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Soares AP, Rodrigues M, Padrão P, Gonçalves C, Moreira A, Moreira P. Association between Urinary Sodium Excretion and Body Fat in School-Aged Children: Insights from the ARIA Study. Nutrients 2024; 16:1197. [PMID: 38674887 PMCID: PMC11054948 DOI: 10.3390/nu16081197] [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: 03/19/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Childhood obesity has been associated with increased sodium intake. Nonetheless, evidence linking sodium intake to Body Mass Index (BMI) and Body Fat Mass Percentage (%BF) remains limited, especially in the pediatric age group. Therefore, this study aims to investigate whether there is an association between 24 h urinary sodium excretion with BMI and %BF in a sample group of children from the ARIA study. This cross-sectional analysis included 303 children aged 7 to 12 from across 20 public schools in Porto, Portugal. Weight and %BF were assessed using the Tanita™ BC-418 Segmental Body Analyzer. Children's Total Energy Intake (TEI) was estimated through a single 24 h Recall Questionnaire, and urinary sodium and potassium excretion was estimated by a 24 h urine collection. The association of %BF and BMI with 24 h sodium excretion was estimated by a binary logistic regression adjusted for sex, age, physical activity, total energy intake, parental education, and 24 h urinary excreted potassium. There was a significant positive association between higher levels of urinary sodium excretion and higher %BF values, even after adjusting for confounders. However, the same was not observed for BMI. Our findings suggest that higher sodium intake is associated with higher values of %BF among children, regardless of TEI and potassium intake.
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Affiliation(s)
- Ana Patrícia Soares
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
| | - Mónica Rodrigues
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
| | - Carla Gonçalves
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - André Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Immuno-Allergology Department, São João Hospital Center, 4200-319 Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
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Woo H, Han A, Park JE, Cha YS. Korean fermented soybean paste (Doenjang) has anti-obesity and anti-hypertensive effects via the renin-angiotensin system (RAS) in high-fat diet-induced obese rats. PLoS One 2023; 18:e0291762. [PMID: 37862361 PMCID: PMC10588895 DOI: 10.1371/journal.pone.0291762] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/05/2023] [Indexed: 10/22/2023] Open
Abstract
The health-beneficial outcomes of doenjang, a Korean fermented food have been questioned due to its high salt content; moreover, the detailed underlying mechanisms of its health beneficial effects are not fully investigated. Thus, this study aimed to investigate doenjang's anti-obesity effects, anti-hypertensive effects, and its underlying mechanisms in high-fat diet -induced obesity. Sprague-Dawley rats fed with normal diet (ND), high-fat diet (HD), HD with 8% additive salt (HDS), or HD with doenjang containing 8% salt (HDJ) for 13 weeks. Compared to HD and HDS groups, the HDJ group had lower body and epididymal fat tissue weight gain and showed hypotrophy and hypoplasia. The RAS-related mRNA levels in the adipose tissue, including Renin and Ace were downregulated in the HDJ group compared to HD and HDS groups. Additionally, HDJ groups had significant improvements in systolic blood pressure, serum RAS-associated parameters (e.g., angiotensin II and aldosterone), renal mRNA levels related to RAS (e.g., angiotensin II receptor type 1 and 2), and aldosterone-associated mRNA expressions (e.g., mineralocorticoid receptor) in the kidney of HD-induced obese rats. Most importantly, HDS and HDJ groups showed distinct outcomes regarding adipogenesis and electrolytes metabolism, even though both diets contain a high level of salt. HDS group showed a higher epididymal fat tissue weight, mass, and adipocyte size than HDJ group. In addition, compared with HDJ group, HDS group significantly decreased the release of Na+ and K+ throughout the urine and feces. The present study addresses that doenjang has anti-obesity effects and anti-hypertensive effects by activating RAS in the adipose tissue and kidney, respectively. Additionally, this study also demonstrates that salt in doenjang and the additive salt differently influences adipogenesis and electrolytes metabolism, supporting doenjang has health advantageous effects regardless of its high salt contents.
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Affiliation(s)
- Hayoung Woo
- Department of Food Science and Human Nutrition, Jeonbuk National University, Jeonju-si, Jeollabuk-do, Republic of Korea
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, United States of America
| | - Anna Han
- Department of Food Science and Human Nutrition, Jeonbuk National University, Jeonju-si, Jeollabuk-do, Republic of Korea
- K-Food Research Center, Jeonbuk National University, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Jung Eun Park
- Department of Food Science and Human Nutrition, Jeonbuk National University, Jeonju-si, Jeollabuk-do, Republic of Korea
- Nutracore Co., Ltd., Suwon, Republic of Korea
| | - Youn-Soo Cha
- Department of Food Science and Human Nutrition, Jeonbuk National University, Jeonju-si, Jeollabuk-do, Republic of Korea
- K-Food Research Center, Jeonbuk National University, Jeonju-si, Jeollabuk-do, Republic of Korea
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3
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Wang X, Ma H, Kou M, Tang R, Xue Q, Li X, Harlan TS, Heianza Y, Qi L. Dietary Sodium Intake and Risk of Incident Type 2 Diabetes. Mayo Clin Proc 2023; 98:S0025-6196(23)00118-0. [PMID: 37921793 DOI: 10.1016/j.mayocp.2023.02.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/15/2023] [Accepted: 02/23/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To fill the knowledge gap of the relation between long-term dietary sodium intake and type 2 diabetes (T2D), we evaluate the association between the frequency of adding salt to foods, a surrogate marker for evaluating the long-term sodium intake, and incident T2D risk. METHODS A total of 402,982 participants from UK Biobank (March 13, 2006 - October 10, 2010) who were free of diabetes, chronic kidney disease, cancer, or cardiovascular disease at baseline, and had completed information on adding salt were analyzed in this study. RESULTS During a median of 11.9 years of follow-up, 13,120 incident cases of T2D were documented. Compared with participants who "never/rarely" added salt to foods, the adjusted HRs were 1.11 (95% CI, 1.06 to 1.15), 1.18 (95% CI, 1.12 to 1.24), and 1.28 (95% CI, 1.20 to 1.37) across the groups of "sometimes," "usually," and "always," respectively (P-trend<.001). We did not find significant interactions between the frequency of adding salt to foods and baseline hypertension status and other covariates on the risk of incident T2D. The observed positive association was partly mediated by body mass index, waist to hip ratio, and C-reactive protein, with a significant mediation effect of 33.8%, 39.9%, and 8.6%, respectively. The significant mediation effect of body mass index was largely driven by the body fat mass rather than the body fat-free mass. CONCLUSION Our findings for the first time indicate that higher frequency of adding salt to foods, a surrogate marker for a person's long-term salt taste preference and intake, is associated with a higher T2D risk.
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Affiliation(s)
- Xuan Wang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Minghao Kou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Rui Tang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Qiaochu Xue
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Timothy S Harlan
- George Washington University Culinary Medicine Program, Washington, DC, USA
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Watso JC, Fancher IS, Gomez DH, Hutchison ZJ, Gutiérrez OM, Robinson AT. The damaging duo: Obesity and excess dietary salt contribute to hypertension and cardiovascular disease. Obes Rev 2023; 24:e13589. [PMID: 37336641 PMCID: PMC10406397 DOI: 10.1111/obr.13589] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 06/21/2023]
Abstract
Hypertension is a primary risk factor for cardiovascular disease. Cardiovascular disease is the leading cause of death among adults worldwide. In this review, we focus on two of the most critical public health challenges that contribute to hypertension-obesity and excess dietary sodium from salt (i.e., sodium chloride). While the independent effects of these factors have been studied extensively, the interplay of obesity and excess salt overconsumption is not well understood. Here, we discuss both the independent and combined effects of excess obesity and dietary salt given their contributions to vascular dysfunction, autonomic cardiovascular dysregulation, kidney dysfunction, and insulin resistance. We discuss the role of ultra-processed foods-accounting for nearly 60% of energy intake in America-as a major contributor to both obesity and salt overconsumption. We highlight the influence of obesity on elevated blood pressure in the presence of a high-salt diet (i.e., salt sensitivity). Throughout the review, we highlight critical gaps in knowledge that should be filled to inform us of the prevention, management, treatment, and mitigation strategies for addressing these public health challenges.
