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Chanpiwat P, Damrongsiri S. From Sea Water to Salt Crystals: An Onsite Investigation of Microplastics in a Conventional Sea Salt Farming System. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:300. [PMID: 38990399 DOI: 10.1007/s10653-024-02079-z] [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: 02/11/2024] [Accepted: 06/14/2024] [Indexed: 07/12/2024]
Abstract
This study investigated microplastic (MP) contamination in conventional sea salt farming systems. Various crude sea salt samples (n = 22) that were traditionally produced were collected from salt farms and local vendors. Salt water (n = 15), macroalgae (n = 6), and clay of pond floors (n = 6) were collected from ponds subjected to different production (stabilization, evaporation, and concentration and crystallization concentration) processes. All samples were analyzed for MP abundance and characteristics. The potential sources of MP contamination in the salt were also investigated. The mean abundance of MPs in the salt water and clay of pond floor increased progressively throughout the production process and reached its highest level in the concentration and crystallization ponds (7400 MP particles/m3 in salt water and 19,336 MP particles/m2 in the clay of the pond floor). A maximum of 26,500 MP particles/kg of macroalgal material indicated the potential sink of MPs on the surface of the algae. Approximately 34-2377 MP particles/kg salt were found in the crude sea salt samples. However, the mean abundance (378 MP particles/kg of salt) indicated nonsignificant impacts of different harvesting processes on MP contamination. Most MP size distributions, shapes and polymer types in the salts were similar to those found in the salt water, macroalgae and clay of the pond floor. Approximately 99% of the MPs were fragments that were suspected to be decomposed from larger plastic debris and plastic machinery and tools used at the salt farm. Similar patterns of polymer distribution, in which PP > PE > PET > PS, were found for all samples studied.
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Affiliation(s)
- Penradee Chanpiwat
- Environmental Research Institute, Chulalongkorn University, Phayathai, Pathumwan, Bangkok, 10330, Thailand
| | - Seelawut Damrongsiri
- Environmental Research Institute, Chulalongkorn University, Phayathai, Pathumwan, Bangkok, 10330, Thailand.
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2
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Zhou R, Chen F, Zhang L, Sun Y, Hu R, Yan J, Jiang H. Association between adding salt in food and dementia in European descent: A mendelian randomization study. Brain Behav 2024; 14:e3516. [PMID: 38702903 PMCID: PMC11069030 DOI: 10.1002/brb3.3516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/10/2024] [Accepted: 04/13/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND High salt intake has been proposed as a risk factor for dementia. However, causal relationship between salt intake and dementia remains uncertain. PURPOSE The aim of this study was to employ a mendelian randomization (MR) design to investigate the causal impact of salt intake on the risk of dementia. METHODS Genome-wide association study (GWAS) data of exposures and outcomes (any dementia, cognitive performance, different types of dementia, Alzheimer's disease [AD], and Parkinson's disease) were obtained from the IEU database. MR estimates were generated though inverse-variance weighted model. MR-Egger, weighted median, and MR-Pleiotropy Residual Sum and Outlier (MR-PRESSO) method also used in our study. Sensitivity analyses included Cochran's Q test, MR-Egger intercept, MR-PRESSO global test and outlier test, leave-one-out analysis, and funnel plot assessment. RESULTS Our MR analysis provided evidence of a causal association between high salt added to food and dementia (odds ratio [OR] = 1.73, 95% confidence interval [CI]: 1.21-2.49, and p = .003), dementia in AD (OR = 2.10, 95% CI: 1.15-3.83, and p = .015), and undefined dementia (OR = 2.61, 95% CI: 1.26-5.39, and p = .009). Higher salt added was also associated with increased risk of AD (OR = 1.80, 95% CI: 1.12-2.87, and p = .014) and lower cognitive performance (β = -.133, 95% CI: -.229 to -.038, and p = .006). CONCLUSION This study provides evidence suggesting that high salt intake is causally associated with an increased risk of developing dementia, including AD and undefined dementia, highlighting the potential importance of reducing salt consumption as a preventive measure.
