1
|
Ribeiro NG, Lelis DF, Griep RH, Barreto SM, Molina MDCB, Schmidt MI, Duncan BB, Bensenor I, Lotufo PA, Mill JG, Baldo MP. Salt Intake in Adults with Diabetes and Hypertension: The Longitudinal Study of Adult Health-Brasil Study. Metab Syndr Relat Disord 2024; 22:356-364. [PMID: 38563778 DOI: 10.1089/met.2023.0304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Background and Objective: Hypertension and type-2 diabetes are strong risk factors for cardiovascular diseases, and their management requires lifestyle changes, including a shift in dietary habits. The consumption of salt has increased in the last decades in some countries, but its association with type-2 diabetes remains unknown. Thus, we aimed to estimate the amount of salt intake among adults with and without diabetes and to assess whether concomitant hypertension and diabetes are associated with higher salt intake. Methods: Data from 11,982 adults 35-74 years of age enrolled in the baseline of the Longitudinal Study of Adult Health-Brasil study (2008-2010) were studied. A clinical and anthropometric evaluation was performed, and their daily salt intake was estimated by the overnight 12-hr urine sodium excretion. Results: Salt intake (gram per day) was higher in participants with diabetes as compared with those without diabetes, regardless of sex (men: 14.2 ± 6.4 vs. 12.4 ± 5.6, P < 0.05; women: 10.5 ± 4.8 vs. 9.1 ± 4.1, P < 0.05). However, salt intake is high in participants with fasting glucose ≥126 mg/dL or HbA1c ≥6.5%, but not in participants with blood glucose 2 hr after the glucose tolerance test ≥200 mg/dL. When hypertension and diabetes coexisted, salt consumption was higher than among people without these conditions. The prevalence of hypertension increased with increasing salt intake in women with diabetes, but not in men with this condition. Conclusions: Our findings highlight the high consumption of salt in individuals with diabetes and/or hypertension, and the need for effective strategies to reduce salt consumption in these groups of increased risk for major cardiovascular events, especially in women.
Collapse
Affiliation(s)
- Natália Gonçalves Ribeiro
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Minas Gerais, Brazil
| | - Deborah F Lelis
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Minas Gerais, Brazil
| | - Rosane H Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sandhi M Barreto
- Faculty of Medicine, Clinical Hospital/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Del Carmen B Molina
- PostgraduateProgram in Public Health, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Maria I Schmidt
- Postgraduate Program in Epidemiology, School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do SulBrazil
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do SulBrazil
| | - Isabela Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, São Paulo, Brazil
| | - José G Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Marcelo Perim Baldo
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Minas Gerais, Brazil
| |
Collapse
|
2
|
Donfrancesco C, Buttari B, Marcozzi B, Sieri S, Di Lonardo A, Lo Noce C, Profumo E, Vespasiano F, Agnoli C, Vannucchi S, Silano M, Galeone D, Bellisario P, Vaia F, Palmieri L. Nutrition, Physical Activity and Smoking Habit in the Italian General Adult Population: CUORE Project Health Examination Survey 2018-2019. Healthcare (Basel) 2024; 12:475. [PMID: 38391850 PMCID: PMC10888300 DOI: 10.3390/healthcare12040475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Tobacco consumption, incorrect nutrition and insufficient physical activity/sedentariness represent modifiable NCDs risk factors in Western countries. To evaluate recent lifestyle indicators in Italy, data from the national Health Examination Survey (HES), implemented in 2018-2019 within the CUORE Project, were assessed. METHODS Age-sex standardized results from random samples of Italian general population (35-74 years) were reported by sex, age-class, educational level and geographical area. From 2106 participants, 2090 were considered for smoking habit, 2016 for physical activity and 1578 for nutrition. Standardized questionnaires were used for smoking habit and physical activity, and the EPIC questionnaire for nutrition. RESULTS Total cigarette current smokers were 23% in men and 19% in women; sedentariness during leisure time was 34% in men and 45% in women and at work 45% and 47% in men and women, respectively. Prevalence of balanced eating behaviours for vegetables was 28% in men and 39% in women; and for fruits 50% and 52%, respectively; prevalence of correct lifestyle (not smoker, regular physical activity and following at least five correct eating behaviours) was 7% and 12% for men and women, respectively. CONCLUSIONS In 2018-2019, levels of unhealthy lifestyles were found to be still epidemic and basically stable compared to 10 years earlier (slight smoking habit decrease, slight sedentariness increase and slight nutrition improvements); intersectoral strategies and monitoring need to be continued.
Collapse
Affiliation(s)
| | | | | | - Sabina Sieri
- Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | | | | | | | | | - Claudia Agnoli
- Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | | | | | | | | | | | | |
Collapse
|
3
|
Strazzullo P, Cairella G, D'Elia L, Scognamiglio U, Simonetti P. Time to define food salt targets in Italy starting with cereal-based products: A safe and practical way to reduce the heavy burden of cardiovascular disease. Nutr Metab Cardiovasc Dis 2024; 34:294-298. [PMID: 38242832 DOI: 10.1016/j.numecd.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND AND AIMS Excess salt intake is the leading dietary risk factor for cardiovascular disease in most countries, including Italy. While the cost-effectiveness of interventions aimed to reduce salt intake has been proved, the WHO recommendation to reduce salt intake by 30 % at the global level by 2025 is far from being reached. METHODS AND RESULTS In Italy, two surveys of the general adult population have established that the average salt intake is still almost twice the WHO recommendation although it was reduced by 1.2 g/day between 2008-12 and 2018-19. Previous investigations had shown that non-discretionary salt added by the industry or by local craft producers represents at least 50 % of the total intake and indicated cereal-based products as the main source of non-discretionary salt. Two recent studies conducted by the Italian Society of Human Nutrition "Young Working Group" have provided updated information on the salt content of almost three thousand cereal-based products currently available on the Italian food market and shown that most of the items evaluated had a sodium content much higher than the sodium benchmarks recently proposed by WHO. CONCLUSIONS Italy has built the foundations of an effective population strategy for salt intake reduction: it is time however to proceed with full commitment to food reformulation if any substantial further progress has to be made. Salt benchmarks for Italy need to be defined for the food categories most relevant to population salt intake and their implementation should ideally be mandatory after consultation with food producers.