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Affiliation(s)
- Joseph C. Watso
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, USA
| | - Ibra S. Fancher
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - Dulce H. Gomez
- School of Kinesiology, Auburn University, Auburn, Alabama, USA
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | - Orlando M. Gutiérrez
- Division of Nephrology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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5
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Wu Q, Burley G, Li L, Lin S, Shi Y. The role of dietary salt in metabolism and energy balance: Insights beyond cardiovascular disease. Diabetes Obes Metab 2023; 25:1147-1161. [PMID: 36655379 PMCID: PMC10946535 DOI: 10.1111/dom.14980] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 01/20/2023]
Abstract
Dietary salt (NaCl) is essential to an organism's survival. However, today's diets are dominated by excessive salt intake, which significantly impacts individual and population health. High salt intake is closely linked to cardiovascular disease (CVD), especially hypertension, through a number of well-studied mechanisms. Emerging evidence indicates that salt overconsumption may also be associated with metabolic disorders. In this review, we first summarize recent updates on the mechanisms of salt-induced CVD, the effects of salt reduction and the use of salt substitution as a therapy. Next, we focus on how high salt intake can impact metabolism and energy balance, describing the mechanisms through which this occurs, including leptin resistance, the overproduction of fructose and ghrelin, insulin resistance and altered hormonal factors. A further influence on metabolism worth noting is the reported role of salt in inducing thermogenesis and increasing body temperature, leading to an increase in energy expenditure. While this result could be viewed as a positive metabolic effect because it promotes a negative energy balance to combat obesity, caution must be taken with this frame of thinking given the deleterious consequences of chronic high salt intake on cardiovascular health. Nevertheless, this review highlights the importance of salt as a noncaloric nutrient in regulating whole-body energy homeostasis. Through this review, we hope to provide a scientific framework for future studies to systematically address the metabolic impacts of dietary salt and salt replacement treatments. In addition, we hope to form a foundation for future clinical trials to explore how these salt-induced metabolic changes impact obesity development and progression, and to elucidate the regulatory mechanisms that drive these changes, with the aim of developing novel therapeutics for obesity and CVD.
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Affiliation(s)
- Qi Wu
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - George Burley
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
| | - Li‐Cheng Li
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Shu Lin
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Yan‐Chuan Shi
- Obesity and Metabolic Disease Research GroupGarvan Institute of Medical ResearchSydneyNew South WalesAustralia
- Centre of Neurological and Metabolic Researchthe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
- School of Clinical Medicine, St Vincent's Clinical CampusFaculty of Medicine and HealthSydneyNew South WalesAustralia
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Xu J, Mao F, Lu Y, Liu T, Li X, Li Y. Hepatic Transcriptomics Reveals Reduced Lipogenesis in High-Salt Diet Mice. Genes (Basel) 2023; 14:genes14050966. [PMID: 37239325 DOI: 10.3390/genes14050966] [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: 03/15/2023] [Revised: 04/15/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
It has been demonstrated that a high salt diet (HSD) increases the risk of cardiovascular disease and metabolic dysfunction. In particular, the impact and molecular mechanisms of long-term HSD on hepatic metabolism remain largely unknown. To identify differentially expressed genes (DEGs) affecting the metabolism of liver tissues from HSD and control groups, a transcriptome analysis of liver tissues was performed in this study. As a result of the transcriptome analysis, the expression of genes related to lipid and steroid biosynthesis (such as Fasn, Scd1, and Cyp7a1) was significantly reduced in the livers of HSD mice. Additionally, several gene ontology (GO) terms have been identified as associated with metabolic processes in the liver, including the lipid metabolic process (GO: 0006629) and the steroid metabolic process (GO: 0008202). An additional quantitative RT-qPCR analysis was conducted to confirm six down-regulated genes and two up-regulated genes. Our findings provide a theoretical basis for further investigation of HSD-induced metabolic disorders.
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Affiliation(s)
- Jing Xu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Fei Mao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yan Lu
- Institute of Metabolism and Regenerative Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Tiemin Liu
- School of Life Sciences, Fudan University, Shanghai 200032, China
| | - Xiaoying Li
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yao Li
- Department of Laboratory Animal Science, Shanghai Jiao Tong University School of Medicine, Shanghai 200032, China
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Lee J, Sohn C, Kim OY, Lee YM, Yoon MO, Lee M. The association between dietary sodium intake and obesity in adults by sodium intake assessment methods: a review of systematic reviews and re-meta-analysis. Nutr Res Pract 2023; 17:175-191. [PMID: 37009133 PMCID: PMC10042719 DOI: 10.4162/nrp.2023.17.2.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/22/2022] [Accepted: 01/17/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND/OBJECTIVES The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults. SUBJECTS/METHODS A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool. RESULTS This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m2; 95% confidence interval [CI], 1.59-2.51; P < 0.001; I2 = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m2; 95% CI, 1.13-1.55; P < 0.001; I2 = 95%) and dietary methods (mean difference = 0.85 kg/m2; 95% CI, 0.1-1.51; P < 0.05; I2 = 95%). CONCLUSIONS Quantitative synthesis of the systematic reviews has shown that cross-sectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.
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Affiliation(s)
- Jounghee Lee
- Department of Food and Nutrition, Kunsan National University, Gunsan 54150, Korea
| | - Cheongmin Sohn
- Department of Food and Nutrition, Wonkwang University, Iksan 54538, Korea
| | - Oh-Yoen Kim
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
| | - Young-Min Lee
- Department of Practical Science Education, Gyeongin National University of Education, Incheon 21044, Korea
| | - Mi Ock Yoon
- Nutrition Information Center, Korean Nutrition Society, Seoul 04376, Korea
| | - Myoungsook Lee
- Department of Food and Nutrition, School of Bio-Health Convergence, Health & Wellness College, Sungshin Women’s University, Seoul 01133, Korea
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Edward OC, Lee EJ, Han A, Mun EG, Yang HJ, Kim JW, Cha YS. Gochujang Consumption Prevents Metabolic Syndrome in a High-Fat Diet Induced Obese Mouse Model. J Med Food 2023; 26:244-254. [PMID: 37001177 DOI: 10.1089/jmf.2022.k.0126] [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: 04/03/2023] Open
Abstract
High-fat and high-salt diets are risk factors for metabolic syndrome development. However, gochujang, which has a high salt content, possesses antiobesity properties in cell and animal models. We aimed to evaluate the effects of Sunchang traditional and modern factory produced gochujang on metabolic syndrome factors in high-fat diet (HFD)-induced obese mice. For 14 weeks, 4-week-old C57BL/6J male mice were separated into five groups and fed a normal diet (ND), a high-fat diet only (HD), a HD with salt (SALT), a HD with traditional Sunchang gochujang (TS), and HD with modern factory made Sunchang gochujang (FS). Compared to HD and SALT groups, the gochujang groups had lower body weight, blood leptin, and insulin levels with reduced Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index and improved serum and liver lipid profiles. In addition, gochujang supplemented groups exhibited a significant reduction in mRNA expression of anabolic lipid metabolism related factors; PPARγ, CEBPα, and FABP4, and a significant increase in mRNA expression of energy expenditure-related factors; PPARα and CPT1. Protein expressions of SREBP1 were downregulated in the gochujang fed groups. TS and FS intakes improved obesity in HFD-induced obese mice. Compared to the gochujang groups, the SALT group did not exhibit any of those benefits suggesting that the high salt content of gochujang has different effects compared with added salt alone. Our findings provide evidence that gochujang could be a functional food to attenuate metabolic syndrome.
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Affiliation(s)
- Olivet Chiamaka Edward
- Department of Food Science and Human Nutrition, Jeonbuk National University, Jeonju, Korea
| | - Eun Ji Lee
- Department of Food Science and Human Nutrition, Jeonbuk National University, Jeonju, Korea
| | - Anna Han
- Department of Food Science and Human Nutrition, Jeonbuk National University, Jeonju, Korea
- K-food Research Center, Jeonbuk National University, Jeonju, Korea
| | - Eun-Gyung Mun
- Department of Food Science and Human Nutrition, Jeonbuk National University, Jeonju, Korea
- K-food Research Center, Jeonbuk National University, Jeonju, Korea
| | - Hee-Jong Yang
- Microbial Institute for Fermentation Industry (MIFI), Sunchang, Korea
| | - Jin-Won Kim
- Microbial Institute for Fermentation Industry (MIFI), Sunchang, Korea
| | - Youn-Soo Cha
- Department of Food Science and Human Nutrition, Jeonbuk National University, Jeonju, Korea
- K-food Research Center, Jeonbuk National University, Jeonju, Korea
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9
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Zhou TL, Schütten MTJ, Kroon AA, Henry RMA, Houben AJHM, van der Kallen CJH, van Greevenbroek MMJ, de Leeuw PW, Stehouwer CDA. Urinary Sodium Excretion and Salt Intake Are Not Associated With Blood Pressure Variability in a White General Population. J Am Heart Assoc 2022; 12:e026578. [PMID: 36565181 PMCID: PMC9973596 DOI: 10.1161/jaha.122.026578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Salt restriction may lower blood pressure variability (BPV), but previous studies have shown inconsistent results. Therefore, we investigated in an observational study and intervention trial whether urinary sodium excretion and salt intake are associated with 24-hour BPV. Methods and Results We used data from the cross-sectional population-based Maastricht Study (n=2652; 60±8 years; 52% men) and from a randomized crossover trial (n=40; 49±11 years; 33% men). In the observational study, we measured 24-hour urinary sodium excretion and 24-hour BPV and performed linear regression adjusted for age, sex, mean blood pressure, lifestyle, and cardiovascular risk factors. In the intervention study, participants adhered to a 7-day low- and high-salt diet (50 and 250 mmol NaCl/24 h) with a washout period of 14 days, 24-hour BPV was measured during each diet. We used linear mixed models adjusted for order of diet, mean blood pressure, and body mass index. In the observational study, 24-hour urinary sodium excretion was not associated with 24-hour systolic or diastolic BPV (β, per 1 g/24 h urinary sodium excretion: 0.05 mm Hg [95% CI, -0.02 to 0.11] and 0.04 mm Hg [95% CI, -0.01 to 0.09], respectively). In the intervention trial, mean difference in 24-hour systolic and diastolic BPV between the low- and high-salt diet was not statistically significantly different (0.62 mm Hg [95% CI, -0.10 to 1.35] and 0.04 mm Hg [95% CI, -0.54 to 0.63], respectively). Conclusions Urinary sodium excretion and salt intake are not independently associated with 24-hour BPV. These findings suggest that salt restriction is not an effective strategy to lower BPV in the White general population. Registration URL: https://clinicaltrials.gov/ct2/show/NCT02068781.
