamine levels, and in non-acutely ill adults all cause mortality, cardiovascular disease, stroke, and coronary heart disease. STUDY APPRAISAL AND SYNTHESIS Potential studies were screened independently and in duplicate and study characteristics and outcomes extracted. When possible we conducted a meta-analysis to estimate the effect of lower sodium intake using the inverse variance method and a random effects model. We present results as mean differences or risk ratios, with 95% confidence intervals. RESULTS We included 14 cohort studies and five randomised controlled trials reporting all cause mortality, cardiovascular disease, stroke, or coronary heart disease; and 37 randomised controlled trials measuring blood pressure, renal function, blood lipids, and catecholamine levels in adults. Nine controlled trials and one cohort study in children reporting on blood pressure were also included. In adults a reduction in sodium intake significantly reduced resting systolic blood pressure by 3.39 mm Hg (95% confidence interval 2.46 to 4.31) and resting diastolic blood pressure by 1.54 mm Hg (0.98 to 2.11). When sodium intake was <2 g/day versus ≥ 2 g/day, systolic blood pressure was reduced by 3.47 mm Hg (0.76 to 6.18) and diastolic blood pressure by 1.81 mm Hg (0.54 to 3.08). Decreased sodium intake had no significant adverse effect on blood lipids, catecholamine levels, or renal function in adults (P>0.05). There were insufficient randomised controlled trials to assess the effects of reduced sodium intake on mortality and morbidity. The associations in cohort studies between sodium intake and all cause mortality, incident fatal and non-fatal cardiovascular disease, and coronary heart disease were non-significant (P>0.05). Increased sodium intake was associated with an increased risk of stroke (risk ratio 1.24, 95% confidence interval 1.08 to 1.43), stroke mortality (1.63, 1.27 to 2.10), and coronary heart disease mortality (1.32, 1.13 to 1.53). In children, a reduction in sodium intake significantly reduced systolic blood pressure by 0.84 mm Hg (0.25 to 1.43) and diastolic blood pressure by 0.87 mm Hg (0.14 to 1.60). CONCLUSIONS High quality evidence in non-acutely ill adults shows that reduced sodium intake reduces blood pressure and has no adverse effect on blood lipids, catecholamine levels, or renal function, and moderate quality evidence in children shows that a reduction in sodium intake reduces blood pressure. Lower sodium intake is also associated with a reduced risk of stroke and fatal coronary heart disease in adults. The totality of evidence suggests that most people will likely benefit from reducing sodium intake.
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Affiliation(s)
- Nancy J Aburto
- Nutrition Policy and Scientific Advice Unit, Department of Nutrition for Health and Development, World Health Organization, 1211 Geneva 27, Switzerland.
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655
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Day L, Fayet C, Homer S. Effect of NaCl on the thermal behaviour of wheat starch in excess and limited water. Carbohydr Polym 2013; 94:31-7. [DOI: 10.1016/j.carbpol.2012.12.063] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 12/17/2012] [Accepted: 12/26/2012] [Indexed: 10/27/2022]
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656
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Kleinewietfeld M, Manzel A, Titze J, Kvakan H, Yosef N, Linker RA, Muller DN, Hafler DA. Sodium chloride drives autoimmune disease by the induction of pathogenic TH17 cells. Nature 2013; 496:518-22. [PMID: 23467095 DOI: 10.1038/nature11868] [Citation(s) in RCA: 978] [Impact Index Per Article: 88.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 12/19/2012] [Indexed: 12/13/2022]
Abstract
There has been a marked increase in the incidence of autoimmune diseases in the past half-century. Although the underlying genetic basis of this class of diseases has recently been elucidated, implicating predominantly immune-response genes, changes in environmental factors must ultimately be driving this increase. The newly identified population of interleukin (IL)-17-producing CD4(+) helper T cells (TH17 cells) has a pivotal role in autoimmune diseases. Pathogenic IL-23-dependent TH17 cells have been shown to be critical for the development of experimental autoimmune encephalomyelitis (EAE), an animal model for multiple sclerosis, and genetic risk factors associated with multiple sclerosis are related to the IL-23-TH17 pathway. However, little is known about the environmental factors that directly influence TH17 cells. Here we show that increased salt (sodium chloride, NaCl) concentrations found locally under physiological conditions in vivo markedly boost the induction of murine and human TH17 cells. High-salt conditions activate the p38/MAPK pathway involving nuclear factor of activated T cells 5 (NFAT5; also called TONEBP) and serum/glucocorticoid-regulated kinase 1 (SGK1) during cytokine-induced TH17 polarization. Gene silencing or chemical inhibition of p38/MAPK, NFAT5 or SGK1 abrogates the high-salt-induced TH17 cell development. The TH17 cells generated under high-salt conditions display a highly pathogenic and stable phenotype characterized by the upregulation of the pro-inflammatory cytokines GM-CSF, TNF-α and IL-2. Moreover, mice fed with a high-salt diet develop a more severe form of EAE, in line with augmented central nervous system infiltrating and peripherally induced antigen-specific TH17 cells. Thus, increased dietary salt intake might represent an environmental risk factor for the development of autoimmune diseases through the induction of pathogenic TH17 cells.
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Affiliation(s)
- Markus Kleinewietfeld
- Departments of Neurology and Immunobiology, Yale School of Medicine, 15 York Street, New Haven, Connecticut 06520, USA.
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657
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Abstract
The aims of this review paper are to provide an overview of the association of sodium intake with cardiovascular health, to identify sodium in our global food supply and to describe problems associated with assessment of dietary sodium intake. Excess sodium intake may contribute to the development of hypertension in some individuals, consequently increasing CVD risk. The average intake of sodium in populations around the world far exceeds the actual body's needs. Processed and restaurant foods contribute the most dietary sodium for Americans and other populations worldwide. There is a worldwide focus on reducing sodium content of food products in an effort to reduce health related issues associated with excessive salt and sodium intake in individuals. In several countries, regulations have been introduced to lower the sodium content of foods. Manufacturers are complying with these regulations by formulating new products to meet these standards. However, the variability in food sodium content poses challenges to researchers to accurately assess dietary sodium intakes of individuals. There are differences in sodium content of foods in databases compared with nutritional information provided by manufacturers for the same food products. Variations also exist in restaurant foods, where values differ from those available on restaurant websites. Sodium may be either underestimated or overestimated; it is not always on target. Awareness of the variability among food products is crucial but capturing sodium content of every food in the market is not feasible. Whenever possible, updating databases is critical. In conclusion, it is not feasible to capture the sodium content of every food in the marketplace but being aware of these differences is essential to assessing actual sodium consumption. Since biological determinations are burdensome and impractical, it is imperative for researchers and other health professionals to participate in the development and implementation of tools to accurately assess sodium intake in individuals.
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658
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Goodman S, Hammond D, Hanning R, Sheeshka J. The impact of adding front-of-package sodium content labels to grocery products: an experimental study. Public Health Nutr 2013; 16:383-91. [PMID: 22857386 PMCID: PMC10271709 DOI: 10.1017/s1368980012003485] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 05/30/2012] [Accepted: 06/04/2012] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Canadians consume approximately twice the daily Adequate Intake of sodium. The present study examined the efficacy of four types of front-of-package (FOP) sodium labels at influencing consumers' selection of products low v. high in sodium. DESIGN Participants were randomly assigned to one of five experimental conditions: (i) control condition with no FOP label; (ii) basic numeric FOP label; (iii) numeric FOP label with 'high' and 'low' sodium content descriptors; (iv) detailed Traffic Light (TL) label with colour coding, content descriptors and numeric information; and (v) simple TL label with no numeric information. Participants were shown pairs of grocery products that varied in sodium content and told they could choose a free sample. Selection of the low-sodium v. the high-sodium product was the primary behavioural outcome, in addition to ratings of effectiveness, understanding, liking and believability. SETTING Waterloo, Ontario, Canada. SUBJECTS Adults (n 430) aged ≥18 years, recruited from community settings. RESULTS Participants in the three FOP conditions with 'high/low' sodium content descriptors were significantly more likely to choose the lower-sodium product compared with the control group. The detailed TL label was ranked most effective at helping participants select low-sodium products, and was rated significantly higher than other formats in liking, understanding and believability. Product selection did not differ significantly across sociodemographic groups. CONCLUSIONS FOP labels that include content descriptors may be more effective in helping consumers to select lower-sodium products. TL labels, which incorporate content descriptors and colour coding, should be considered for future FOP labelling initiatives.