Collapse
Affiliation(s)
- Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy.
| | - Giulia Cairella
- Department of Prevention, Unit Local Health Roma 2, Rome, Italy
| | - Lanfranco D'Elia
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - Umberto Scognamiglio
- CREA-Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Paolo Simonetti
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
4
|
De Angelis S, Medda E, Rotondi D, Masocco M, Minardi V, Contoli B, Possenti V, Sorbo A, D’Amato M, Turco AC, Pastorelli AA, Stacchini P, Cas RD, Bagnasco M, Bonofiglio D, Gasperi M, Meringolo D, Mian C, Moleti M, Vermiglio F, Puxeddu E, Taccaliti A, Tonacchera M, Ulisse S, Dimida A, Rago T, Nazzari E, Schiavo M, Bossert I, Sturniolo G, Corbetta C, Cereda C, Cappelletti L, Camilot M, Teofoli F, Ciatti R, Tarsi E, Perrotti N, Marasco O, Scozzafava G, Righetti F, Andò S, Catalano S, Cristofaro M, Sorrenti G, Censi S, Morelli S, Baldini E, Plutino G, Copparoni R, Alonzo E, Giacomozzi C, Silano M, Olivieri A. Fifteen Years of Iodine Prophylaxis in Italy: Results of a Nationwide Surveillance (Period 2015-2019). J Clin Endocrinol Metab 2024; 109:e495-e507. [PMID: 37820735 PMCID: PMC10795908 DOI: 10.1210/clinem/dgad593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/05/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Abstract
CONTEXT In 2005, a nationwide program of iodine prophylaxis on a voluntary basis was implemented in Italy by law. However, recent data on iodine status are lacking. OBJECTIVE The aim of this study was to evaluate efficiency, effectiveness, and possible adverse effects (increased occurrence of thyroid autoimmunity and hyperthyroidism) of the Italian iodine prophylaxis program. METHODS From 2015 to 2019, a nationwide survey was performed. The use of iodized salt was evaluated in a sample of 164 593 adults and in 998 school canteens. A sample of 4233 schoolchildren (aged 11-13 years) was recruited to assess urinary iodine concentration, prevalence of goiter, and thyroid hypoechogenicity on ultrasound, with the latter being an indirect indicator of thyroid autoimmunity. Neonatal TSH values of 197 677 infants screened in regions representative of Northern, Central, and Southern Italy were analyzed to investigate the percentage of TSH values >5.0 mIU/L. Data on methimazole prescriptions were analyzed as indirect indicators of new cases of hyperthyroidism. RESULTS The prevalence of the use of iodized salt was 71.5% in adult population and 78% in school canteens. A median urinary iodine concentration of 124 μg/L, a prevalence of goiter of 2.2%, and a prevalence of thyroid hypoechogenicity of 5.7% were observed in schoolchildren. The percentage of neonatal TSH values >5.0 mIU/L resulted still higher (5.1%) than the World Health Organization threshold of 3.0%, whereas the prescriptions of methimazole showed a reduction of 13.5%. CONCLUSION Fifteen years of iodine prophylaxis have led to iodine sufficiency in Italy, although there still is concern about iodine nutritional status during pregnancy.
Collapse
Affiliation(s)
- Simona De Angelis
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome 00161, Italy
| | - Emanuela Medda
- Reference Center for Behavioral Sciences and Mental Health, Italian National Institute of Health, Rome 00161, Italy
| | - Daniela Rotondi
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome 00161, Italy
| | - Maria Masocco
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome 00161, Italy
| | - Valentina Minardi
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome 00161, Italy
| | - Benedetta Contoli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome 00161, Italy
| | - Valentina Possenti
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome 00161, Italy
| | - Angela Sorbo
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome 00161, Italy
| | - Marilena D’Amato
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome 00161, Italy
| | - Anna Chiara Turco
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome 00161, Italy
| | - Alberto Augusto Pastorelli
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome 00161, Italy
| | - Paolo Stacchini
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome 00161, Italy
| | - Roberto Da Cas
- National Centre for Drug Research and Evaluation, Italian National Institute of Health, Rome 00161, Italy
| | - Marcello Bagnasco
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa 16132, Italy
| | - Daniela Bonofiglio
- Department of Pharmacy, Health and Nutritional Sciences, Centro Sanitario, University of Calabria, Cosenza 87036, Italy
| | - Maurizio Gasperi
- Department of Medicine and Health Sciences “V. Tiberio,” University of Molise, Campobasso 86100, Italy
| | | | - Caterina Mian
- Department of Medicine, University of Padua, Padua 35128, Italy
| | - Mariacarla Moleti
- Department of Clinical and Experimental Medicine, University of Messina, Messina 98125, Italy
| | - Francesco Vermiglio
- Department of Clinical and Experimental Medicine, University of Messina, Messina 98125, Italy
| | - Efisio Puxeddu
- Department of Medicine and Surgery, University of Perugia, Perugia 06132, Italy
| | - Augusto Taccaliti
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona 60126, Italy
| | - Massimo Tonacchera
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56124, Italy
| | - Salvatore Ulisse
- Department of Surgery, “Sapienza” University of Rome, Rome 00185, Italy
| | - Antonio Dimida
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56124, Italy
| | - Teresa Rago
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56124, Italy
| | - Elena Nazzari
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa 16132, Italy
| | - Mara Schiavo
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa 16132, Italy
| | - Irene Bossert
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa 16132, Italy
| | - Giacomo Sturniolo
- Department of Clinical and Experimental Medicine, University of Messina, Messina 98125, Italy
| | - Carlo Corbetta
- Department of Woman, Mother and Neonate, “Vittore Buzzi” Children's Hospital, Milan 20154, Italy
| | - Cristina Cereda
- Department of Pediatrics, “Vittore Buzzi” Children's Hospital, Milan 20154, Italy
| | - Laura Cappelletti
- Department of Pediatrics, “Vittore Buzzi” Children's Hospital, Milan 20154, Italy
| | - Marta Camilot
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona 37134, Italy
| | - Francesca Teofoli
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona 37134, Italy
| | - Renzo Ciatti
- Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio Ospedaliero Santa Croce, Fano 61032, Italy
| | - Elisabetta Tarsi
- Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio Ospedaliero Santa Croce, Fano 61032, Italy