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Affiliation(s)
- Ren Zhou
- Department of AnesthesiologyThe Ninth People's Hospital of ShanghaiJiao Tong University School of MedicineShanghaiP. R. China
| | - Fei Chen
- Department of AnesthesiologyThe Ninth People's Hospital of ShanghaiJiao Tong University School of MedicineShanghaiP. R. China
| | - Lei Zhang
- Department of AnesthesiologyThe Ninth People's Hospital of ShanghaiJiao Tong University School of MedicineShanghaiP. R. China
| | - Yu Sun
- Department of AnesthesiologyThe Ninth People's Hospital of ShanghaiJiao Tong University School of MedicineShanghaiP. R. China
| | - Rong Hu
- Department of AnesthesiologyThe Ninth People's Hospital of ShanghaiJiao Tong University School of MedicineShanghaiP. R. China
| | - Jia Yan
- Department of AnesthesiologyThe Ninth People's Hospital of ShanghaiJiao Tong University School of MedicineShanghaiP. R. China
| | - Hong Jiang
- Department of AnesthesiologyThe Ninth People's Hospital of ShanghaiJiao Tong University School of MedicineShanghaiP. R. China
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Holvik K, Abel MH, Holmen J, Krokstad S, Totland TH, Meyer HE. No change in 24-h sodium intake estimated from spot urine in Norwegian adults from 2006 to 2019: the population-based Trøndelag Health Study (HUNT). Public Health Nutr 2024; 27:e117. [PMID: 38602104 PMCID: PMC11036440 DOI: 10.1017/s136898002400082x] [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: 08/14/2023] [Revised: 03/06/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE Monitoring time trends in salt consumption is important for evaluating the impact of salt reduction initiatives on public health outcomes. There has so far not been available data to indicate if salt consumption in Norway has changed during the previous decade. We aimed to assess whether average 24-h salt intake estimated from spot urine samples in the adult population of mid-Norway changed from 2006-2008 to 2017-2019 and to describe variations by sex, age and educational level. DESIGN Repeated cross-sectional studies. SETTING The population-based Trøndelag Health Study (HUNT). PARTICIPANTS In each of two consecutive waves (HUNT3: 2006-2008 and HUNT4: 2017-2019), spot urine samples were collected from 500 men and women aged 25-64 years, in addition to 250 men and women aged 70-79 years in HUNT4. Based on spot urine concentrations of Na, K and creatinine and age, sex and BMI, we estimated 24-h Na intake using the International Cooperative Study on Salt and Blood Pressure (INTERSALT) equation for the Northern European region. RESULTS Mean (95 % CI) estimated 24-h salt intakes in men were 11·1 (95 % CI 10·8, 11·3) g in HUNT3 and 10·9 (95 % CI 10·6, 11·1) g in HUNT4, P = 0·25. Corresponding values in women were 7·7 (95 % CI 7·5, 7·9) g and 7·7 (95 % CI 7·5, 7·9) g, P = 0·88. Mean estimated salt intake in HUNT4 decreased with increasing age in women, but not in men, and it did not differ significantly across educational level in either sex. CONCLUSIONS Estimated 24-h salt intake in adult men and women in mid-Norway did not change from 2006-2008 to 2017-2019.
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Affiliation(s)
- Kristin Holvik
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
| | - Marianne Hope Abel
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
| | - Jostein Holmen
- HUNT Research Center, Department of Public Health and Nursing,
Norwegian University of Science and Technology (NTNU),
Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Center, Department of Public Health and Nursing,
Norwegian University of Science and Technology (NTNU),
Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust,
Levanger, Norway
| | - Torunn Holm Totland
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
| | - Haakon E Meyer
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health
and Society, University of Oslo, Oslo,
Norway
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Dauw J, Meekers E, Martens P, Deferm S, Dhont S, Marchal W, Mesotten L, Dupont M, Nijst P, Tang WHW, Janssens SP, Mullens W. Sodium loading in ambulatory patients with heart failure with reduced ejection fraction: Mechanistic insights into sodium handling. Eur J Heart Fail 2024. [PMID: 38247136 DOI: 10.1002/ejhf.3131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/17/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
AIMS Sodium restriction was not associated with improved outcomes in heart failure patients in recent trials. The skin might act as a sodium buffer, potentially explaining tolerance to fluctuations in sodium intake without volume overload, but this is insufficiently understood. Therefore, we studied the handling of an increased sodium load in patients with heart failure with reduced ejection fraction (HFrEF). METHODS AND RESULTS Twenty-one ambulatory, stable HFrEF patients and 10 healthy controls underwent a 2-week run-in phase, followed by a 4-week period of daily 1.2 g (51 mmol) sodium intake increment. Clinical, echocardiographic, 24-h urine collection, and bioelectrical impedance data were collected every 2 weeks. Blood volume, skin sodium content, and skin glycosaminoglycan content were assessed before and after sodium loading. Sodium loading did not significantly affect weight, blood pressure, congestion score, N-terminal pro-brain natriuretic peptide, echocardiographic indices of congestion, or total body water in HFrEF (all p > 0.09). There was no change in total blood volume (4748 ml vs. 4885 ml; p = 0.327). Natriuresis increased from 150 mmol/24 h to 173 mmol/24 h (p = 0.024), while plasma renin decreased from 286 to 88 μU/L (p = 0.002). There were no significant changes in skin sodium content, total glycosaminoglycan content, or sulfated glycosaminoglycan content (all p > 0.265). Healthy controls had no change in volume status, but a higher increase in natriuresis without any change in renin. CONCLUSIONS Selected HFrEF patients can tolerate sodium loading, with increased renal sodium excretion and decreased neurohormonal activation.
