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Modou N, Motoula Latou LN, Maimouna T, Dia AD, Seck SM. Dietary salt intake and kidney function in rural Senegalese populations: a cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:97. [PMID: 38926879 PMCID: PMC11210187 DOI: 10.1186/s41043-024-00542-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/23/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION High salt intake is a major risk factor for hypertension and its complications such as chronic kidney disease (CKD) and cardiovascular diseases. The present study aimed to determine level of sodium consumption and its relation with kidney function in the rural populations of Ferlo (centre of Senegal). SUBJECTS AND METHODS We performed a cross-sectional study including 400 volunteers aged > 18 years. Clinical, biological and dietary data were collected during household visits. Daily sodium intake was measured in the 24 h-urine outpout and CKD was defined as eGFR < 60 ml/min. Linear regression analysis was used to assess association between sodium intake and covariates. RESULTS Mean age was 46.42 ± 15.60 and sex-ratio was 1.05. Prevalence of hypertension, CKD and overweight were 21.5, 11.7 and 20.5%, respectively. The median daily salt intake was 11.7 g with interquartile range of 14.8 g. Only 11.25% of participants consumed less than 5 g/day. After multivariate analysis, high salt intake was associated with age > 60 years, overweight and CKD. However, gender and hypertension were not significantly associated with salt intake. Industrial broths (91.5%) and bread (85%) represented the main sources of dietary salt. CONCLUSION This study revealed high levels of daily salt intake contrasting with low potassium intakes in the majority of participants. Participants with CKD, overweight and age > 60 years presented higher salt consumption. Stategies to reduce salt consumption are urgently needed to reduce burden of CKD in rural Senegalese populations.
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Affiliation(s)
- Ndongo Modou
- Nephrology and Dialysis, Regional Hospital of Kedougou, Kedougou, Senegal
| | | | - Toure Maimouna
- Department of Physiology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Amadou Diop Dia
- Nephrology Department, Faculty of Health Sciences, University Gaston Berger, Route de Ngalléle, BP 234, Sanar, Saint-Louis, Senegal
| | - Sidy Mohamed Seck
- Nephrology Department, Faculty of Health Sciences, University Gaston Berger, Route de Ngalléle, BP 234, Sanar, Saint-Louis, Senegal.
- IRL-3189 ESS/UGB/CNRS/UCAD/CNRST/USTB, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal.
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Zhang Q, Shen Y, Yu M, Yang Z, Huang Z, Ding J, Zhu X. Associations between estimation of salt intake and salt-restriction spoons and hypertension status in patients with poorly controlled hypertension: a community-based study from Huzhou City, Eastern China. Nutr J 2024; 23:9. [PMID: 38225607 PMCID: PMC10789056 DOI: 10.1186/s12937-024-00912-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND As the prevalence of hypertension increases in China, it is advised to use salt-restriction spoons (SRS) as a lifestyle modification. This study aimed to examine the associations between estimated salt consumption, SRS usage, and the hypertension status in individuals with poorly controlled hypertension. METHODS Data was collected in Huzhou City, Zhejiang Province, in 2021 using convenience sampling. The analysis involved ordinal logistic regression and restricted cubic splines to assess the relevant factors. RESULTS The study found that 73.34% of the 1215 patients had uncontrolled blood pressure (BP). Urinary excretion was assessed through the utilization of the Kawasaki, INTERSALT, and Tanaka formulas. The outcomes of these three methodologies revealed average daily sodium excretion values of 208.70 (65.65), 154.78 (33.91), and 162.61 (40.87) mmol, respectively. The prevalence of utilizing SRS was found to be 37.78% in this study. Despite the acknowledgment among SRS users of the potential hazards associated with excessive salt consumption, there exists a contradictory pattern of attitudes and behaviors concerning salt reduction. Among individuals with different levels of salt intake (quartiles 1-4, Q1 vs Q4), there was a positive association between limiting salt and hypertension status when controlling for other variables (Kawasaki adjusted OR = 0.58, 95% CI = 0.43-0.79; INTERSALT adjusted OR = 0.62, 95% CI = 0.41-0.92; Tanaka adjusted OR = 0.61, 95% CI = 0.45-0.92, p < 0.05). Our research also revealed that using or used SRS was a protective factor for blood BP control (adjusted OR = 0.79, 95% CI = 0.64-0.99, P < 0.05). The restricted cubic spline plots illustrated a monotonic upward relationship between estimated 24-h urinary Na and BP (P-overall association < 0.05; P-non-linear association > 0.05). CONCLUSIONS The use of dietary SRS could result in decrease in daily salt intake for BP control in patients with poorly controlled hypertension. To reduce the impact of high BP in China, additional studies are required to create interventions that can enhance the results for patients.
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Affiliation(s)
- Qi Zhang
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Yimei Shen
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China.
| | - Meihua Yu
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Zhongrong Yang
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Zheng Huang
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Jingying Ding
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Xinfeng Zhu
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
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Wilms JN, Ghaffari MH, Daniel JB, Leal LN, Mica JH, Martín-Tereso J. Water, mineral, and blood acid-base balance in calves with naturally occurring diarrhea receiving two alternative oral rehydration solutions or a placebo. J Dairy Sci 2024; 107:202-219. [PMID: 37678765 DOI: 10.3168/jds.2022-23197] [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] [Received: 12/23/2022] [Accepted: 07/20/2023] [Indexed: 09/09/2023]
Abstract
Quantifying the water and mineral losses in feces is essential to determine the optimal composition of oral rehydration solutions (ORS) for diarrheic animals. In a randomized complete block design, this study evaluated water, mineral, and blood acid-base balance of calves with naturally occurring diarrhea receiving ORS or a placebo. On d 0, 45 calves (age: 18 ± 3.2 d; mean ± SD) were selected based on the presence of visual signs of diarrhea, such as dirty tail or wet feces, along with clinical symptoms evaluated by measuring the skin turgor and the degree of enophthalmos. On d 1, calves were divided into blocks of 3 animals based on blood base excess (BE) measured at 0900 h, and within each block, calves were randomly assigned to 1 of 3 treatments (15 calves per treatment) including (1) a hypertonic ORS (HYPER; Na+ = 110 mmol/L; 370 mOsm/kg; strong ion difference [SID] = 60 mEq/L), (2) a hypotonic ORS with low Na+ (HYPO; Na+ = 77 mmol/L; 278 mOsm/kg; SID = 71 mEq/L), and (3) a placebo consisting of lukewarm water with 5 g/L of whey powder (CON). Milk replacer (MR) was fed through teat buckets twice daily at 0630 h and 1700 h in 2 equally sized meals of 2.5 L from d 1 to 3 and of 3.0 L on d 4 and 5. Treatments consisting of 2.0 L lukewarm solutions were administered between milk meals from d 1 to 3 at 1200 h and 2030 h through teat buckets. Refusals of MR and treatments were recorded daily, and blood samples were collected from the jugular vein once daily at arrival in the afternoon of d 0 and at 0900 h from d 1 to 5 after arrival. Urine and feces were collected quantitatively over a 48-h period from 1200 h on d 1 to 1200 h on d 3, and a representative sample of each 24-h period was stored. In addition, the volume of extracellular fluid was evaluated on d 2 by postprandial sampling over a 4-h period relative to the injection of sodium thiosulfate at 1300 h. Total daily fluid intake (MR, treatment, and water) from d 1 to 3 was greater in HYPER (LSM ± SEM; 8.9 ± 0.36 L/d) and HYPO (7.8 ± 0.34 L/d) than in CON (6.6 ± 0.34 L/d). This resulted in a greater water balance (water intake - fluid output in urine and feces) in calves receiving ORS (59.6 ± 6.28 g/kg BW per 24 h vs. 39.6 ± 6.08 g/kg BW per 24 h). Fecal Na+ losses were greater in HYPER than in the other treatments (81 ± 12.0 mg/kg BW per 24 h vs. 24 ± 11.8 mg/kg BW per 24 h). Blood pH was higher in HYPO (7.41 ± 0.016) than CON (7.35 ± 0.016) over the 5 monitoring days, whereas HYPER (7.37 ± 0.017) did not differ with other treatments. In this experimental model, diarrheic calves were likely unable to absorb the high Na+ load from HYPER, resulting in greater Na+ losses in feces, which might have impaired the alkalinizing capacity of HYPER. In contrast, HYPO significantly sustained blood acid-base balance compared with CON, whereas HYPER did not. This suggests that low tonicity ORS with a high SID are more suitable for diarrheic calves.
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Affiliation(s)
- J N Wilms
- Trouw Nutrition R&D, 3800 AG, Amersfoort, the Netherlands.
| | - M H Ghaffari
- Institute of Animal Science, University of Bonn, 53111 Bonn, Germany
| | - J B Daniel
- Trouw Nutrition R&D, 3800 AG, Amersfoort, the Netherlands
| | - L N Leal
- Trouw Nutrition R&D, 3800 AG, Amersfoort, the Netherlands
| | - J H Mica
- Trouw Nutrition R&D, 3800 AG, Amersfoort, the Netherlands
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Liu Z, Man Q, Li Y, Yang X, Ding G, Zhang J, Zhao W. Estimation of 24-hour urinary sodium and potassium excretion among Chinese adults: a cross-sectional study from the China National Nutrition Survey. Am J Clin Nutr 2024; 119:164-173. [PMID: 38176776 DOI: 10.1016/j.ajcnut.2023.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/01/2023] [Accepted: 09/12/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND High-sodium intake is one of the most important risk factors for hypertension and cardiovascular disease, yet reliable national estimates of sodium intake in Chinese adults have not been reported. OBJECTIVES We estimated 24-h urinary sodium and potassium excretion and population daily sodium and potassium intake of Chinese adults for the first time at a national level. METHODS A nationally representative cross-sectional survey was conducted to collect 24-h urine specimens from Chinese adults aged ≥18 y as part of the China National Nutrition Survey 2015. Finally, 10,114 participants (4932 males and 5182 females) with complete 24-h urine specimens were included in the analysis. Estimates of mean urinary electrolyte excretion and demographic, socioeconomic, and health characteristics were used with weighted coefficients that accounted for sample selection probabilities, poststratification weighting, and nonresponse rates. RESULTS The estimation of overall weighted mean 24-h urinary sodium excretion was 4121 mg (95% confidence interval [CI]: 3993, 4250), 4155 mg (95% CI: 3993, 4317) in males and 4081 mg (95% CI: 3953, 4209) in females (P for sex difference = 0.36). Overall mean 24-h urinary potassium excretion was 1534 mg (95% CI: 1492, 1577), 1468 mg (95% CI: 1424, 1513) in males and 1614 mg (95% CI: 1569-1660) in females (P for sex difference <0.001). Mean 24-h urinary sodium excretion was significantly higher in rural adults (4350 mg; 95% CI: 4217, 4483) than in urban residents (3909 mg; 95% CI: 3739, 4080; P < 0.001), and in northern residents (4388 mg; 95% CI: 4237, 4539) than in southern residents (3998 mg; 95% CI: 3832, 4163; P = 0.002). CONCLUSIONS The first nationwide survey with 24-h urine collection confirmed that mean sodium intake in Chinese adults was more than twice the upper limit, whereas mean potassium intake was <60% of the lower limit, recommended by the World Health Organization. Urgent measures should be taken to reduce sodium intake and increase potassium intake in China.
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Affiliation(s)
- Zhen Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qingqing Man
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China; Key Laboratory of Trace Element Nutrition of National Health Commission, Beijing, China
| | - Yuqian Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoguang Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China; Key Laboratory of Trace Element Nutrition of National Health Commission, Beijing, China
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China; Key Laboratory of Trace Element Nutrition of National Health Commission, Beijing, China
| | - Jian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China; Key Laboratory of Trace Element Nutrition of National Health Commission, Beijing, China
| | - Wenhua Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China; Key Laboratory of Trace Element Nutrition of National Health Commission, Beijing, China.
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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.
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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
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García-Lithgow CH, Durán-Cabral M, Winter-Matos A, García-Estrella K, García-Durán J, Di-Sanzo E, Martínez-De-La-Cruz N, Rodríguez-Abreu J, Olmedilla-Alonso B. Assessment of 24 h Sodium and Potassium Urinary Excretion in Normotensive and Hypertensive Dominican Adults. Nutrients 2023; 15:3197. [PMID: 37513615 PMCID: PMC10385228 DOI: 10.3390/nu15143197] [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: 06/03/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Higher salt (sodium) intake has been associated with higher blood pressure (BP). The degree of association may be influenced by factors such as age, origin, and dietary components. This study aimed to evaluate the 24 h urinary sodium (Na) and potassium (K) excretion in normotensive and hypertensive Dominican adults and estimate their salt intake. 163 volunteers (18-80 years old) participated in a cross-sectional study. The 24 h Na and K urinary excretion were measured using an ion-selective electrode technique. Na and K urinary excretion (99.4 ± 46.5 and 35.0 ± 17.5 mmol/24 h) did not correlate with BP, except in the normotensive group, in which K correlated with SBP (0.249, p = 0.019). Na and K excretion were similar in normotensive and hypertensive subjects. When considering two age groups (18-45, 46-80 years), the Na-to-K molar ratio (3.1 ± 1.3) was higher in younger subjects (p = 0.040). Na-to-K ratio was associated with DBP in the total group (r = 0.153, p = 0.052), in the hypertensive group (r = 0.395, p < 0.001), and in the older group with SBP (0.350, p = 0.002) and DBP (0.373, p < 0.001). In the older group, Na-to-K ratio and DBP correlated after controlling for subjects with hypertension controlled by treatment (r = 0.236, p = 0.041). The Na-to-K ratio correlated, when salt intake was over 5 g/day (52.2%), with SBP (rho = 0.219, p = 0.044) and DBP (rho = 0.259, p = 0.017). Determinants of BP in the total sample were age (SBP, beta: 0.6 ± 0.1, p < 0.001; DBP, beta: 0.2 ± 0.1, p < 0.002), sex (SBP, beta: 11.2 ± 3.5, p = 0.001), body mass index (BMI) (SBP, beta: 1.0 ± 0.3, p < 0.001; DBP, beta: 0.4 ± 0.2, p = 0.01), and Na-to-K ratio (SBP, beta: 3.0 ± 1.1, p = 0.008; DBP, beta: -12.3 ± 4.0, p = 0.002). Sex and BMI were determinants in the younger group. Na-to-K molar ratio was determinant in the older group (SBP, beta: 6.7 ± 2.4, p = 0.005; DBP, beta: 3.8 ± 1.1, p < 0.001). The mean Na and salt intakes (2.3 and 5.8 g/day) were slightly higher and the K intake lower (1.4 g/day) than WHO recommendations.