| | - Nicola Perrotti
- Department of Health Sciences, University Magna Graecia, Catanzaro 88100, Italy
| | - Onorina Marasco
- Regional Neonatal Screening Laboratory, Azienda Ospedaliera Mater Domini, Catanzaro 88100, Italy
| | - Giovanna Scozzafava
- Regional Neonatal Screening Laboratory, Azienda Ospedaliera Mater Domini, Catanzaro 88100, Italy
| | - Francesca Righetti
- Regional Laboratory for Neonatal Screening and Endocrine-Metabolic Diseases, IRCCS University Sant'Orsola Hospital, Bologna 40138, Italy
| | - Sebastiano Andò
- Department of Pharmacy, Health and Nutritional Sciences, Centro Sanitario, University of Calabria, Cosenza 87036, Italy
| | - Stefania Catalano
- Department of Pharmacy, Health and Nutritional Sciences, Centro Sanitario, University of Calabria, Cosenza 87036, Italy
- Annunziata Hospital, Cosenza 87100, Italy
| | | | | | - Simona Censi
- Department of Medicine, University of Padua, Padua 35128, Italy
| | - Silvia Morelli
- Department of Medicine and Surgery, University of Perugia, Perugia 06132, Italy
| | - Enke Baldini
- Department of Surgery, “Sapienza” University of Rome, Rome 00185, Italy
| | - Giuseppe Plutino
- General Direction of Food Safety and Nutrition, Italian Ministry of Health, Rome 00144, Italy
| | - Roberto Copparoni
- General Direction of Food Safety and Nutrition, Italian Ministry of Health, Rome 00144, Italy
| | - Elena Alonzo
- Food Hygiene and Nutrition Service–SIAN, Local Health Authority of Catania, Catania 95027, Italy
| | - Claudia Giacomozzi
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome 00161, Italy
| | - Marco Silano
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome 00161, Italy
| | - Antonella Olivieri
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome 00161, Italy
| |
Collapse
|
5
|
Kwong EJL, Whiting S, Bunge AC, Leven Y, Breda J, Rakovac I, Cappuccio FP, Wickramasinghe K. Population-level salt intake in the WHO European Region in 2022: a systematic review. Public Health Nutr 2023; 26:s6-s19. [PMID: 36263661 PMCID: PMC10801383 DOI: 10.1017/s136898002200218x] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 07/06/2022] [Accepted: 09/20/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The WHO recommends that adults consume less than 5 g of salt per day to reduce the risk of CVD. This study aims to examine the average population daily salt intake in the fifty-three Member States of the WHO European Region. DESIGN A systematic review was conducted to examine the most up-to-date salt intake data for adults published between 2000 and 2022. Data were obtained from peer-reviewed and grey literature, WHO surveys and studies, as well as from national and global experts. SETTING The fifty-three Member States of the WHO European Region. PARTICIPANTS People aged 12 years or more. RESULTS We identified fifty studies published between 2010 and 2021. Most countries in the WHO European Region (n 52, 98 %) reported salt intake above WHO recommended maximum levels. In almost all countries (n 52, 98 %), men consume more salt than women, ranging between 5·39 and 18·51 g for men and 4·27 and 16·14 g for women. Generally, Western and Northern European countries have the lowest average salt intake, whilst Eastern European and Central Asian countries have the highest average. Forty-two percentage of the fifty-three countries (n 22) measured salt intake using 24 h urinary collection, considered the gold standard method. CONCLUSIONS This study found that salt intakes in the WHO European Region are significantly above WHO recommended levels. Most Member States of the Region have conducted some form of population salt intake. However, methodologies to estimate salt intake are highly disparate and underestimations are very likely.
Collapse
Affiliation(s)
- Edwin Jit Leung Kwong
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, 9 Leontyevsky Pereulok, Moscow125009, Russian Federation
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Stephen Whiting
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, 9 Leontyevsky Pereulok, Moscow125009, Russian Federation
| | - Anne Charlotte Bunge
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, 9 Leontyevsky Pereulok, Moscow125009, Russian Federation
- Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
| | - Yana Leven
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, 9 Leontyevsky Pereulok, Moscow125009, Russian Federation
| | - Joao Breda
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Ivo Rakovac
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, 9 Leontyevsky Pereulok, Moscow125009, Russian Federation
| | | | - Kremlin Wickramasinghe
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, 9 Leontyevsky Pereulok, Moscow125009, Russian Federation
| |
Collapse
|
6
|
Margozzini P, Tolonen H, Bernabe-Ortiz A, Cuschieri S, Donfrancesco C, Palmieri L, Sanchez Romero LM, Mindell JS, Oyebode O. National Health Examination Surveys: an essential piece of the health planning puzzle. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.11.23292221. [PMID: 37503238 PMCID: PMC10370235 DOI: 10.1101/2023.07.11.23292221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
National health examination surveys (HESs) have been developed to provide important information that cannot be obtained from other sources. A HES combines information obtained by asking participants questions with biophysical measurements taken by trained field staff. They are observational studies with the highest external validity and make specific contributions to both population (public health) and individual health. Few countries have a track record of a regular wide-ranging HES, but these are the basis of many reports and scientific papers. Despite this, little evidence about HES usefulness and impact or the factors that influence HES effectiveness have been disseminated. This paper presents examples of HES contributions to society in both Europe and the Americas. We sought information by emailing a wide list of people involved in running or using national HESs across Europe and the Americas. We asked for examples of where examination data from their HES had been used in national or regional policymaking. We found multiple examples of HES data being used for agenda-setting, including by highlighting nutritional needs and identifying underdiagnosis and poor management of certain conditions. We also found many ways in which HES have been used to monitor the impact of policies and define population norms. HES data have also been used in policy formation and implementation. HES data are influential and powerful. There is need for global support, financing and networking to transfer capacities and innovation in both fieldwork and laboratory technology.