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Affiliation(s)
- Tan Lai Zhou
- Department of Internal MedicineMaastricht University Medical Center+MaastrichtThe Netherlands,Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Monica T. J. Schütten
- Department of Internal MedicineMaastricht University Medical Center+MaastrichtThe Netherlands,Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Abraham A. Kroon
- Department of Internal MedicineMaastricht University Medical Center+MaastrichtThe Netherlands,Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Ronald M. A. Henry
- Department of Internal MedicineMaastricht University Medical Center+MaastrichtThe Netherlands,Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands,Heart and Vascular Center Maastricht University Medical Center+MaastrichtThe Netherlands
| | - Alfonsius J. H. M. Houben
- Department of Internal MedicineMaastricht University Medical Center+MaastrichtThe Netherlands,Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Carla J. H. van der Kallen
- Department of Internal MedicineMaastricht University Medical Center+MaastrichtThe Netherlands,Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Marleen M. J. van Greevenbroek
- Department of Internal MedicineMaastricht University Medical Center+MaastrichtThe Netherlands,Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Peter W. de Leeuw
- Department of Internal MedicineMaastricht University Medical Center+MaastrichtThe Netherlands,Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Coen D. A. Stehouwer
- Department of Internal MedicineMaastricht University Medical Center+MaastrichtThe Netherlands,Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
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Kozioł-Kozakowska A, Wójcik M, Stochel-Gaudyn A, Szczudlik E, Suder A, Piórecka B. The Severity of Obesity Promotes Greater Dehydration in Children: Preliminary Results. Nutrients 2022; 14:5150. [PMID: 36501180 PMCID: PMC9739486 DOI: 10.3390/nu14235150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
The state of hydration of the body depends on the balance between the amount of water and salt consumed and excreted (the urinary extraction of excess sodium requires water). Inappropriate nutrition, particularly consuming too much processed food, causes obesity in children and additionally causes excessive sodium consumption, thus increasing the risk of excessive water loss. The aim of this study was to assess the hydration status of children with obesity and the relation between hydration, body composition, urinary sodium extraction, and nutrient intake. The study group consisted of 27 patients with obesity, with a mean age of 12.89 ± SD 2.79. Each patient's height, weight, body composition (electrical bioimpedance (BIA)), diet (7-day record), and biochemical tests were assessed. The hydration status was assessed using 24-hour urine collection, 24-hour urine osmolality, and an ultrasound of the vena cava (IVC/Ao index). Overall, 55% of children (n = 15) had urine osmolality values above 800 mOsm/kgH2O, which indicates significant dehydration, and 53% (n = 14) were dehydrated, based on the IVC/Ao index. Children with obesity and dehydration had a significantly higher BMI (31.79 vs. 27.32; p = 0.0228), fat mass percentage (37.23% vs. 30.07% p = 0.0051), and fat mass in kg (30.89 vs. 20.55; p = 0.0158), and significantly higher sodium intake from their diet (3390.0 mg vs. 2921.0 mg; p = 0.0230), as well as their sodium/potassium ratio (2.4 vs. 2.0; p = 0.0043). The 24-hour urinary sodium excretion and osmolality values were directly related to fat-mass percentage and fat-mass (in kg) in a simple linear correlation analysis. Our preliminary results confirm that obesity is related to dehydration. The overall high sodium excretion in children with obesity indicates an excessive salt intake along with low potassium intake, which is a significant predictor of dehydration, regardless of the total water intake (TWI).
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Affiliation(s)
- Agnieszka Kozioł-Kozakowska
- Department of Pediatrics, Gastroenterology and Nutrition, Pediatric Institute, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescents Endocrinology, Pediatric Institute, Faculty of Medicine,, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Anna Stochel-Gaudyn
- Department of Pediatrics, Gastroenterology and Nutrition, Pediatric Institute, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Ewa Szczudlik
- Department of Pediatric and Adolescents Endocrinology, Pediatric Institute, Faculty of Medicine,, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Agnieszka Suder
- Department of Anatomy, Institute of Basic Sciences, Faculty of Motor Rehabilitation, University of Physical Education in Cracow, 31-571 Krakow, Poland
| | - Beata Piórecka
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Science, Jagiellonian University Medical College, 31-531 Krakow, Poland
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11
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Yousefzadeh N, Jeddi S, Afzali H, Kashfi K, Ghasemi A. Chronic nitrate administration increases the expression the genes involved in the browning of white adipose tissue in female rats. Cell Biochem Funct 2022; 40:750-759. [PMID: 36098488 DOI: 10.1002/cbf.3741] [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: 06/06/2022] [Revised: 08/06/2022] [Accepted: 08/19/2022] [Indexed: 11/08/2022]
Abstract
Nitrate, a nitric oxide (NO) donor, has antiobesity effect in female rats. This study hypothesized that the antiobesity effect of nitrate in female rats is due to the browning of white adipose tissue (WAT). Female Wistar rats (aged 8 months) were divided into two groups (n = 10/group): the control group received tap water and the nitrate group received water containing 100 mg/L of sodium nitrate for 9 months. At months 0, 3, 6, and 9, obesity indices were measured. At month 9, gonadal adipose tissue was used to measure messenger RNA (mRNA) and protein levels of peroxisome proliferator-activated receptor-γ (PPAR-γ), PPAR-γ coactivator 1-α (PGC1-α), uncoupling protein 1 (UCP1), and adipocyte density and area. After the 9-month intervention, nitrate-treated rats had lower body weight, body mass index, thoracic circumference, and abdominal circumference by 6.4% (p = .012), 9.1% (p = .029), 6.0% (p = .056), and 5.7% (p = .098), respectively. In addition, nitrate-treated rats had higher PPAR-γ (mRNA: 1.78-fold, p = .016 and protein: 19%, p = .076), PGC1-α (mRNA: 1.69-fold, p = .012 and protein: 68%, p = .001), and UCP1 (mRNA: 2.50-fold, p = .001 and protein: 81%, p = .001) in gonadal adipose tissue. Nitrate also reduced adipocyte area by 35% (p = .054) and increased adipocyte density by 31% (p = .086). In conclusion, antiobesity effect of nitrate in female rats is associated with increased browning of gonadal adipose tissue as indicated by higher expression of PPAR-γ, PGC1-α, and UCP1 and reduced adipocyte area and increased adipocyte density.
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Affiliation(s)
- Nasibeh Yousefzadeh
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sajad Jeddi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Afzali
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khosrow Kashfi
- Department of Molecular, Cellular, and Biomedical Sciences, Sophie Davis School of Biomedical Education, City University of New York School of Medicine, New York, New York, USA
| | - Asghar Ghasemi
- Endocrine Physiology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Role of high-salt diet in non-alcoholic fatty liver disease: a mini-review of the evidence. Eur J Clin Nutr 2022; 76:1053-1059. [PMID: 34773093 DOI: 10.1038/s41430-021-01044-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/11/2021] [Accepted: 10/22/2021] [Indexed: 11/08/2022]
Abstract
With the rising incidence of both obesity and diabetes, non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide. However, lifestyle intervention remains to be an effective approach for NAFLD due to lack of therapeutic medication. Recently, salt, an essential micronutrient free of calories, has raised a global concern owing to its wide-range healthy relevance. Accumulated evidence has suggested that a long-term high-salt diet (HSD) independently increases the risk of NAFLD. In the past decades, a number of studies have been reported regarding the mechanism of much investigation concerning HSD-induced NAFLD. Here, we review the updates in epidemiology and molecular mechanism of HSD-induced NAFLD and provide a novel insight into the role of HSD in the regulation of lipid metabolism.