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Affiliation(s)
- Jeroen Dauw
- Ziekenhuis Oost-Limburg, Department of Cardiology, Genk, Belgium
- UHasselt - Hasselt University, Doctoral School for Medicine and Life Sciences, LCRC, Diepenbeek, Belgium
| | - Evelyne Meekers
- Ziekenhuis Oost-Limburg, Department of Cardiology, Genk, Belgium
- UHasselt - Hasselt University, Doctoral School for Medicine and Life Sciences, LCRC, Diepenbeek, Belgium
| | - Pieter Martens
- Ziekenhuis Oost-Limburg, Department of Cardiology, Genk, Belgium
| | - Sébastien Deferm
- Ziekenhuis Oost-Limburg, Department of Cardiology, Genk, Belgium
| | - Sebastiaan Dhont
- Ziekenhuis Oost-Limburg, Department of Cardiology, Genk, Belgium
- UHasselt - Hasselt University, Doctoral School for Medicine and Life Sciences, LCRC, Diepenbeek, Belgium
| | - Wouter Marchal
- UHasselt - Hasselt University, Institute for Materials Research (IMO-IMOMEC), Diepenbeek, Belgium
| | - Liesbeth Mesotten
- Ziekenhuis Oost-Limburg, Department of Nuclear Medicine, Genk, Belgium
| | - Matthias Dupont
- Ziekenhuis Oost-Limburg, Department of Cardiology, Genk, Belgium
| | - Petra Nijst
- Ziekenhuis Oost-Limburg, Department of Cardiology, Genk, Belgium
| | | | - Stefan P Janssens
- Department of Cardiovascular Diseases, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Wilfried Mullens
- Ziekenhuis Oost-Limburg, Department of Cardiology, Genk, Belgium
- Faculty of Medicine and Life Sciences, LCRC, UHasselt - Hasselt University, Biomedical Research Institute, Diepenbeek, Belgium
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Dewan SMR, Meem SS, Proma AY, Shahriar M. Dietary Salt Can Be Crucial for Food-Induced Vascular Inflammation. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2024; 17:2632010X241228039. [PMID: 38313416 PMCID: PMC10838034 DOI: 10.1177/2632010x241228039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/06/2024] [Indexed: 02/06/2024]
Abstract
Salt enhances the taste as well as the nutritional value of food. Besides, several reports are available on the incidence and epidemiology of various illnesses in relation to salt intake. Excessive salt consumption has been found to be linked with high blood pressure, renal disease, and other cardiovascular disorders due to the result of vascular inflammation. Nevertheless, studies aimed at elucidating the molecular processes that produce vascular inflammation have yet to reach their conclusions. This article emphasizes the significance of investigating the mechanisms underlying both acute and chronic vascular inflammation induced by salt. It also explores the logical inferences behind cellular oxidative stress and the role of endothelial dysfunction as the potential initiator of the inflammatory segments that remain poorly understood. It is therefore hypothesized that salt is one of the causes of chronic vascular inflammation such as atherosclerosis. The hypothesis's secrets, when revealed, can help assure cardiovascular health by proactive efforts and the development of appropriate preventative measures, in combination with medication, dietary and lifestyle adjustments.
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Affiliation(s)
| | - Sara Shahid Meem
- Department of Pharmacy, School of Medicine, University of Asia Pacific, Dhaka, Bangladesh
| | - Amrin Yeasin Proma
- Department of Pharmacy, School of Medicine, University of Asia Pacific, Dhaka, Bangladesh
| | - Mohammad Shahriar
- Department of Pharmacy, School of Medicine, University of Asia Pacific, Dhaka, Bangladesh
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Mueller K, Messner A, Nairz J, Winder B, Staudt A, Stock K, Gande N, Hochmayr C, Bernar B, Pechlaner R, Griesmacher A, Egger AE, Geiger R, Kiechl-Kohlendorfer U, Knoflach M, Kiechl SJ. Determinants of Diet Quality in Adolescents: Results from the Prospective Population-Based EVA-Tyrol and EVA4YOU Cohorts. Nutrients 2023; 15:5140. [PMID: 38140399 PMCID: PMC10746085 DOI: 10.3390/nu15245140] [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: 11/23/2023] [Revised: 12/09/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Unhealthy dietary behaviors are estimated to be one of the leading causes of death globally and are often shaped at a young age. Here, we investigated adolescent diet quality and its predictors, including nutrition knowledge, in two large Central European cohorts. (2) Methods: In 3056 participants of the EVA-Tyrol and EVA4YOU prospective population-based cohort studies aged 14 to 19 years, diet quality was assessed using the AHEI-2010 and DASH scores, and nutrition knowledge was assessed using the questionnaire from Turconi et al. Associations were examined utilizing multivariable linear regression. (3) Results: The mean overall AHEI-2010 score was 42%, and the DASH score was 45%. Female participants (60.6%) had a significantly higher diet quality according to the AHEI-2010 and DASH score. AHEI-2010 and DASH scores were significantly associated (p < 0.001) with sex, school type, smoking, and total daily energy intake. The DASH score was additionally significantly associated (p < 0.001) with age, socioeconomic status, and physical activity. Participants with better nutrition knowledge were more likely to be older, to attend a general high school, to live in a high-income household, to be non-smokers, and to have a higher diet quality according to the AHEI-2010 and DASH score. (4) Conclusions: Predictors of better diet quality included female sex, physical activity, educational level, and nutrition knowledge. These results may aid focused interventions to improve diet quality in adolescents.
