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Validation of salt intake measurements: comparisons of a food record checklist and spot-urine collection to 24-hour-urine collection. Public Health Nutr 2022; 25:2983-2994. [PMID: 35850716 PMCID: PMC7613718 DOI: 10.1017/s1368980022001537] [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] [Indexed: 11/08/2022]
Abstract
Objective Monitoring population salt intake is operationally and economically challenging. We explored whether a questionnaire assessment and a prediction of Na intake from spot-urine could replace or complement the recommended measurement of Na in 24-h urine (24-h U). Design Compare the agreement of a Na-specific food record checklist (FRCL) and a late-afternoon spot-urine measurement (PM-spot) with 24-h U measurement in estimating Na intake at group level. Each participant’s use of these methods extended over 3 d. Agreement was assessed using mean (95 % CI) differences, linear regression models and Bland−Altman plots. Setting The validation study was part of a 1-year workplace intervention trial to lower salt intake in Switzerland. Participants Seventy women and 71 men, aged 21−61 years, completed three FRCL, and acceptable PM-spot and 24-h U samples at baseline (April−October 2015). Results Mean Na intake estimates varied slightly across methods (3·5-3·9 g/d). Mean Na intake differences from 24-h U were 0·2 (95% CI (0, 0·5)) g/d for FRCL and 0·4 (95 % CI (0·2, 0·6)) g/d for PM-spot. Linear regression models and Bland-Altmann plots more clearly depicted differences by sex and discretionary salt use. Conclusions Although 24-h U remains the best reference method for monitoring Na intake at the population level, PM-spot and FRCL might be more practical instruments for frequent, periodic Na intake assessments. Population-specific prediction models to estimate 24-h U could be developed and evaluated.
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Farapti F, Buanasita A, Atmaka DR, Setyaningtyas SW, Adriani M, Rejeki PS, Yamaoka Y, Miftahussurur M. Potassium intake is associated with nutritional quality and actual diet cost: a study at formulating a low sodium high potassium (LSHP) healthy diet. J Nutr Sci 2022; 11:e11. [PMID: 35291270 PMCID: PMC8889219 DOI: 10.1017/jns.2021.104] [Citation(s) in RCA: 6] [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: 02/06/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/24/2022] Open
Abstract
Increasing potassium and reducing sodium intake have been identified as a priority intervention to reduce non-communicable diseases. A low sodium high potassium (LSHP) healthy diet can be a predictor of overall dietary quality and is associated with higher diet costs. The present study was a randomised controlled-feeding trial, formulating menus of low sodium and potassium-rich healthy diet and comparing with usual diet (a control diet based on typical Indonesian diet) to assess the association of potassium intake in the menus with other nutritional contents and diet cost. Totally seventy menus, which consisted of LSHP diets and the usual diets for a 7-d cycle, were composed from the analysis of the Indonesian food composition database. The correlation coefficient of the potassium content of all menus with nutritional quality and diet cost was analysed using the Pearson test. Multiple linear regression analysis was performed to determine the most important nutrient in determining diet cost. A comparison of nutrition quality and diet cost from the two menus was analysed using the independent t-test. LSHP diet had significantly higher carbohydrate, protein, fibre, magnesium, calcium, vitamin C, potassium density and diet cost but lower total fat, saturated fat and energy density than the usual diet (P < 0⋅05). Furthermore, there was a strong positive correlation between fibre, potassium and diet cost (coefficient correlation of >0⋅8). Potassium is a nutrient that is closely related to diet quality although the cost of the diet often may inhibit its intake. A targeted and effective strategy is required to provide affordable food for achieving a sustainable nutrient-rich diet.