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13
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Rahman MJ, Parvez SM, Rahman M, He FJ, Cunningham SA, Narayan KMV, Abedin J, Naser AM. Urinary Sodium Excretion and Obesity Markers among Bangladeshi Adult Population: Pooled Data from Three Cohort Studies. Nutrients 2022; 14:3000. [PMID: 35889957 PMCID: PMC9323227 DOI: 10.3390/nu14143000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/05/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
We evaluated the relationship of urinary sodium excretion with a conditional mean, 10th and 90th percentiles of body mass index (BMI), and waist circumference among 10,034 person-visits of Bangladeshi population. We fitted linear mixed models with participant-level random intercept and restricted maximum likelihood estimation for conditional mean models; and quantile mixed-effect models with participant-level random intercept and Laplace estimation for 10th and 90th percentiles models. For each 100 mmol/24 h increase in urinary sodium excretion, participants had a 0.10 kg/m2 (95% CI: 0.00, 0.10) increase in the mean; a 0.39 kg/m2 (95% CI: 0.23, 0.54) increase in the 10th percentile; and a 0.59 kg/m2 (95% CI: 0.39, 0.78) increase in the 90th percentile of BMI. For each 100 mmol/24 h increase in urinary sodium excretion, participants had a 0.20 cm (95% CI: 0.10, 0.30) increase in mean; a 0.18 cm (95% CI: -0.03, 0.40) change in the 10th percentile; and a 0.23 cm (95% CI: 0.03, 0.43) increase in the 90th percentile of waist circumference. We found a modest association between urine sodium and conditional mean of BMI and waist circumference. The magnitude of associations between urine sodium and the 10th and 90th percentile BMI distributions were higher compared to the conditional mean models, suggesting high sodium intake could be more detrimental to underweight and obese participants.
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Affiliation(s)
- Musarrat J. Rahman
- International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Sarker M. Parvez
- Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh; (S.M.P.); (M.R.)
| | - Mahbubur Rahman
- Environmental Interventions Unit, Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh; (S.M.P.); (M.R.)
| | - Feng J. He
- Centre for Public Health and Policy, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK;
| | - Solveig A. Cunningham
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (S.A.C.); (K.M.V.N.)
| | - K. M. Venkat Narayan
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (S.A.C.); (K.M.V.N.)
| | - Jaynal Abedin
- Data Science Institute, National University of Ireland Galway, H91 TK33 Galway, Ireland;
| | - Abu Mohd Naser
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38152, USA
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14
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Takahashi F, Hashimoto Y, Kaji A, Sakai R, Kawate Y, Okamura T, Kitagawa N, Okada H, Nakanishi N, Majima S, Osaka T, Senmaru T, Ushigome E, Hamaguchi M, Fukui M. The Association of Salt Intake and Non-alcoholic Fatty Liver Disease in People With Type 2 Diabetes: A Cross-Sectional Study. Front Nutr 2022; 9:943790. [PMID: 35911124 PMCID: PMC9326474 DOI: 10.3389/fnut.2022.943790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 06/23/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives Non-alcoholic fatty liver disease (NAFLD), which has a close relationship with type 2 diabetes (T2D), is related to salt intake in the general population. In contrast, the relationship between salt intake and the presence of NAFLD in patients with T2D has not been clarified. Methods Salt intake (g/day) was assessed using urinary sodium excretion, and a high salt intake was defined as an intake greater than the median amount of 9.5 g/day. Hepatic steatosis index (HSI) ≥ 36 points was used to diagnosed NAFLD. Odds ratios of high salt intake to the presence of NAFLD were evaluated by logistic regression analysis. Results The frequency of NAFLD was 36.5% in 310 patients with T2D (66.7 ± 10.7 years old and 148 men). The patients with high salt intake had a higher body mass index (25.0 ± 4.0 vs. 23.4 ± 3.8 kg/m2, p < 0.001) than those with low salt intake. HSI in patients with high salt intake was higher than that in patients with low salt intake (36.2 ± 6.2 vs. 34.3 ± 5.5 points, p = 0.005). In addition, the presence of NALFD in patients with high salt intake was higher than that in patients with low salt intake (44.5% vs. 28.4%, p = 0.005). High salt intake was associated with the prevalence of NAFLD [adjusted odds ratio, 1.76 (95% confidence interval: 1.02–3.03), p = 0.043]. Conclusion This cross-sectional study revealed that salt intake is related to the prevalence of NAFLD in patients with T2D.
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Affiliation(s)
- Fuyuko Takahashi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi, Japan
- *Correspondence: Yoshitaka Hashimoto
| | - Ayumi Kaji
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryosuke Sakai
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuka Kawate
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Noriyuki Kitagawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Diabetology, Kameoka Municipal Hospital, Kameoka, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Saori Majima
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takafumi Osaka
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takafumi Senmaru
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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15
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Shojaei‐Zarghani S, Safarpour AR, Fattahi MR, Keshtkar A. Sodium in relation with nonalcoholic fatty liver disease: A systematic review and meta-analysis of observational studies. Food Sci Nutr 2022; 10:1579-1591. [PMID: 35592291 PMCID: PMC9094449 DOI: 10.1002/fsn3.2781] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/06/2022] [Accepted: 01/25/2022] [Indexed: 12/11/2022] Open
Abstract
Findings on the association of sodium with nonalcoholic fatty liver disease (NAFLD) are conflicting. The present systematic review and meta‐analysis study aimed to assess the association between salt or sodium intake or serum sodium levels and NAFLD risk. Relevant articles were identified by searching PubMed, Web of Knowledge, Scopus, Proquest, and Embase databases through May 1, 2021, without language restriction. The pooled odds ratio (OR) and 95% confidence interval (CI) were estimated using Der‐Simonian and Laird method and random‐effects meta‐analysis. The certainty of the evidence was rated using the GRADE method. Out of 6470 documents, 7 epidemiological/observational (1 cohort, 1 case–control, and 5 cross‐sectional) studies on the relationship between dietary salt/sodium intakes and NAFLD risk met our inclusion criteria. The meta‐analysis of all studies showed a significant positive association between the highest salt/sodium intake and NALFD risk (OR = 1.60, 95% CI: 1.19–2.15) with a meaningful heterogeneity among studies (I2 = 96.70%, p‐value <.001). The NAFLD risk was greater in the studies with higher quality (OR = 1.81, 95% CI: 1.24–2.65) or using the equation‐based methods for NAFLD ascertainment (OR = 2.02, 95% CI: 1.29–3.17) or urinary sodium collection as a sodium intake assessment (OR = 2.48, 95% CI: 1.52–4.06). The overall certainty of the evidence was very low. In conclusion, high sodium intake seems to be related to increased NAFLD risk. Further well‐designed studies are needed to clarify this association and shed light on the underlying mechanisms.
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Affiliation(s)
- Sara Shojaei‐Zarghani
- Gastroenterohepatology Research CenterShiraz University of Medical SciencesShirazIran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research CenterShiraz University of Medical SciencesShirazIran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research CenterShiraz University of Medical SciencesShirazIran
| | - Abbasali Keshtkar
- Department of Health Sciences Education DevelopmentSchool of Public HealthTehran University of Medical SciencesTehranIran
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16
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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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17
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Itoh N, Tsuya A, Togashi H, Kimura H, Konta T, Nemoto K, Yamashita H, Kayama T. Increased salt intake is associated with diabetes and characteristic dietary habits: a community-based cross-sectional study in Japan. J Clin Biochem Nutr 2022; 71:143-150. [PMID: 36213786 PMCID: PMC9519413 DOI: 10.3164/jcbn.21-153] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/29/2022] [Indexed: 11/22/2022] Open
Abstract
We investigated the association of salt intake with lifestyle-related diseases and also the association of habitually consumed foods with salt intake. A cross-sectional study was conducted using data from a baseline survey of 2,129 residents of Yonezawa city (980 males and 1,149 females), Yamagata prefecture. The residents were divided into three groups based on their estimated daily salt intake: low, medium, and high. In both genders, the prevalence of hypertension and diabetes increased in the order of high > medium > low salt intake (trend p<0.001). Similar trends were observed in the prevalence of hyperlipidemia in females and metabolic syndrome in males. The prevalence of diabetes in the high salt intake group was significantly higher than that in the control group (matched from the low and medium salt intake groups), even when confounding factors were excluded by propensity score matching (p<0.01). Network analysis showed that the low salt intake group had a greater tendency to habitually consume various vegetables than the high salt intake group. Our findings reveal that the prevalence of lifestyle-related diseases increased with higher salt intake. We speculate that a dietary shift to multiple vegetable consumption could have salt-lowering effects.