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Affiliation(s)
- Carlos Heriberto García-Lithgow
- Centro Cardio-Neuro-Oftalmológico y Transplante (CECANOT), Santo Domingo 10306, Dominican Republic
- Centro de Diagnóstico, Medicina Avanzada y Telemedicina (CEDIMAT), Santo Domingo 10216, Dominican Republic
- Facultad de Ciencias de la Salud, Universidad Nacional Pedro Henríquez Ureña (UNPHU), Santo Domingo 10602, Dominican Republic
| | - Madeline Durán-Cabral
- Dirección de Investigación, Universidad Nacional Pedro Henríquez Ureña (UNPHU), Santo Domingo 10602, Dominican Republic
| | - Alexandra Winter-Matos
- Centro Cardio-Neuro-Oftalmológico y Transplante (CECANOT), Santo Domingo 10306, Dominican Republic
| | - Kilsaris García-Estrella
- Centro Cardio-Neuro-Oftalmológico y Transplante (CECANOT), Santo Domingo 10306, Dominican Republic
| | - Julen García-Durán
- Centro de Diagnóstico, Medicina Avanzada y Telemedicina (CEDIMAT), Santo Domingo 10216, Dominican Republic
| | - Estefanía Di-Sanzo
- Centro Cardio-Neuro-Oftalmológico y Transplante (CECANOT), Santo Domingo 10306, Dominican Republic
| | | | - Julia Rodríguez-Abreu
- Centro de Diagnóstico, Medicina Avanzada y Telemedicina (CEDIMAT), Santo Domingo 10216, Dominican Republic
| | - Begoña Olmedilla-Alonso
- Departamento de Metabolismo y Nutrición, Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), 28040 Madrid, Spain
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Hikita N, Batsaikhan E, Sasaki S, Haruna M, Yura A, Oidovsuren O. Evaluation of salt intake estimated from 24-h urinary sodium excretion in medical professionals in Darkhan-Uul Province, Mongolia: a cross-sectional study. Sci Rep 2023; 13:10456. [PMID: 37380730 DOI: 10.1038/s41598-023-37631-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 06/24/2023] [Indexed: 06/30/2023] Open
Abstract
This cross-sectional study aimed to estimate the daily salt intake of medical professionals working in public health facilities in Darkhan-Uul Province, Mongolia. We conducted a multiple logistic regression analysis to identify factors associated with their consumption of salt exceeding the recommended daily salt intake (≥ 5 g/day). A self-administered questionnaire and 24-h urine samples were used to obtain data on the participants' salt intake. Of 338 participants, 159 completed the 24-h urine collection. The mean sodium excretion into urine was 122.3 mmol/day, which was equivalent to a mean salt intake of 7.7 g/day when the urinary excretion rate was considered as 93%. Body mass index was positively correlated with excess salt intake (adjusted odds ratio [AOR]: 1.27; 95% confidence interval [CI] 1.10-1.46), while age was negatively correlated with excess salt intake (AOR: 0.95; 95% CI 0.91-1.00). Participants who consumed ≥ 2 cups of salted suutei tsai (Mongolian milk tea) daily had a higher risk of consuming ≥ 5 g/day of salt than those who consumed ≤ 1 cup/day. The average estimated salt intake of the participants was higher than the recommended value. Medical professionals should be aware of factors associated with excessive salt consumption and make appropriate adjustments to minimize it.
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Affiliation(s)
- Naoko Hikita
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| | - Enkhtungalag Batsaikhan
- Department of Nutrition Research of the National Center for Public Health, Peace Avenue -17, Ulaanbaatar, 210349, Mongolia
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Megumi Haruna
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Ariunaa Yura
- Darkhan-Uul General Hospital, 13-Bag, Darkhan Soum, Darkhan-Uul, Mongolia
| | - Otgontogoo Oidovsuren
- Darkhan-Uul Medical School, Mongolian National University of Medical Sciences, P.O. Box 903, Darkhan-Uul, Mongolia
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Idrissi M, Saeid N, Mounach S, Berri HE, Al Jawaldah A, Rahhaoui F, Mouzouni FZ, Rami A, Benjeddou K, Lahmam H, Benkirane H, Elmzibri M, Kari KE, Bagri A, Aguenaou H, Belakhel L. Estimated 24-Hour urinary sodium and potassium excretion in adults in the Northwest Region of Morocco, 2017. Arch Public Health 2023; 81:59. [PMID: 37081546 PMCID: PMC10116680 DOI: 10.1186/s13690-023-01053-y] [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: 12/11/2021] [Accepted: 03/01/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Excessive sodium (Na) and insufficient potassium (K) intake contribute to a high risk of cardiovascular events. Morocco lacks data on actual Na and K intake in adults. We estimated mean Na and K intake in a Moroccan population of adults residing in the Northwest region using 24-h urinary excretion and examined their association with blood pressure (BP). METHODS A total of 371 adults from this region, who were recruited for the STEPs Survey Morocco 2017, completed demographic, anthropometric as well as BP data and provided a valid 24-h urine collection according to the standard World Health Organization (WHO) protocol. Multiple Linear Regression analysis was used to examine the association between 24-h urinary sodium (24-hUNa) and 24-h potassium excretion (24-hUK) with BP. RESULTS Mean Na excretion was 2794 mg/day and mean K excretion was 1898 mg/day. Overall, only 114 (30.7%) adults met the WHO recommendation for Na intake (< 2000 mg/d) and 31 (8.4%) met the adequate level for K intake (⩾3510 mg/d). There was no association between 24-hUNa and 24-hUK with BP (P > 0.05 for all). CONCLUSION Na intake was higher and K intake was lower than WHO recommendations in the study population. There was no association between estimated Na and K intake levels with BP in this population.
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Affiliation(s)
- Mohamed Idrissi
- Ibn Tofaïl University-CNESTEN, Joint Research Unit in Nutrition, Health and Environment, RDC-Nutrition AFRA/IAEA, Rabat-Kénitra, Morocco.
- Integrative and Computational Neurosciences Team, Laboratory BNRNE, Hassan 1th University, Faculty of Sciences and Technology., BP: 577, Km 3.5 Casablanca Road, Settat, Morocco.
| | - Naima Saeid
- Ibn Tofaïl University-CNESTEN, Joint Research Unit in Nutrition, Health and Environment, RDC-Nutrition AFRA/IAEA, Rabat-Kénitra, Morocco
| | - Samir Mounach
- Ministry of Health and Social Protection, Division of Non-Communicable Diseases, Rabat, Morocco
| | - Hicham El Berri
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo, 7608, Egypt
| | - Ayoub Al Jawaldah
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo, 7608, Egypt
| | - Fadoua Rahhaoui
- Ministry of Health and Social Protection, Division of Non-Communicable Diseases, Rabat, Morocco
| | - Fatima-Zahra Mouzouni
- Ministry of Health and Social Protection, Division of Non-Communicable Diseases, Rabat, Morocco
| | - Anass Rami
- Ibn Tofaïl University-CNESTEN, Joint Research Unit in Nutrition, Health and Environment, RDC-Nutrition AFRA/IAEA, Rabat-Kénitra, Morocco
| | - Kaoutar Benjeddou
- Ibn Tofaïl University-CNESTEN, Joint Research Unit in Nutrition, Health and Environment, RDC-Nutrition AFRA/IAEA, Rabat-Kénitra, Morocco
| | - Houria Lahmam
- Ibn Tofaïl University-CNESTEN, Joint Research Unit in Nutrition, Health and Environment, RDC-Nutrition AFRA/IAEA, Rabat-Kénitra, Morocco
| | - Hasnae Benkirane
- Ibn Tofaïl University-CNESTEN, Joint Research Unit in Nutrition, Health and Environment, RDC-Nutrition AFRA/IAEA, Rabat-Kénitra, Morocco
| | - Mohammed Elmzibri
- Ibn Tofaïl University-CNESTEN, Joint Research Unit in Nutrition, Health and Environment, RDC-Nutrition AFRA/IAEA, Rabat-Kénitra, Morocco
| | - Khalid El Kari
- Ibn Tofaïl University-CNESTEN, Joint Research Unit in Nutrition, Health and Environment, RDC-Nutrition AFRA/IAEA, Rabat-Kénitra, Morocco
| | - Abdallah Bagri
- Integrative and Computational Neurosciences Team, Laboratory BNRNE, Hassan 1th University, Faculty of Sciences and Technology., BP: 577, Km 3.5 Casablanca Road, Settat, Morocco
| | - Hassan Aguenaou
- Ibn Tofaïl University-CNESTEN, Joint Research Unit in Nutrition, Health and Environment, RDC-Nutrition AFRA/IAEA, Rabat-Kénitra, Morocco
| | - Latifa Belakhel
- Ministry of Health and Social Protection, Division of Non-Communicable Diseases, Rabat, Morocco
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9
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Shi Q, Tang X, Liu BQ, Liu WH, Li H, Luo YY. Correlation between microbial communities and key odourants in fermented capsicum inoculated with Pediococcus pentosaceus and Cyberlindnera rhodanensis. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:1139-1151. [PMID: 36349455 DOI: 10.1002/jsfa.12321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/02/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Fermented capsicum (i.e. pickled pepper) is one of the most popular fermented vegetables. However, the effect of inoculated microbial fermentation on pickled pepper is not yet fully understood. RESULTS Cyberlindnera rhodanensis J52 with a rich ester flavour and Pediococcus pentosaceus AL with a strong inhibitory effect on foodborne pathogenic bacteria were selected to prepare single- and double-strain fermented capsicum under low salt (< 10 g L-1 sodium chloride) conditions. The inhibition zone of P. pentosaceus AL against Escherichia coli was up to 44 mm in diameter. Biochemical indicator analyses found that co-fermentation of P. pentosaceus AL and C. rhodanensis J52 changed the contents of vitamin C and short-chain fatty acids. Analysis of microbial diversity and volatile metabolome showed that 125 microbial species and 72 volatile compounds were detected, and P. pentosaceus was the dominant bacterium that inhibited the growth of other bacteria, while C. rhodanensis was the fungus that contributed the most to flavour. Correlation analysis between microorganisms and flavour compounds showed 725 correlations, and 124 microbial species may have participated in the formation of 69 compounds. Furthermore, 10 and 29 correlations were detected between P. pentosaceus AL or C. rhodanensis J52 and flavour compounds, respectively. Among them, 3-methyl-1-butanol acetate is speculated to be the main substance affecting the flavour of fermented capsicum by inoculation with C. rhodanensis J52. CONCLUSION The inoculation of P. pentosaceus and C. rhodanensis had a significant impact on the microbial community and volatile compounds of fermented capsicum and helped to improve its organoleptic qualities. © 2022 Society of Chemical Industry.
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Affiliation(s)
- Qiao Shi
- Fermentation Engineering Research Center, Institute of Agro-Products Processing, Yunnan Academy of Agricultural Sciences, Kunming, China
| | - Xin Tang
- National R&D Centre for Freshwater Fish Processing, College of Life Sciences, Jiangxi Normal University, Nanchang, China
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Bi-Qin Liu
- Fermentation Engineering Research Center, Institute of Agro-Products Processing, Yunnan Academy of Agricultural Sciences, Kunming, China
| | - Wei-Hong Liu
- National R&D Centre for Freshwater Fish Processing, College of Life Sciences, Jiangxi Normal University, Nanchang, China
| | - Hong Li
- Fermentation Engineering Research Center, Institute of Agro-Products Processing, Yunnan Academy of Agricultural Sciences, Kunming, China
- College of Food Science and Technology, Yunnan Agricultural University, Kunming, China
| | - Yi-Yong Luo
- National R&D Centre for Freshwater Fish Processing, College of Life Sciences, Jiangxi Normal University, Nanchang, China
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
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10
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Jiménez Rodríguez A, Palomo Cobos L, Rodríguez Martín A, Fernández del Valle P, Novalbos-Ruiz JP. [Correlations between dietary salt intake and 24-h urine sodium excretion in a sample of the urban population of Cáceres]. Aten Primaria 2023; 55:102513. [PMID: 36401891 PMCID: PMC9676135 DOI: 10.1016/j.aprim.2022.102513] [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: 07/07/2022] [Revised: 10/12/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Excessive salt intake is associated with higher levels of AHT and prevalence of cardiovascular diseases. WHO recommends consuming less than 5 g/day of salt (equivalent to 2 g Na+/day). Identifying foods and behaviours with greater contribution to excess intake would facilitate preventive dietary advice. DESIGN Observational study. SITE: Urban Health Center in Cáceres. MAIN MEASUREMENTS We estimated salt consumption using two food consumption frequency (FFQ) questionnaires, one generic and one with high Na+ content, and a 24 h follow-up survey. We use the Evalfinut program for nutritional evaluation of the diet. We analyzed correlations between estimated salt intake and 24-h urine sodium elimination (gold standard). RESULTS 92% of the population had consumption higher than the recommendations with intakes equivalent to 9.5 g/day of salt (3.7 g/d of Na+). When sodium intake is determined by the Na+/K+ ratio, 79.54% have high intakes. Sodium elimination follows a slightly increasing trend with BMI. The perception of salt consumption is low, 56.3% consider it "adequate". 32.4% add salt to food once served. FFQ underestimate Na+ intake and targeted surveys provide higher values. The correlation between FFQ and Na+ urinary elimination is weak. CONCLUSION We must reduce salt intake by increasing the perception of consumption, improving knowledge about the salt content in food and identifying target patients of the health council.