Collapse
Affiliation(s)
- Paula Margozzini
- Department of Public Health, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Hanna Tolonen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Spiteri G, Monaco MGL, Carta A, Torroni L, Taus F, Verlato G, Porru S. Reduction of Excessive Dietary Sodium Consumption: Effectiveness of a Prevention Intervention among Health Workers in a Large Italian Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085478. [PMID: 37107760 PMCID: PMC10138373 DOI: 10.3390/ijerph20085478] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 05/11/2023]
Abstract
Excessive salt consumption is one of the leading causes of high blood pressure. Worldwide salt intake largely exceeds the WHO recommended amount. This study aimed to evaluate the prevalence of high salt consumers and the effectiveness of a short-term workplace educational intervention among health workers. An online survey, assessing daily salt consumption through the MINISAL-SIIA questionnaire, was sent to the 4911 health workers employed by the University Hospital of Verona, Italy. Health workers who had a high (total score ≥ 10) or moderate (total score = 8/9) salt consumption associated with obesity or arterial hypertension were invited to undergo a medical examination and a short individual counselling session. A total of 1665 health workers (34.0%) completed the online questionnaire; 40.9% and 12.6% had moderate and high salt intake, respectively. High salt intake was more prevalent in men, current and past smokers, and obese and overweight subjects. In 95 participants completing the clinical phase, median daily salt consumption decreased from 10 (p25-p75 8-11) to 7 g (6-8) (p < 0.001), systolic blood pressure from 130 (120-140) to 120 (120-130) mmHg and weight from 78 (62-87) to 75 (62-86) kg. More than half of health workers had an excessive salt intake. However, a brief educational intervention in the healthcare working setting can substantially reduce unhealthy dietary habits, fostering weight loss and blood pressure control. Studies with a longer follow-up are needed to evaluate the persistence over time of these effects.
Collapse
Affiliation(s)
- Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy
| | - Maria Grazia Lourdes Monaco
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy
- Correspondence: ; Tel.: +39-045-812-3946
| | - Angela Carta
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy
- Section of Occupational Health, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Lorena Torroni
- Section of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Francesco Taus
- Section of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
- Unit of Forensic Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Giuseppe Verlato
- Section of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Stefano Porru
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy
- Section of Occupational Health, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| |
Collapse
|
8
|
Donfrancesco C, Di Lonardo A, Lo Noce C, Buttari B, Profumo E, Vespasiano F, Vannucchi S, Galletti F, Onder G, Gulizia MM, Galeone D, Bellisario P, Palmieri L. Trends of blood pressure, raised blood pressure, hypertension and its control among Italian adults: CUORE Project cross-sectional health examination surveys 1998/2008/2018. BMJ Open 2022; 12:e064270. [PMID: 36375969 PMCID: PMC9664280 DOI: 10.1136/bmjopen-2022-064270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess in the Italian general adult population the trends of blood pressure (BP) and prevalence of raised BP (RBP), hypertension and its control in order to evaluate population health and care, and the achievement of an RBP 25% relative reduction as recommended by the WHO at population level. DESIGN Results comparison of health examination surveys, cross-sectional observational studies based on health examination of randomly selected age and sex stratified samples including residents aged 35-74 years. Data of the 2018/2019 survey were compared with the previous ones collected in 1998/2002 and 2008/2012. SETTING Health examination surveys conducted in Italy within the CUORE Project following standardised methodologies. PARTICIPANTS 2985 men and 2955 women examined in 1998/2002, 2218 men and 2204 women examined in 2008/2012 and 1031 men and 1066 women examined in 2018/2019. PRIMARY AND SECONDARY OUTCOME MEASURES Age-standardised mean of BP, prevalence of RBP (systolic BP and/or diastolic BP ≥140/90 mm Hg), hypertension (presenting or being treated for RBP) and its awareness and control, according to sex, age class and educational level. RESULTS In 2018/2019, a significant reduction was observed in systolic BP and diastolic BP in men (1998/2002: 136/86 mm Hg; 2008/2012: 132/84 mm Hg; and 2018/2019: 132/78 mm Hg) and women (132/82 mm Hg, 126/78 mm Hg and 122/73 mm Hg), and in the prevalence of RBP (50%, 40% and 30% in men and 39%, 25% and 16% in women) and of hypertension (54%, 49% and 44% in men and 45%, 35% and 32% in women). Trends were consistent by age and education attainment. In 2018/2019, hypertensive men and women with controlled BP were only 27% and 41%, but a significant favourable trend was observed. CONCLUSIONS Data from 2018/2019 underlined that RBP is still commonly observed in the Italian population aged 35-74 years, however, the WHO RBP target at that time may be considered met.