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Affiliation(s)
- Farapti Farapti
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya60115, Indonesia
- Post Graduate Doctoral Program, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Annas Buanasita
- Nutrition Department, Surabaya Health Polytechnic, Surabaya60282, Indonesia
| | - Dominikus R. Atmaka
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya60115, Indonesia
| | | | - Merryana Adriani
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya60115, Indonesia
| | - Purwo S. Rejeki
- Department of Physiology, Faculty of Medicine, Universitas Airlangga, Surabaya60132, Indonesia
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu879-5593, Japan
- Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, USA
- Gastroentero-Hepatology Division, Department of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya60286, Indonesia
| | - Muhammad Miftahussurur
- Gastroentero-Hepatology Division, Department of Internal Medicine, Faculty of Medicine-Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya60286, Indonesia
- Institute of Tropical Disease, Universitas Airlangga, Surabaya60115, Indonesia
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Kang M, Shim JE, Kwon K, Song S. Contribution of foods to absolute nutrient intake and between-person variations of nutrient intake in Korean preschoolers. Nutr Res Pract 2019; 13:323-332. [PMID: 31388409 PMCID: PMC6669073 DOI: 10.4162/nrp.2019.13.4.323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/30/2019] [Accepted: 07/05/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES The aim of this study was to analyze specific foods influencing absolute nutrient intake and between-person variations of nutrient intake among Korean preschoolers. SUBJECTS/METHODS This study included 2,766 participants aged 1–5 years in the 2009–2013 Korea National Health and Nutrition Examination Surveys. Dietary data were obtained from a 24-h dietary recall method. Major food sources of absolute nutrient intake were evaluated based on percent contribution of each food. To assess the contribution of specific foods to between-person variations in nutrient intake, stepwise multiple regressions were performed and cumulative R2 was used. RESULTS White rice and milk were main food sources of energy, protein, carbohydrate, phosphorus, iron, potassium, thiamin, riboflavin, and niacin. The percentage of fat contributed by milk was 21.3% which was the highest, followed by pork, soybean oil, and egg. White rice accounted for 25% and 40% of total variability in total energy and carbohydrate intakes, respectively. About 39% of variation in calcium intake was explained by milk while 40% of variation in phosphorous intake was explained by cheese. The top 10 foods contributing to between-person variations in nutrient intakes were similar with food items that mainly contributed to absolute nutrient intakes. The number of foods explaining 90% of absolute amounts of nutrient intakes varied from 28 for vitamin A to 80 for iron. CONCLUSIONS This study identified specific foods that contributed to absolute nutrient intakes and between-person variations in nutrient intakes among Korean preschoolers. Our findings can be used to develop dietary assessment tools and establish food-based dietary guidelines for young children.
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Affiliation(s)
- Minji Kang
- Center for Gendered Innovations in Science and Technology Research (GISTeR), Korea Federation of Women's Science & Technology Associations, Seoul, 06130, Korea
| | - Jae Eun Shim
- Department of Food and Nutrition, Daejeon University, Daejeon, 34520, Korea.,Daejeon Dong-gu Center for Children's Food Service Management, Daejeon, 34520, Korea.,Nutrition Counseling Center, Daejeon University, Daejeon, 34520, Korea
| | - Kyungmin Kwon
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, 08826, Korea
| | - SuJin Song
- Department of Food and Nutrition, Hannam University, 1646 Yuseong-daero, Yuseong-gu, Daejeon, 34054, Korea
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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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Dietary ratio of animal:plant protein is associated with 24-h urinary iodine excretion in healthy school children. Br J Nutr 2015; 114:24-33. [PMID: 26059089 DOI: 10.1017/s0007114515001567] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED Adequate dietary iodine intake in children is essential for optimal physical and neurological development. Whether lower dietary animal food and salt intake may adversely affect iodine status is under discussion. We examined the association between dietary animal:plant protein ratio with 24-h urinary iodine excretion (24-h UI, μg/d), and whether this is modified by salt intake. A 24-h UI was measured in 1959 24-h urine samples from 516 6- to 12-year-old participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study. Parallel 3 d weighed food records were used to estimate dietary intakes. Protein sources were classified as dairy, animal and plant. A repeated-measures regression model (PROC MIXED) was used to analyse the effect of animal:plant protein ratios on 24-h UI. ANIMAL plant protein ratios ranged from 0.5 (95 % CI 0.4, 0.6) to 1.6 (95 % CI 1.4, 1.9) (lowest and highest quartile). After adjustment for total energy intake, main dietary iodine sources (dairy and salt intake), and further covariates, the inter-individual variation in animal:plant protein ratio was significantly associated with variation in 24-h UI. One unit higher animal:plant protein ratio predicted 6 μg/d higher 24-h UI (P= 0.002) in boys and 5 μg/d (P= 0.03) in girls. This relationship was partially mediated by a higher salt intake at higher animal:plant protein ratios. These results suggest that lower consumption of animal protein is associated with a small decline in iodine excretion, partially mediated by decreased salt intake. Because limited salt and increased intake of plant-based foods are part of a preferable healthy food pattern, effective nutrition political strategies will be required in the future to ensure appropriate iodine nutrition in adherent populations.