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Affiliation(s)
- Nanami Itoh
- Yamagata University Health Administration Center
| | - Atsushi Tsuya
- Institute for Promotion of Medical Science Research, Yamagata University Faculty of Medicine
| | | | - Hirohito Kimura
- Institute for Promotion of Medical Science Research, Yamagata University Faculty of Medicine
| | - Tsuneo Konta
- Department of Public Health and Hygiene, Yamagata University Faculty of Medicine
| | - Kenji Nemoto
- Institute for Promotion of Medical Science Research, Yamagata University Faculty of Medicine
| | - Hidetoshi Yamashita
- Institute for Promotion of Medical Science Research, Yamagata University Faculty of Medicine
| | - Takamasa Kayama
- Institute for Promotion of Medical Science Research, Yamagata University Faculty of Medicine
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18
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Feng Q, Yang Z, May M, Tsoi KK, Ingle S, Lee EK, Wong SY, Kim JH. The role of body mass index in the association between dietary sodium intake and blood pressure: A mediation analysis with NHANES. Nutr Metab Cardiovasc Dis 2021; 31:3335-3344. [PMID: 34629246 DOI: 10.1016/j.numecd.2021.08.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 08/19/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Recent research demonstrated that obesity and high dietary sodium intake, the two established risk factors for hypertension, were associated with each other. The objective was to investigate the potential indirect effect of sodium intake on blood pressure via body mass index (BMI). METHODS AND RESULTS Using ten years data from US NHANES (2007-2016), the study included adult participants (>20 years old) who were not taking antihypertensive medications and without baseline diseases (n = 12,262). BMI was modelled as the mediator of sodium intake on systolic and diastolic blood pressure, adjusted for age, sex, socioeconomic status, smoking, drinking, physical activity, calorie intake, fluid intake and potassium intake. Mediation analysis was performed to evaluate total effect, direct effect and indirect effect via BMI. Subgroup analyses based on three age subgroups (20-40, 41-60 and ≥61 years old) were performed. The mean age was 39.29 (13.4) years and 53.1 (0.45) % were males. The mean BMI was 27.8 (6.20) kg/m2. Overall, 1 g/d increase in sodium intake was associated with an increased systolic blood pressure by 0.36 (95% confidence interval 0.14 to 0.58) mmHg, with a direct effect (0.14 (0.09-0.19)) and an indirect effect via BMI (0.23 (0.02-0.44)). The indirect effect was mainly observed in participants ≤60 years old. CONCLUSION Sodium intake showed both direct effect and indirect effect (via BMI) on systolic blood pressure in US NHANES. The findings provide evidence for combining sodium restriction and weight reduction measures for prevention of hypertension. Cautions should be taken when generalizing the findings to other populations with lower average BMI.
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Affiliation(s)
- Qi Feng
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zuyao Yang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Margaret May
- Population Health Sciences, University of Bristol, UK
| | - Kelvin K Tsoi
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Suzanne Ingle
- Population Health Sciences, University of Bristol, UK
| | - Eric K Lee
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Y Wong
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jean H Kim
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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19
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Frieler RA, Vigil TM, Song J, Leung C, Lumeng CN, Mortensen RM. High-fat and high-sodium diet induces metabolic dysfunction in the absence of obesity. Obesity (Silver Spring) 2021; 29:1868-1881. [PMID: 34549547 PMCID: PMC8571049 DOI: 10.1002/oby.23264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Excess dietary fat and sodium (NaCl) are both associated with obesity and metabolic dysfunction. In mice, high NaCl has been shown to block high-fat (HF) diet-induced weight gain. Here, the impact of an HF/NaCl diet on metabolic function in the absence of obesity was investigated. METHODS Wild-type mice were administered chow, NaCl (4%), HF, and HF/NaCl diets. Metabolic analysis was performed by measuring fasted blood glucose and insulin levels and by glucose tolerance test and insulin tolerance test. RESULTS After 10 weeks on diets, male and female mice on the HF diet gained weight, and HF/NaCl mice had significantly reduced weight gain similar to chow-fed mice. In the absence of obesity, HF/NaCl mice had significantly elevated fasting blood glucose and impaired glucose control during glucose tolerance tests. Both NaCl and HF/NaCl mice had decreased pancreas and β-cell mass. Administration of NaCl in drinking water did not protect mice from HF-diet-induced weight gain and obesity. Further analysis revealed that longer administration of HF/NaCl diets for 20 weeks resulted in significant weight gain and insulin resistance. CONCLUSIONS The data demonstrate that despite early inhibitory effects on fat deposition and weight gain, an HF/NaCl diet does not prevent the metabolic consequences of HF diet consumption.
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Affiliation(s)
- Ryan A. Frieler
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI
| | - Thomas M. Vigil
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI
| | - Jianrui Song
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI
| | - Christy Leung
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI
| | - Carey N. Lumeng
- Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI
| | - Richard M. Mortensen
- Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI
- Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan Medical School, Ann Arbor, MI
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI
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20
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Yoo BM, Kim M, Kang MJ. Association between childhood obesity and familial salt intake: analysis of data from Korean National Health and Nutrition Examination Survey, 2014-2017. Endocr J 2021; 68:1127-1134. [PMID: 33907059 DOI: 10.1507/endocrj.ej21-0111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
High salt intake is known as a risk factor of childhood obesity. As family members share not only genes but also their diet habit, parents' salt intake may affect to their children's obesity. In this study, we investigated correlations between childhood obesity and parents' or children's sodium intakes based on a nationwide survey data. From the Korean National Health and Nutrition Examination Survey data from 2014 to 2017, 802 boys and 657 girls aged 10-18 years, and their parents were included. BMI z-score and 24-hour urinary sodium excretion, which is estimated through Tanaka's equation, were used to examine associations between obesity and sodium intakes. The BMI status and the prevalence of obesity between children and their parents showed strong positive correlations in both sexes (all p < 0.001). The urinary sodium excretion between children and their parents showed positive correlations in both sexes (all p < 0.05). Children with higher urinary sodium excretion showed higher BMI (in both sexes, p < 0.001) and higher parental obesity compared to those with lower urinary sodium excretion, however, statistical significances of the latter relationship were varied by sex. In conclusion, our study suggests close relationship between childhood obesity and their sodium intakes, which also correlate well with parental BMIs and diet behavior. Therefore, parental education and active participation could be crucial in regulating childhood obesity.
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Affiliation(s)
- Byung Min Yoo
- Department of Pediatrics, Hallym University College of Medicine, 1, Hallymdaehak-gil, Chuncheon-si, Gangwon-do 24252, Republic of Korea
| | - Mijin Kim
- Department of Pediatrics, Hallym University College of Medicine, 1, Hallymdaehak-gil, Chuncheon-si, Gangwon-do 24252, Republic of Korea
| | - Min Jae Kang
- Department of Pediatrics, Hallym University College of Medicine, 1, Hallymdaehak-gil, Chuncheon-si, Gangwon-do 24252, Republic of Korea
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21
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Takahashi F, Hashimoto Y, Kaji A, Sakai R, Miki A, Kawate Y, Okamura T, Kitagawa N, Okada H, Nakanishi N, Majima S, Senmaru T, Ushigome E, Hamaguchi M, Asano M, Yamazaki M, Fukui M. Association of Estimated Salt and Miso Intake with the Prevalence of Obesity in People with Type 2 Diabetes: A Cross-Sectional Study. Nutrients 2021; 13:3014. [PMID: 34578892 PMCID: PMC8472052 DOI: 10.3390/nu13093014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022] Open
Abstract
Salt intake is often estimated by the amount of sodium excreted in urine, and miso has been reported to increase it. This cross-sectional study investigated the relationship between obesity and high estimated salt intake with and without habitual miso consumption. Estimates of salt intake (g/day) were calculated using urinary sodium excretion, and a high estimated intake was defined as greater than the median amount of 9.5 g/day. Participants were divided into four groups based on estimated salt intake and miso consumption. Among 300 people, the proportions of obesity were 77.8% (n = 14/18), 40.2% (n = 53/132), 26.0% (n = 33/127), and 34.8% (n = 8/23) in the (+/-), (+/+), (-/+), and (-/-) groups of high estimated salt intake/habitual miso consumption, respectively. Compared with the (+/-) group, the adjusted odds ratios for obesity were 0.07 (95% confidence interval (CI): 0.02-0.26, p < 0.001), 0.16 (95% CI: 0.03-0.76, p = 0.022), and 0.14 (95% CI: 0.04-0.51, p = 0.003) in the (-/+), (-/-), and (+/+) groups, respectively. The presence of obesity was not much higher in people with high estimated salt intake with habitual miso consumption than that in people without. Clinicians should be aware that miso consumption promotes salt excretion, which may lead to an apparently higher estimated salt intake than actual.
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Affiliation(s)
- Fuyuko Takahashi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Ayumi Kaji
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Ryosuke Sakai
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Akane Miki
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Yuka Kawate
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Noriyuki Kitagawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
- Department of Diabetology, Kameoka Municipal Hospital, Kyoto 621-8585, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi 570-8540, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Saori Majima
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Takafumi Senmaru
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Mai Asano
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (Y.K.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
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22
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Dudenbostel T, Li P, Calhoun DA. Paradoxical Increase of 24-Hour Urinary Aldosterone Levels in Obese Patients With Resistant Hypertension on a High Salt Diet. Am J Hypertens 2021; 34:600-608. [PMID: 33290515 DOI: 10.1093/ajh/hpaa208] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/12/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Having previously reported that aldosterone levels increase progressively with body mass index (BMI), the current analysis was done to determine to what extent this association is related to dietary high salt intake. We anticipated that aldosterone levels would decrease with higher sodium status consistent with classical suppression of aldosterone release secondary to progressive fluid retention induced by high dietary sodium intake. METHODS Cross-sectional analysis of a large diverse cohort of 2,705 patients with resistant hypertension (HTN) seen in a referral HTN Clinic. Dietary sodium intake was indexed by 24-hour (h) urinary sodium (UNa), aldosterone status was determined by plasma aldosterone concentration, plasma renin activity, and 24 h urinary aldosterone (UAldo). Patients with normal weight served as control. RESULTS In this study, 1,572 individuals with complete 24 h urine collections were analyzed. Mean BMI was 32.5 ± 7.1 kg/m2 and ranged from 24.6 ± 2.4 kg/m2 (first quartile) to 41.0 ± 4.2 kg/m2 (fourth quartile). BMI was positively associated with 24 h UNa and UAldo levels (P < 0.0001), 24 h UNa and UAldo. There was a positively stronger correlation in obese (r = 0.273, P < 0.0001) compared with normal weight individuals (r = 0.108, P = 0.0342) independent of number and classes of antihypertensive medications. CONCLUSIONS Our analysis shows that there is an altered regulation of aldosterone in obese patients in the setting of high dietary salt intake.