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Affiliation(s)
- Katharina Mueller
- VASCage, Centre on Clinical Stroke Research, Adamgasse 23, 6020 Innsbruck, Austria;
- Department of Paediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (A.M.); (A.S.); (K.S.); (N.G.); (C.H.); (U.K.-K.)
| | - Alex Messner
- Department of Paediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (A.M.); (A.S.); (K.S.); (N.G.); (C.H.); (U.K.-K.)
| | - Johannes Nairz
- Department of Paediatrics III, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.N.); (R.G.)
| | - Bernhard Winder
- Department of Vascular Surgery, Feldkirch Hospital, Carinagasse 41, 6800 Feldkirch, Austria;
| | - Anna Staudt
- Department of Paediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (A.M.); (A.S.); (K.S.); (N.G.); (C.H.); (U.K.-K.)
| | - Katharina Stock
- Department of Paediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (A.M.); (A.S.); (K.S.); (N.G.); (C.H.); (U.K.-K.)
| | - Nina Gande
- Department of Paediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (A.M.); (A.S.); (K.S.); (N.G.); (C.H.); (U.K.-K.)
| | - Christoph Hochmayr
- Department of Paediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (A.M.); (A.S.); (K.S.); (N.G.); (C.H.); (U.K.-K.)
| | - Benoît Bernar
- Department of Paediatrics I, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria;
| | - Raimund Pechlaner
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria;
| | - Andrea Griesmacher
- The Central Institute of Clinical Chemistry and Laboratory Medicine (ZIMCL), Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria;
| | - Alexander E. Egger
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria;
| | - Ralf Geiger
- Department of Paediatrics III, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (J.N.); (R.G.)
| | - Ursula Kiechl-Kohlendorfer
- Department of Paediatrics II, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria; (A.M.); (A.S.); (K.S.); (N.G.); (C.H.); (U.K.-K.)
| | - Michael Knoflach
- VASCage, Centre on Clinical Stroke Research, Adamgasse 23, 6020 Innsbruck, Austria;
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria;
| | - Sophia J. Kiechl
- VASCage, Centre on Clinical Stroke Research, Adamgasse 23, 6020 Innsbruck, Austria;
- Department of Neurology Hochzirl Hospital, Hochzirl 1, 6170 Zirl, Austria
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Kumar R, Marrapu S. Dietary salt in liver cirrhosis: With a pinch of salt! World J Hepatol 2023; 15:1084-1090. [PMID: 37970619 PMCID: PMC10642432 DOI: 10.4254/wjh.v15.i10.1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/21/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023] Open
Abstract
Patients with liver cirrhosis are advised to limit their sodium consumption to control excessive fluid accumulation. Salt is the most common form in which sodium is consumed daily. Consequently, various recommendations urge patients to limit salt intake. However, there is a lack of consistency regarding salt restriction across the guidelines. Moreover, there is conflicting evidence regarding the efficacy of salt restriction in the treatment of ascites. Numerous studies have shown that there is no difference in ascites control between patients with restriction of salt intake and those without restriction. Moreover, patients with cirrhosis may have several negative effects from consuming too little salt, although there are no recommendations on the lower limit of salt intake. Sodium is necessary to maintain the extracellular fluid volume; hence, excessive salt restriction can result in volume contraction, which could negatively impact kidney function in a cirrhotic patient. Salt restriction in cirrhotic patients can also compromise nutrient intake, which can have a negative impact on the overall outcome. There is insufficient evidence to recommend restricted salt intake for all patients with cirrhosis, including those with severe hyponatremia. The existing guidelines on salt restriction do not consider the salt sensitivity of patients; their nutritional state, volume status and sodium storage sites; and the risk of hypochloremia. This opinion article aims to critically analyze the existing literature with regard to salt recommendations for patients with liver cirrhosis and identify potential knowledge gaps that call for further research.
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Affiliation(s)
- Ramesh Kumar
- Department of Gastroenterology, All India Institute of Medical Sciences, Patna 801507, India.