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Affiliation(s)
| | | | - Amelia Rodríguez Martín
- Departamento de Biomedicina, Biotecnología y Salud Pública, Universidad de Cádiz, Cádiz, España
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11
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Pourkhajoei S, Yazdi‐Feyzabadi V, Amiresmaeili M, Nakhaee N, Goudarzi R. Mean population salt intake in Iran: A systematic review and meta-analysis. Health Sci Rep 2022; 5:e855. [PMID: 36226320 PMCID: PMC9531774 DOI: 10.1002/hsr2.855] [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: 12/22/2021] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION High salt intake has been connected with the increase of many non-communicable diseases (NCDs) worldwide. Like other middle-income countries, Iran is experiencing a considerable increase in NCDs, necessitating attempts to reduce dietary salt intake. As in Iran there is uncertainty about the existing rate of salt intake. The present study aimed to estimate mean salt intake of Iranian population by systematically reviewing existing literature. METHODS This research is a systematic review and meta-analysis (PRISMA Protocol) of published article data, with no time constraint until the end of 2020, to estimate mean salt intake of Iranian population. A comprehensive literature search was performed on international databases of Medline, Science Direct, PubMed, Embase, Scopus, Springer, Online Library Wiley, Web of Science, Cochrane, and Google Scholar and domestic data bases of Iranmedex, Magiran, SID, and Medlib. Subgroup analysis was conducted for gender, region, measurement method, and age group. Research homogeneity was evaluated by I 2 statistic. We reviewed all studies which met inclusion criteria. STATA Ver.13.1 was used to perform meta-analysis. RESULTS Meta-analysis of data from 32 studies showed that the average salt intake in all ages was 9.674 g/day (95% CI, 9.033-10.316 g/day). The lowest estimation of salt intake was 9.33 g/day (95% CI, 7.75-10.91 g/day) which was estimated from studies which used point collection method, and the highest estimate using the food reminder questionnaire was 10.41 g/day (95% CI, 8.49-12.34 g/day). Also, the average weight salt intake for men over 18 years old in different cities was 10.39 g/day (95% CI, 9.01-11.78 g/day), for women over 18 years in different cities 9.52 g/day (95% CI, 8.42-10.62 g/day), and children and adolescents was estimated at 5.664 g/day (95% CI, 2.91-8.41 g/day). CONCLUSION The intake of salt in the Iranian population is near twice the WHO recommendation. Therefore, it is necessary to consider effective strategies and interventions to reduce dietary salt intake in Iran as a health priority.
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Affiliation(s)
- Sirous Pourkhajoei
- Faculty of Management and Medical Information SciencesKerman University of Medical SciencesKermanIran
| | - Vahid Yazdi‐Feyzabadi
- Social Determinants of Health Research Center, Institute for Futures Studies in HealthKerman University of Medical SciencesKermanIran
| | - Mohamadreza Amiresmaeili
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in HealthKerman University of Medical SciencesKermanIran
| | - Nouzar Nakhaee
- Health Services Menagement Research Center, Institute for Furtures Studies in HealthKerman University of Medical SciencesKermanIran
| | - Reza Goudarzi
- Health Services Menagement Research Center, Institute for Furtures Studies in HealthKerman University of Medical SciencesKermanIran
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12
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Golpour-Hamedani S, Rafie N, Pourmasoumi M, Morteza Safavi S, Mohammadifard N. Sodium and potassium intakes and adiposity among Iranian pre-adolescents and adolescents: a cross-sectional study. Nutr J 2022; 21:23. [PMID: 35477471 PMCID: PMC9047328 DOI: 10.1186/s12937-022-00776-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/14/2022] [Indexed: 09/14/2023] Open
Abstract
Background High sodium and low potassium intakes are associated with the early development of chronic diseases (e.g., hypertension, obesity). Taking into account the limited data on sodium and potassium intakes by 24-h excretion in urine in pre-adolescents and adolescents, we wished to determine baseline salt intake in Iranian subjects aged 11–18 years. Methods This was an observational study involving 374 pre-adolescents and adolescents (154 boys and 220 girls). Sodium and potassium intakes were ascertained by measuring sodium and potassium excretion in urine over 24 h. Creatinine level was used to validate the completeness of the urine collections. The association between sodium and potassium intake and adiposity was determined based on body fat percentage. Results The mean 24-h urine sodium concentration was 3130 ± 2200 mg/day, equal to 7.961 ± 5.596 g/day salt intake. Approximately half of the study participants exceeded the upper limit of Na intake. The mean potassium intake was estimated 1480 ± 1050 mg/day. There was a positive association between urinary sodium excretion and adiposity in crude (OR 1.79; 95% CI: 1.08—2.74) and full adjusted model (OR: 3.15; 95% CI: 2.28–4.63). Also, in subsample analysis, there was a positive correlation between urinary sodium and adiposity in both pre-adolescents (OR: 2.71; 95% CI: 2.29—3.93) and adolescents (OR: 3.55; 95% CI: 2.17—4.74). However, no significant association was found between 24-h urinary potassium and adiposity. Conclusion Sodium intake, as estimated by 24-h urinary excretion, was higher than recommended and it was positively associated with adiposity. Also, this study reported low compliance of potassium intake recommendations in 11–18 years’ Iranian pre-adolescents and adolescents. Health promotion interventions are needed in order to broaden public awareness of high sodium intake and potassium inadequacy to reduce chronic diseases.
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Affiliation(s)
- Sahar Golpour-Hamedani
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nahid Rafie
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Makan Pourmasoumi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Sayyed Morteza Safavi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. .,Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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Estimation of sodium and potassium intakes assessed by two 24-hour urine collections in a city of Indonesia. Br J Nutr 2021; 126:1537-1548. [PMID: 33494843 PMCID: PMC8524422 DOI: 10.1017/s0007114521000271] [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] [Indexed: 12/17/2022]
Abstract
Intakes of excess Na and insufficient K are two major contributors of heart diseases and stroke development. However, no precise study has previously been carried out on Na and K intakes among Indonesian adults. The present study aimed to estimate the Na and K intakes using two consecutive 24-h urine collections. Participants were community-dwelling adults aged between 20 and 96 years, randomly selected from a pool of resident registration numbers. Of the 506 participants, 479 (240 men and 239 women) completed urine collections. The mean Na excretion was 102·8 and 100·6 mmol/d, while the mean K excretion was 25·0 and 23·4 mmol/d for men and women, respectively. Na and K excretions were higher in participants with a higher BMI. A higher K excretion was associated only with younger age. More than 80 % of the participants consumed more than 5 g/d of salt (the upper limit recommended by the Indonesian government), whereas none of them consumed more than 3510 mg/d of K (the lower limit). The high Na and low K intakes, especially high Na among participants with high BMI, should be considered when future intervention programmes are planned in this country.
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14
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Sodium Content of Foods Sold in the Spanish Market. Results from the BADALI Project. Nutrients 2021; 13:nu13103410. [PMID: 34684411 PMCID: PMC8539754 DOI: 10.3390/nu13103410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 12/27/2022] Open
Abstract
High sodium/salt intake is a risk factor for Non-Communicable Diseases (NCDs). Excess sodium intake has been associated with high coronary heart disease, stroke and high blood pressure. The sodium daily intake is above the recommendations in the world as well as in Spain. Reducing salt content in processed foods and ready meals is one of the main strategies for reducing sodium intake. The aim of the present work is to characterise the presence of sodium in foods sold in the Spanish market. We also study a possible shift in sodium content in products over the last few years. For this purpose, 3897 products included in the BADALI food database were analysed, classified into 16 groups (G). We found that 93.3% of all foods displayed the sodium/salt content in the nutrition declaration. Meat—processed and derivatives (G8) had the highest mean and median values for sodium content, followed by snacks (G15) and sauces (G14). Only 12.7% of foods were sodium-free (≤5 mg/100 g or 100 mL), 32.4% had very low sodium (≤40 mg/100 g or 100 mL) and 48.2% were low in sodium (≤120 mg/100 g or 100 mL). On the contrary, 47.2% were high in sodium according to the Pan American Health Organisation Nutrient Profile Model (PAHO-NPM), while there were 31.9% according to the Chile-NPM. The agreement between the two NPMs was considered ‘substantial’ (κ = 0.67). When sodium content was compared over the years, no decrease was observed. This analysis was performed in the entire food population, by food group and in matched products. Therefore, more effort should be made by all parties involved in order to decrease the sodium/salt intake in the population.
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15
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Ambak R, He FJ, Othman F, Michael V, Mohd Yusoff MF, Aris T. Salt intake was higher among males and those with high BMI and waist circumference: introduction to the Malaysian Community Salt Survey (MyCoSS), a population-based salt intake survey in Malaysia. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:23. [PMID: 34059145 PMCID: PMC8165995 DOI: 10.1186/s41043-021-00229-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Recognising that excessive dietary salt intake is associated with high blood pressure and adverse cardiovascular health, the Ministry of Health Malaysia conducted the Malaysian Community Salt Survey (MyCoSS) among Malaysian adults. This paper introduced MyCoSS projects and presented findings on the salt intake of the Malaysian adult population. METHODS MyCoSS was a nationally representative survey, designed to provide valuable data on dietary salt intake, sources of salt in the diet, and knowledge, perception, and practice about salt among Malaysian adults. It was a cross-sectional household survey, covering Malaysian citizens of 18 years old and above. Multi-stage-stratified sampling was used to warrant national representativeness. Sample size was calculated on all objectives studied, and the biggest sample size was derived from the knowledge on the effect of high salt on health (1300 participants). Salt intake was estimated using a single 24-h urine collection and its sources from a food frequency questionnaire. Knowledge, attitude, and practice were determined from a pre-tested questionnaire. All questionnaires were fully administered by trained interviewers using mobile devices. Anthropometric indices (weight, height, and waist circumference) and blood pressure were measured using a standardised protocol. Ethical approvals were obtained from the Medical Research Ethics Committee, Ministry of Health Malaysia, and Queen Mary University of London prior to conducting the survey. RESULTS Findings showed that the average sodium intake of Malaysian adults (3167 mg/day) was higher than the WHO recommendation of 2000 mg/day. Daily intake was significantly higher among males and individuals with higher BMI and higher waist circumference. CONCLUSION Salt intake in the Malaysian population was higher than the WHO recommendation. MyCoSS's findings will be used for the development and implementation of national salt reduction policy. A successful implementation of a national salt reduction programme in Malaysia will benefit the whole population.
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Affiliation(s)
- Rashidah Ambak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Feng J He
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Fatimah Othman
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Viola Michael
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | | | - Tahir Aris
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
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16
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Doggui R, El Ati J, Sassi S, Ben Gharbia H, Al‐Jawaldeh A, El Ati‐Hellal M. Unbalanced intakes of sodium and potassium among Tunisian adults: A cross-sectional study. Food Sci Nutr 2021; 9:2234-2246. [PMID: 33841839 PMCID: PMC8020952 DOI: 10.1002/fsn3.2197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/10/2022] Open
Abstract
The prevention and management of hypertension are untimely associated with a lowering of sodium intake. The present study aimed to evaluate the sodium and potassium intake levels of Tunisian population through measurement of 24-hr urinary sodium excretions. A randomly, multistage, cross-sectional study was conducted in an urban region (Bizerte) in Tunisia during 2015. The target population involved adults aged from 25 to 64 years. Sodium, potassium, and creatinine concentrations were determined in each urine sample using indirect potentiometric method. From the 420 selected participants, only 194 gave urine samples complying completeness criteria. A multivariate regression model was used to assess the variables related to sodium and potassium excretion. The daily mean excretion of sodium and potassium was 138.3 ± 46.5 mmol/d (corresponding to 8.1 ± 2.7 g/d of salt intake) and 61.0 ± 22.7 mmol/d, respectively. More than 87.1% of the participants (89.8% for men vs. 84.9% for women; p = .31) exceeded the WHO recommendation of 5 g/d. The upper limit of 10 g salt intake per day was still exceeded by 26.3%. After adjusted analysis, sex (for women, coef = -1.6; (95% CI: -2.4, -0.7)), level of instruction (≥30 kg/m2, coef = +1.1; (95% IC: 0.4-2.0)), and body mass index (≥30 kg/m2, coef = +1.1; (95% CI: 0.1, 2.0)) were associated with the sodium excretion. High sodium intake and inadequate potassium intake were found among participants. This consumption profile complies with the diet westernization context occurring in Tunisia. The initiated strategy focused on the downward of sodium in bread (the main source of salt intake) seems to be promising.