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Affiliation(s)
- Samantha Goodman
- Department of Family Relations & Human Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - David Hammond
- School of Public Health & Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1
| | - Rhona Hanning
- School of Public Health & Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1
| | - Judy Sheeshka
- Department of Family Relations & Human Nutrition, University of Guelph, Guelph, Ontario, Canada
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659
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Smith P, Phillips KD. Development and validation of the dietary sodium reduction self-care agency scale. Res Gerontol Nurs 2013; 6:139-47. [PMID: 23330942 DOI: 10.3928/19404921-20130108-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Accepted: 09/19/2012] [Indexed: 11/20/2022]
Abstract
A scale did not exist for measuring the capability or self-care agency of lowering salt consumption in older adults with hypertension. Therefore, our objectives were to develop and validate the Dietary Sodium Reduction Self-Care Agency Scale (DSR-SCA Scale). A 24-item scale was developed and tested in 242 older adults with hypertension. Exploratory factor analysis using principal components extraction, Rasch analysis, and internal consistency reliability were used to evaluate the DSR-SCA Scale. Principal components extraction with Promax rotation was used. An 11-item DSR-SCA Scale with three factor loadings, which measure proficiency, persuasiveness, and resourcefulness, was finalized after it was found to meet the criteria of a minimal factor loading of 0.40, with eigenvalues of 2.20, 1.73, and 1.64, respectively. The Kaiser-Meyer-Olkin was 0.80, and Bartlett's test was significant, χ(2) (df = 55) 403.71, p < 0.0001. The measures accounted for 51% of the total variance. Item infit and outfit mean square ranged from 0.88 to 1.18 and the infit and outfit standardized mean square was -1.8 to 1.7. The 11-item scale demonstrated internal consistency with a Cronbach's alpha coefficient of 0.73 for the total scale. The results showed that the DSR-SCA Scale consisted of three factors that have adequate construct validity and reliability to measure power components and enabling capability related to Orem's self-care theory. This scale is brief, easy-to-complete, and useful for measuring salt reduction self-care agency in older adults with hypertension
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660
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Gaziano TA, Pagidipati N. Scaling up chronic disease prevention interventions in lower- and middle-income countries. Annu Rev Public Health 2013; 34:317-35. [PMID: 23297660 PMCID: PMC3686269 DOI: 10.1146/annurev-publhealth-031912-114402] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Chronic diseases are increasingly becoming a health burden in lower- and middle-income countries, putting pressure on public health efforts to scale up interventions. This article reviews current efforts in interventions on a population and individual level. Population-level interventions include ongoing efforts to reduce smoking rates, reduce intake of salt and trans-fatty acids, and increase physical activity in increasingly sedentary populations. Individual-level interventions include control and treatment of risk factors for chronic diseases and secondary prevention. This review also discusses the barriers in interventions, particularly those specific to low- and middle-income countries. Continued discussion of proven cost-effective interventions for chronic diseases in the developing world will be useful for improving public health policy.
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Affiliation(s)
- Thomas A. Gaziano
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115;
- Harvard School of Public Health, Harvard University, Boston, Massachusetts 02115
| | - Neha Pagidipati
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115;
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661
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Ekmekcioglu C, Blasche G, Dorner TE. Too Much Salt and How We Can Get Rid of It. ACTA ACUST UNITED AC 2013; 20:454-60. [DOI: 10.1159/000357413] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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662
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Seo H, Iannilli E, Hummel C, Okazaki Y, Buschhüter D, Gerber J, Krammer GE, van Lengerich B, Hummel T. A salty-congruent odor enhances saltiness: functional magnetic resonance imaging study. Hum Brain Mapp 2013; 34:62-76. [PMID: 22020878 PMCID: PMC6870243 DOI: 10.1002/hbm.21414] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 05/30/2011] [Accepted: 07/01/2011] [Indexed: 11/07/2022] Open
Abstract
Excessive intake of dietary salt (sodium chloride) may increase the risk of chronic diseases. Accordingly, various strategies to reduce salt intake have been conducted. This study aimed to investigate whether a salty-congruent odor can enhance saltiness on the basis of psychophysical (Experiment 1) and neuroanatomical levels (Experiment 2). In Experiment 1, after receiving one of six stimulus conditions: three odor conditions (odorless air, congruent, or incongruent odor) by two concentrations (low or high) of either salty or sweet taste solution, participants were asked to rate taste intensity and pleasantness. In Experiment 2, participants received the same stimuli during the functional magnetic resonance imaging scan. In Experiment 1, compared with an incongruent odor and/or odorless air, a congruent odor enhanced not only taste intensity but also either pleasantness of sweetness or unpleasantness of saltiness. In Experiment 2, a salty-congruent combination of odor and taste produced significantly higher neuronal activations in brain regions associated with odor-taste integration (e.g., insula, frontal operculum, anterior cingulate cortex, and orbitofrontal cortex) than an incongruent combination and/or odorless air with taste solution. In addition, the congruent odor-induced saltiness enhancement was more pronounced in the low-concentrated tastant than in the high-concentrated one. In conclusion, this study demonstrates the congruent odor-induced saltiness enhancement on the basis of psychophysical and neuroanatomical results. These findings support an alternative strategy to reduce excessive salt intake by adding salty-congruent aroma to sodium reduced food. However, there are open questions regarding the salty-congruent odor-induced taste unpleasantness.
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Affiliation(s)
- Han‐Seok Seo
- Smell & Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
| | - Emilia Iannilli
- Smell & Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
| | - Cornelia Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
| | - Yoshiro Okazaki
- Smell & Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
| | - Dorothee Buschhüter
- Smell & Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
| | - Johannes Gerber
- Department of Neuroradiology, University of Dresden Medical School, Dresden, Germany
| | | | | | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
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663
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Grimes CA, Campbell KJ, Riddell LJ, Nowson CA. Is socioeconomic status associated with dietary sodium intake in Australian children? A cross-sectional study. BMJ Open 2013; 3:bmjopen-2012-002106. [PMID: 23396559 PMCID: PMC3585971 DOI: 10.1136/bmjopen-2012-002106] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the association between socioeconomic status (SES) and dietary sodium intake, and to identify if the major dietary sources of sodium differ by socioeconomic group in a nationally representative sample of Australian children. DESIGN Cross-sectional survey. SETTING 2007 Australian National Children's Nutrition and Physical Activity Survey. PARTICIPANTS A total of 4487 children aged 2-16 years completed all components of the survey. PRIMARY AND SECONDARY OUTCOME MEASURES Sodium intake was determined via one 24 h dietary recall. The population proportion formula was used to identify the major sources of dietary salt. SES was defined by the level of education attained by the primary carer. In addition, parental income was used as a secondary indicator of SES. RESULTS Dietary sodium intake of children of low SES background was 2576 (SEM 42) mg/day (salt equivalent 6.6 (0.1) g/day), which was greater than that of children of high SES background 2370 (35) mg/day (salt 6.1 (0.1) g/day; p<0.001). After adjustment for age, gender, energy intake and body mass index, low SES children consumed 195 mg/day (salt 0.5 g/day) more sodium than high SES children (p<0.001). Low SES children had a greater intake of sodium from processed meat, gravies/sauces, pastries, breakfast cereals, potatoes and potato snacks (all p<0.05). CONCLUSIONS Australian children from a low SES background have on average a 9% greater intake of sodium from food sources compared with those from a high SES background. Understanding the socioeconomic patterning of salt intake during childhood should be considered in interventions to reduce cardiovascular disease.