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Affiliation(s)
- Tanja Dudenbostel
- Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Peng Li
- Department of Acute, Chronic & Continuing Care, School of Nursing, University of Alabama, Birmingham, Alabama, USA
| | - David A Calhoun
- Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama, Birmingham, Alabama, USA
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23
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Saldanha Melo H, Monnerat JADS, Costa NDS, Bento Bernardes T, Magliano DC, Pereira AD, Almeida PP, Lima GF, Ferreira de Brito FC, Stockler Pinto MB, Kindlovits R, Nogueira AB, Sepúlveda-Fragoso V, Nóbrega ACLD, Motta NAVD, Medeiros RF. Impact of Brazil Nut ( Bertholletia excelsa, H.B.K.) Supplementation on Body Composition, Blood Pressure, and the Vascular Reactivity of Wistar Rats When Submitted to a Hypersodium Diet. J Am Coll Nutr 2021; 41:559-568. [PMID: 34156903 DOI: 10.1080/07315724.2021.1925995] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introdution: Endothelium integrity is a key that maintains vascular homeostasis but it can suffer irreversible damage by blood pressure changes, reflecting an imbalance in the maintenance of vascular homeostasis.Objective: The aim of this study was to investigate the impact of Brazil nut (Bertholletia excelsa, H.B.K.) (BN) supplementation (10% in chow, wt/wt) on the vascular reactivity of Wistar rats during chronic exposure to a sodium overload (1% in water).Methods: First, male Wistar rats were allocated into two groups: Control Group (CG) and the Hypersodic Group (HG) for 4 weeks. Afterward, the CG was divided into the Brazil Nut Group (BNG) and the HG Group into the Hypersodic Brazil Nut Group (HBNG) for a further 8 weeks, totaling 4 groups. Blood pressure was measured during the protocol. At the end of the protocol, the vascular reactivity procedure was performed. Glucose, lipid profile, lipid peroxidation, and platelet aggregation were analyzed in the serum. Body composition was determined by the carcass technique.Results: The groups that were supplemented with the BN chow presented less body mass gain and body fat mass, together with lower serum glucose levels. The HG Group presented an increase in blood pressure and a higher platelet aggregation, while the BN supplementation was able to blunt this effect. The HG Group also showed an increase in contractile response that was phenylephrine-induced and a decrease in maximum relaxation that was acetylcholine-induced when compared to the other groups.Conclusion: The BN supplementation was able to prevent an impaired vascular function in the early stages of arterial hypertension, while also improving body composition, serum glucose, and platelet aggregation.
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Affiliation(s)
- Henrique Saldanha Melo
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | | | - Nathalia da Silva Costa
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Thais Bento Bernardes
- Molecular Endocrinology Laboratory, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Niterói, Rio de Janeiro, Brazil
| | - D'Angelo Carlo Magliano
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Morphological and Metabolic Analyses, Department of Morphology, Biomedical Institute, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Aline D'Avila Pereira
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Patricia Pereira Almeida
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Gabriel Ferreira Lima
- Laboratory of Experimental Pharmacology, Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Fernanda Carla Ferreira de Brito
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Experimental Pharmacology, Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Milena Barcza Stockler Pinto
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Department of Nutrition and Dietetics, College of Nutrition, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Nutrition Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Raquel Kindlovits
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Anna Beatriz Nogueira
- Laboratory of Exercise Sciences, Department of Physiology and Pharmacology, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Vinicius Sepúlveda-Fragoso
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Antonio Claudio Lucas da Nóbrega
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Exercise Sciences, Department of Physiology and Pharmacology, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Nadia Alice Vieira da Motta
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Experimental Pharmacology, Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Renata Frauches Medeiros
- Cardiovascular Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Department of Nutrition and Dietetics, College of Nutrition, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Nutrition Sciences Postgraduate Program, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Exercise Sciences, Department of Physiology and Pharmacology, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
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24
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Fang K, He Y, Fang Y, Lian Y. Relationship of Sodium Intake with Overweight/Obesity among Chinese Children and Adolescents: Data from the CNNHS 2010-2012. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094551. [PMID: 33923000 PMCID: PMC8123343 DOI: 10.3390/ijerph18094551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/14/2021] [Accepted: 04/23/2021] [Indexed: 12/20/2022]
Abstract
This study aims to examine association between sodium intake and overweight/obesity among Chinese children and adolescents. Data were obtained from China National Nutrition and Health Surveillance (CNNHS), 2010–2012. All participants recruited in this study aged 7–18 years old and provided complete dietary data on three-day consecutive 24 h dietary recalls combining with the household weighing method. Body Mass Index (BMI) was used to define overweight/obesity, and waist-to-height ratio (WHtR) was used to define abdominal obesity. Sodium intake showed association with risk of overweight/obesity assessed by BMI in the highest tertile group with OR of 1.48 (95%CI 1.13–1.94) and 1.89 (95%CI 1.33–2.67) for WHtR. After adjusted for gender, age, household income, area, energy, carbohydrates, protein, fat, saturated fatty acids, and fiber intake, the relationship between sodium intake and overweight/obesity and abdominal obesity are not changed. The same results were founded in subjects aged 10–18 years old. Our results reveal a positive association between sodium intake and overweight/obesity in Chinese children and adolescents, independent of energy consumption.
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Affiliation(s)
| | - Yuna He
- Correspondence: ; Tel.: +86-010-67791292
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25
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Zhao L, Ogden CL, Yang Q, Jackson SL, Loria CM, Galuska DA, Wiltz JL, Merritt R, Cogswell ME. Association of Usual Sodium Intake with Obesity Among US Children and Adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021; 29:587-594. [PMID: 33528899 PMCID: PMC9134125 DOI: 10.1002/oby.23102] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the association of sodium intake with obesity in US children and adolescents. METHODS Cross-sectional data were analyzed for 9,026 children and adolescents in the National Health and Nutrition Examination Survey (NHANES) 2009-2016. Usual sodium intake was estimated from 24-hour dietary recalls using a measurement error model. Logistic regression was used to assess the association of sodium intake with overweight/obesity, obesity, and central obesity (waist to height ratio [WtHR] ≥ 0.5; waist circumferences (WC) ≥ age- and sex-specific 90th percentile). RESULTS Mean (SE) sodium intake was 3,010 (9) and 3,404 (20) mg/d for children and adolescents, respectively. The adjusted odds ratio (AOR) comparing Q4 versus Q1 (87.5th vs. 12.5th percentile of sodium intake) among children was 1.98 (95% CI: 1.19-3.28) for overweight/obesity, 2.20 (1.30-3.73) for obesity, 2.10 (1.12-3.95) for WC ≥ 90th percentile, and 1.68 (0.95-2.97) for WtHR ≥ 0.5, adjusting for demographics, energy, and sugar-sweetened beverage intake. Among adolescents, AOR was 1.81 (0.98-3.37) for overweight/obesity, 1.71 (0.82-3.56) for obesity, 1.62 (0.71-3.66) for WC ≥ 90th percentile, and 1.73 (0.85-3.50) for WtHR ≥ 0.5. CONCLUSIONS Sodium intake was positively associated with overweight/obesity, obesity, and central obesity among US children independent of energy and SSB intake, but the association did not reach significance among adolescents.
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Affiliation(s)
- Lixia Zhao
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- IHRC, Inc., Atlanta, Georgia, USA
| | - Cynthia L. Ogden
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA
| | - Quanhe Yang
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sandra L. Jackson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Catherine M. Loria
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Deborah A. Galuska
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer L. Wiltz
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- United States Public Health Service, Atlanta, Georgia, USA
| | - Robert Merritt
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary E. Cogswell
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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26
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Chailimpamontree W, Kantachuvesiri S, Aekplakorn W, Lappichetpaiboon R, Sripaiboonkij Thokanit N, Vathesatogkit P, Kunjang A, Boonyagarn N, Sukhonthachit P, Chuaykarn N, Sonkhammee P, Khunsaard P, Nuntapanich P, Charoenbut P, Thongchai C, Uttarachai A, Kwankhoom W, Rattanakanahutanon F, Ruangchai K, Yanti N, Sasang N, Bunluesin S, Garg R. Estimated dietary sodium intake in Thailand: A nationwide population survey with 24-hour urine collections. J Clin Hypertens (Greenwich) 2021; 23:744-754. [PMID: 33420751 PMCID: PMC8678751 DOI: 10.1111/jch.14147] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 01/21/2023]
Abstract
Thailand has committed to reducing population sodium intake by 30% by 2025. However, reliable nationally representative data are unavailable for monitoring progress toward the goal. We estimated dietary sodium consumption using 24‐hour urinary analyses in a nationally representative, cross‐sectional population‐based survey. We selected 2388 adults (aged ≥ 18 years) from the North, South, North‐east, Central Regions, and Bangkok, using multi‐stage cluster sampling. Mean sodium excretion was inflated by 10% to adjust for non‐urinary sources. Multivariate logistic regression was performed to assess factors associated with sodium consumption ≥ 2000 mg. Among 1599 (67%) who completed urine collection, mean age was 43 years, 53% were female, and 30% had hypertension. Mean dietary sodium intake (mg/day) was 3636 (±1722), highest in South (4108 ± 1677), and lowest in North‐east (3316 ± 1608). Higher sodium consumption was independently associated with younger age (Adjusted Odds Ratio (AOR) 2.81; 95% Confidence interval (CI): 1.53‐5.17; p = .001); higher education (AOR 1.79; 95% CI: 1.19‐2.67; p = .005), BMI ≥ 25 (AOR 1.55; 95% CI: 1.09‐2.21; p=.016), and hypertension (AOR 1.58; 95% CI: 1.02‐2.44; p = .038). Urine potassium excretion was 1221 mg/day with little variation across Regions. Estimated dietary sodium consumption in Thai adults is nearly twice as high as recommended levels. These data provide a benchmark for future monitoring.