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Affiliation(s)
- Radhouene Doggui
- INNTA (National Institute of Nutrition and Food Technology)SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research LaboratoryTunisTunisia
- University of Tunis El ManarTunisTunisia
| | - Jalila El Ati
- INNTA (National Institute of Nutrition and Food Technology)SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research LaboratoryTunisTunisia
- University of Tunis El ManarTunisTunisia
| | - Sonia Sassi
- INNTA (National Institute of Nutrition and Food Technology)SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research LaboratoryTunisTunisia
- University of Tunis El ManarTunisTunisia
| | - Houda Ben Gharbia
- INNTA (National Institute of Nutrition and Food Technology)SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research LaboratoryTunisTunisia
- University of Tunis El ManarTunisTunisia
| | - Ayoub Al‐Jawaldeh
- World Health Organization (WHO)Regional Office for the Eastern Mediterranean (EMRO)CairoEgypt
| | - Myriam El Ati‐Hellal
- Laboratory Materials Molecules and Applications LR11ES22TunisTunisia
- IPESTUniversity of CarthageTunisTunisia
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17
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Soltani T, Mazloomy Mahmoodabad SS, Vaezi AA, Nadjarzadeh A, Namayandeh SM, Soltani MH, Fallahzadeh H. Incentives to Reduce Salt Intake Resulting From Women's Experiences: A Qualitative Study. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021; 42:272684X21991375. [PMID: 33615900 DOI: 10.1177/0272684x21991375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Over consumption of salt adversely affects health and is associated with some diseases. Salt over consumption has been reported to be higher in Asian countries including Iran. This research aimed to identify the facilitative factors of reduced salt consumption among 20-65 year-old women to develop effective educational interventions. Methods: This research used qualitative content analysis. We included 42 (31 women aged 20-65 years residing in Hamidia, Yazd and 11 healthcare providers) using Purposeful sampling method. Data were collected through focal group discussions (three groups of 6) and in-depth semi-structured individual interviews with 24 Participants. Data analysis was done using Graneheim and Lundman's approach. Results: Motivators and facilitators were extracted. The former consisted of sub-categories: physical fitness and healthcare, obtaining others' approval, family cooperation and support, internal motivators, contextual motivators and healthcare staff support. Sub-categories of the latter were gaining more information from different instructions, willingness to acquire self-protection skills and nutritional advice. These factors affected to reduce the salt intake among women. Conclusion: In the light of the qualitative results of motivating and facilitating factors, it is essential to enhance internal motivators and increase access to information via different communicative channels in community including schools, medical care providers and public associations. It is also necessary to pave the way for more family and medical staff support, provide appropriate educational and advertising programs, raise women's awareness and change their attitude and behavior with this concern.
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Affiliation(s)
- Tahere Soltani
- Department of Health Education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Saeed Mazloomy Mahmoodabad
- Department of Health Education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Akbar Vaezi
- Department of Nursing, School of Nursing & Midwifery, Research Center for Nursing & Midwifery Care in Family Health, Shahid Sadoughi University of Medical Science, Yazd, Iran
| | - Azadeh Nadjarzadeh
- Department of Nutrition, Nutrition and Food Security Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Mohammad Hossein Soltani
- Department of Cardiology, School of Medicine, Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences,Yazd, Iran
| | - Hossien Fallahzadeh
- Departments of Biostatistics and Epidemiology, Center For Healthcare Data Modeling, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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18
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Gamba M, Moreira P, Borges N, Santos A, Afonso C, Amaral TF, Padrão P. Are older adults with excessive sodium intake at increased risk of hypohydration? J Hum Nutr Diet 2021; 34:834-840. [PMID: 33513297 DOI: 10.1111/jhn.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sodium intake is expected to affect water needs, although compensation mechanisms may not work efficiently particularly in older adults. The aim of this cross-sectional study was to quantify the association between sodium excretion and hydration status in a representative sample of Portuguese older adults. METHODS A cluster sampling approach was used, representing Portuguese older adults (≥65 years) according to sex, education level and region. From a sample size of 1500 participants, 1318 were eligible for the present analysis. A 24-h urine sample was collected, and volume, osmolality, creatinine and sodium were quantified. Free water reserve (FWR) was used to assess hydration status. Excessive sodium intake was defined as above 2000 mg day-1 as recommended by the World Health Organization. A multivariable binary logistic regression model was used to estimate the association between FWR and sodium excretion. Odds ratios (OR) and respective 95% confidence intervals (95% CI) were calculated. RESULTS Excessive sodium excretion was observed in 80.0% of women and 91.5% of men, whereas hypohydration affected 10.9% of women and 23.6% of men. After adjusting for confounders, excessive sodium excretion was associated with an increased risk of hypohydration among men (OR = 2.75; 95% CI = 1.06-7.15). CONCLUSIONS These results stress the positive association between excessive sodium intake and hypohydration in men and highlight the need for implementing strategies regarding the reduction of salt consumption and the promotion of water intake.
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Affiliation(s)
- Marta Gamba
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Centro de Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Nuno Borges
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Alejandro Santos
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,I3S-Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - Cláudia Afonso
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Teresa F Amaral
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,UISPA-IDMEC, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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Huang Z, Zeng D. Factors Affecting Salt Reduction Measure Adoption among Chinese Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020445. [PMID: 33429901 PMCID: PMC7827444 DOI: 10.3390/ijerph18020445] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/03/2022]
Abstract
China has the highest mortality rate caused by diseases and conditions associated with its high-salt diet. Since 2016, China has initiated a national salt reduction campaign that aims at promoting the usage of salt information on food labels and salt-restriction spoons and reducing condiment and pickled food intake. However, factors affecting individuals’ decisions to adopt these salt reduction measures remain largely unknown. By comparing the performances of logistic regression, stepwise logistic regression, lasso logistic regression and adaptive lasso logistic regression, this study aims to fill this gap by analyzing the adoption behaviour of 1610 individuals from a nationally representative online survey. It was found that the practices were far from adopted and only 26.40%, 22.98%, 33.54% and 37.20% reported the adoption of labelled salt information, salt-restriction spoons, reduced condiment use in home cooking and reduced pickled food intake, respectively. Knowledge on salt, the perceived benefits of salt reduction, participation in nutrition education and training programs on sodium reduction were positively associated with using salt information labels. Adoption of the other measures was largely explained by people’s awareness of hypertension risks and taste preferences. It is therefore recommended that policy interventions should enhance Chinese individuals’ knowledge of salt, raise the awareness of the benefits associated with a low-salt diet and the risks associated with consuming excessive salt and reshape their taste choices.
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Affiliation(s)
- Zeying Huang
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing 100081, China
- Correspondence: ; Tel.: +86-13716627967
| | - Di Zeng
- Centre for Global Food and Resources, The University of Adelaide, Adelaide, SA 5005, Australia;
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Shuvo SD, Zahid MA, Rahman MM, Parvin R. Exploring the impact of soil and water salinity on dietary behavior and health risk of coastal communities in Bangladesh. JOURNAL OF WATER AND HEALTH 2020; 18:1110-1123. [PMID: 33328380 DOI: 10.2166/wh.2020.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to evaluate the impact of soil and water salinity on dietary behavior and health risk in the coastal people of Bangladesh. This study was conducted among 240 respondents in rural coastal sub-districts in Khulna and Patuakhali of Bangladesh using a simple random sampling technique. To evaluate the association between health risk and salinity exposure categories, a multinomial logit regression analysis was conducted and statistical significance was declared at p ≤ 0.05. A significantly higher amount of salinity (NaCl) level was found in radish, potato, bean, bitter gourd, rice, shallow tube-well, and pond water from Patuakhali than Khulna. Males and those aged 36-50 years (RRR:1.89, SE:0.58) and 51-65 years (RRR:4.51, SE:1.81) were associated with hypertension compared with the females (RRR:0.57, SE:0.18) and age group 20-35 years. Consumption of shallow tube-well water (RRR:3.12, SE:1.46), salt content rice (RRR:1.36, SE:0.50), salt content vegetables (RRR:1.09, SE:0.09), salt content fish (RRR:2.77, SE:0.47), and intake of table salt (RRR:1.05, SE:0.03) were significantly associated with risk factors of hypertension (p < 0.01). A sustainable policy for salt reduction through dietary interventions along with the promotion of low saline foods and drinking water must be a priority with special emphasis on coastal areas.
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Affiliation(s)
- Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh E-mail:
| | - Md Ashrafuzzaman Zahid
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh E-mail:
| | - Mohammad Mahfuzur Rahman
- Department of Environmental Science and Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Rashida Parvin
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh E-mail:
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Layeghiasl M, Malekzadeh J, Shams M, Maleki M. Using Social Marketing to Reduce Salt Intake in Iran. Front Public Health 2020; 8:207. [PMID: 32582611 PMCID: PMC7289950 DOI: 10.3389/fpubh.2020.00207] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/05/2020] [Indexed: 01/21/2023] Open
Abstract
Objectives: WHO has recommended that the average salt intake must be <5 grams per day. However, people consume salt much more in many countries. In this study, we design and implement an intervention based on social marketing model to reduce salt consumption in Yasuj, Iran. Materials and Methods: This study employed a quasi-experimental pretest-posttest with control group design which consisted of a formative research (qualitative-quantitative) and an interventional phase. To collect the qualitative data, six focus group discussions by participating of 66 people were established. The qualitative data were analyzed manually using directed content analysis. In quantitative study, 166 people aged 25-50 years completed a KAP questionnaire, and their average salt intake was determined through measuring sodium in their urine sample. By analyzing the data, marketing mix components were determined for designing an intervention. An educational package (including posters for installing in the kitchen, pamphlets, phone counseling, four educational classes, and brief interventions done by physicians and other health personnel) focused on reducing salt intake and using alternatives was developed. For one month, program was implemented for intervention group. Two months later, KAP survey and measuring the urine sodium were repeated for intervention and control groups. The data was compared for two groups, before and after the intervention by using independent t-test, paired t-tests and repeated measures ANOVA. Results: The qualitative findings showed that most participants agreed that the salt intake was high in Iran. Most of them recommended home-based and family-driven strategies to reduce salt intake, offered using healthier alternatives for salt, and recognized physicians and health care providers in healthcare facilities as the most important to encourage people to reduce salt intake. After the intervention, the mean and standard deviation of KAP were improved significantly in intervention group. The mean salt intake decreased significantly by 3.01 ± 2.38 in the intervention group and repeated measures ANOVA showed significant change over time (P < 0.001) and a significant difference between two groups (P = 0.04). Also, the interaction between time and group was significant (P = 0.001). Conclusion: The mean salt intake among the study population was approximately three times more than the level recommended by the WHO. The social marketing-based intervention succeeded in reducing the salt intake of the study subjects by ~3 grams on average.
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Affiliation(s)
- Mehdi Layeghiasl
- Department of Health Education and Promotion, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Janmohamad Malekzadeh
- Department of Nutrition, Yasuj University of Medical Sciences, Yasuj, Iran.,Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mohsen Shams
- Department of Health Education and Promotion, School of Health, Yasuj University of Medical Sciences, Yasuj, Iran.,Iranian Social Marketing Association, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mostafa Maleki
- Iranian Social Marketing Association, Yasuj University of Medical Sciences, Yasuj, Iran.,Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Zhao Y, Liu W, Liu S, Li X, Yin T, Liu X, Wang F, Chang X, Zhang T, Tian M, Zhang Y. Estimating 24-h urinary sodium excretion from casual spot urine specimen among hypertensive patients in Northwest China: the Salt Substitute and Stroke Study. Public Health Nutr 2020; 24:1-7. [PMID: 32345383 DOI: 10.1017/s1368980019005019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To develop an equation that can estimate the 24-h urinary Na excretion by using casual spot urine specimen for older hypertensive participants in rural Ningxia and further to compare with the INTERSALT method, Kawasaki method and Tanaka method. DESIGN Older hypertensive participants in rural Ningxia provided their casual spot urine samples and 24-h urine samples between January 2015 and February 2017. Sex-specific equation was developed using linear forward stepwise regression analysis. Model fit was assessed using adjusted R2. Approximately half of all participants were randomly selected to validate the equation. Mean differences, intraclass correlation coefficients and Bland-Altman plots were used to evaluate the performance of all methods. SETTING Pingluo County and Qingtongxia County in Ningxia Hui Autonomous Region, China. PARTICIPANTS Older hypertensive participants in rural Ningxia. RESULTS Totally, 807 of 1120 invited participants provided qualified 24-h urine samples and spot urine samples. There was no statistical difference comparing the laboratory-based method against the new method and the INTERSALT method, while Kawasaki method had the largest bias with a mean difference of 40·81 g/d (95 % CI 39·27, 42·35 g/d). Bland-Altman plots showed similar pattern of the results. CONCLUSION The INTERSALT method and the new equation have the potential to estimate the 24-h urinary Na excretion in this study population. However, the extrapolation of the results to other population needs to be careful. Future research is required to establish a more reliable method to estimate 24-h urinary Na excretion.