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Affiliation(s)
- Carley A Grimes
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
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664
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Zhou YL, Liu J, Ma LJ, Sun F, Shen Y, Huang J, Cui TG. Effects of Increasing Diffusive Sodium Removal on Blood Pressure Control in Hemodialysis Patients with Optimal Dry Weight. Blood Purif 2013; 35:209-15. [DOI: 10.1159/000346631] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 12/11/2012] [Indexed: 11/19/2022]
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665
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666
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Galvis-Sánchez AC, Lopes JA, Delgadillo I, Rangel AO. Sea Salt. FOOD PROTECTED DESIGNATION OF ORIGIN - METHODOLOGIES AND APPLICATIONS 2013. [DOI: 10.1016/b978-0-444-59562-1.00026-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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667
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He FJ, Wu Y, Ma J, Feng X, Wang H, Zhang J, Lin CP, Yuan J, Ma Y, Yang Y, Yan LL, Jan S, Nowson C, Macgregor GA. A school-based education programme to reduce salt intake in children and their families (School-EduSalt): protocol of a cluster randomised controlled trial. BMJ Open 2013; 3:bmjopen-2013-003388. [PMID: 23864214 PMCID: PMC3717470 DOI: 10.1136/bmjopen-2013-003388] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The current salt intake is very high for children as well as adults in China. A reduction in salt intake is one of the most cost-effective measures to curb the rapidly growing disease burden attributed to blood pressure and cardiovascular disease in the Chinese population. A lower salt diet starting from childhood has the potential to prevent the development of such conditions. The School-EduSalt (School-based Education Programme to Reduce Salt) study aims to determine whether an education programme targeted at school children can lower salt intake in children and their families. METHODS AND ANALYSIS The study is designed as a cluster randomised controlled trial. The location is Changzhi, Shanxi province in northern China. The study population will consist of 28 primary schools with 280 children aged ≈11 years and 560 adult family members. Children in the intervention group will be educated on how to reduce salt intake. They will then be empowered to deliver the salt reduction message home to their families. In particular, children need to persuade the person who does the cooking to reduce the amount of salt used during food preparations. The duration of the intervention is one school term (≈4.5 months). The primary outcome is the difference between the intervention and the control group in the change in 24 h urinary sodium and the secondary outcome is the difference between the intervention and control group in the change of blood pressure. An economic evaluation will be undertaken to assess cost-effectiveness. ETHICS AND DISSEMINATION The study has been approved by The Queen Mary Research Ethics Committee (QMREC2012/81) and Peking University Health Science Centre IRB (IRB00001052-12072). Study findings will be disseminated widely through conference presentations and peer-reviewed publications. PROTOCOL REGISTRATION Protocol Registered on ClinicalTrials.gov NCT01821144.
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Affiliation(s)
- Feng J He
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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668
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Charlton KE, Jooste PL, Steyn K, Levitt NS, Ghosh A. A lowered salt intake does not compromise iodine status in Cape Town, South Africa, where salt iodization is mandatory. Nutrition 2012; 29:630-4. [PMID: 23274097 DOI: 10.1016/j.nut.2012.09.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 08/28/2012] [Accepted: 09/14/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Universal salt iodization is an effective strategy to optimize population-level iodine. At the same time as salt-lowering initiatives are encouraged globally, there is concern about compromised iodine intakes. This study investigated whether salt intakes at recommended levels resulted in a suboptimal iodine status in a country where salt is the vehicle for iodine fortification. METHODS Three 24-h urine samples were collected for the assessment of urinary sodium and one sample was taken for urinary iodine concentrations (UICs) in a convenience sample of 262 adult men and women in Cape Town, South Africa. Median UIC was compared across categories of sodium excretion equivalent to salt intakes lower than 5, 5 to 9, and greater than or equal to 9 g/d. RESULTS The median UIC was 120 μg/L (interquartile range 75.3-196.3), indicating iodine sufficiency. Less one-fourth (23.2%) of subjects had urinary sodium excretion values within the desirable range (salt <5 g/d), 50.7% had high values (5-9 g/d), and 22.8% had very high values (≥9 g/d). No association between urinary iodine and mean 3 × 24-h urinary sodium concentration was found (r = 0.087, P = 0.198) and UIC status did not differ according to urinary sodium categories (P = 0.804). CONCLUSION In a country with mandatory universal salt iodization, consumers with salt intakes within the recommended range (<5 g/d) are iodine replete, and median UIC does not differ across categories of salt intake. This indicates that much of the dietary salt is provided from non-iodinated sources, presumably added to processed foods.
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Affiliation(s)
- Karen E Charlton
- School of Health Sciences, Faculty of Health and Behavioural Sciences, University of Wollongong, Wollongong, New South Wales, Australia.
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669
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O'Donnell M, Mente A, Smyth A, Yusuf S. Salt intake and cardiovascular disease: why are the data inconsistent? Eur Heart J 2012; 34:1034-40. [DOI: 10.1093/eurheartj/ehs409] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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670
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Zimmermann MB, Andersson M. Assessment of iodine nutrition in populations: past, present, and future. Nutr Rev 2012; 70:553-70. [PMID: 23035804 DOI: 10.1111/j.1753-4887.2012.00528.x] [Citation(s) in RCA: 337] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Iodine status has been historically assessed by palpation of the thyroid and reported as goiter rates. Goiter is a functional biomarker that can be applied to both individuals and populations, but it is subjective. Iodine status is now assessed using an objective biomarker of exposure, i.e., urinary iodine concentrations (UICs) in spot samples and comparison of the median UIC to UIC cut-offs to categorize population status. This has improved standardization, but inappropriate use of the crude proportion of UICs below the cut-off level of 100 µg/L to estimate the number of iodine-deficient children has led to an overestimation of the prevalence of iodine deficiency. In this review, a new approach is proposed in which UIC data are extrapolated to iodine intakes, adjusted for intraindividual variation, and then interpreted using the estimated average requirement cut-point model. This may allow national programs to define the prevalence of iodine deficiency in the population and to quantify the necessary increase in iodine intakes to ensure sufficiency. In addition, thyroglobulin can be measured on dried blood spots to provide an additional sensitive functional biomarker of iodine status.
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Affiliation(s)
- Michael B Zimmermann
- Human Nutrition Laboratory, Institute of Food, Nutrition, and Health, ETH Zurich, CH-8092 Zurich, Switzerland.