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Affiliation(s)
- Worawon Chailimpamontree
- Division of Nephrology, Department of Medicine, Chandrubeksa hospital, Nakhon Pathom, Thailand.,Thai low salt network, Nephrology Society of Thailand, Bangkok, Thailand
| | - Surasak Kantachuvesiri
- Thai low salt network, Nephrology Society of Thailand, Bangkok, Thailand.,Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Raweewan Lappichetpaiboon
- Thai low salt network, Nephrology Society of Thailand, Bangkok, Thailand.,Department of Nutrition, Fort Nawamintharachini Hospital, Chon Buri, Thailand
| | | | - Prin Vathesatogkit
- Division of Cardiology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ananthaya Kunjang
- Thai low salt network, Nephrology Society of Thailand, Bangkok, Thailand
| | | | - Penmat Sukhonthachit
- Faculty of Science and Technology, Songkhla Rajabhat University, Songkhla, Thailand
| | - Narinphop Chuaykarn
- Faculty of Liberal Arts, Rajamangala University of Technology Srivijaya, Songkhla, Thailand
| | | | - Payong Khunsaard
- Faculty of Public Health, Chiang Rai College, Chiang Rai, Thailand
| | | | - Pattaraporn Charoenbut
- Faculty of Public Health, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
| | - Comsun Thongchai
- Faculty of Public Health, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
| | - Apinya Uttarachai
- Faculty of Public Health, Valaya Alongkorn Rajabhat University under the Royal Patronage, Pathum Thani, Thailand
| | - Wisrut Kwankhoom
- Faculty of Science and Technology, Valaya Alongkorn Rajabhat University under the Royal Patronage, Pathum Thani, Thailand
| | - Fuangfah Rattanakanahutanon
- Faculty of Public Health, Valaya Alongkorn Rajabhat University under the Royal Patronage, Pathum Thani, Thailand
| | - Krich Ruangchai
- Faculty of Public Health, Valaya Alongkorn Rajabhat University under the Royal Patronage, Pathum Thani, Thailand
| | - Nadchar Yanti
- Faculty of Public Health, Valaya Alongkorn Rajabhat University under the Royal Patronage, Pathum Thani, Thailand
| | - Natnapa Sasang
- Faculty of Public Health, Phranakhon Si Ayutthaya Rajabhat University, Phra Nakhon Si Ayutthaya, Thailand
| | | | - Renu Garg
- WHO Country Office for Thailand, Bangkok, Thailand
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Causal associations between urinary sodium with body mass, shape and composition: a Mendelian randomization study. Sci Rep 2020; 10:17475. [PMID: 33060734 PMCID: PMC7562909 DOI: 10.1038/s41598-020-74657-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/06/2020] [Indexed: 12/26/2022] Open
Abstract
Observational studies have found associations between urinary sodium (UNa) with obesity, body shape and composition; but the findings may be biased by residual confounding. The objective of this two-sample Mendelian randomization (MR) study was to analyze their causal associations in both sex-combined and sex-specific models. Genome-wide association studies of UNa, body mass index (BMI), BMI-adjusted waist-to-hip ratio (WHR), body fat (BF) percentage and estimated glomerular filtration rate (eGFR) were identified. We initially extracted fifty SNPs associated with UNa at significance level of 5 × 10–8, but further removed those SNPs with potential horizontal pleiotropy. Univariable and multivariable MR with adjustment for eGFR were performed. Inverse-variance weighted MR was performed as the primary analysis, with MR-Egger methods as sensitivity analysis. The potential bidirectional association between BMI and UNa was investigated. All exposure and outcomes were continuous, and the effect measure was regression coefficients (beta) and their 95% confidence intervals (95% CI). The total sample size was up to 322 154. UNa was causally associated with increased BMI in both men [eGFR-adjusted beta 0.443 (0.163–0.724)] and women [0.594 (0.333–0.855)]. UNa caused BF percentage increase in men [0.622 (0.268–0.976)] and women [0.334 (0.007–0.662)]. UNa significantly elevated BMI-adjusted WHR in men [0.321 (0.094–0.548)], but not in women [0.170 (− 0.052 to 0.391)]. Additionally, we found that BMI causally increased UNa [0.043 (0.023–0.063)]. UNa increased BMI and BF percentage. Salt intake affects male body shape by increasing BMI-adjusted WHR, but showed no effects on female body shape. The bidirectional association between BMI and UNa suggested that salt reduction measures and weight reduction measures should be implemented simultaneously to break the vicious cycle and gain more health benefits.
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The association between dietary sodium intake, adiposity and sugar-sweetened beverages in children and adults: a systematic review and meta-analysis. Br J Nutr 2020; 126:409-427. [PMID: 33054868 DOI: 10.1017/s0007114520004122] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Higher intakes of Na may contribute to weight gain. The primary aim of this systematic review and meta-analysis was to examine the relationship between dietary Na intake and measures of adiposity in children and adults. Given the previous link between Na intake and the consumption of sugar-sweetened beverages (SSB), which are a known risk factor for obesity, a secondary aim examining the relationship between Na intake and SSB consumption was assessed. A systematic literature search identified cross-sectional and longitudinal studies and randomised controlled trials (RCT) which reduced dietary Na (≥3 months). Meta-analysis was performed for outcomes with ≥3 studies. Cross-sectionally higher Na intakes were associated with overweight/obesity in adults (five studies; n 11 067; OR 1·74; 95 % CI 1·43, 2·13) and in children (three studies; n 3625, OR 3·29; 95 % CI 2·25, 4·80), and abdominal obesity (five studies; n 19 744; OR 2·04; 95 % CI 1·72, 2·42) in adults. Overall, associations remained in sensitivity analyses which adjusted for energy. Findings from longitudinal studies were inconsistent. RCT in adults indicated a trend for lower body weight on reduced-Na compared with control diets (fifteen studies; n 5274; -0·29 kg; 95 % CI -0·59, 0·01; P = 0·06); however, it is unclear if energy intakes were also altered on reduced-Na diets. Among children higher Na intakes were associated with higher intake of SSB (four studies, n 10 329, b = 22, 16 and 26 g/d); no studies were retrieved for adults. Overall, there was a lack of high-quality studies retrieved. While cross-sectional evidence indicates Na intake was positively associated with adiposity, these findings have not been clearly confirmed by longitudinal studies or RCT.
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He FJ, Tan M, Ma Y, MacGregor GA. Salt Reduction to Prevent Hypertension and Cardiovascular Disease: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 75:632-647. [PMID: 32057379 DOI: 10.1016/j.jacc.2019.11.055] [Citation(s) in RCA: 275] [Impact Index Per Article: 68.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/04/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022]
Abstract
There is strong evidence for a causal relationship between salt intake and blood pressure. Randomized trials demonstrate that salt reduction lowers blood pressure in both individuals who are hypertensive and those who are normotensive, additively to antihypertensive treatments. Methodologically robust studies with accurate salt intake assessment have shown that a lower salt intake is associated with a reduced risk of cardiovascular disease, all-cause mortality, and other conditions, such as kidney disease, stomach cancer, and osteoporosis. Multiple complex and interconnected physiological mechanisms are implicated, including fluid homeostasis, hormonal and inflammatory mechanisms, as well as more novel pathways such as the immune response and the gut microbiome. High salt intake is a top dietary risk factor. Salt reduction programs are cost-effective and should be implemented or accelerated in all countries. This review provides an update on the evidence relating salt to health, with a particular focus on blood pressure and cardiovascular disease, as well as the potential mechanisms.