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Affiliation(s)
- Yi Zhao
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Wanlu Liu
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Sha Liu
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Xiaoxia Li
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Ting Yin
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Xiuying Liu
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Faxuan Wang
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Xiaoyu Chang
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
| | - Tianjing Zhang
- The People's Hospital of Anyang City, Anyang City, Henan Province, China
| | - Maoyi Tian
- The George Institute for Global Health at Peking University Health Science Center, Haidian District, Beijing100088, China
- The George Institute for Global Health, University of New South Wales, Newtown, NSW2042, Australia
| | - Yuhong Zhang
- Public Health and Management School of Ningxia Medical University, Yinchuan City, Ningxia, China
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Yusta-Boyo MJ, Bermejo LM, García-Solano M, López-Sobaler AM, Ortega RM, García-Pérez M, Dal-Re Saavedra MÁ. Sugar Content in Processed Foods in Spain and a Comparison of Mandatory Nutrition Labelling and Laboratory Values. Nutrients 2020; 12:E1078. [PMID: 32295050 PMCID: PMC7231220 DOI: 10.3390/nu12041078] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 11/16/2022] Open
Abstract
To reduce the sugar content of processed foods through reformulation, the first step is to determine the content of the largest sources of sugars in each country's diet. The aim of this work was to describe the sugar content in the most commonly consumed processed foods in Spain and to compare that sugar's labelling and laboratory analysis values (LVs and AVs, respectively) to confirm its adequacy. A sample of the 1173 most commonly consumed processed foods in Spain (28 groups; 77 subcategories) was collected. For each product, the total sugar content was compared according to its AV and LV. The median (25th -75th percentiles, interquartile range) sugar content by group was calculated for the total sample, and the groups were classified as "high sugar content" when this value was above 22.5 g/100g of product. The adequacy of the LV, according to the European Union (EU) tolerance requirements, was then evaluated, and each subcategory median was compared with the AV to determine its appropriateness via a median test for independent samples (p < 0.05). In total, 10 out of 28 groups presented high sugar content. Moreover, 98.4% of the products met the EU tolerance ranges. Finally, only one subcategory ("cured ham") presented significant differences between the AV and LV median values (0.4 g vs. 0.1 g sugar/100g, p < 0.05). The groups of food products whose sugar content reduction could have the greatest impact on public health were identified. In addition, our study showed the high adequacy of LV with the EU labeling tolerance requirements, as well as the LV's appropriateness as a tool to implement actions aimed at reducing sugar consumption.
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Affiliation(s)
- María José Yusta-Boyo
- Spanish Food Safety and Nutrition Agency, Alcala, 56., 28014 Madrid, Spain; (M.G.-S.); (M.G.-P.); (M.Á.D.-R.S.)
| | - Laura M. Bermejo
- Nutrition and Food Science Department, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (L.M.B.); (A.M.L.-S.); (R.M.O.)
- VALORNUT Research Group, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Marta García-Solano
- Spanish Food Safety and Nutrition Agency, Alcala, 56., 28014 Madrid, Spain; (M.G.-S.); (M.G.-P.); (M.Á.D.-R.S.)
| | - Ana M. López-Sobaler
- Nutrition and Food Science Department, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (L.M.B.); (A.M.L.-S.); (R.M.O.)
- VALORNUT Research Group, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Rosa M. Ortega
- Nutrition and Food Science Department, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (L.M.B.); (A.M.L.-S.); (R.M.O.)
- VALORNUT Research Group, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Marta García-Pérez
- Spanish Food Safety and Nutrition Agency, Alcala, 56., 28014 Madrid, Spain; (M.G.-S.); (M.G.-P.); (M.Á.D.-R.S.)
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Cuadrado-Soto E, Peral-Suarez Á, Rodríguez-Rodríguez E, Aparicio A, Andrés P, Ortega RM, López-Sobaler AM. The association of parents' behaviors related to salt with 24 h urinary sodium excretion of their children: A Spanish cross-sectional study. PLoS One 2019; 14:e0227035. [PMID: 31881048 PMCID: PMC6934279 DOI: 10.1371/journal.pone.0227035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 12/11/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Sodium intake is excessive among Spanish children, but the salt use behaviors of parents and children are unknown. This study aims to determine behaviors related to salt intake in both schoolchildren and parents and the relationship between parental behaviors and 24 h urinary sodium excretion (UNa-24h) in children. SUBJECTS AND METHODS A convenience sample was taken from a cross-sectional analysis. Parents completed a self-reported questionnaire about their behaviors related to salt, and their responses were compared with the UNa-24h of their own children. The median test was used to identify differences in UNa-24h according to behaviors. Logistic regression was used to assess the relationship between the behaviors of parents and high sodium excretion in the children and the risk of children's use of table salt, adjusting for age, sex, and BMI. Multinomial logistic regression models, adjusted by the covariates, were used to study the children's salt preferences. RESULTS A total of 329 schoolchildren from different Spanish provinces were included in the study (mean age: 9.0 ± 1.2 years, 157 girls). The majority of families (parents mean age: 42.0 ± 5.2 years) reported adding salt to food during cooking (92%), and 59% of them never looked at the sodium content on food labels. However, none of these behaviors were related to UNa-24h (p > 0.05). The use of iodized salt (53%), the presence of a salt shaker on the table (6%), and the use of table salt by fathers (57%), mothers (52%) or children (17%) increased the odds (p < 0.05) of children having a higher UNa-24h. Checking sodium content on food labels and the use of table salt by the children or father was associated with a lower preference for salty foods (p < 0.05). CONCLUSIONS It is important to make parents aware of the relationship between their behaviors regarding the use of discretionary salt and their children's sodium intake. Our data suggest that salt-specific education programs on how to reduce salt both in-home and outside the home should be implemented to improve behavior skills related to salt consumption in parents and children.
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Affiliation(s)
- Esther Cuadrado-Soto
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, Madrid, Spain
| | - África Peral-Suarez
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, Madrid, Spain
| | - Elena Rodríguez-Rodríguez
- Department of Chemistry in Pharmaceutical Sciences, Analytical Chemistry, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
- UCM Research Group: VALORNUT-920030, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, Madrid, Spain
| | - Aránzazu Aparicio
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, Madrid, Spain
- UCM Research Group: VALORNUT-920030, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, Madrid, Spain
| | - Pedro Andrés
- Department of Chemistry in Pharmaceutical Sciences, Analytical Chemistry, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
- UCM Research Group: VALORNUT-920030, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, Madrid, Spain
| | - Rosa M. Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, Madrid, Spain
- UCM Research Group: VALORNUT-920030, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, Madrid, Spain
| | - Ana M. López-Sobaler
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, Madrid, Spain
- UCM Research Group: VALORNUT-920030, Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, Madrid, Spain
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Sodium Intake from Foods Exceeds Recommended Limits in the Spanish Population: The ANIBES Study. Nutrients 2019; 11:nu11102451. [PMID: 31615065 PMCID: PMC6835313 DOI: 10.3390/nu11102451] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 09/20/2019] [Accepted: 10/03/2019] [Indexed: 02/08/2023] Open
Abstract
Excessive sodium consumption is associated with adverse health effects. An elevated dietary intake of salt (sodium chloride) has been related to high blood pressure or hypertension, a major but modifiable risk factor for cardiovascular disease, as well as to other ill health conditions. In the present work, our aim was to describe the contribution of foods to sodium consumption within the Spanish population in a representative sample from the “anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles in Spain” (ANIBES) study (9–75 years), to identify high consumer groups, as well as the major food groups that contribute to sodium intake in the Spanish diet. Intakes were assessed by 3-day food records collected on a tablet device. Sodium intakes across the ANIBES study population exceeded recommendations, as total intakes reached 2025 ± 805 mg of sodium per day, that is approximately 5.06 g/day of salt (excluding discretionary salt, added at the table or during cooking). Sodium intakes were higher in males than in females and within the youngest groups. Main dietary sources of sodium were meat and meat products (27%), cereals and grains (26%), milk and dairy products (14%) and ready-to-eat meals (13%). Given the established health benefits of dietary salt reduction, it would be advisable to continue and even improve the current national initiatives of awareness and educational campaigns and particularly food reformulation to decrease overall salt intakes across the Spanish population.
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Pirasteh A, Pouraram H, Kholdi N, Abtahi M. Discretionary Salt Intake and Readiness for Behavioral Change Among Women in Tehran. Int J Prev Med 2019; 10:167. [PMID: 32133085 PMCID: PMC6826771 DOI: 10.4103/ijpvm.ijpvm_523_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 08/29/2019] [Indexed: 11/26/2022] Open
Abstract
Background: Since women's readiness for dietary behavioral change can be one of the most effective fundamental measures for reducing dietary salt intake in line with preventing chronic diseases in developing countries, the present study is aimed to determine the readiness for behavioral change in discretionary salt intake among women living in Tehran. Methods: The present cross-sectional study was conducted on 561 women referring to the women care units across city of Tehran. The self-administered questionnaire included assessment of nutrition-related knowledge on salt intake and its association with diseases, discretionary salt intake, stages of change, and self-efficacy of women. In addition, the logistic regression test was used to determine the predictors of women's readiness for behavioral change in discretionary salt intake. Results: 40% women had someone in the family who had such a limitation (salt intake-limited exposure group), while 81.6% always or often added salt to their foods. Moreover, one-third of the participants were in the stage of pre-contemplation and 41.2% were in the stage of preparation for reducing salt intake. Self-efficacy and salt intake-limited exposure were the two most important determinants of the women's readiness for behavioral change in discretionary salt intake, respectively: (OR = 1.1 95% CI: 1.06--1.14 P < 0.001; OR = 1.58, 95% CI: 1.03--2.42 P < 0.03). Conclusions: Results of the present study showed that increased self-efficacy is associated with higher levels of behavioral change among women. Since self-efficacy is very important for initiating and maintaining the behavioral change, women's empowerment for reducing salt intake necessitates putting the emphasis on increased self-efficacy as well as community-based nutritional interventions.
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Affiliation(s)
- Ashraf Pirasteh
- Department of Health and Social Medicine, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Kholdi
- Department of Health and Social Medicine, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Mitra Abtahi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Turck D, Castenmiller J, de Henauw S, Hirsch-Ernst KI, Kearney J, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Aggett P, Fairweather-Tait S, Martin A, Przyrembel H, Ciccolallo L, de Sesmaisons-Lecarré A, Valtueña Martinez S, Martino L, Naska A. Dietary reference values for sodium. EFSA J 2019; 17:e05778. [PMID: 32626425 PMCID: PMC7009309 DOI: 10.2903/j.efsa.2019.5778] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) derived dietary reference values (DRVs) for sodium. Evidence from balance studies on sodium and on the relationship between sodium intake and health outcomes, in particular cardiovascular disease (CVD)-related endpoints and bone health, was reviewed. The data were not sufficient to enable an average requirement (AR) or population reference intake (PRI) to be derived. However, by integrating the available evidence and associated uncertainties, the Panel considers that a sodium intake of 2.0 g/day represents a level of sodium for which there is sufficient confidence in a reduced risk of CVD in the general adult population. In addition, a sodium intake of 2.0 g/day is likely to allow most of the general adult population to maintain sodium balance. Therefore, the Panel considers that 2.0 g sodium/day is a safe and adequate intake for the general EU population of adults. The same value applies to pregnant and lactating women. Sodium intakes that are considered safe and adequate for children are extrapolated from the value for adults, adjusting for their respective energy requirement and including a growth factor, and are as follows: 1.1 g/day for children aged 1-3 years, 1.3 g/day for children aged 4-6 years, 1.7 g/day for children aged 7-10 years and 2.0 g/day for children aged 11-17 years, respectively. For infants aged 7-11 months, an Adequate Intake (AI) of 0.2 g/day is proposed based on upwards extrapolation of the estimated sodium intake in exclusively breast-fed infants aged 0-6 months.
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Measurement of Iodine in Consumed Salts at the Distribution Level and Assessing Post-Training Attitude Status in Providers in Qom. PAJOUHAN SCIENTIFIC JOURNAL 2019. [DOI: 10.52547/psj.17.3.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Associations of urinary sodium levels with overweight and central obesity in a population with a sodium intake. BMC Nutr 2018; 4:47. [PMID: 32153908 PMCID: PMC7050808 DOI: 10.1186/s40795-018-0255-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/26/2018] [Indexed: 12/12/2022] Open
Abstract
Background Previous studies have reported an association between dietary sodium intake and overweight/central obesity. However, dietary survey methods were prone to underestimate sodium intake. Therefore, this study investigated the associations of calculated 24-h urinary sodium excretion, an index of dietary sodium intake, with various obesity parameters including body mass index (BMI) and waist circumference (WC) in a population with a relatively high sodium intake. Methods A total of 16,250 adults (aged ≥19 years) and 1476 adolescents (aged 10-18 years), with available information on spot urine sodium levels and anthropometric measurements from the Korea National Health and Nutrition Examination Survey (KNHANES) were included in this study. We calculated 24-h urine sodium excretion levels from spot urine sodium levels using the Tanaka formula. Results In adults, those with high sodium excretion levels (≥ 3200 mg) showed increased odds of overweight and central obesity compared to those with low urinary sodium excretion level (< 2200 mg) (odds ratio [OR] = 2.17, 95% confidence interval [CI] = 1.90-2.49 for overweight; OR = 2.50, 95% CI = 2.13-2.94 for central obesity). These associations were also observed in adolescents (OR = 5.80, 95% CI = 3.17-10.60 for overweight; OR = 4.19, 95% CI = 1.78-9.89 for central obesity). Conclusions The present study suggests that reducing salt intake might be important for preventing overweight and central obesity, especially in adolescents. However, because the present study was conducted with cross-sectional study design, further longitudinal studies are warranted to confirm the causal relationship between urinary sodium excretion and overweight/central obesity.