Collapse
Affiliation(s)
- Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Anna Di Lonardo
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Cinzia Lo Noce
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Brigitta Buttari
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Elisabetta Profumo
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | | | - Serena Vannucchi
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Michele Massimo Gulizia
- National Enterprise of National Relevance and High Specialization 'Garibaldi-Nesima Hospital', Catania, Italy
- Heart Care Foundation, Florence, Italy
| | | | | | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| |
Collapse
|
9
|
Ferrari GT, Proserpio C, Stragliotto LK, Boff JM, Pagliarini E, Oliveira VRD. Salt reduction in bakery products: A critical review on the worldwide scenario, its impacts and different strategies. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
10
|
Wu B, Yang H, Ren X, Qi Z, Tang S, Yin X, Huang L, Tian M, Wu Y, Feng X, Li Z. A Method for Estimating 24 h Urinary Sodium and Potassium Excretion by Spot Urine Specimen in Stroke Patients. Nutrients 2022; 14:nu14194105. [PMID: 36235755 PMCID: PMC9573759 DOI: 10.3390/nu14194105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
Spot urine specimens have been used to estimate 24 h urinary sodium (Na) excretion (24UNaV) and potassium (K) excretion (24UKV). However, the validity is limited for 24UNaV and unknown for 24UKV in stroke patients, using the existing formulas. Herein, we developed and validated a new formula for 24UNaV and 24UKV by spot urine specimens in stroke patients. Spot and 24 h urine samples were collected from 970 stroke patients. The models of 24UNaV and 24UKV were developed using stepwise multivariate linear regression in 689 patients. The performance of different formulas was internally validated in 281 patients at the population and individual levels. The obtained new formulas were: (1) estimated 24UNaV (mmol/day): -0.191 × Age + 4.349 × BMI + 0.229 × SpotNa + 1.744 × SpotNa/Spot creatinine (Cr) + 41.492 (for male); -1.030 × Age + 2.011 × BMI + 0.143 × SpotNa + 1.035 × SpotNa/SpotCr + 147.159 (for female); and (2) estimated 24UKV (mmol/day): -0.052 × Age + 0.410 × BMI + 0.031 × SpotK + 33.280 × Ln (spotK/spot Cr) - 5.789 × Ln (spotNa/spot Cr) - 1.035 (for male); -0.235 × Age + 0.530 × BMI + 0.040 × SpotK + 30.990 × Ln (spot K/spot Cr) - 7.837 × Ln (spotNa/spotCr) + 4.318 (for female). The new formula obtained the lowest mean bias (5.17 mmol/day for 24UNaV and 0.85 mmol/day for 24UKV) and highest proportion at the cutoff under the ±30% level for the estimation of 24UNaV (59.43%) and 24UKV (70.11%). The new formula provides a meaningful exploration to estimate 24UNaV and 24UKV in stroke patients by using spot urine specimens.
Collapse
Affiliation(s)
- Beike Wu
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Hongmei Yang
- School of Public Health, Changzhi Medical College, Changzhi 046000, China
| | - Xinyu Ren
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Zijing Qi
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Shuai Tang
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Xuejun Yin
- The George Institute for Global Health, University of New South Wales, Newtown, NSW 2042, Australia
| | - Liping Huang
- The George Institute for Global Health, University of New South Wales, Newtown, NSW 2042, Australia
| | - Maoyi Tian
- The George Institute for Global Health, University of New South Wales, Newtown, NSW 2042, Australia
- School of Public Health, Harbin Medical University, Harbin 150081, China
| | - Yangfeng Wu
- Clinical Research Center, Peking University, Beijing 100088, China
| | - Xiangxian Feng
- School of Public Health, Changzhi Medical College, Changzhi 046000, China
| | - Zhifang Li
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
- School of Public Health, Changzhi Medical College, Changzhi 046000, China
- Correspondence: ; Tel.: +86-18636517556
| |
Collapse
|
11
|
Martini D, Strazzullo P, Serafini M, Porrini M, Pellegrini N, Angelino D. Sodium Content in Cereal-Based Products Sold in Italy: How Far Are We from the Global Benchmarks? Nutrients 2022; 14:nu14153088. [PMID: 35956263 PMCID: PMC9370200 DOI: 10.3390/nu14153088] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 12/28/2022] Open
Abstract
Reformulation of food products is one of the measures needed for reducing salt consumption. Accordingly, the World Health Organization (WHO) recently proposed global sodium benchmarks for different food categories to be used for setting national policies. Therefore, the sodium content of cereal-based products currently sold in Italy was compared with the WHO benchmarks, highlighting those categories primarily needing a reformulation. To this aim, the sodium content and several declarations (i.e., nutrition and health claims, organic or gluten free declaration) were retrieved from 2917 cereal-based products sold on the Italian market. All “minimally processed breakfast cereals” had a sodium content below the benchmark, while “flatbreads” and “leavened bread” had the highest percentage of items above the respective sodium benchmarks. Flatbreads and “crackers/savory biscuits” showed the highest median delta values from the respective benchmarks of 360 and 278 mg/100 g, respectively. Large variability in terms of percentage of products with sodium content above the benchmark was observed within the same categories, as well as among products with different declarations. A large number of food products currently sold on the Italian market have a sodium content above the benchmark. This result suggests the need to reformulate many food products currently on the market to achieve the WHO/United Nations (UN) objective of 30% global reduction in sodium intake by 2025.
Collapse
Affiliation(s)
- Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (D.M.); (M.P.)
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy
- Correspondence: (P.S.); (N.P.); Tel.: +39-0432-558183 (N.P.)
| | - Mauro Serafini
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, 64100 Teramo, Italy; (M.S.); (D.A.)
| | - Marisa Porrini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (D.M.); (M.P.)
| | - Nicoletta Pellegrini
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy
- Correspondence: (P.S.); (N.P.); Tel.: +39-0432-558183 (N.P.)
| | - Donato Angelino
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, 64100 Teramo, Italy; (M.S.); (D.A.)