| | - Sudheer Marrapu
- Department of Gastroenterology, All India Institute of Medical Sciences, Patna 801507, India
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Afroza U, Abrar AK, Nowar A, Akhtar J, Mamun MAA, Sobhan SMM, Cobb L, Ide N, Choudhury SR. Salt Intake Estimation from Urine Samples in South Asian Population: Scoping Review. Nutrients 2023; 15:4358. [PMID: 37892433 PMCID: PMC10609745 DOI: 10.3390/nu15204358] [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: 08/26/2023] [Revised: 10/01/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
The World Health Organization recommended reducing one's salt intake below 5 g/day to prevent disability and death from cardiovascular and other chronic diseases. This review aimed to identify salt estimation at the population level in South Asian countries, namely Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka. We searched electronic databases and government websites for the literature and reports published between January 2011 and October 2021 and also consulted key informants for unpublished reports. We included studies that assessed salt intake from urinary sodium excretion, either spot urine or a 24 h urine sample, on a minimum of 100 samples in South Asian countries. We included 12 studies meeting the criteria after screening 2043 studies, out of which five followed nationally representative methods. This review revealed that salt intake in South Asian countries ranges from 6.7-13.3 g/day. The reported lowest level of salt intake was in Bangladesh and India, and the highest one was in Nepal. The estimated salt intake reported in the nationally representative studies were ranging from 8 g/day (in India) to 12.1 g/day (in Afghanistan). Salt consumption in men (8.9-12.5 g/day) was reported higher than in women (7.1-12.5 g/day). Despite the global target of population salt intake reduction, people in South Asian countries consume a much higher amount of salt than the WHO-recommended level.
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Affiliation(s)
- Ummay Afroza
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (A.K.A.); (A.N.); (J.A.); (M.A.A.M.); (S.M.M.S.); (S.R.C.)
| | - Ahmad Khairul Abrar
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (A.K.A.); (A.N.); (J.A.); (M.A.A.M.); (S.M.M.S.); (S.R.C.)
| | - Abira Nowar
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (A.K.A.); (A.N.); (J.A.); (M.A.A.M.); (S.M.M.S.); (S.R.C.)
| | - Jubaida Akhtar
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (A.K.A.); (A.N.); (J.A.); (M.A.A.M.); (S.M.M.S.); (S.R.C.)
| | - Mohammad Abdullah Al Mamun
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (A.K.A.); (A.N.); (J.A.); (M.A.A.M.); (S.M.M.S.); (S.R.C.)
| | - Sheikh Mohammad Mahbubus Sobhan
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (A.K.A.); (A.N.); (J.A.); (M.A.A.M.); (S.M.M.S.); (S.R.C.)
| | - Laura Cobb
- Resolve To Save Lives (RTSL), New York, NY 10004, USA; (L.C.); (N.I.)
| | - Nicole Ide
- Resolve To Save Lives (RTSL), New York, NY 10004, USA; (L.C.); (N.I.)
| | - Sohel Reza Choudhury
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka 1216, Bangladesh; (A.K.A.); (A.N.); (J.A.); (M.A.A.M.); (S.M.M.S.); (S.R.C.)
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9
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Krušič S, Hristov H, Hribar M, Lavriša Ž, Žmitek K, Pravst I. Changes in the Sodium Content in Branded Foods in the Slovenian Food Supply (2011-2020). Nutrients 2023; 15:4304. [PMID: 37836588 PMCID: PMC10574098 DOI: 10.3390/nu15194304] [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: 08/04/2023] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
High sodium intake is the leading diet-related risk factor for mortality globally. Many countries have introduced policies to support the reformulation of foods and to reduce sodium intake, mainly on a voluntary basis, but there are limited data available about the long-term efficiency of such measures. Slovenia implemented salt reduction policies for the period of 2010-2020; these policies also included the voluntary reformulation of foods with the lowering of sodium content. This study's aim was to explore the nationally representative branded food datasets collected in the years 2011, 2015, 2017, and 2020 to investigate the changes in the sodium content in prepacked branded foods. The study was conducted with datasets collected from food labels using standard food monitoring studies and included all the major retailers. Differences in market shares were adjusted by sales weighting, which was conducted using the yearly sales data provided by the major retailers. The food categories with a major contribution to the overall sales of sodium in prepacked branded foods were processed meat and derivatives (19.0%), canned vegetables (7.1%), water (6.7%), bread (7.2%), and cheese (6.3%). Considering the available food products, a notable decreasing sodium content trend was observed in biscuits, breakfast cereals, pizza, and spreads. Year-to-year differences were much less expressed after the correction for market share differences, and neutral trends were most frequently highlighted. This indicates that sodium was less frequently reduced in market-leading products. The study results revealed that very limited progress in sodium food reformulation was achieved in the 10-year period, indicating the need for more efficient policy approaches. The study demonstrated the importance of the systematic monitoring of the food supply for the evaluation of food policies.
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Affiliation(s)
- Sanja Krušič
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
| | - Hristo Hristov
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
| | - Maša Hribar
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
| | - Živa Lavriša
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
| | - Katja Žmitek
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
- VIST–Faculty of Applied Sciences, Gerbičeva Cesta 51A, SI-1000 Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition Institute, Koprska Ulica 98, SI-1000 Ljubljana, Slovenia; (S.K.); (H.H.); (M.H.); (Ž.L.); (K.Ž.)