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671
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Buehlmeier J, Frings-Meuthen P, Remer T, Maser-Gluth C, Stehle P, Biolo G, Heer M. Alkaline salts to counteract bone resorption and protein wasting induced by high salt intake: results of a randomized controlled trial. J Clin Endocrinol Metab 2012; 97:4789-97. [PMID: 23027921 DOI: 10.1210/jc.2012-2857] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
High sodium chloride (NaCl) intake can induce low-grade metabolic acidosis (LGMA) and may thus influence bone and protein metabolism. We hypothesized that oral potassium bicarbonate (KHCO(3)) supplementation may compensate for NaCl-induced, LGMA-associated bone resorption and protein losses. Eight healthy male subjects participated in a randomized trial with a crossover design. Each of two study campaigns consisted of 5 d of dietary and environmental adaptation followed by 10 d of intervention and 1.5 d of recovery. In one study campaign, 90 mmol KHCO(3)/d were supplemented to counteract NaCl-induced LGMA, whereas the other campaign served as a control with only high NaCl intake. When KHCO(3) was ingested during high NaCl intake, postprandial buffer capacity ([HCO(3)(-)]) increased (P = 0.002). Concomitantly, urinary excretion of free potentially bioactive glucocorticoids [urinary free cortisol (UFF) and urinary free cortisone (UFE)] was reduced by 14% [∑(UFF,UFE); P = 0.024]. Urinary excretion of calcium and bone resorption marker N-terminal telopeptide of type I collagen was reduced by 12 and 8%, respectively (calcium, P = 0.047; N-terminal bone collagen telopeptide, P = 0.044). There was a trend of declining net protein catabolism when high NaCl was combined with KHCO(3) (P = 0.052). We conclude that during high salt intake, the KHCO(3)-induced postprandial shift to a more alkaline state reduces metabolic stress. This leads to decreased bone resorption and protein degradation, which in turn might initiate an anticatabolic state for the musculoskeletal system in the long run.
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Affiliation(s)
- Judith Buehlmeier
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Linder Hoehe, 51147 Cologne, Germany.
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672
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Antonini S, Arias MA, Eichert T, Clemens J. Greenhouse evaluation and environmental impact assessment of different urine-derived struvite fertilizers as phosphorus sources for plants. CHEMOSPHERE 2012; 89:1202-10. [PMID: 22901433 DOI: 10.1016/j.chemosphere.2012.07.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 07/16/2012] [Accepted: 07/18/2012] [Indexed: 05/19/2023]
Abstract
A selection of six urine-derived struvite fertilizers generated by innovative precipitation technologies was assessed for their quality and their effectiveness as phosphorus sources for crops. Struvite purity was influenced by drying techniques and magnesium dosage. In a greenhouse experiment, the urine fertilizers led to biomass yields and phosphorus uptakes comparable to or higher than those induced by a commercial mineral fertilizer. Heavy metal concentrations of the different struvite fertilizers were below the threshold limits specified by the German Fertilizer and Sewage Sludge Regulations. The computed loading rates of heavy metals to agricultural land were also below the threshold limits decreed by the Federal Soil Protection Act. Urine-derived struvite contributed less to heavy metal inputs to farmland than other recycling products or commercial mineral and organic fertilizers. When combined with other soil conditioners, urine-derived struvite is an efficient fertilizer which covers the magnesium and more than half of the phosphorus demand of crops.
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Affiliation(s)
- Samantha Antonini
- University of Bonn, Institute of Crop Science and Resource Conservation, Department of Plant Nutrition, Karlrobert-Kreiten Straße 13, 53115 Bonn, Germany.
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673
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A cross-national comparative study of blood pressure levels and hypertension prevalence in Canada and Hungary. J Hypertens 2012; 30:2105-11. [DOI: 10.1097/hjh.0b013e3283589ec3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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674
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Kastorini CM, Milionis HJ, Kalantzi K, Trichia E, Nikolaou V, Vemmos KN, Goudevenos JA, Panagiotakos DB. The mediating effect of the Mediterranean diet on the role of discretionary and hidden salt intake regarding non-fatal acute coronary syndrome or stroke events: A case/case-control study. Atherosclerosis 2012; 225:187-93. [DOI: 10.1016/j.atherosclerosis.2012.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 07/27/2012] [Accepted: 08/03/2012] [Indexed: 12/19/2022]
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675
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Affiliation(s)
- Joan Quilez
- Human Nutrition Unit, School of Medicine, IISSPV, Universitat Rovira i Virgili, Reus, Spain, and CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
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676
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Saint-Remy A, Somja M, Gellner K, Weekers L, Bonvoisin C, Krzesinski JM. Urinary and dietary sodium and potassium associated with blood pressure control in treated hypertensive kidney transplant recipients: an observational study. BMC Nephrol 2012; 13:121. [PMID: 23013269 PMCID: PMC3506486 DOI: 10.1186/1471-2369-13-121] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 09/22/2012] [Indexed: 02/07/2023] Open
Abstract
Background In kidney transplant (Kt) recipients , hypertension is a major risk for cardiovascular complications but also for graft failure. Blood pressure (BP) control is therefore mandatory. Office BP (OBP) remains frequently used for clinical decisions, however home BP (HBP) have brought a significant improvement in the BP control. Sodium is a modifiable risk factor, many studies accounted for a decrease of BP with a sodium restricted diet. Increased potassium intake has been also recommended in hypertension management. Using an agreement between office and home BP, the present study investigated the relations between the BP control in Kt recipients and their urinary excretion and dietary consumption of sodium and potassium. Methods The BP control defined by OBP <140/90 mmHg and HBP <135/85 mmHg was tested in 70 Kt recipients (mean age 56 ± 11.5 years; mean graft survival 7 ± 6.6 years) treated with antihypertensive medications. OBP and HBP were measured with a validated oscillometric device (Omron M6®). The 24-hour urinary sodium (Na+) and potassium (K+) excretions as well as dietary intakes were compared between controlled and uncontrolled (in office and at home) recipients. Non parametric Wilcoxon Mann–Whitney Test was used for between groups comparisons and Fisher's exact test for frequencies comparisons. Pearson correlation coefficients and paired t-test were used when sample size was >30. Results Using an agreement between OBP and HBP, we identified controlled (21%) and uncontrolled recipients (49%). Major confounding effects susceptible to interfere with the BP regulation did not differ between groups, the amounts of sodium excretion were similar (154 ± 93 vs 162 ± 88 mmol/24 h) but uncontrolled patients excreted less potassium (68 ± 14 vs 54 ± 20 mmol/24 h; P = 0.029) and had significantly lower potassium intakes (3279 ± 753 vs 2208 ± 720 mg/24 h; P = 0.009), associated with a higher urinary Na+/K + ratio. Systolic HBP was inversely and significantly correlated to urinary potassium (r = −0.48; P = 0.002), a positive but non significant relation was observed with urinary sodium (r = 0,30;P = 0.074). Conclusions Half of the treated hypertensive Kt recipients remained uncontrolled in office and at home. Restoring a well-balanced sodium/potassium ratio intakes could be a non pharmacological opportunity to improve blood pressure control.
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Affiliation(s)
- Annie Saint-Remy
- Nephrology-Hypertension Unit, University Hospital of Liege, Liege, Belgium.
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677
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Liem D, Toraman Aydin N, Zandstra E. Effects of health labels on expected and actual taste perception of soup. Food Qual Prefer 2012. [DOI: 10.1016/j.foodqual.2012.02.015] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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678
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Assumpção DD, Barros MBDA, Fisberg RM, Carandina L, Goldbaum M, Cesar CLG. Qualidade da dieta de adolescentes: estudo de base populacional em Campinas, SP. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2012; 15:605-16. [DOI: 10.1590/s1415-790x2012000300014] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 05/23/2012] [Indexed: 11/21/2022] Open
Abstract
O objetivo deste estudo foi avaliar a qualidade global da dieta e a adequação do consumo de cada componente da dieta de adolescentes segundo fatores demográficos, socioeconômicos e índice de massa corporal (IMC). Trata-se de estudo transversal, de base populacional, que analisou amostra representativa de 409 adolescentes, de 12 a 19 anos, utilizando o Índice de Qualidade da Dieta (IQD). Foram estimadas as prevalências de dietas classificadas no 1º quartil do IQD e as médias de escores de cada componente do IQD. Regressões múltiplas linear e de Poisson foram utilizadas nas análises. O escore médio do IQD foi de 59,7. Observou-se menor prevalência de dietas inadequadas no segmento de melhor escolaridade do chefe da família. Os estratos de menor nível socioeconômico, avaliados por renda e escolaridade, mostram um consumo inferior de verduras e legumes, frutas, leite e derivados e menor variedade da dieta e uma ingestão superior de cereais e derivados e leguminosas. Adolescentes com sobrepeso/obesidade consomem mais carnes e ovos e menos frutas comparados aos que apresentam baixo peso/eutrofia. As meninas tiveram maior ingestão de gordura total e menor ingestão de sódio. Os resultados identificam os componentes que merecem atenção nas estratégias de promoção de alimentação saudável e os segmentos mais vulneráveis à má alimentação.
