Factors Predicting Sodium Intake of Korean Americans with Type 2 Diabetes

Examining the Potential Effect of a Salt Sensitivity Biomarker in Korean American Immigrants: A Pilot Study

The genetic factors involved with salt sensitivity (SS) have been studied using a genetic approach to identify individuals at high risk for developing hypertension and could benefit from a low sodium diet intervention, but this has not been well-studied in Korean American immigrants (KAIs). The purpose of this pilot study was to investigate the influence of SS that moderates blood pressure (BP) in KAIs (n = 34). KAIs were recruited from local communities and completed a blood draw, a 8-day food log, and BP testing. The dietary sodium intake was measured using the Fitbit mobile app, and an SS biomarker was assessed using targeted genotyping. out of five GNAI2 single nucleotide polymorphisms (SNPs) tested, rs4547694 significantly moderated the relationship of dietary sodium intake on BP in KAIs. Conclusions: Further studies are warranted to test the effect of a reduced sodium diet on BP while accounting for the moderating influence of an SS genotype.

Disparities in chronic kidney disease-the state of the evidence

PURPOSE OF REVIEW

The purpose of this review was to assess the prevalence of United States chronic kidney disease (CKD) health disparities, focusing on racial/ethnic groups, immigrants and refugees, sex or gender, and older adults.

RECENT FINDINGS

There are major racial/ethnic disparities in CKD, with possible contributions from the social determinants of health, socioeconomics, and racial discrimination. Racial/ethnic minority patients experience faster progression to end-stage kidney disease (ESKD) and higher mortality predialysis, however, once on dialysis, appear to live longer. Similarly, men are quicker to progress to ESKD than women, with potential biological, behavioral, and measurement error factors. There is a lack of substantial evidence for intersex, nonbinary, or transgender patients. There are also strikingly few studies about US immigrants or older adults with CKD despite the fact that they are at high risk for CKD due to a variety of factors.

SUMMARY

As providers and scientists, we must combat both conscious and unconscious biases, advocate for minority patient populations, and be inclusive and diverse in our treatment regimens and provision of care. We need to acknowledge that sufficient evidence exists to change treatment guidelines, and that more is required to support the diversity of our patient population.

Is Colorectal Cancer Screening Associated with Stages of Weight Control Among Korean Americans Aged 50-75 Years Old?: Implications for Weight Control Practice

OBJECTIVE

To examine the associations of colorectal cancer (CRC) screening with stages of weight control among Korean Americans (KAs) using the transtheoretical model and provide implications for their weight control practice.

METHODS

A quantitative, cross-sectional survey was employed to collect data on current weight control behaviors and intentions, CRC screening history, previous cancer diagnosis, body mass index, number of chronic conditions, perceived health status, health insurance, and sociodemographics. Purposive sampling was implemented to recruit KA participants in the Atlanta metropolitan area in the USA from May 2015 to February 2016. A total of 433 KAs aged 50 to 75 years completed a self-report survey questionnaire. Descriptive and bivariate analyses and multiple logistic regressions were performed using Stata Version 14/MP software.

RESULTS

Applying the stages of the transtheoretical model 53% were positioned in the first two stages (precontemplation and contemplation) of weight control with 47% being in the last two stages (action and maintenance). Participants who had been screened for CRC were more likely to be in the last two stages of weight control compared with those who had not been screened (OR = 2.49; p = 0.003).

CONCLUSIONS

The findings suggest that preventive healthcare such as CRC screening may provide the opportunity for health education interventions to help encourage weight control efforts and behaviors in the KA community. Future research is warranted to investigate the underlying mechanism behind the link between CRC screening and weight control to guide the development of interventions for eliminating health disparities.

Trends in Dietary Sodium Intake in the United States and the Impact of USDA Guidelines: NHANES 1999-2016

BACKGROUND

Moderation in sodium consumption is recommended to reduce morbidity and mortality; however, trends in intake and the impact of guidelines have not been examined.

METHODS

Sodium intake data collected from 1999-2016 in the National Health and Nutrition Examination Surveys were analyzed. Trends in sodium intake for individuals aged 18 years or over and in subgroups based on age, sex, race and ethnicity, and sodium-sensitive chronic diseases were examined. Adherence to US Department of Agriculture guidelines was assessed. Multivariable regression analysis was performed to identify predictors of sodium intake from 2011-2016.

RESULTS

A total of 47,509 individuals (median age = 44.0 years, 48.3% male) were included in the study. Median sodium consumption was 3232 mg per day (95% confidence interval [CI], 3210-3255), increasing from 3156 mg per day (95% CI 3,038-3,273) in 1999-2000 to 3273 mg per day (95% CI, 3218-3328) in 2015-2016 (P < .001). Intake declined with age (3427 mg per day for individuals aged 18-50 years, 3101 mg per day for individuals aged 51-70 years, and 2620 mg per day for individuals aged ≥71 years; P < .001) and was greater in males than in females (3827 mg per day vs 2778 mg per day; P < .001). Caucasians, Hispanics, and African Americans consumed 3278, 3117, and 3027 mg of dietary sodium per day respectively (P < .001). Individuals with hypertension, diabetes mellitus, and chronic kidney disease consumed 3073, 3062, and 2658 mg of dietary sodium per day respectively. Population adherence to US Department of Agriculture recommendations declined from 34% to 23% and all high-risk subgroups had < 10% adherence. Daily total calories was the strongest predictor of sodium consumption (overall r² = 0.680).

CONCLUSION

Sodium intake has remained above recommended levels in all segments of the adult population and adherence to guidelines is poor. Novel interventions are needed to reduce sodium intake.

Factors Predicting Sodium Intake of Korean Americans with Type 2 Diabetes

The increasing prevalence of type 2 diabetes mellitus (T2DM) and its complications including cardiovascular disease and chronic kidney disease threaten Korean Americans (KAs). High dietary sodium intake contributes to both conditions. The purpose of the study was to assess dietary sodium consumption and to examine the predictors of sodium intake among KA with T2DM. A total 232 KA who had uncontrolled diabetes participated in this study. The majority of the sample (69%) consumed more sodium than current national guidelines. A high level of energy intake was the strongest predictor for sodium intake with gender and marital status also related. Our findings identified predictive factors to excessive sodium intake and these data support the need for culturally-tailored education about appropriate dietary sodium and energy intake are needed for patients about T2DM.