- VIST–Faculty of Applied Sciences, Gerbičeva Cesta 51A, SI-1000 Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
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10
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Abstract
Background: Guidelines recommend comprehensive lifestyle change in patients with peripheral arterial disease (PAD) to prevent cardiovascular events and death. When compared with other populations, patients with PAD are less likely to receive best medical therapies (BMT). The aim of this pilot study was to integrate all aspects of BMT in an intervention program and to determine the feasibility of such an approach by highlighting strengths and obstacles of a multi-aspect intervention. Patients and methods: Patients consecutively hospitalized due to symptomatic PAD between 01 December 2021 and 28 February 2022 were included and followed for ten weeks. We randomized into a lifestyle intervention (education on BMT, a list of regional contact data for supervised exercise, weekly counselling by phone for ten times) vs. standard of care (one contact to talk about BMT). Vascular Quality of Life Questionnaire - 6 (VascuQoL-6) was used to collect patient reported outcomes. Results: Of 50 eligible patients 40 agreed to participate (32.5% female, 72.5 years in mean). During follow-up nine patients dropped out (4 in intervention group vs. 5). As for risk factor modification one patient was able to reach a normal weight body-mass-index (BMI) and nine reduced weight. Two patients stopped smoking, three reduced their consumption. The reported adherence to medication was a hundred percent. No patient attended supervised exercise therapy but eight trained at a home-based setting according to guidelines. The mean score of VascuQoL-6 at follow-up was higher in the intervention group compared to the control group (17.4 vs. 13.8 points) at last contact with both groups increasing from baseline. Conclusions: This pilot study followed 40 patients for up to 10 weeks after inpatient treatment while we randomized a multi-aspect lifestyle intervention versus standard of care. Thereby, the current study illustrated the numerous obstacles and provided pragmatic solutions for the planning of studies on BMT in this target population.
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Affiliation(s)
- Yvonne Rosenberg
- Research Group GermanVasc, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christian-Alexander Behrendt
- Research Group GermanVasc, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Vascular and Endovascular Surgery, Asklepios Clinic Wandsbek, Hamburg, Germany
- Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
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11
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Dorobantu M, Cojocaru C, Stanciulescu L, Pop C, Bala C, Benedek T, Parepa I, Lighezan D, Darabont R, Darabantiu D, Mitu F, Gheorghita V, Scafa-Udriste A, Gheorghe-Fronea OF. Ups and downs of conducting a national representative survey on hypertension during pandemic time: main results of SEPHAR IV. J Hypertens 2023; 41:1271-1280. [PMID: 37195226 DOI: 10.1097/hjh.0000000000003461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVES This national representative survey sought to assess hypertension's prevalence, awareness, treatment and control in Romania. METHODS A representative sample (by age, sex and residence) of 1477 Romanian adults (51.19 ± 16.61 years, range 18-80 years, 59.9% women) was multimodally evaluated during two study visits. Hypertension was defined as SBP at least 140 mmHg and/or DBP at least 90 mmHg or previously diagnosed hypertension, regardless of BP. Awareness was defined by knowledge of previous hypertension diagnosis or of current use of antihypertensive treatment. Treatment was defined by antihypertensive medication taken at least 2 weeks prior to enrolment. Control was defined as SBP less than 140 mmHg and DBP less than 90 mmHg at both visits in treated hypertensive patients. RESULTS Hypertension prevalence was 46% ( n = 680) consisting of 81.02% ( n = 551) known hypertensive patients and 18.98% ( n = 129) newly diagnosed hypertensive patients. Awareness, treatment and control of hypertension were: 81% ( n = 551), 83.8% ( n = 462) and 39.2% ( n = 181). CONCLUSION Despite numerous pandemic-related obstacles in conducting a national survey, SEPHAR IV updates hypertension epidemiological data of a high-cardiovascular-risk Eastern-European population. This study confirms previous predictions of hypertension prevalence, treatment and control, which remain unfavourable because of unsatisfactory control of promoting factors.