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679
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Response to Fujisawa: Elevated blood pressure in different populations: the role of dietary salt consumption. Hypertens Res 2012; 35:961-2. [DOI: 10.1038/hr.2012.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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680
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Wang B, Guo Q, Peng Y, Lu J, Singh B, Hua B. Association of AGT M235T and ACE I/D polymorphisms with the risk of ischemic stroke: Meta-analysis in Han Chinese population. J Neurol Sci 2012; 320:79-84. [DOI: 10.1016/j.jns.2012.06.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 06/21/2012] [Accepted: 06/26/2012] [Indexed: 11/17/2022]
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681
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Foods contributing to sodium intake and urinary sodium excretion in a group of Australian women. Public Health Nutr 2012; 16:1837-42. [PMID: 22935554 DOI: 10.1017/s1368980012004016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To identify food sources of Na in a group of community-dwelling women in Adelaide, South Australia. A secondary aim was to measure Na excretion in this group. DESIGN Survey. SETTING Community setting, Adelaide, South Australia. SUBJECTS Seventy healthy women (mean age 48.6 (SD 8.1) years, mean BMI 28.6 (SD 6.3) kg/m2) living in metropolitan Adelaide, South Australia and participating in a validation study of an FFQ. Dietary intake was derived from two 4 d weighed food records. Foods from the 4 d weighed food records were grouped according to foods or food groups to establish contributors to Na intake. Na excretion was measured in two 24 h urine samples. Completeness of urine collections was verified using creatinine excretion. RESULTS Bread alone contributed 19.0% of Na intake, with an overall contribution from the breads and cereals group of 32.5%. Meat products contributed 14.4% of intake, the dairy and eggs group (excluding cheese) 9.6% and combination dishes (e.g. pizza, quiche, sandwiches and stir fry dishes) 8.4%. Na excretion was 126 (SD 42) mmol/d, i.e. approximately 7.6 (SD 2.5) g salt/d. Seventy per cent of participants (n 48) had Na excretion ≥100 mmol/d (146 (SD 34) mmol/d). CONCLUSIONS Effective Na reduction could be achieved by reducing the amount in staple foods such as bread and meat products.
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682
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Dietary salt intake assessed by 24 h urinary sodium excretion in Australian schoolchildren aged 5–13 years. Public Health Nutr 2012; 16:1789-95. [DOI: 10.1017/s1368980012003679] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo measure total daily salt intake using 24 h urinary Na excretion within a sample of Victorian schoolchildren aged 5–13 years and to assess discretionary salt use habits of children and parents.DesignCross-sectional study.SettingCompleted within a convenience sample of independent primary schools (n9) located in Victoria, Australia.SubjectsTwo hundred and sixty children completed a 24 h urine collection over a school (34 %) or non-school day (66 %). Samples deemed incomplete (n18), an over-collection (n1) or that were incorrectly processed at the laboratory (n3) were excluded.ResultsThe sample comprised 120 boys and 118 girls with a mean age of 9·8 (sd1·7) years. The average 24 h urinary Na excretion (n238) was 103 (sd43) mmol/24 h (salt equivalent 6·0 (sd2·5) g/d). Daily Na excretion did not differ by sex; boys 105 (sd46) mmol/24 h (salt equivalent 6·1 (sd2·7) g/d) and girls 100 (sd41) mmol/24 h (salt equivalent 5·9 (sd2·4) g/d;P= 0·38). Sixty-nine per cent of children (n164) exceeded the recommended daily Upper Limit for Na. Reported discretionary salt use was common: two-thirds of parents reported adding salt during cooking and almost half of children reported adding salt at the table.ConclusionsThe majority of children had salt intakes exceeding the recommended daily Upper Limit. Strategies to lower salt intake in children are urgently required, and should include product reformulation of lower-sodium food products combined with interventions targeting discretionary salt use within the home.
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683
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Abstract
Data from different national and regional surveys show that hypertension is common in developing countries, particularly in urban areas, and that rates of awareness, treatment, and control are low. Several hypertension risk factors seem to be more common in developing countries than in developed regions. Findings from serial surveys show an increasing prevalence of hypertension in developing countries, possibly caused by urbanisation, ageing of population, changes to dietary habits, and social stress. High illiteracy rates, poor access to health facilities, bad dietary habits, poverty, and high costs of drugs contribute to poor blood pressure control. The health system in many developing countries is inadequate because of low funds, poor infrastructure, and inexperience. Priority is given to acute disorders, child and maternal health care, and control of communicable diseases. Governments, together with medical societies and non-governmental organisations, should support and promote preventive programmes aiming to increase public awareness, educate physicians, and reduce salt intake. Regulations for the food industry and the production and availability of generic drugs should be reinforced.
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684
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The role of number of meals, coffee intake, salt and type of cookware on colorectal cancer development in the context of the Mediterranean diet. Public Health Nutr 2012; 16:928-35. [PMID: 22874008 DOI: 10.1017/s1368980012003369] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the association between dietary behaviours and colorectal cancer (CRC) in the context of the Mediterranean diet. DESIGN Case-control study. SETTING All patients (cases) were recruited from Saint Savvas Cancer Hospital and Alexandra General Hospital in Athens, Greece. Controls were voluntarily selected from the general population and matched to cases by age group (±10 years) and sex. SUBJECTS Two hundred and fifty cases with newly diagnosed CRC (mean age 63 (sd 12) years, 59·6 % males) and 250 controls matched on age and sex were studied. A standardized questionnaire assessing sociodemographic, clinical, lifestyle, dietary characteristics and nutritional behaviours was applied. Multiple logistic regression analysis was used to evaluate the aforementioned factors in addition to the MedDietScore (an index that evaluates adherence to the Mediterranean diet) on CRC development. RESULTS The higher the daily number of meals, the lower the likelihood of having CRC (OR = 0·74, 95 % CI 0·61, 0·89); coffee drinking was associated with higher likelihood of having CRC (OR = 3·27, 95 % CI 1·09, 9·8); the use of non-stick cookware was positively associated with CRC (OR = 1·57, 95 % CI 1·02, 2·4). However, these associations slightly lost their significance when adherence to the Mediterranean diet was taken into account. Moreover, a 1/75 increase in the modified-MedDietScore plus the aforementioned nutritional behaviours was associated with 13 % lower odds (95 % CI 0·83, 0·91, P < 0·001) of having CRC. CONCLUSIONS Nutritional behaviours in addition to dietary habits should be taken into account in detecting individuals prone to the development of CRC.