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Kang E, Lee J, Kim HJ, Han M, Kim SW, Lee KB, Sung S, Yoo TH, Chung W, Ahn C, Oh KH. The association between socioeconomic disparities and left ventricular hypertrophy in chronic kidney disease: results from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD). BMC Nephrol 2018; 19:203. [PMID: 30115015 PMCID: PMC6097450 DOI: 10.1186/s12882-018-1005-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 08/07/2018] [Indexed: 11/10/2022] Open
Abstract
Background Left ventricular hypertrophy (LVH) is one of the risk factors for cardiovascular (CV) disease and mortality. However, the relationship between socioeconomic status (SES) and LVH in chronic kidney disease remains unclear. Methods Data were collected from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD, NCT01630486 at http://www.clinicaltrials.gov). Subjects with CKD and aged ≥50 were included. SES was characterized based on monthly income and educational attainment, each of which was divided into three strata. LVH was defined as LV mass/height2.7 ≥ 47 g/m2.7 in female and ≥ 50 g/m2.7 in male. Age, sex, diabetes, CKD stage, body mass index, blood pressure and physical activity were included as covariates. Results A total of 1361 patients were included. Mean age was 60.9 ± 6.9 years, and 63.2% were men. Higher education level was associated with higher monthly income (P for trend < 0.001). The lowest education level was independently associated with LVH (lower than high school, adjusted odds ratio [OR] 1.485, 95% CI 1.069–2.063, P = 0.018; completed high school, adjusted OR 1.150, 95% confidence interval [CI] 0.834–1.584, P = 0.394; highest education level as the reference). Monthly income level was marginally associated with LVH after adjusting for covariates ($1500-4500, adjusted OR 1.230, 95% CI 0.866–1.748, P = 0.247; < $1500, adjusted OR 1.471, 95% CI 1.002–2.158, P = 0.049; > $4500; reference). Conclusions In the CKD population, lower SES, defined by educational attainment and low income level exhibited a significant association with LVH, respectively. Longitudinal follow-up will reveal whether lower SES is associated with poor CKD outcomes.
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Affiliation(s)
- Eunjeong Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Joongyub Lee
- School of Medicine, Inha University, Incheon, Korea.,Department of Prevention and Management, Inha University Hospital, Incheon, Korea
| | - Hyo Jin Kim
- Department of Internal Medicine, Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Miyeun Han
- Department of Internal Medicine, Pusan National University Hospital, Pusan, Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Kyu-Beck Lee
- Division of Nephrology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suah Sung
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Wookyung Chung
- Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Pino A, De Angelis M, Todaro A, Van Hoorde K, Randazzo CL, Caggia C. Fermentation of Nocellara Etnea Table Olives by Functional Starter Cultures at Different Low Salt Concentrations. Front Microbiol 2018; 9:1125. [PMID: 29922251 PMCID: PMC5996112 DOI: 10.3389/fmicb.2018.01125] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/14/2018] [Indexed: 11/13/2022] Open
Abstract
Nocellara Etnea is one of the main Sicilian cultivars traditionally used to produce both olive oil and naturally fermented table olives. In the present study, the effect of different salt concentrations on physico-chemical, microbiological, sensorial, and volatile organic compounds (VOCs) formation was evaluated in order to obtain functional Nocellara Etnea table olives. The experimental design consisted of 8 treatments as follow: fermentations at 4, 5, 6, and 8% of salt with (E1-E4 samples) and without (C1-C4 samples) the addition of starters. All the trials were carried out at room temperature (18 ± 2°C) and monitored for an overall period of 120 d. In addition, the persistence of the potential probiotic Lactobacillus paracasei N24 at the end of the process was investigated. Microbiological data revealed the dominance of lactic acid bacteria (LAB), starting from the 7th d of fermentation, and the reduction of yeasts and enterobacteria in the final product inoculated with starters. VOCs profile highlighted a high amount of aldehydes at the beginning of fermentation, which significantly decreased through the process and a concomitant increase of alcohols, acids, esters, and phenols. In particular, esters showed an occurrence percentage higher in experimental samples rather than in control ones, contributing to more pleasant flavors. Moreover, acetic acid, ethanol, and phenols, which often generate off-flavors, were negatively correlated with mesophilic bacteria and LAB. It is interesting to note that salt content did not affect the performances of starter cultures and slightly influenced the metabolome of table olives. Sensory data demonstrated significant differences among samples registering the highest overall acceptability in the experimental sample at 5% of NaCl. The persistence of the L. paracasei N24 strain in experimental samples, at the end of the process, revealed its promising perspectives as starter culture for the production of functional table olives with reduced salt content.
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Affiliation(s)
- Alessandra Pino
- Department of Agricultural, Food and Environment, University of Catania, Catania, Italy
| | - Maria De Angelis
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Aldo Todaro
- Department of Agricultural, Food and Forest Science, University of Palermo, Palermo, Italy
| | - Koenraad Van Hoorde
- Laboratory of Brewing and Biochemistry, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Cinzia L. Randazzo
- Department of Agricultural, Food and Environment, University of Catania, Catania, Italy
| | - Cinzia Caggia
- Department of Agricultural, Food and Environment, University of Catania, Catania, Italy
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Abstract
The relationship between salt and hypertension is the focus of a large amount of research, there are few reviews of the relationship between salt and diabetes, despite the increasing incidence of diabetes. By searching PubMed and the Cochrane Library, we summarized the relationships between diabetic risk factors, diabetic complications and salt intake. The pathophysiological mechanisms underlying the effects of salt on diabetes risk factors and diabetic complications are also discussed. Our findings should assist experts and scholars to understand the current research of salt intake and to pay more attention to the prevention and treatment of related diseases caused by excessive salt intake; guide treatment for patients with diabetes mellitus; and provide a reference for government departments to formulate a reasonable salt restriction policy. We also recommend future research directions.
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Affiliation(s)
- Shuang Han
- Department of Endocrinology, The First Hospital Affiliated of Harbin Medical University, Harbin, China
| | - Daolin Cheng
- Department of Orthopaedics, The First Hospital Affiliated of Harbin Medical University, Harbin, China
| | - Nianjiao Liu
- Department of Endocrinology, The First Hospital Affiliated of Harbin Medical University, Harbin, China
| | - Hongyu Kuang
- Department of Endocrinology, The First Hospital Affiliated of Harbin Medical University, Harbin, China.
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Duan L, Liu W, Zhang P, Liu S, Liu X, Sang M, Liu L, Lin H, Sang Z. Salt Intake of Lactating Women as Assessed by Modified Food Weighted Records. J Am Coll Nutr 2018; 37:614-619. [PMID: 29667517 DOI: 10.1080/07315724.2018.1454354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE High salt intake among lactating women can increase the risk of hypertension and cardiovascular disease in infants/offspring. However, considering the limited salt intake data in lactating women, the aims of this study were to compare the salt intake assessed by modified food weighted records (FWR) with that estimated by 24-h urinary sodium excretion and to investigate the salt intake of lactating women. METHODS In total, 30 lactating women aged 20-39 years who were 2 to 4 months postpartum were recruited from the cities of Tianjin and Luoyang in China. The household salt intakes of the lactating women were collected by modified FWR for 3 days. Information on the gender, age, eating behaviours and labour intensity of the family members and guests dining at home during the 3 days was recorded. Meanwhile, 24-h urine samples of lactating women were collected. RESULTS The salt intakes of the lactating women estimated by modified FWR and 24-h urinary sodium excretion were 8.50 ± 5.32 g/d and 9.34±3.74 g/d (t=-1.29, P=0.207), respectively, which exceeded the WHO recommendation of 5 g/d. There was a significant correlation (r=0.628, P < 0.001) between the salt intakes assessed by the two methods. A Bland-Altman plot showed no significant mean difference between the two methods (salt intake measured by 24-h urinary sodium excretion-salt intake assessed by modified FWR=0.46 g/d, P=0.207). CONCLUSIONS The modified FWR is a reliable tool to assess the salt intake of lactating women. The salt intake of lactating women in China remains higher than the WHO recommendation and should be restricted through further efforts.
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Affiliation(s)
- Lijun Duan
- a Department of endocrinology , Tianjin First Center Hospital , Tianjin , China
| | - Wendi Liu
- b Department of Nutrition and Food Hygiene , School of Public Health, Tianjin Medical University , Tianjin , China
| | - Peng Zhang
- b Department of Nutrition and Food Hygiene , School of Public Health, Tianjin Medical University , Tianjin , China
| | - Shiyan Liu
- b Department of Nutrition and Food Hygiene , School of Public Health, Tianjin Medical University , Tianjin , China
| | - Xiaotong Liu
- b Department of Nutrition and Food Hygiene , School of Public Health, Tianjin Medical University , Tianjin , China
| | - Maocheng Sang
- b Department of Nutrition and Food Hygiene , School of Public Health, Tianjin Medical University , Tianjin , China
| | - Lu Liu
- b Department of Nutrition and Food Hygiene , School of Public Health, Tianjin Medical University , Tianjin , China
| | - Haiyue Lin
- b Department of Nutrition and Food Hygiene , School of Public Health, Tianjin Medical University , Tianjin , China
| | - Zhongna Sang
- b Department of Nutrition and Food Hygiene , School of Public Health, Tianjin Medical University , Tianjin , China
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Lazda I, Goldmanis M, Siksna I. Salt Consumption in Latvian Population: A Pilot Study. MEDICINA-LITHUANIA 2018; 54:medicina54010010. [PMID: 30344241 PMCID: PMC6037234 DOI: 10.3390/medicina54010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 11/16/2022]
Abstract
Background and objective: High dietary sodium intake is associated with multiple health risks, and the average sodium intake in Latvia is higher than the World Health Organization has recommended. In Latvia, no study so far has combined self-reported dietary data on sodium and potassium intake with objective measurements in 24-h urine samples. This pilot study aimed to cross-validate both methods and to assess any possible factors interfering with the collection of samples and data in large, population-based future studies of sodium and potassium intake in Latvian adults. Materials and methods: A stratified random sample of healthy Latvian adults aged 19–64 (n = 30) was drawn. Dietary data of sodium and potassium was collected using one 24-h dietary recall and a two-day food diary. Sodium and potassium excretion was measured by one 24-h urinary collection. Results: Median intake of sodium and potassium based on dietary data was 2276.4 mg/day (interquartile range (IQR), 1683.3–3979.4) and 2172.0 mg/day (IQR, 1740.6–3506.5), respectively. Median intake of sodium and potassium based on urinary data was 3500.3 mg/day (IQR, 2191.0–5535.0) and 2965.4 mg/day (IQR, 2530.2–3749.9), respectively. Urinary data showed significantly higher results than dietary records (Wilcoxon signed rank test, p = 0.023). Only 13% of the subjects did not exceed the WHO-recommended limit of 2000 mg of sodium per day, and only 33% consumed at least the recommended allowance of 3510 mg of potassium per day. Median intake of salt was 8.8 g/day (IQR, 5.5–13.8) (according to urinary data). Conclusions: The findings from the present study showed considerable underestimation of dietary sodium and potassium intake based on self-reported dietary data. Urinary data revealed more accurate results, and showed that Latvian adults exceed the amount of salt recommended and consume less potassium than recommended. The pilot study also showed that the chosen methods are adequate for implementation in large, population-based studies to evaluate dietary intake of salt, sodium, and potassium in populations of Latvian adults.
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Affiliation(s)
- Ilva Lazda
- Department of Risk Assessment and Epidemiology, Institute of Food Safety, Animal Health and Environment BIOR, Lejupes Street 3, LV-1076 Riga, Latvia.
| | - Māris Goldmanis
- Department of Economics, Royal Holloway University of London, Egham TW20 0EX, UK.
| | - Inese Siksna
- Department of Risk Assessment and Epidemiology, Institute of Food Safety, Animal Health and Environment BIOR, Lejupes Street 3, LV-1076 Riga, Latvia.