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Hashem KM, He FJ, Jenner KH, MacGregor GA. Cross-sectional survey of salt content in cheese: a major contributor to salt intake in the UK. BMJ Open 2014; 4:e005051. [PMID: 25099933 PMCID: PMC4139634 DOI: 10.1136/bmjopen-2014-005051] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 05/29/2014] [Accepted: 06/06/2014] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To investigate the salt (sodium chloride) content in cheese sold in UK supermarkets. STUDY DESIGN We carried out a cross-sectional survey in 2012, including 612 cheeses available in UK supermarkets. METHODS The salt content (g/100 g) was collected from product packaging and nutrient information panels of cheeses available in the top seven retailers. RESULTS Salt content in cheese was high with a mean (±SD) of 1.7±0.58 g/100 g. There was a large variation in salt content between different types of cheeses and within the same type of cheese. On average, halloumi (2.71±0.34 g/100 g) and imported blue cheese (2.71±0.83 g/100 g) contained the highest amounts of salt and cottage cheese (0.55±0.14 g/100 g) contained the lowest amount of salt. Overall, among the 394 cheeses that had salt reduction targets, 84.5% have already met their respective Department of Health 2012 salt targets. Cheddar and cheddar-style cheese is the most popular/biggest selling cheese in the UK and has the highest number of products in the analysis (N=250). On average, salt level was higher in branded compared with supermarket own brand cheddar and cheddar-style products (1.78±0.13 vs 1.72±0.14 g/100 g, p<0.01). Ninety per cent of supermarket own brand products met the 2012 target for cheddar and cheddar-style cheese compared with 73% of branded products (p=0.001). CONCLUSIONS Salt content in cheese in the UK is high. There is a wide variation in the salt content of different types of cheeses and even within the same type of cheese. Despite this, 84.5% of cheeses have already met their respective 2012 targets. These findings demonstrate that much larger reductions in the amount of salt added to cheese could be made and more challenging targets need to be set, so that the UK can continue to lead the world in salt reduction.
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Affiliation(s)
- Kawther M Hashem
- Centre for Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Feng J He
- Centre for Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Katharine H Jenner
- Centre for Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Graham A MacGregor
- Centre for Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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Felicio T, Esmerino E, Cruz A, Nogueira L, Raices R, Deliza R, Bolini H, Pollonio M. Cheese. What is its contribution to the sodium intake of Brazilians? Appetite 2013; 66:84-8. [DOI: 10.1016/j.appet.2013.03.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 03/04/2013] [Accepted: 03/05/2013] [Indexed: 01/03/2023]
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Huybrechts I, Börnhorst C, Pala V, Moreno LA, Barba G, Lissner L, Fraterman A, Veidebaum T, Hebestreit A, Sieri S, Ottevaere C, Tornaritis M, Molnár D, Ahrens W, De Henauw S. Evaluation of the Children's Eating Habits Questionnaire used in the IDEFICS study by relating urinary calcium and potassium to milk consumption frequencies among European children. Int J Obes (Lond) 2011; 35 Suppl 1:S69-78. [PMID: 21483425 DOI: 10.1038/ijo.2011.37] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Measuring dietary intake in children is notoriously difficult. Therefore, it is crucial to evaluate the performance of dietary intake assessment methods in children. Given the important contribution of milk consumption to calcium (Ca) and potassium (K) intakes, urinary calcium (UCa) and potassium (UK) excretions in spot urine samples could be used for estimating correlations with milk consumption frequencies. OBJECTIVE The aim of this study was to evaluate the assessment of milk consumption frequencies derived from the Food Frequency Questionnaire section of the Children's Eating Habits Questionnaire (CEHQ-FFQ) used in the IDEFICS (Identification and prevention of dietary- and lifestyle induced health effects in children and infants) study by comparing with UCa and UK excretions in spot urine samples. DESIGN This study was conducted as a setting-based community-oriented intervention study and results from the first cross-sectional survey have been included in the analysis. SUBJECTS A total of 10,309 children aged 2-10 years from eight European countries are included in this analysis. METHODS UCa and UK excretions were measured in morning spot urine samples. Calcium and potassium urine concentrations were standardised for urinary creatinine (Cr) excretion. Ratios of UCa/Cr and UK/Cr were used for multivariate regression analyses after logarithmic transformation to obtain normal distributions of data. Milk consumption frequencies were obtained from the CEHQ-FFQ. Multivariate regression analyses were used to investigate the effect of milk consumption frequencies on UCa and UK concentrations, adjusting for age, gender, study centre, soft drink consumption and frequency of main meals consumed at home. RESULTS A significant positive correlation was found between milk consumption frequencies and ratios of UK/Cr and a weaker but still significant positive correlation with ratios of UCa/Cr, when using crude or partial Spearman's correlations. Multivariate regression analyses showed that milk consumption frequencies were predictive of UCa/Cr and UK/Cr ratios, when adjusted for age, gender, study centre, soft drink consumption and frequency of main meals consumed at home. Mean ratios of UK/Cr for increasing milk consumption frequency tertiles showed a progressive increase in UK/Cr. Children consuming at least two milk servings per day had significantly higher mean UCa/Cr and UK/Cr ratios than children who did not. Large differences in correlations between milk consumption frequencies and ratios of UCa/Cr and UK/Cr were found between the different study centres. CONCLUSION Higher milk consumption frequencies resulted in a progressive increase in UK/Cr and UCa/Cr ratios, reflecting the higher Ca and K intakes that coincide with increasing milk consumption, which constitutes a major K and Ca source in children's diet.
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Affiliation(s)
- I Huybrechts
- Department of Public Health, Ghent University, Belgium.
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