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Affiliation(s)
- Maria Dorobantu
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy
- Romanian Academy
| | - Cosmin Cojocaru
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy
- Cardiology Department, Clinical Emergency Hospital, Bucharest
| | | | - Calin Pop
- Emergency Clinical County Hospital of Baia Mare, Baia Mare
| | - Cornelia Bala
- Faculty of Medicine, "Iuliu Hateganu" University of Medicine and Pharmacy, Cluj-Napoca
| | - Theodora Benedek
- Cardiology Department, County Clinical Emergency Hospital, Targu Mures
| | - Irinel Parepa
- Cardiology Department, "Ovidius" University Constanta, Constanta
| | - Daniel Lighezan
- Faculty of Medicine, "Victor Babeş" University of Medicine and Pharmacy, Timisoara
| | - Roxana Darabont
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy
- Cardiology Department, University Emergency Hospital Bucharest, Bucharest
| | | | - Florin Mitu
- Cardiology Department, Clinical Rehabilitation Hospital, Iaşi
| | - Valeriu Gheorghita
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy
- Central Military Emergency University Hospital Dr Carol Davila, Bucharest, Romania
| | - Alexandru Scafa-Udriste
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy
- Cardiology Department, Clinical Emergency Hospital, Bucharest
| | - Oana-Florentina Gheorghe-Fronea
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy
- Cardiology Department, Clinical Emergency Hospital, Bucharest
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12
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Kouvari M, Diamantis DV, Katsas K, Radaios V, Veloudaki A, Linos A. Nutritional Value of Meals Designed for a School-Based Food Aid Program and Comparison with Similar Commercial Products: An Example of Good Practice from the DIATROFI Program. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1268. [PMID: 37508765 PMCID: PMC10378201 DOI: 10.3390/children10071268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023]
Abstract
Providing meals of high nutritional value should be the principal objective of large-scale school-based food aid programs. This study aimed at highlighting the nutritional value of meals distributed in the school-based food assistance DIATROFI Program by comparing them to their commercially available counterparts. For the purpose of this study, n = 13 DIATROFI meals and n = 50 commercial products from the 2016-2017 school year, and n = 12 DIATROFI meals and n = 40 commercial products from the 2022-2023 school year were selected. The protein, carbohydrate, total sugar, dietary fiber, total fat, sodium/salt content, and fatty acid methyl ester profile of DIATROFI meals were estimated through recipe simulation and national/international food databases, and verified through laboratory analyses while the relevant information was extracted from the label for commercial products. As verified by laboratory analyses and in comparison with food labels, most DIATROFI meals had lower total fat, saturated fatty acid, and sugar content, and most had higher dietary fiber content during both years. Many recipes' nutrient profiles also improved over time. DIATROFI meals present significant advantages over available commercial products. Such tailored-made school meals can prove to be advantageous in terms of nutrition profile compared to commercially available, which have yet to be impacted by food reformulation.
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Affiliation(s)
- Matina Kouvari
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athen, Greece
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Dimitrios V Diamantis
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece
| | - Konstantinos Katsas
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Vasiliki Radaios
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece
| | - Afroditi Veloudaki
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece
| | - Athena Linos
- PROLEPSIS Civil Law Non-Profit Organization of Preventive Environmental and Occupational Medicine, 15121 Athens, Greece
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13
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Perera V, Allen LN, Farrand C, Kwong EJL, Liyanage I, Wickramasinghe K. Evaluating the role of salt intake in achieving WHO NCD targets in the Eurasian Economic Union: A PRIME modeling study. PLoS One 2023; 18:e0289112. [PMID: 37478108 PMCID: PMC10361522 DOI: 10.1371/journal.pone.0289112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 07/11/2023] [Indexed: 07/23/2023] Open
Abstract
The World Health Organization has set clear global targets in reducing non-communicable disease mortality by 2030 in its sustainable development goals. This study models the number of deaths that could be averted if Eurasian Economic Union (EEU) member states met the target of reducing their population's current mean salt intake by 30% to achieve mortality reduction targets. Using the WHO Preventable Risk Integrated ModEl (PRIME), we modelled the mortality impact of reducing salt consumption by 30%, as well as according to WHO recommended levels (5 g/person/day), for the five member states of the EEU. PRIME models the number of averted deaths from reducing salt intake by applying established risk ratios to a given population. The baseline demographic and mortality data that are required to generate these estimates were obtained from the relevant government statistical bodies, and salt intake data were referenced from surveillance studies. Uncertainty intervals were generated using Monte Carlo simulation. If salt consumption was reduced by 30%, we estimate that there would have been 94,150 (95%UI: 47,329 to 137,131) fewer deaths due to cardiovascular disease in the EEU in the baseline year, with males and the elderly being more affected. If the WHO-recommended maximum salt intake of 5 g/day was achieved, a total of 193,155 (95%UI: 98,548 to 272,536) deaths would have been prevented. These findings underline the importance of incorporating effective policy changes to meet targets in reducing NCD mortality by one-third by 2030.
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Affiliation(s)
- Vern Perera
- Faculty of Medical Sciences, University of Sri Jayewardenepura, Colombo, Sri Lanka
| | - Luke N. Allen
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Clare Farrand
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Edwin Jit Leung Kwong
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Isurujith Liyanage
- Faculty of Medical Sciences, University of Sri Jayewardenepura, Colombo, Sri Lanka
| | - Kremlin Wickramasinghe
- WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office), Moscow, Russian Federation
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14
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Cappuccio FP, D'Elia L, Rakovac I. Spot urine samples and estimation of population salt intake: the return of the phoenix? J Hypertens 2023; 41:869-871. [PMID: 37017034 DOI: 10.1097/hjh.0000000000003405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Affiliation(s)
- Francesco P Cappuccio
- University of Warwick, Warwick Medical School, Division of Health Sciences, Coventry, UK
| | | | - Ivo Rakovac
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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15
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Jelena M, Slobodan L, Danijela V, Milica Z, Branka B, Marija G, Mirjana G, Dragan M. Dietary Intake of Salt from Meat Products in Serbian Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4192. [PMID: 36901203 PMCID: PMC10001836 DOI: 10.3390/ijerph20054192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Salt intake above 5 g/day correlates with prevalence of hypertension and cardiovascular diseases (CVD). CVD, the leading cause of mortality and morbidity in Europe, account for 45% of all deaths, while, in Serbia in 2021, CVD accounted for 47.3%. The objective was to investigate salt content labelled on meat products from the Serbian market and estimate dietary exposure to salt from meat products in the Serbian population using consumption data. Data on salt content were collected from 339 meat products and classified in eight groups. Consumption data were collected using the EFSA EU Menu methodology (2017-2021) from 576 children and 3018 adults (145 pregnant women) in four geographical regions of Serbia. The highest salt content was in dry fermented sausages and dry meat, average 3.78 ± 0.37 g/100 g and 4.40 ± 1.21 g/100 g, respectively. The average intake of meat products is 45.21 ± 39.0 g/day and estimated daily salt intake from meat products per person is 1.192 g, which is 24% of the daily recommended amount. The actual meat product consumption and content of salt in meat products in Serbia present a risk factor for development of CVD and related comorbidities. A targeted strategy, policy and legislation for salt reduction are needed.