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685
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van Lee L, Geelen A, van Huysduynen E, de Vries JHM, van’t Veer P, Feskens EJM. The Dutch Healthy Diet index (DHD-index): an instrument to measure adherence to the Dutch Guidelines for a Healthy Diet. Nutr J 2012; 11:49. [PMID: 22818824 PMCID: PMC3439289 DOI: 10.1186/1475-2891-11-49] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 06/28/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The objective was to develop an index based on the Dutch Guidelines for a healthy Diet of 2006 that reflects dietary quality and to apply it to the Dutch National Food Consumption Survey (DNFCS) to examine the associations with micronutrient intakes. METHODS A total of 749 men and women, aged 19-30 years, contributed two 24-hour recalls and additional questionnaires in the DNFCS of 2003. The Dutch Healthy Diet index (DHD-index) includes ten components representing the ten Dutch Guidelines for a Healthy Diet. Per component the score ranges between zero and ten, resulting in a total score between zero (no adherence) and 100 (complete adherence). RESULTS The mean ± SD of the DHD-index was 60.4 ± 11.5 for women and 57.8 ± 10.8 for men (P for difference = 0.002). Each component score increased across the sex-specific quintiles of the DHD-index. An inverse association was observed between the sex-specific quintiles of the DHD-index and total energy intake. Calcium, riboflavin, and vitamin E intake decreased with increasing DHD-index, an inverse association which disappeared after energy adjustment. Vitamin C showed a positive association across quintiles, also when adjusted for energy. For folate, iron, magnesium, potassium, thiamin, and vitamin B6 a positive association emerged after adjustment for energy. CONCLUSIONS The DHD-index is capable of ranking participants according to their adherence to the Dutch Guidelines for a Healthy Diet by reflecting variation in nine out of ten components that constitute the index when based on two 24-hour recalls. Furthermore, the index showed to be a good measure of nutrient density of diets.
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Affiliation(s)
- Linde van Lee
- Division of human Nutrition, Wageningen University, 8129, 6700 EV, Wageningen, The Netherlands
| | - Anouk Geelen
- Division of human Nutrition, Wageningen University, 8129, 6700 EV, Wageningen, The Netherlands
| | | | - Jeanne H M de Vries
- Division of human Nutrition, Wageningen University, 8129, 6700 EV, Wageningen, The Netherlands
| | - Pieter van’t Veer
- Division of human Nutrition, Wageningen University, 8129, 6700 EV, Wageningen, The Netherlands
| | - Edith J M Feskens
- Division of human Nutrition, Wageningen University, 8129, 6700 EV, Wageningen, The Netherlands
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686
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Abstract
Abstract
Background
The concept of enhancing saltiness perception in emulsions and a liquid food formulated with the emulsions (ambient vegetable soup) through increasing salt concentration in the continuous phase while retaining the fat content of the (aqueous continuous) product was evaluated. This was accomplished by increasing the droplet phase volume using duplex emulsion technology. Viscosity and droplet size distribution was measured. Saltiness evaluation was based on simple paired comparison testing (2-Alternate Forced Choice tests, BS ISO 5495:2007).
Results
Single and duplex emulsions and emulsion-based products had comparable mean oil droplet diameters (25 to 30 μm); however, viscosity of the duplex emulsion systems was considerably higher. Sensory assessment of saltiness of emulsion pairs (2AFC) indicated duplex technology enhanced saltiness perception compared to a single emulsion product at the same salt content (6.3 g/100 g) in both simple emulsions and the formulated food product (P = 0.0596 and 0.0004 respectively) although assessors noted the increased viscosity of the duplex systems. The formulated food product also contained pea starch particles which may have aided product mixing with saliva and thus accelerated tastant transport to the taste buds. Lowering salt content in the duplex systems (to levels of aqueous phase salt concentration similar to the level in the single systems) resulted in duplex systems being perceived as less salty than the single system. It appears that the higher viscosity of the duplex systems could not be “overruled” by enhanced mixing through increased droplet phase volume at lowered salt content.
Conclusions
The results showed that salt reduction may be possible despite the added technology of duplex systems increasing the overall measured viscosity of the product. The changes in viscosity behavior impact mouthfeel, which may be exploitable in addition to the contribution towards salt reduction. With a view to applying this technology to real processed foods, it needs to be tested for the product in question but it should be considered as part of a salt reduction tool box.
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687
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Jaworowska A, Blackham T, Stevenson L, Davies IG. Determination of salt content in hot takeaway meals in the United Kingdom. Appetite 2012; 59:517-22. [PMID: 22772043 DOI: 10.1016/j.appet.2012.06.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 05/07/2012] [Accepted: 06/27/2012] [Indexed: 01/30/2023]
Abstract
High sodium intake is associated with negative health outcomes, including an independent correlation with high blood pressure which increases the risk of cardiovascular disease. A high proportion of sodium intake in the UK is from processed and out of the home food; this includes takeaway food which is increasing in popularity. The aim of the present study was to evaluate salt levels in popular hot takeaway meals. A total of 411 samples of 23 different types of takeaway meals were analysed. Obtained results show the salt content in these kinds of foods is alarmingly high. Comparing medians (interquartile range) for different meal categories, Pizzas contained the highest salt content per portion (9.45 g (6.97-12.83)), followed by Chinese meals (8.07 g (5.47-10.99 g)), Kebabs (6.21 g (4.01-8.35)) and Indian meals (4.73 g (3.61-6.10)). In addition, significant differences in the salt content between meals within the same category were reported. To enable the consumer to meet the UK's target salt intake, a significant reduction in the salt content of hot takeaway meals should be considered.
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Affiliation(s)
- Agnieszka Jaworowska
- Faculty of Education, Community and Leisure, Centre for Tourism, Events & Food Studies, Liverpool John Moores University, I.M. Marsh Campus, Barkhill Road, L17 6BD Liverpool, United Kingdom.
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688
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Affiliation(s)
- Bina Joe
- Center for Hypertension and Personalized Medicine, University of Toledo College of Medicine and Life Sciences Toledo, OH (B.J., J.I.S.) ; Department of Physiology/Pharmacology, University of Toledo College of Medicine and Life Sciences Toledo, OH (B.J., J.I.S.)
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689
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Woodward E, Eyles H, Ni Mhurchu C. Key opportunities for sodium reduction in New Zealand processed foods. Aust N Z J Public Health 2012; 36:84-9. [PMID: 22313711 DOI: 10.1111/j.1753-6405.2012.00829.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To identify key opportunities for reformulation of processed foods that could best decrease population sodium intakes in New Zealand (NZ). METHOD Relevant national literature and reports were used to identify major food groups contributing to population sodium intakes in NZ. Sodium content data for these food groups were collected from the Nutrition Information Panels of processed foods in one large supermarket. Key opportunities for reformulation were identified by comparing mean sodium content with 2012 targets from the United Kingdom (UK) Food Standards Agency (FSA) and mean sodium values from Australia and the UK. RESULTS Major contributors to NZ sodium intakes are: bread (26%), processed meats (10%), and sauces (6%). Mean (SD) sodium contents of these processed foods were: 447 (125) mg/100 g, 1,169 (444) mg/100 g, and 1,046 (1,235) mg/100 g, respectively. Food categories with the lowest percentage of products meeting corresponding FSA targets were: sausages/hot dogs and sliced meat (0%); salami/cured meat (2%); liquid meal-based sauces (4%); and multigrain bread (14%). Mean sodium contents of NZ products were higher than for similar products in the UK. Key opportunities identified for sodium reduction were: white bread, sausages and hot dogs, and salami/cured meats. CONCLUSION There is substantial scope to reduce the sodium content of NZ processed foods. IMPLICATIONS This paper identifies three key opportunities for reformulation of processed foods that could produce substantial decreases in sodium intakes in NZ, and benefits to population health.
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Affiliation(s)
- Eleanor Woodward
- Clinical Trials Research Unit, The University of Auckland, New Zealand
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690
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Meyer F, Volterman KA, Timmons BW, Wilk B. Fluid Balance and Dehydration in the Young Athlete. Am J Lifestyle Med 2012. [DOI: 10.1177/1559827612444525] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Many young athletes train and compete under conditions that put their body fluid balance at risk, and hypohydration is usually the major concern. Another less frequent condition is hyperhydration that—if accompanied by other risk factors—may cause hyponatremia. Water and electrolyte losses during physical activities occur primarily from sweat. Such losses have been identified mostly in active (but nonathletic) young populations under laboratory settings. Studies have been trying to estimate fluid losses in the athletic population under field conditions, taking into account the sport modality and environmental conditions. Besides these external conditions, young athletes adopt different drinking attitudes, which may depend on knowledge, education, and the opportunities to drink during the break periods as well as fluid availability. Focusing on the young athlete, this review will discuss water and sodium losses from sweat, the effects of hypohydration on performance, and fluid intake attitudes within and during practices and competitions. Some considerations related to the methods of identifying hydration status and guidelines are also given, with the understanding that they should be individually adapted for the athlete and activity. The young athlete, parents, coaches, and athletic/health professionals should be aware of such information to prevent fluid imbalances and the consequent hazardous effects on performance and health.