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The Effect of the Education Program on the Adherence Intention to the Dietary Sodium Restriction and the Amount of Sodium Intake in Patients With Chronic Heart Failure. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.12925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Kong JS, Lee YK, Kim MK, Choi MK, Heo YR, Hyun T, Kim SM, Lyu ES, Oh SY, Park HR, Rhee MY, Ro HK, Song MK. Estimation model for habitual 24-hour urinary-sodium excretion using simple questionnaires from normotensive Koreans. PLoS One 2018; 13:e0192588. [PMID: 29447201 PMCID: PMC5813954 DOI: 10.1371/journal.pone.0192588] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 01/27/2018] [Indexed: 11/19/2022] Open
Abstract
This study was conducted to develop an equation for estimation of 24-h urinary-sodium excretion that can serve as an alternative to 24-h dietary recall and 24-h urine collection for normotensive Korean adults. In total, data on 640 healthy Korean adults aged 19 to 69 years from 4 regions of the country were collected as a training set. In order to externally validate the equation developed from that training set, 200 subjects were recruited independently as a validation set. Due to heterogeneity by gender, we constructed a gender-specific equation for estimation of 24-h urinary-sodium excretion by using a multivariable linear regression model and assessed the performance of the developed equation in validation set. The best model consisted of age, body weight, dietary behavior (‘eating salty food’, ‘Kimchi consumption’, ‘Korean soup or stew consumption’, ‘soy sauce or red pepper paste consumption’), and smoking status in men, and age, body weight, dietary behavior (‘salt preference’, ‘eating salty food’, ‘checking sodium content for processed foods’, ‘nut consumption’), and smoking status in women, respectively. When this model was tested in the external validation set, the mean bias between the measured and estimated 24-h urinary-sodium excretion from Bland-Altman plots was -1.92 (95% CI: -113, 110) mmol/d for men and -1.51 (95% CI: -90.6, 87.6) mmol/d for women. The cut-points of sodium intake calculated based on the equations were ≥4,000 mg/d for men and ≥3,500 mg/d for women, with 89.8 and 76.6% sensitivity and 29.3 and 64.2% specificity, respectively. In this study, a habitual 24-hour urinary-sodium-excretion-estimation model of normotensive Korean adults based on anthropometric and lifestyle factors was developed and showed feasibility for an asymptomatic population.
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Affiliation(s)
- Ji-Sook Kong
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Goyang, Gyeonggi, South Korea
| | - Yeon-Kyung Lee
- Department of Food Science and Nutrition, Kyungpook National University, Daegu, South Korea
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Goyang, Gyeonggi, South Korea
- * E-mail:
| | - Mi-Kyeong Choi
- Division of Food Science, Kongju National University, Yesan, South Korea
| | - Young-Ran Heo
- Department of Food and Nutrition, Chonnam National University, Gwangju, South Korea
| | - Taisun Hyun
- Department of Food and Nutrition, Chungbuk National University, Cheongju, South Korea
| | - Sun Mee Kim
- Department of Family Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Eun-Soon Lyu
- Department of Food Science and Nutrition, Pukyong National University, Busan, South Korea
| | - Se-Young Oh
- Department of Food and Nutrition, Kyunghee University, Seoul, South Korea
| | - Hae-Ryun Park
- Department of Food and Nutrition, Myongji University, Yongin, South Korea
| | - Moo-Yong Rhee
- Cardiovascular Center, Dongguk University Ilsan Hospital, Goyang, Gyeonggi, South Korea
| | - Hee-Kyong Ro
- Department of Food and Nutrition, Dongshin University, Naju, South Korea
| | - Mi Kyung Song
- Biometrics Research Branch and Biostatistics Collaboration Unit, Division of Cancer Epidemiology and Prevention, Research Institute and Hospital, National Cancer Center, Goyang, Korea, National Cancer Center, Goyang, Gyeonggi, South Korea
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Huybrechts I, Aglago EK, Mullee A, De Keyzer W, Leclercq C, Allemand P, Balcerzak A, Zotor FB, Gunter MJ. Global comparison of national individual food consumption surveys as a basis for health research and integration in national health surveillance programmes. Proc Nutr Soc 2017; 76:549-567. [PMID: 28803558 DOI: 10.1017/s0029665117001161] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Individual food consumption surveys (IFCS) are performed to evaluate compliance with food/nutrient intake requirements or exposure to potential harmful dietary contaminants/components. In this review, we inventoried methods and designs used in national IFCS and discussed the methodologies applied across countries. Literature searches were performed using fixed sets of search terms in different online databases. We identified IFCS in thirty-nine countries from six world continents. National IFCS systems are available in most of the high-income countries, while such surveys are scarce in low- and middle-income countries (e.g. Africa, Eastern Europe and several Asian countries). Few countries (n 9) have their national IFCS incorporated into national health and nutrition surveys, allowing the investigation of dietary-related disease outcomes. Of the integrated surveys, most have the advantage of being continuous/regular, contrary to other IFCS that are mostly erratic. This review serves as the basis to define gaps and needs in IFCS worldwide and assists in defining priorities for resource allocation. In addition, it can serve as a source of inspiration for countries that do not have an IFCS system in place yet and advocate for national IFCS to be incorporated into national health and nutrition surveys in order to create: (1) research opportunities for investigating diet-disease relationships and (2) a frame to plan and evaluate the effect of diet-related policies (e.g. promotion of local nutrient-rich foods) and of nutrition recommendations, such as food-based dietary guidelines. Countries that integrate their IFCS within their national health and nutrition survey can serve as proof-of-principle for other countries.
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Affiliation(s)
| | - Elom K Aglago
- International Agency for Research on Cancer,Lyon,France
| | - Amy Mullee
- International Agency for Research on Cancer,Lyon,France
| | - Willem De Keyzer
- Faculty of Science and Technology, Department of Bio- and Food Sciences,University College Ghent,Valentin Vaerwyckweg 1, B-9000 Ghent,Belgium
| | - Catherine Leclercq
- Nutrition Assessment & Scientific Advice Group,Nutrition and Food Systems Division, Food and Agricultural Organization of the United Nations,Viale Terme di Caracalla, 00153 Rome,Italy
| | - Pauline Allemand
- Nutrition Assessment & Scientific Advice Group,Nutrition and Food Systems Division, Food and Agricultural Organization of the United Nations,Viale Terme di Caracalla, 00153 Rome,Italy
| | - Agnieszka Balcerzak
- Nutrition Assessment & Scientific Advice Group,Nutrition and Food Systems Division, Food and Agricultural Organization of the United Nations,Viale Terme di Caracalla, 00153 Rome,Italy
| | - Francis B Zotor
- School of Public Health, University of Health and Allied Sciences,Ho,Ghana
| | - Marc J Gunter
- International Agency for Research on Cancer,Lyon,France
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Baldo M, Faria T, Mill J. 19. Epidemiological aspects underlying the association between dietary salt intake and hypertension. HUMAN HEALTH HANDBOOKS 2017. [DOI: 10.3920/978-90-8686-853-7_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- M.P. Baldo
- Department of Pathophysiology, Montes Claros State University – UNIMONTES, Av Rui Braga, Vila Mauriceia 39401-089, Montes Claros, MG, Brazil
| | - T.O. Faria
- Department of Physiological Sciences, Federal University of Espírito Santo, Av Marechal Campos, Maruípe 29042-755, Vitória, ES, Brazil
| | - J.G. Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Av Marechal Campos, Maruípe 29042-755, Vitória, ES, Brazil
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Farapti F, Nadhiroh SR, Sayogo S, Mardiana N. Urinary and dietary sodium to potassium ratio as a useful marker for estimating blood pressure among older women in Indonesian urban coastal areas. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2017. [DOI: 10.3233/mnm-17138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Farapti Farapti
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Siti Rahayu Nadhiroh
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Savitri Sayogo
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Nunuk Mardiana
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
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Stages of Behavioral Change for Reducing Sodium Intake in Korean Consumers: Comparison of Characteristics Based on Social Cognitive Theory. Nutrients 2017; 9:nu9080808. [PMID: 28749441 PMCID: PMC5579602 DOI: 10.3390/nu9080808] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 07/20/2017] [Accepted: 07/25/2017] [Indexed: 11/17/2022] Open
Abstract
High sodium intake increases the risk of cardiovascular disease. Given the importance of behavioral changes to reducing sodium intake, this study aims to investigate the stages of change and the differences in cognitive and behavioral characteristics by stage in Korean consumers. Adult participants (N = 3892) completed a questionnaire on the stages of behavioral change, recognition of social efforts, outcome expectancy, barriers to practice, nutrition knowledge and dietary behaviors, and self-efficiency related to reduced sodium intake. The numbers of participants in each stage of behavioral change for reducing sodium intake was 29.5% in the maintenance stage, 19.5% in the action stage, and 51.0% in the preaction stage that included the precontemplation, contemplation, and preparation stages. Multiple logistic regression showed that the factors differentiating the three stages were recognizing a supportive social environment, perceived barriers to the practice of reducing sodium intake, and self-efficacy to be conscious of sodium content and to request less salt when eating out. Purchasing experience of sodium-reduced products for salty foods, knowledge of the recommended intake of salt and the difference between sodium and salt, and improving dietary habits of eating salted fish, processed food, and salty snacks were factors for being in the action stage versus the preaction stage. These findings suggest that tailored intervention according to the characteristics of each stage is helpful in reducing sodium intake.
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Salt intake, blood pressure, and socioeconomic disparities among government employees in Sri Lanka: a cross-sectional study. J Public Health Policy 2017; 38:327-344. [PMID: 28596554 DOI: 10.1057/s41271-017-0073-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Our study estimated salt intake, examined the association between blood pressure (BP) and salt intake, and explored the socioeconomic variations in salt intake among administrators (government employees). This is a cross-sectional study. We studied 168 randomly selected administrators aged 30-60 years attached to government offices in Colombo, Sri Lanka. Self-administered questionnaire gathered information on socio-demographic, work-related information, lifestyle practices, and medical history. BP, 24-hour urine collection, and anthropometric indices were measured. Mean salt intake levels measured by 24-hour Sodium (Na) excretion in hypertensives and non-hypertensives were 202.56 (SD ± 85.45) mmol/day and 176.79 (SD ± 82.02) mmol/day, respectively. A 100-mmol increase in sodium was associated with an average increase of 3.1 (95 per cent CI 2-4.2) mmHg in systolic BP and 1.8 (95 per cent CI 0.89-2.6) mmHg in diastolic BP. Higher salt intake was found in managerial assistants (12.38 ± 5.0 g) compared with senior officers (10.84 ± 4.9 g). Salt intake among these administrators was alarmingly high. High salt intake was positively associated with hypertension and more prevalent in lower socioeconomic strata.
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Vasara E, Marakis G, Breda J, Skepastianos P, Hassapidou M, Kafatos A, Rodopaios N, Koulouri AA, Cappuccio FP. Sodium and Potassium Intake in Healthy Adults in Thessaloniki Greater Metropolitan Area-The Salt Intake in Northern Greece (SING) Study. Nutrients 2017; 9:E417. [PMID: 28441726 PMCID: PMC5409756 DOI: 10.3390/nu9040417] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/06/2017] [Accepted: 04/20/2017] [Indexed: 12/14/2022] Open
Abstract
A reduction in population sodium (as salt) consumption is a global health priority, as well as one of the most cost-effective strategies to reduce the burden of cardiovascular disease. High potassium intake is also recommended to reduce cardiovascular disease. To establish effective policies for setting targets and monitoring effectiveness within each country, the current level of consumption should be known. Greece lacks data on actual sodium and potassium intake. The aim of the present study was therefore to assess dietary salt (using sodium as biomarker) and potassium intakes in a sample of healthy adults in northern Greece, and to determine whether adherence to a Mediterranean diet is related to different sodium intakes or sodium-to-potassium ratio. A cross-sectional survey was carried out in the Thessaloniki greater metropolitan area (northern Greece) (n = 252, aged 18-75 years, 45.2% males). Participants' dietary sodium and potassium intakes were determined by 24-hour urinary sodium and potassium excretions. In addition, we estimated their adherence to Mediterranean diet by the use of an 11-item MedDietScore (range 0-55). The mean sodium excretion was 175 (SD 72) mmol/day, equivalent to 4220 (1745) mg of sodium or 10.7 (4.4) g of salt per day, and the potassium excretion was 65 (25) mmol/day, equivalent to 3303 (1247) mg per day. Men had higher sodium and potassium excretions compared to women. Only 5.6% of the sample had salt intake <5 g/day, which is the target intake recommended by the World Health Organization. Mean sodium-to-potassium excretion ratio was 2.82 (1.07). There was no significant difference in salt or potassium intake or their ratio across MedDietScore quartiles. No significant relationships were found between salt intake and adherence to a Mediterranean diet, suggesting that the perception of the health benefits of the Mediterranean diet does not hold when referring to salt consumption. These results suggest the need for a larger, nation-wide survey on salt intake in Greece and underline the importance of continuation of salt reduction initiatives in Greece.
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Affiliation(s)
- Eleni Vasara
- Laboratory of Animal Physiology, Department of Zoology, School of Biology, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece.
| | - Georgios Marakis
- Nutrition Policy and Research Directorate, Hellenic Food Authority, 124 Kifisias Av. & 2 Iatridou Str., Athens 11526, Greece.
| | - Joao Breda
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, WHO Regional Office for Europe, Copenhagen DK-2100, Denmark.
| | - Petros Skepastianos
- Department of Medical Laboratory Studies, Alexander Technological and Educational Institute of Thessaloniki, Sindos, Thessaloniki 57400, Greece.
| | - Maria Hassapidou
- Department of Nutrition and Dietetics, Alexander Technological and Educational Institute of Thessaloniki, Sindos, Thessaloniki 57400, Greece.
| | - Anthony Kafatos
- Department of Social Medicine, Preventive Medicine and Nutrition Clinic, Medical School, University of Crete, Heraklion 71003, Crete, Greece.
| | - Nikolaos Rodopaios
- Department of Social Medicine, Preventive Medicine and Nutrition Clinic, Medical School, University of Crete, Heraklion 71003, Crete, Greece.
| | - Alexandra A Koulouri
- Department of Social Medicine, Preventive Medicine and Nutrition Clinic, Medical School, University of Crete, Heraklion 71003, Crete, Greece.
| | - Francesco P Cappuccio
- Division of Health Sciences (Mental Health & Wellbeing), Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, CV2 2DX, UK.