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Affiliation(s)
- Milešević Jelena
- Centre of Research Excellence in Nutrition and Metabolism, National Institute of Republic of Serbia, Institute for Medical Research, University of Belgrade, Tadeuša Košćuška, 111000 Belgrade, Serbia
| | - Lilić Slobodan
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11040 Belgrade, Serbia
| | - Vranić Danijela
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11040 Belgrade, Serbia
| | - Zeković Milica
- Centre of Research Excellence in Nutrition and Metabolism, National Institute of Republic of Serbia, Institute for Medical Research, University of Belgrade, Tadeuša Košćuška, 111000 Belgrade, Serbia
| | - Borović Branka
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11040 Belgrade, Serbia
| | - Glibetić Marija
- Centre of Research Excellence in Nutrition and Metabolism, National Institute of Republic of Serbia, Institute for Medical Research, University of Belgrade, Tadeuša Košćuška, 111000 Belgrade, Serbia
| | - Gurinović Mirjana
- Centre of Research Excellence in Nutrition and Metabolism, National Institute of Republic of Serbia, Institute for Medical Research, University of Belgrade, Tadeuša Košćuška, 111000 Belgrade, Serbia
| | - Milićević Dragan
- Institute of Meat Hygiene and Technology, Kaćanskog 13, 11040 Belgrade, Serbia
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16
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Endaltseva A, Coeurquetin P, Thomas-Danguin T, Poulain JP, Tibère L, Dupuy A. Eater-oriented knowledge framework for reducing salt and dietary sodium intake (scoping review). Front Nutr 2023; 10:1110446. [PMID: 36925961 PMCID: PMC10011657 DOI: 10.3389/fnut.2023.1110446] [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: 11/28/2022] [Accepted: 01/31/2023] [Indexed: 03/08/2023] Open
Abstract
Salt and dietary sodium are ubiquitously present in daily food practices and, at the same time, reducing salt intake presents an important public health issue. Given such an ambivalent position of salt in human diet, we argue that public health guidelines toward dietary sodium reduction require an eater-oriented knowledge framework. In this article we are making the first steps toward a flexible interdisciplinary database which would include nutritional, socio-economic, cultural, material, and socio-psychological determinants of salt consumption for comprehensive public health campaigns. We employ an explorative scoping review of academic articles and reports, limiting our review to the original data on salt or sodium consumption published in English or French between 2000 and 2022. We describe salt consumption as research object, identifying its representation in different research fields, data sources, methodologies, samples, and links with nutritional recommendations. We synthesize existing approaches via four eater-oriented categories: Socio-demographic and cultural descriptors of salt consumers; Knowledge, attitudes, and beliefs on nutritional norms; Salt practices associated with dietary or medical regimes; Salt materialities: interactions and contexts. In each category, we identify the dominant relational features, i.e., what kind of 'eater-salt' relation is being put forward. We thus build an interdisciplinary documentary base of dietary sodium consumption factors. We discuss the results, suggesting that comprehensive nutritional policies for global salt reduction require interdisciplinary eater-oriented data frameworks.
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Affiliation(s)
| | - Paul Coeurquetin
- LISST-Cers UMR, University of Toulouse Jean Jaurès, Toulouse, France
| | - Thierry Thomas-Danguin
- Centre des Sciences du Goût et de l'Alimentation (CSGA), CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, Dijon, France
| | - Jean-Pierre Poulain
- CERTOP UMR CNRS, University of Toulouse Jean Jaurès, Toulouse, France.,ISTHIA, University of Toulouse Jean Jaurès, Toulouse, France
| | - Laurence Tibère
- CERTOP UMR CNRS, University of Toulouse Jean Jaurès, Toulouse, France.,ISTHIA, University of Toulouse Jean Jaurès, Toulouse, France
| | - Anne Dupuy
- CERTOP UMR CNRS, University of Toulouse Jean Jaurès, Toulouse, France.,ISTHIA, University of Toulouse Jean Jaurès, Toulouse, France
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