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Affiliation(s)
- Flavia Meyer
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (FM)
- McMaster University, Hamilton, ON, Canada (KAV, BWT)
- McMaster Children’s Hospital, Hamilton, ON, Canada (BW)
| | - Kimberly A. Volterman
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (FM)
- McMaster University, Hamilton, ON, Canada (KAV, BWT)
- McMaster Children’s Hospital, Hamilton, ON, Canada (BW)
| | - Brian W. Timmons
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (FM)
- McMaster University, Hamilton, ON, Canada (KAV, BWT)
- McMaster Children’s Hospital, Hamilton, ON, Canada (BW)
| | - Boguslaw Wilk
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (FM)
- McMaster University, Hamilton, ON, Canada (KAV, BWT)
- McMaster Children’s Hospital, Hamilton, ON, Canada (BW)
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691
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Abstract
There is overwhelming evidence that a reduction in salt intake from the current level of approximately 9-12 g/d in most countries of the world to the recommended level of 5-6 g/d lowers blood pressure (BP) in both hypertensive and normotensive individuals. A further reduction to 3-4 g/d has a greater effect. Prospective studies and outcome trials have demonstrated that a lower salt intake is related to a reduced risk of cardiovascular disease. Cost-effectiveness analyses have documented that salt reduction is more or at the very least just as cost-effective as tobacco control in reducing cardiovascular disease, the leading cause of death and disability worldwide. The mechanisms whereby salt raises blood pressure and increases cardiovascular risk are not fully understood. The existing concepts focus on the tendency for an increase in extracellular fluid volume. Increasing evidence suggests that small increases in plasma sodium may have a direct effect on BP and the cardiovascular system, independent of extracellular volume. All countries should adopt a coherent and workable strategy to reduce salt intake in the whole population. Even a modest reduction in population salt intake will have major beneficial effects on health, along with major cost savings.
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Affiliation(s)
- Feng J He
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK.
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692
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Choong SSY, Balan SN, Chua LS, Say YH. Preference and intake frequency of high sodium foods and dishes and their correlations with anthropometric measurements among Malaysian subjects. Nutr Res Pract 2012; 6:238-45. [PMID: 22808349 PMCID: PMC3395790 DOI: 10.4162/nrp.2012.6.3.238] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 05/24/2012] [Accepted: 05/24/2012] [Indexed: 11/04/2022] Open
Abstract
This study investigated the preference and intake frequency of a list of 15 commonly available high sodium Malaysian foods/dishes, discretionary salt use, and their possible association with demographics, blood pressures and anthropometric measurements among 300 Malaysian university students (114 males, 186 females; 259 ethnic Chinese, 41 Indians; 220 lean, 80 overweight). French fries and instant soup noodle were found to be the most preferred and most frequently consumed salty food, respectively, while salted fish was least preferred and least frequently consumed. Males had a significantly higher intake frequency of at least 6 of the salty foods, but the preference of most salty foods was not significantly different between genders. Ethnic Chinese significantly preferred more and took more frequently traditional and conventional Malaysian foods like asam laksa (a Malaysian salty-sour-spicy noodle in fish stock), salted biscuits and salted vegetable, while Indians have more affinity and frequency towards eating salty Western foods. Body Mass Index was significantly negatively correlated with the intake frequency of canned/packet soup and salted fish while waist circumference was significantly positively correlated with the preference of instant noodle. Also, an increased preference of potato chips and intake frequency of salted biscuits seemed to lead to a decreased WHR. Other than these, all the other overweight/obesity indicators did not seem to fully correlate with the salty food preference and intake frequency. Nevertheless, the preference and intake frequency of asam laksa seemed to be significant negative predictors for blood pressures. Finally, increased preference and intake frequency of high sodium shrimp paste (belacan)-based foods like asam laksa and belacan fried rice seemed to discourage discretionary salt use. In conclusion, the preference and intake frequency of the high sodium belacan-based dish asam laksa seems to be a good predictor for ethnic difference, discretionary salt use and blood pressures.
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Affiliation(s)
- Stella Sinn-Yee Choong
- Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman (UTAR) Perak Campus, Jalan Universiti, Bandar Barat, 31900 Kampar, Perak, Malaysia
| | - Sumitha Nair Balan
- Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman (UTAR) Perak Campus, Jalan Universiti, Bandar Barat, 31900 Kampar, Perak, Malaysia
| | - Leong-Siong Chua
- Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman (UTAR) Perak Campus, Jalan Universiti, Bandar Barat, 31900 Kampar, Perak, Malaysia
| | - Yee-How Say
- Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman (UTAR) Perak Campus, Jalan Universiti, Bandar Barat, 31900 Kampar, Perak, Malaysia
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693
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Tayo BO, Luke A, McKenzie CA, Kramer H, Cao G, Durazo-Arvizu R, Forrester T, Adeyemo AA, Cooper RS. Patterns of sodium and potassium excretion and blood pressure in the African Diaspora. J Hum Hypertens 2012; 26:315-24. [PMID: 21593783 PMCID: PMC3158967 DOI: 10.1038/jhh.2011.39] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 03/21/2011] [Accepted: 03/25/2011] [Indexed: 11/30/2022]
Abstract
Habitual levels of dietary sodium and potassium are correlated with age-related increases in blood pressure (BP) and likely have a role in this phenomenon. Although extensive published evidence exists from randomized trials, relatively few large-scale community surveys with multiple 24-h urine collections have been reported. We obtained three 24-h samples from 2704 individuals from Nigeria, Jamaica and the United States to evaluate patterns of intake and within-person relationships with BP. The average (±s.d.) age and weight of the participants across all the three sites were 39.9±8.6 years and 76.1±21.2 kg, respectively, and 55% of the total participants were females. Sodium excretion increased across the East-West gradient (for example, 123.9±54.6, 134.1±48.8, 176.6±71.0 (±s.d.) mmol, Nigeria, Jamaica and US, respectively), whereas potassium was essentially unchanged (for example, 46.3±22.9, 40.7±16.1, 44.7±16.4 (±s.d.) mmol, respectively). In multivariate analyses both sodium (positively) and potassium (negatively) were strongly correlated with BP (P<0.001); quantitatively the association was stronger, and more consistent in each site individually, for potassium. The within-population day-to-day variation was also greater for sodium than for potassium. Among each population group, a significant correlation was observed between sodium and urine volume, supporting the prior finding of sodium as a determinant of fluid intake in free-living individuals. These data confirm the consistency with the possible role of dietary electrolytes as hypertension risk factors, reinforcing the relevance of potassium in these populations.