| |
Collapse
|
12
|
Trends of overweight, obesity and anthropometric measurements among the adult population in Italy: The CUORE Project health examination surveys 1998, 2008, and 2018. PLoS One 2022; 17:e0264778. [PMID: 35231070 PMCID: PMC8887738 DOI: 10.1371/journal.pone.0264778] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/16/2022] [Indexed: 12/23/2022] Open
Abstract
Background/Objectives Obesity is associated with an increased risk of noncommunicable diseases, such as diabetes, coronary heart disease, stroke, cancers, and conditions, including obstructive sleep apnea and osteoarthritis. Obesity is largely preventable, and halting its rise is one of the World Health Organization Global Action Plan for the Prevention of Noncommunicable Diseases targets. This study aimed to assess trends of anthropometric measurements in Italy using the data collected within the CUORE Project health examination surveys (HESs) 1998, 2008, and 2018. Subjects/Methods Within the HESs 1998–2002, 2008–2012, and 2018–2019, anthropometric measurements were collected in random samples of the resident population aged 35–74 years, stratified by age and sex, from 10 Italian Regions in Northern, Central, and Southern Italy (2984 men and 2944 women, 2224 men and 2188 women, 1035 men and 1065 women, respectively). Weight, height, and waist and hip circumferences were measured using standardized methodologies. A standardized questionnaire was used to collect data on education. Indicators were age standardized. Results For both men and women, mean body mass index in 2018 was comparable with those in 1998 and 2008 (in 1998, 2008, and 2018—men: 26.7, 27.5, and 27.0 kg/m2; women: 26.2, 26.6, and 26.3 kg/m2). In 1998, 2008, 2018 prevalence of overweight resulted 49%, 47%, 46% in men and 33%, 32%, 28% in women respectively; prevalence of obesity resulted 17%, 24% 20% in men and 19%, 23%, 23% in women respectively. All indicators of excess weight worsen with increasing age and are more severe in persons with a lower educational level. Conclusions Although the overall trend of excess weight over the past two decades appeared to be substantially stable in the Italian adult population, the continuous strengthening of undertaken initiatives should continue since there remains a high proportion of overweight or obesity and a gap between educational levels.
Collapse
|
13
|
Olivieri A, Giorgino F, Maffeis C, Bagnasco M. Salt reduction and iodine intake in Italy. J Endocrinol Invest 2022; 45:883-885. [PMID: 34807431 DOI: 10.1007/s40618-021-01708-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Affiliation(s)
- A Olivieri
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Responsible for the Italian National Observatory for Monitoring Iodine Prophylaxis, Rome, Italy.
| | - F Giorgino
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Past President of the Italian Society of Endocrinology, University of Bari Aldo Moro, Bari, Italy
| | - C Maffeis
- Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, President of the Italian Society of Pediatric Endocrinology and Diabetology, University of Verona, Verona, Italy
| | - M Bagnasco
- Department of Internal Medicine and Medical Specialties, President-elect of the Italian Thyroid Association, University of Genoa, Genoa, Italy
| |
Collapse
|
14
|
Nutritional Quality of Wholegrain Cereal-Based Products Sold on the Italian Market: Data from the FLIP Study. Nutrients 2022; 14:nu14040798. [PMID: 35215446 PMCID: PMC8877440 DOI: 10.3390/nu14040798] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 01/07/2023] Open
Abstract
The consumption of wholegrains (WG) is encouraged worldwide, but the lack of a common legal definition of such products leads to an unclear classification and identification on the grocery store shelf. In Italy, several products are generally sold as WG, but it cannot be determined if they are made entirely with all WG cereal(s) or if they are partially produced with WG ingredients (PWG). The aims of this study were to (a) survey the number of cereal-based food items formulated with WG, PWG, or refined (RG) present on the Italian market; and (b) analyse the nutritional quality, intended as nutrition facts, of WG products in comparison to PWG and RG. Nutritional information and declarations were retrieved from packs of 3040 products belonging to five different categories: breakfast cereals, biscuits, sweet snacks, bread, and bread substitutes. A descriptive analysis of the products and comparison of energy, macronutrients, fibre and salt among RG, PWG and WG products within each category was performed. In all categories, a major portion of the products did not contain WG ingredients. Results showed that the nutritional quality of RG, PWG, and WG products varied in relation to the product category and that WG inclusion cannot be always considered a marker of the overall nutritional quality of foods. Instead, it is necessary to evaluate the global product characteristics, and it is important to pay attention to differences between WG and PWG products that can be perceived by consumers as equivalent.
Collapse
|
15
|
De Angelis S, Rotondi D, Gilardi E, Stacchini P, Pastorelli AA, Sorbo A, D’Amato M, Turco AC, Medda E, Da Cas R, Andò S, Bonofiglio D, Bagnasco M, Gasperi M, Meringolo D, Mian C, Puxeddu E, Regalbuto C, Moleti M, Taccaliti A, Ulisse S, Tonacchera M, Tanda ML, Boi F, Ruggiero V, Mariotti S, Corbetta C, Ciatti R, Tarsi E, Stoppioni V, Perrotti N, Marasco O, Scozzafava G, Camilot M, Teofoli F, Righetti F, Dimida A, Plutino G, Carrano E, Copparoni R, Gabbianelli M, Vitti P, Olivieri A. Aggiornamento sulla nutrizione iodica in Italia: i risultati della seconda sorveglianza dell’Osservatorio per il Monitoraggio della Iodoprofilassi in Italia-OSNAMI (2015-2019). L'ENDOCRINOLOGO 2022. [PMCID: PMC8790550 DOI: 10.1007/s40619-022-01018-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Simona De Angelis
- Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia
| | - Daniela Rotondi
- Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia
| | - Enzo Gilardi
- Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia
| | - Paolo Stacchini
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Roma, Italia
| | - Augusto Alberto Pastorelli
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Roma, Italia
| | - Angela Sorbo
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Roma, Italia
| | - Marilena D’Amato
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Roma, Italia
| | - Anna Chiara Turco
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Roma, Italia
| | - Emanuela Medda
- Centro di Riferimento per le Scienze Comportamentali e la Salute Mentale, Istituto Superiore di Sanità, Roma, Italia
| | - Roberto Da Cas
- Centro Nazionale Ricerca e Valutazione Preclinica e Clinica dei Farmaci, Istituto Superiore di Sanità, Roma, Italia
| | - Sebastiano Andò
- Centro Sanitario, Dipartimento di Farmacia e Scienze della Salute e della Nutrizione, Università della Calabria, Cosenza, Italia