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Christou GA, Kiortsis DN. The effects of body weight status on orthostatic intolerance and predisposition to noncardiac syncope. Obes Rev 2017; 18:370-379. [PMID: 28112481 DOI: 10.1111/obr.12501] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/07/2016] [Accepted: 11/24/2016] [Indexed: 12/16/2022]
Abstract
Orthostatic intolerance (OI) is frequently the mechanism underlying the occurrence of noncardiac syncope (NCS) and is associated with substantial risk for injury. Body weight status appears to be a modifier of orthostatic responses and possibly influences the propensity to NCS. The majority of cross-sectional studies have found that the lower the body mass index (BMI) the greater the predisposition to OI is, accompanied with both down-regulation of sympathetic nervous system activity and up-regulation of parasympathetic nervous system activity. These changes appear to occur across the whole spectrum of BMI values from underweight to obesity, while they may be associated more strongly with central body fat than total body fat. Weight loss following bariatric surgery has been consistently found to increase OI, attributed first to the effects of weight loss per se, second to the specific type of surgical procedure and third to the potential postoperative autonomic neuropathy due to vitamin deficiency. The increased OI following bariatric surgery renders this intervention not easily tolerable for the affected individuals, mandating increased fluid and salt intake, pharmacological measures or surgical adjustments to attenuate OI. All future studies investigating orthostatic responses and NCS should implement a matching of the population arms for BMI and ideally for body fat.
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Affiliation(s)
- G A Christou
- Laboratory of Physiology, Medical School, University of Ioannina, Ioannina, Greece
| | - D N Kiortsis
- Laboratory of Physiology, Medical School, University of Ioannina, Ioannina, Greece
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44
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The effect of potassium supplementation on blood pressure in hypertensive subjects: A systematic review and meta-analysis. Int J Cardiol 2017; 230:127-135. [DOI: 10.1016/j.ijcard.2016.12.048] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 11/24/2016] [Accepted: 12/16/2016] [Indexed: 12/25/2022]
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Aparicio A, Rodríguez-Rodríguez E, Cuadrado-Soto E, Navia B, López-Sobaler AM, Ortega RM. Estimation of salt intake assessed by urinary excretion of sodium over 24 h in Spanish subjects aged 7-11 years. Eur J Nutr 2017; 56:171-178. [PMID: 26482149 PMCID: PMC5290043 DOI: 10.1007/s00394-015-1067-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 09/30/2015] [Indexed: 11/01/2022]
Abstract
PURPOSE High intake of salt is associated with early development of cardiovascular risk factors (e.g., hypertension, obesity). In "developed" countries, individuals frequently exceed dietary recommendations for salt intake. Taking into account the limited data on sodium intake by 24-h excretion in urine in schoolchildren, we wished to determine baseline salt intake in Spanish subjects aged 7-11 years. METHODS The present study was an observational study involving 205 schoolchildren (109 boys and 96 girls) selected from various Spanish provinces. Sodium intake was ascertained by measuring sodium excretion in urine over 24 h. Creatinine was used to validate completeness of urine collections. The correlation between fat-free mass determined by anthropometry and that determined via urinary excretion of creatinine was calculated (r = 0.651; p < 0.001). RESULTS Mean 24-h urinary excretion of sodium was 132.7 ± 51.4 mmol/24 h (salt equivalent: 7.8 ± 3.1 g/day). Hence, 84.5 % of subjects aged ≤10 years had intakes of >4 g salt/day, and 66.7 % of those aged >10 years had intakes of >5 g salt/day. Urinary excretion of sodium was correlated with systolic blood pressure and diastolic blood pressure (r = 0.1574 and r = 0.1400, respectively). Logistic regression analyses, adjusted by sex, showed that a high body mass index (odds ratio = 1.159; 95 % CI 1.041-1.290; p < 0.05) was associated with an increased likelihood of high urinary excretion of sodium. CONCLUSIONS Sodium intake, as estimated by 24-h urinary excretion, was (on average) higher than recommended. Reducing the sodium content children's diet is a sound policy to reduce cardiovascular risk.
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Affiliation(s)
- A Aparicio
- Departamento de Nutrición Y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain.
- UCM Research Group: VALORNUT-920030, Madrid, Spain.
| | - E Rodríguez-Rodríguez
- Sección Departamental de Química Analítica, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
- UCM Research Group: VALORNUT-920030, Madrid, Spain
| | - E Cuadrado-Soto
- Departamento de Nutrición Y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
- UCM Research Group: VALORNUT-920030, Madrid, Spain
| | - B Navia
- Departamento de Nutrición Y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
- UCM Research Group: VALORNUT-920030, Madrid, Spain
| | - A M López-Sobaler
- Departamento de Nutrición Y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
- UCM Research Group: VALORNUT-920030, Madrid, Spain
| | - R M Ortega
- Departamento de Nutrición Y Bromatología I (Nutrición), Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
- UCM Research Group: VALORNUT-920030, Madrid, Spain
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46
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Webster J, Su'a SAF, Ieremia M, Bompoint S, Johnson C, Faeamani G, Vaiaso M, Snowdon W, Land MA, Trieu K, Viali S, Moodie M, Bell C, Neal B, Woodward M. Salt Intakes, Knowledge, and Behavior in Samoa: Monitoring Salt-Consumption Patterns Through the World Health Organization's Surveillance of Noncommunicable Disease Risk Factors (STEPS). J Clin Hypertens (Greenwich) 2016; 18:884-91. [PMID: 26843490 PMCID: PMC5067650 DOI: 10.1111/jch.12778] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 11/16/2015] [Accepted: 11/18/2015] [Indexed: 11/26/2022]
Abstract
This project measured population salt intake in Samoa by integrating urinary sodium analysis into the World Health Organization's (WHO's) STEPwise approach to surveillance of noncommunicable disease risk factors (STEPS). A subsample of the Samoan Ministry of Health's 2013 STEPS Survey collected 24‐hour and spot urine samples and completed questions on salt‐related behaviors. Complete urine samples were available for 293 participants. Overall, weighted mean population 24‐hour urine excretion of salt was 7.09 g (standard error 0.19) to 7.63 g (standard error 0.27) for men and 6.39 g (standard error 0.14) for women (P=.0014). Salt intake increased with body mass index (P=.0004), and people who added salt at the table had 1.5 g higher salt intakes than those who did not add salt (P=.0422). A total of 70% of the population had urinary excretion values above the 5 g/d cutoff recommended by the WHO. A reduction of 30% (2 g) would reduce average population salt intake to 5 g/d, in line with WHO recommendations. While challenging, integration of salt monitoring into STEPS provides clear logistical and cost benefits and the lessons communicated here can help inform future programs.
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Affiliation(s)
- Jacqui Webster
- The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia.
| | | | | | - Severine Bompoint
- The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia
| | - Claire Johnson
- The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia
| | | | | | - Wendy Snowdon
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Mary-Anne Land
- The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia
| | - Kathy Trieu
- The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia
| | - Satu Viali
- Medical Specialist Clinic and Ministry of Health, Apia, Samoa
| | - Marj Moodie
- Deakin Health Economics, Faculty of Health, Deakin University, VIC, Australia
| | - Colin Bell
- School of Medicine, Deakin University, Melbourne, VIC, Australia
| | - Bruce Neal
- The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia
| | - Mark Woodward
- The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia.,The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK.,Department of Epidemiology, Johns Hopkins University, Baltimore, MD
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Martínez-Tomé M, Murcia MA, Mariscal M, Lorenzo ML, Gómez-Murcia V, Bibiloni M, Jiménez-Monreal AM. Evaluation of antioxidant activity and nutritional composition of flavoured dehydrated soups packaged in different formats. Reducing the sodium content. JOURNAL OF FOOD SCIENCE AND TECHNOLOGY 2015; 52:7850-60. [PMID: 26604357 PMCID: PMC4648876 DOI: 10.1007/s13197-015-1940-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 06/11/2015] [Accepted: 07/02/2015] [Indexed: 11/26/2022]
Abstract
The antioxidant activity and nutritional composition of four dehydrated soups (vegetables, meat, chicken and fish) packaged in four formats - carton, plastic, and aluminium bags (the last with and without modified atmosphere) - were evaluated during 12 months' storage. The results showed that all four soups had a good or very good antioxidant capacity as tested by the lipid peroxidation, deoxyribose, and Trolox equivalent antioxidant capacity (TEAC) tests. Of interest from a nutritional point of view was the finding that the lipid fraction of all the soups was below 1 %. The sodium content of the four soups and their ingredients was also analysed. By modifying some of the ingredients, a 25 % reduction in the sodium content of the soups was obtained, permitting them to be labelled as "sodium reduced". The monosodium glutamate (MSG) content of the reformulated soups (lower sodium content) was below levels permitted by European legislation.
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Affiliation(s)
- Magdalena Martínez-Tomé
- />Department of Nutrition and Food Science, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
- />CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- />Department of Food Science Faculty of Veterinary, University of Murcia, Campus of Espinardo, 30100 Murcia, Spain
| | - M. Antonia Murcia
- />Department of Nutrition and Food Science, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
- />CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Miguel Mariscal
- />Department of Nutrition and Food Science, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
| | - Mª Luisa Lorenzo
- />Department of Nutrition and Food Science, Cartuja Campus, University of Granada, Granada, Spain
| | - V. Gómez-Murcia
- />Department of Nutrition and Food Science, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
| | - Mar Bibiloni
- />CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- />Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, E-07122 Palma de Mallorca, Spain
| | - Antonia Mª Jiménez-Monreal
- />Department of Nutrition and Food Science, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Murcia, Spain
- />CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Chen X, Guo X, Ma J, Zhang J, Tang J, Yan L, Xu C, Zhang X, Ren J, Lu Z, Zhang G, Dong J, Xu A. RETRACTED: Urinary sodium or potassium excretion and blood pressure in adults of Shandong province, China: preliminary results of the SMASH project. ACTA ACUST UNITED AC 2015; 9:754-762. [DOI: 10.1016/j.jash.2015.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/12/2015] [Accepted: 07/17/2015] [Indexed: 11/26/2022]
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Rodrigues SL, Souza Júnior PR, Pimentel EB, Baldo MP, Malta DC, Mill JG, Szwarcwald CL. Relationship between salt consumption measured by 24-h urine collection and blood pressure in the adult population of Vitória (Brazil). ACTA ACUST UNITED AC 2015; 48:728-35. [PMID: 26132095 PMCID: PMC4541693 DOI: 10.1590/1414-431x20154455] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 04/06/2015] [Indexed: 11/22/2022]
Abstract
High salt intake is related to an increase in blood pressure and development of hypertension. However, currently, there are no national representative data in Brazil using the gold standard method of 24-h urine collection to measure sodium consumption. This study aimed to determine salt intake based on 24-h urine collection in a sample of 272 adults of both genders and to correlate it with blood pressure levels. We used a rigorous protocol to assure an empty bladder prior to initiating urine collection. We excluded subjects with a urine volume <500 mL, collection period outside of an interval of 23-25 h, and subjects with creatinine excretion that was not within the range of 14.4-33.6 mg/kg (men) and 10.8-25.2 mg/kg (women). The mean salt intake was 10.4±4.1 g/day (d), and 94% of the participants (98% of men and 90% of women) ingested more than the recommended level of 5 g/d. We found a positive association between salt and body mass index (BMI) categories, as well as with salt and blood pressure, independent of age and BMI. The difference in systolic blood pressure reached 13 mmHg between subjects consuming less than 6 g/d of salt and those ingesting more than 18 g/d. Subjects with hypertension had a higher estimated salt intake than normotensive subjects (11.4±5.0 vs 9.8±3.6 g/d, P<0.01), regardless of whether they were under treatment. Our data indicate the need for interventions to reduce sodium intake, as well the need for ongoing, appropriate monitoring of salt consumption in the general population.
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Affiliation(s)
- S L Rodrigues
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - P R Souza Júnior
- Centro de Informação Científica e Tecnológica, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - E B Pimentel
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - M P Baldo
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - D C Malta
- Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde, Ministério da Saúde, Brasília, DF, Brasil
| | - J G Mill
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - C L Szwarcwald
- Centro de Informação Científica e Tecnológica, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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50
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Rhee MY. High sodium intake: review of recent issues on its association with cardiovascular events and measurement methods. Korean Circ J 2015; 45:175-83. [PMID: 26023304 PMCID: PMC4446810 DOI: 10.4070/kcj.2015.45.3.175] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 12/17/2014] [Accepted: 12/22/2014] [Indexed: 11/11/2022] Open
Abstract
There has been a long-known association between high dietary sodium intake and hypertension, as well as the increased risk of cardiovascular disease. Reduction of sodium intake is a major challenge for public health. Recently, there have been several controversial large population-based studies regarding the current recommendation for dietary sodium intake. Although these studies were performed in a large population, they aroused controversies because they had a flaw in the study design and methods. In addition, knowledge of the advantages and disadvantages of the methods is essential in order to obtain an accurate estimation of sodium intake. I have reviewed the current literatures on the association between sodium intake and cardiovascular events, as well as the methods for the estimation of sodium intake.
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Affiliation(s)
- Moo-Yong Rhee
- Cardiovascular Center, Clinical Trial Center, Dongguk University Ilsan Hospital, Goyang, Korea
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