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Affiliation(s)
- Bamidele O. Tayo
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Amy Luke
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Colin A. McKenzie
- Tropical Metabolism Research Unit, University of the West Indies, Kingston, Jamaica
| | - Holly Kramer
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Guichan Cao
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Ramon Durazo-Arvizu
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Terrence Forrester
- Tropical Metabolism Research Unit, University of the West Indies, Kingston, Jamaica
| | - Adebowale A. Adeyemo
- Department of Pediatrics/Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, MD
| | - Richard S. Cooper
- Department of Preventive Medicine and Epidemiology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
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694
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Kita T, Yokota N, Ichiki Y, Ayabe T, Etoh T, Tamaki N, Kato J, Eto T, Kitamura K. Three-year safety and effectiveness of fixed-dose losartan/hydrochlorothiazide combination therapy in Japanese patients with hypertension under clinical setting (PALM-1 Extension Study). Clin Exp Hypertens 2012; 34:498-503. [PMID: 22533546 PMCID: PMC3507276 DOI: 10.3109/10641963.2012.666606] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Concerns about metabolic complications often disturb prolonged use of diuretics in Japan. We investigated 3-year safety and efficacy in Japanese patients with hypertension who were uncontrolled with angiotensin receptor blocker or angiotensin-converting enzyme inhibitor regimens and then switched to losartan (50 mg)/hydrochlorothiazide (12.5 mg; HCTZ) combinations. Blood pressure decreased favorably and maintained a steady state for 3 years (157 ± 16/88 ± 11 mm Hg to 132 ± 13/75 ± 9 mm Hg, P < .0001). Metabolic parameters maintained a limited range of changes after 3 years, and adverse events were markedly decreased after 1-year treatment. The losartan/HCTZ combination minimized diuretic-related adverse effects and thus may be useful for the treatment of Japanese patients with hypertension.
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Affiliation(s)
- Toshihiro Kita
- Division of Circulatory and Body Fluid Regulation, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan.
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695
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Hosoya T, Kuriyama S, Ohno I, Kawamura T, Ogura M, Ikeda M, Ishikawa M, Hayashi F, Kanai T, Tomonari H, Soejima M, Akaba K, Tokudome G. Antihypertensive effect of a fixed-dose combination of losartan/hydrochlorothiazide in patients with uncontrolled hypertension: a multicenter study. Clin Exp Nephrol 2012; 16:269-78. [PMID: 22127399 PMCID: PMC3328675 DOI: 10.1007/s10157-011-0564-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 11/10/2011] [Indexed: 01/13/2023]
Abstract
BACKGROUND Achieving adequate blood pressure (BP) control often requires more than one antihypertensive agent. The purpose of this study was to determine whether a fixed-dose formulation of losartan (LOS) plus hydrochlorothiazide (HCTZ) (LOS/HCTZ) is effective in achieving a greater BP lowering in patients with uncontrolled hypertension. METHODS The study was a prospective, multicenter, observational trial exploring the antihypertensive effect of a single tablet of LOS 50 mg/HCTZ 12.5 mg. A total of 228 patients whose BP had previously been treated with more than one antihypertensive agents without having achieved BP goal below 130/80 mmHg enrolled in the study. RESULTS A significant decrease in systolic and diastolic BP was observed in both clinic and home measurement after switching from the previous treatment to LOS/HCTZ. There was a significant decrease in both B-type natriuretic peptide (BNP) and urinary albumin creatinine (Cr) excretion ratio (ACR), especially in patients with elevated values. In contrast, there was a significant increase in serum Cr concentration in conjunction with a decrease in estimated glomerular filtration rate (eGFR). Overall serum uric acid (UA) concentration increased, whereas in patients with hyperuricemia there was a significant reduction in this value. CONCLUSION Switching to LOS/HCTZ provides a greater reduction in clinic and home BP in patients with uncontrolled hypertension. This combination therapy may lead to cardio-, reno protection and improve UA metabolism.
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Affiliation(s)
- Tatsuo Hosoya
- Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan
| | - Satoru Kuriyama
- Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan
- Division of Nephrology, Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo, 108-0073 Japan
| | - Iwao Ohno
- Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan
| | - Tetsuya Kawamura
- Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan
| | - Makoto Ogura
- Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan
| | - Masato Ikeda
- Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan
| | - Masahiro Ishikawa
- Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan
- Kawaguchi Medical Center, Saitama, Japan
| | - Fumihiro Hayashi
- Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan
- Tokyu Hospital, Tokyo, Japan
| | | | | | | | | | - Goro Tokudome
- Department of Kidney and Hypertension, Jikei University School of Medicine, Tokyo, Japan
- Tokyu Hospital, Tokyo, Japan
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696
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Salt-inducible kinase 1 influences Na(+),K(+)-ATPase activity in vascular smooth muscle cells and associates with variations in blood pressure. J Hypertens 2012; 29:2395-403. [PMID: 22045124 DOI: 10.1097/hjh.0b013e32834d3d55] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Essential hypertension is a complex condition whose cause involves the interaction of multiple genetic and environmental factors such as salt intake. Salt-inducible kinase 1 (SIK1) is a sucrose-nonfermenting-like kinase isoform that belongs to the AMPK (5' adenosine monophosphate-activated protein kinase) family. SIK1 activity is increased by high salt intake and plays an essential role in regulating the plasma membrane Na(+),K(+)-ATPase. The objective of this study was to examine whether SIK1 is present in vascular smooth muscle cells (VSMCs) and endothelial cells, whether it affects VSMC Na(+),K(+)-ATPase activity and whether human SIK1 (hSIK1) represents a potential candidate for blood pressure regulation. METHODS Localization of SIK1 was performed using immunohistochemistry, mRNA and western blot. Functional assays (Na(+),K(+)-ATPase activity) were performed in VSMCs derived from rat aorta. Genotype-phenotype association studies were performed in three Swedish and one Japanese population-based cohorts. RESULTS SIK1 was localized in human VSMCs and endothelial cells, as well as a cell line derived from rat aorta. A nonsynonymous single nucleotide polymorphism in the hSIK1 gene exon 3 (C→T, rs3746951) results in the amino acid change (15)Gly→Ser in the SIK1 protein. SIK1-(15)Ser was found to increase plasma membrane Na(+),K(+)-ATPase activity in cultured VSMC line from rat aorta. Genotype-phenotype association studies in three Swedish and one Japanese population-based cohorts suggested that T allele (coding for (15)Ser) was associated with lower blood pressure (P = 0.005 for SBP and P = 0.002 for DBP) and with a decrease in left ventricular mass (P = 0.048). CONCLUSION The hSIK1 appears to be of potential relevance within VSMC function and blood pressure regulation.
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697
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Cornélio ME, Gallani MCBJ, Godin G, Rodrigues RCM, Nadruz W, Mendez RDR. Behavioural determinants of salt consumption among hypertensive individuals. J Hum Nutr Diet 2012; 25:334-44. [DOI: 10.1111/j.1365-277x.2012.01238.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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698
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Villani AM, Clifton PM, Keogh JB. Sodium intake and excretion in individuals with type 2 diabetes mellitus: a cross-sectional analysis of overweight and obese males and females in Australia. J Hum Nutr Diet 2012; 25:129-39. [DOI: 10.1111/j.1365-277x.2011.01223.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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699
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Blood pressure and body mass index: a comparison of the associations in the Caucasian and Asian populations. Hypertens Res 2012; 35:523-30. [DOI: 10.1038/hr.2011.219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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700
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Sodium Consumption: An Individual's Choice? Int J Hypertens 2012; 2012:860954. [PMID: 22263106 PMCID: PMC3259482 DOI: 10.1155/2012/860954] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 11/14/2011] [Indexed: 02/06/2023] Open
Abstract
Excess intake of dietary salt is estimated to be one of the leading risks to health worldwide. Major national and international health organizations, along with many governments around the world, have called for reductions in the consumption of dietary salt. This paper discusses behavioural and population interventions as mechanisms to reduce dietary salt. In developed countries, salt added during food processing is the dominant source of salt and largely outside of the direct control of individuals. Population-based interventions have the potential to improve health and to be cost saving for these countries. In developing economies, where salt added in cooking and at the table is the dominant source, interventions based on education and behaviour change have been estimated to be highly cost effective. Regardless, countries with either developed or developing economies can benefit from the integration of both population and behavioural change interventions.
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