| | - Daniela Bonofiglio
- Centro Sanitario, Dipartimento di Farmacia e Scienze della Salute e della Nutrizione, Università della Calabria, Cosenza, Italia
| | - Marcello Bagnasco
- Dipartimento di Medicina Interna e Specialità Mediche, Università di Genova, IRCCS Ospedale Policlinico S. Martino, Genova, Italia
| | - Maurizio Gasperi
- Dipartimento di Medicina e Scienze per la Salute, Università degli Studi del Molise, Campobasso, Italia
| | | | - Caterina Mian
- Dipartimento di Medicina, Azienda Ospedaliera di Padova, Padova, Italia
| | - Efisio Puxeddu
- Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italia
| | - Concetto Regalbuto
- Dipartimento di Biomedicina Clinica e Molecolare, Università di Catania, Catania, Italia
| | - Mariacarla Moleti
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, Messina, Italia
| | - Augusto Taccaliti
- Clinica di Endocrinologia e Malattie del Metabolismo, Università Politecnica delle Marche, Ancona, Italia
| | - Salvatore Ulisse
- Dipartimento di Scienze Chirurgiche, “Sapienza” Università di Roma, Roma, Italia
| | - Massimo Tonacchera
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italia
| | - Maria Laura Tanda
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell’Insubria, ASST-Settelaghi, Varese, Italia
| | - Francesco Boi
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italia
| | - Valeria Ruggiero
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italia
| | - Stefano Mariotti
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italia
| | - Carlo Corbetta
- Laboratorio di Riferimento Regionale per lo Screening Neonatale, Ospedale V. Buzzi, Milano, Italia
| | - Renzo Ciatti
- Centro Screening Neonatale Regione Marche, UOC di Neuropsichiatria Infantile, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio Ospedaliero Santa Croce, Fano, Italia
| | - Elisabetta Tarsi
- Centro Screening Neonatale Regione Marche, UOC di Neuropsichiatria Infantile, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio Ospedaliero Santa Croce, Fano, Italia
| | - Vera Stoppioni
- Centro Screening Neonatale Regione Marche, UOC di Neuropsichiatria Infantile, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio Ospedaliero Santa Croce, Fano, Italia
| | - Nicola Perrotti
- Dipartimento Scienze della Salute, Università Magna Graecia, Catanzaro, Italia
| | - Onorina Marasco
- Laboratorio Regionale di Screening Neonatale, Azienda Ospedaliera Mater Domini, Catanzaro, Italia
| | - Giovanna Scozzafava
- Laboratorio Regionale di Screening Neonatale, Azienda Ospedaliera Mater Domini, Catanzaro, Italia
| | - Marta Camilot
- Laboratorio Regionale di Screening Neonatale, Azienda Ospedaliera Universitaria Integrata di Verona, Ospedale Borgo Roma, Verona, Italia
| | - Francesca Teofoli
- Laboratorio Regionale di Screening Neonatale, Azienda Ospedaliera Universitaria Integrata di Verona, Ospedale Borgo Roma, Verona, Italia
| | - Francesca Righetti
- Centro Laboratoristico Regionale di Riferimento per lo Screening Neonatale e Malattie Endocrino-Metaboliche, Azienda Ospedaliero-Universitaria Policlinico Sant’Orsola-Malpighi, Bologna, Italia
| | - Antonio Dimida
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italia
| | - Giuseppe Plutino
- Direzione Generale per l’Igiene e la Sicurezza degli Alimenti e la Nutrizione, Ministero della Salute, Roma, Italia
| | - Elena Carrano
- Direzione Generale per l’Igiene e la Sicurezza degli Alimenti e la Nutrizione, Ministero della Salute, Roma, Italia
| | - Roberto Copparoni
- Direzione Generale per l’Igiene e la Sicurezza degli Alimenti e la Nutrizione, Ministero della Salute, Roma, Italia
| | - Marco Gabbianelli
- Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia
| | - Paolo Vitti
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italia
| | - Antonella Olivieri
- Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia
| |
Collapse
|
16
|
Durazzo A, Lombardi-Boccia G, Santini A, Lucarini M. Sodium Intake and Related Diseases 2.0. Int J Mol Sci 2021; 23:ijms23010170. [PMID: 35008596 PMCID: PMC8745626 DOI: 10.3390/ijms23010170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/18/2021] [Indexed: 01/02/2023] Open
Affiliation(s)
- Alessandra Durazzo
- CREA–Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy
- Correspondence: (A.D.); (G.L.-B.); (A.S.); (M.L.)
| | - Ginevra Lombardi-Boccia
- CREA–Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy
- Correspondence: (A.D.); (G.L.-B.); (A.S.); (M.L.)
| | - Antonello Santini
- Department of Pharmacy, University of Napoli Federico II, Via D. Montesano 49, 80131 Napoli, Italy
- Correspondence: (A.D.); (G.L.-B.); (A.S.); (M.L.)
| | - Massimo Lucarini
- CREA–Research Centre for Food and Nutrition, Via Ardeatina 546, 00178 Rome, Italy
- Correspondence: (A.D.); (G.L.-B.); (A.S.); (M.L.)
| |
Collapse
|
17
|
Iacone R, Iaccarino Idelson P, Russo O, Donfrancesco C, Krogh V, Sieri S, Macchia PE, Formisano P, Lo Noce C, Palmieri L, Galeone D, Rendina D, Galletti F, Di Lenarda A, Giampaoli S, Strazzullo P. Iodine Intake from Food and Iodized Salt as Related to Dietary Salt Consumption in the Italian Adult General Population. Nutrients 2021; 13:nu13103486. [PMID: 34684487 PMCID: PMC8537510 DOI: 10.3390/nu13103486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/19/2022] Open
Abstract
Since the Italian iodoprophylaxis strategy is based on the use of iodized salt, we assessed the relationship between dietary salt consumption and iodine intake in the Italian adult population. We estimated the relative contribution given by the use of iodized salt and by the iodine introduced by foods to the total iodine intake. The study population included 2219 adults aged 25-79 years (1138 men and 1081 women) from all Italian regions, participating to the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008-2012 (OEC/HES), and examined for sodium and iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary sodium and total iodine intake were assessed by the measurement of 24 h urinary excretion, while the EPIC questionnaire was used to evaluate the iodine intake from food. Sodium and iodine intake were significantly and directly associated, upon accounting for age, sex, and BMI (Spearman rho = 0.298; p < 0.001). The iodine intake increased gradually across quintiles of salt consumption in both men and women (p < 0.001). The European Food Safety Authority (EFSA) adequacy level for iodine intake was met by men, but not women, only in the highest quintile of salt consumption. We estimated that approximately 57% of the iodine intake is derived from food and 43% from salt. Iodized salt contributed 24% of the total salt intake, including both discretionary and non-discretionary salt consumption. In conclusion, in this random sample of the Italian general adult population examined in 2008-2012, the total iodine intake secured by iodized salt and the iodine provision by food was insufficient to meet the EFSA adequate iodine intake.
Collapse
Affiliation(s)
- Roberto Iacone
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
- Correspondence: (R.I.); (P.I.I.)
| | - Paola Iaccarino Idelson
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
- Correspondence: (R.I.); (P.I.I.)
| | - Ornella Russo
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
| | - Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.D.); (C.L.N.); (L.P.)
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (V.K.); (S.S.)
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (V.K.); (S.S.)
| | - Paolo Emidio Macchia
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
| | - Pietro Formisano
- Department of Translational Medical Science, Federico II University of Naples Medical School, 80131 Naples, Italy;
| | - Cinzia Lo Noce
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.D.); (C.L.N.); (L.P.)
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.D.); (C.L.N.); (L.P.)
| | - Daniela Galeone
- Italian Ministry of Health, Center for Disease Prevention and Control, 00161 Rome, Italy;
| | - Domenico Rendina
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
| | - Andrea Di Lenarda
- ANMCO, Italian Association of Hospital Cardiology, 50121 Florence, Italy;
- Cardiovascular Center, University Hospital and Health Services, 34122 Trieste, Italy
| | - Simona Giampaoli
- Former Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
| | | |
Collapse
|
18
|
Sun L, Duan S, Zuo C, Sun Z, Nie G, Zhang C, Zeng M, Sun B, Yuan Y, Wang N, Mao H, Xing C, Zhang B. Characteristics of urinary sodium excretion in patients with chronic kidney disease in Jiangsu, China. J Clin Hypertens (Greenwich) 2021; 23:1372-1379. [PMID: 34132028 PMCID: PMC8678707 DOI: 10.1111/jch.14307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/17/2021] [Accepted: 05/22/2021] [Indexed: 11/29/2022]
Abstract
The current study aimed to assess the dietary salt intake in patients with CKD in Jiangsu province and investigate the relationship of urinary sodium excretion with blood pressure. A total of 800 patients with CKD stages 1-4 were recruited. All enrolled patients were asked to collect complete 24-h urine specimen. At the same time, patient's demographic and laboratory data were recorded. The mean age was 47.45 ± 15.25 years old, including 423 men and 377 women. There was no significant difference in urinary sodium excretion among different stages of CKD (p = .748). This study revealed that the median urinary sodium excretion of all patients was 127.20 mmol/d (IQR 91.03-172.06), corresponding to a salt intake of 7.4 g/d. Among them, only 167 (20.9%) cases had salt intake <5 g/d. Moreover, urinary sodium excretion in overweight group and obese group was higher than that in normal weight group (p = .001, p ˂ .001). Likewise, urinary sodium excretion in men was higher than that in women (p ˂ .001). Spearman correlation analysis indicated that urinary sodium excretion positively correlated with urinary protein excretion (r = .178, p ˂ .001), SBP (r = .109, p = .002), and DBP (r = .086, p = .015). After adjusting for age, gender, BMI, eGFR, urinary protein excretion, and history of taking antihypertensive drug, multivariate linear regression demonstrated that higher level of urinary sodium excretion associated with increased level of SBP, DBP, and MAP (β = 0.020, p = .049; β = 0.015, p = .040; β = 0.016, p = .025, respectively). In conclusion, the dietary salt intake in CKD patients, especially in male, overweight and obese subjects, remains high in Jiangsu province. It is vital to decline salt intake to control blood pressure in Jiangsu patients with CKD.
Collapse
Affiliation(s)
- Lianqin Sun
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Suyan Duan
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Chenyan Zuo
- Department of Gastroenterology, Lianyungang No 1 People's Hospital, Lianyungang, China
| | - Zhiying Sun
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Guangyan Nie
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Chengning Zhang
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Ming Zeng
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Bin Sun
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Yanggang Yuan
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Ningning Wang
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Huijuan Mao
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Changying Xing
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Bo Zhang
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| |
Collapse
|
19
|
Iodine Intake Estimated by 24 h Urine Collection in the Italian Adult Population: 2008-2012 Survey. Nutrients 2021; 13:nu13051529. [PMID: 34062834 PMCID: PMC8147380 DOI: 10.3390/nu13051529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/16/2022] Open
Abstract
Monitoring the population iodine status is essential for iodine deficiency eradication. This study assessed the average dietary iodine intake and the iodine status of a random sample of the Italian general adult population. The study population included 2378 adults aged 35–79 years (1229 men and 1149 women) from all 20 Italian regions, participating in the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008–2012 (OEC/HES), and were examined for iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary iodine intake was assessed by the measurement of 24 h urinary iodine excretion. The median daily iodine intake of the whole population was lower (96 µg/d, interquartile range 51–165) than the daily adequate iodine intake according to both EFSA and WHO recommendation (150 µg/d), with a significantly lower value among women (85 µg/d) compared with men (111 µg/d). Iodine intake diminished with age and increased with BMI (body mass index) in male but not in female participants, without achieving the adequate intake in any sex, age, or BMI category. In this random sample of Italian general adult population examined in 2008–2012, iodine intake still remained lower than the recommended values despite the implementation of a strategy of iodoprophylaxis based on salt iodization in 2005. These data represent a valuable reference for future monitoring of iodine status in our country.
Collapse
|