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Affiliation(s)
- Feng J He
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
| | - Monique Tan
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yuan Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Graham A MacGregor
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Naser AM, Rahman M, Unicomb L, Doza S, Selim S, Chaity M, Luby SP, Anand S, Staimez L, Clasen TF, Gujral UP, Gribble MO, Narayan KMV. Past Sodium Intake, Contemporary Sodium Intake, and Cardiometabolic Health in Southwest Coastal Bangladesh. J Am Heart Assoc 2020; 9:e014978. [PMID: 32875927 PMCID: PMC7727005 DOI: 10.1161/jaha.119.014978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 07/30/2020] [Indexed: 02/07/2023]
Abstract
Background We compared the relationship of past and contemporary sodium (Na) intake with cardiometabolic biomarkers. Methods and Results A total of 1191 participants' data from a randomized controlled trial in coastal Bangladesh were analyzed. Participants provided 24-hour urine Na (24UNa) data for 5 monthly visits. Their fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein, blood pressure, and 24-hour urine protein were measured at the fifth visit. Participants' mean 24UNa over the first 4 visits was the past Na, and 24UNa of the fifth visit was the contemporary Na intake. We estimated the prevalence ratios of elevated cardiometabolic biomarkers and metabolic syndrome across 24UNa tertiles by multilevel logistic regression using participant-, household-, and community-level random intercepts. Models were adjusted for age, sex, body mass index, smoking, physical activity, alcohol consumption, sleep hours, religion, and household wealth. Compared with participants in tertile 1 of past urine Na, those in tertile 3 had 1.46 (95% CI, 1.08-1.99) times higher prevalence of prediabetes or diabetes mellitus, 5.49 (95% CI, 2.73-11.01) times higher prevalence of large waist circumference, and 1.60 (95% CI, 1.04-2.46) times higher prevalence of metabolic syndrome. Compared with participants in tertile 1 of contemporary urine Na, those in tertile 3 had 1.93 (95% CI, 1.24-3.00) times higher prevalence of prediabetes or diabetes mellitus, 3.14 (95% CI, 1.45-6.83) times higher prevalence of proteinuria, and 2.23 (95% CI, 1.34-3.71) times higher prevalence of large waist circumference. Conclusions Both past and contemporary Na intakes were associated with higher cardiometabolic disease risk.
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Affiliation(s)
- Abu Mohd Naser
- Emory Global Diabetes Research CenterHubert Department of Global HealthRollins School of Public HealthEmory UniversityAtlantaGA
| | - Mahbubur Rahman
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b)DhakaBangladesh
| | - Leanne Unicomb
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b)DhakaBangladesh
| | - Solaiman Doza
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b)DhakaBangladesh
| | - Shahjada Selim
- Department of EndocrinologyBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | | | - Stephen P. Luby
- Division of Infectious Diseases and Geographic MedicineStanford UniversityStanfordCA
| | - Shuchi Anand
- Division of NephrologySchool of MedicineStanford UniversityStanfordCA
| | - Lisa Staimez
- Emory Global Diabetes Research CenterHubert Department of Global HealthRollins School of Public HealthEmory UniversityAtlantaGA
| | - Thomas F. Clasen
- Gangarosa Department of Environmental Health SciencesRollins School of Public HealthEmory UniversityAtlantaGA
| | - Unjali P. Gujral
- Emory Global Diabetes Research CenterHubert Department of Global HealthRollins School of Public HealthEmory UniversityAtlantaGA
| | - Matthew O. Gribble
- Gangarosa Department of Environmental Health SciencesRollins School of Public HealthEmory UniversityAtlantaGA
- Department of EpidemiologyRollins School of Public HealthEmory UniversityAtlantaGA
| | - K. M. Venkat Narayan
- Emory Global Diabetes Research CenterHubert Department of Global HealthRollins School of Public HealthEmory UniversityAtlantaGA
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Mohammadifard N, Haghighatdoost F, Nouri F, Khosravi A, Sarrafzadegan N. Is urinary sodium excretion related to anthropometric indicators of adiposity in adults? JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:50. [PMID: 32765620 PMCID: PMC7377121 DOI: 10.4103/jrms.jrms_1048_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 10/22/2019] [Accepted: 01/22/2020] [Indexed: 11/04/2022]
Abstract
Background Although increasing salt intake is associated with greater odds of obesity, little is known about its relationship with body fat. We investigated the relation of urinary sodium (UNa) with obesity indices, including Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), a body shape index (ABSI), body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). Materials and Methods A total of 508 free-living adults aged ≥ 19 years were selected through stratified multistage random method as a representative of general population from central parts of Iran and were included in this cross-sectional study. Dietary sodium intake was measured using 24-h UNa (24-UNa) excretion. Weight, height, and WC were measured using standard protocols and calibrated equipment and used to measure obesity indicators, including BMI, WHtR, ABSI, and CUN-BAE. Adjusted univariate multiple logistic regression was used to assess the risk of having greater obesity measures across the tertiles of 24-UNa. Results Individuals in the top tertile of 24-UNa in comparison with those in the first tertile had greater body weight (72.02 ± 1.00 vs. 66.02 ± 0.89 kg; P < 0.0001), BMI (26.14 ± 0.33 vs. 24.82 ± 0.29 kg/m2; P = 0.007), and CUN-BAE (29.89 ± 0.42 vs. 28.38 ± 0.78; P = 0.036). There was a trend toward an increment in WC by increasing sodium intake (P = 0.073). After controlling for potential confounders, individuals with greater sodium consumption had greater chance for overweight (odds ratio [OR]: 1.004, 95% confidence interval [CI]: 1.001-1.007; P = 0.015), abdominal obesity (OR: 1.004, 95% CI: 1.00-1.008; P = 0.031), and more body fat (OR: 1.007, 95% CI: 1.003-1.01; P = 0.001). No significant association was found for sodium and WHtR and ABSI. Conclusion Greater 24-UNa excretion was associated with greater means of body weight, BMI, WC, and CUN-BAE. Although changes in obesity indices per each additional 24-UNa excretion were small, our findings are relevant because of the rising obesity epidemic.
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Affiliation(s)
- Noushin Mohammadifard
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Sakboonyarat B, Pornpongsawad C, Sangkool T, Phanmanas C, Kesonphaet N, Tangthongtawi N, Limsakul A, Assavapisitkul R, Thangthai T, Janenopparkarnjana P, Varodomvitaya P, Dachoviboon W, Laohasara J, Kruthakool N, Limprasert S, Mungthin M, Hatthachote P, Rangsin R. Trends, prevalence and associated factors of obesity among adults in a rural community in Thailand: serial cross-sectional surveys, 2012 and 2018. BMC Public Health 2020; 20:850. [PMID: 32493314 PMCID: PMC7271557 DOI: 10.1186/s12889-020-09004-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/27/2020] [Indexed: 01/17/2023] Open
Abstract
Background Obesity is one principle risk factor increasing the risk of noncommunicable diseases including diabetes, hypertension and atherosclerosis. In Thailand, a 2014 study reported obesity (BMI ≥25 kg/m2) in a Thai population aged ≥15 years was 37.5, 32.9 and 41.8% overall and among males and females, respectively. The study aimed to determine trends in the prevalence of obesity among adults residing in a Thai rural community between 2012 and 2018 and investigate the associations between obesity and behavioral factors. Methods Serial cross-sectional studies were conducted in 2012 and 2018 among adults in Na-Ngam rural community. In 2012 and 2018, all 635 and 627 individuals, respectively, were interviewed using structured questionnaires related to demographics, risk behaviors, comorbidities and arthrometric measurement. Spot urine was collected by participants and obesity was defined as BMI ≥25 kg/m2. The risk factors for obesity were analyzed in the 2018 survey. Results A total of 1262 adults in Na-Ngam rural community were included in the study. The prevalence of obesity was 33.9% in 2012 and 44.8% in 2018 (P < 0.001). The average BMI increased from 23.9 ± 4.2 kg/m2 in 2012 to 25.0 ± 4.52 kg/m2 in 2018 (P < 0.001). Obesity was associated with higher age (AOR 0.99; 95%CI 0.97–0.99), smoking (AOR 0.52; 95%CI 0.28–0.94), instant coffee-mix consumption > 1 cup/week (AOR 1.44; 95%CI 1.02–2.04), higher number of chronic diseases (≥1 disease AOR 1.82; 95%CI 1.01–2.68, > 2 diseases AOR 2.15; 95%CI 1.32–3.50), and higher spot urine sodium level (AOR 1.002; 95%CI 0.99–1.01). Conclusion Our data emphasized that obesity constituted a serious problem among adults residing in a rural community. A trend in significant increase was found regarding the prevalence of obesity and average BMI in the rural community over 6 years. Effective public health interventions should be provided at the community level to reduce BMI. Moreover, modifiable risk factors for obesity should be attenuated to inhibit the progression of metabolic syndrome, noncommunicable diseases and their complications.
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Affiliation(s)
- Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
| | | | | | | | | | | | - Ammiga Limsakul
- Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | | | | | | | | | | | | | | | - Sarawuth Limprasert
- Department of Internal Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Mathirut Mungthin
- Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Panadda Hatthachote
- Department of Physiology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
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Association between dietary sodium intake and non-alcoholic fatty liver disease in the US population. Public Health Nutr 2020; 24:993-1000. [PMID: 32312347 DOI: 10.1017/s136898001900483x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To explore the association between dietary Na intake and non-alcoholic fatty liver disease (NAFLD) in a nationally representative sample of the US population. DESIGN In this cross-sectional study, the associations between Na intake and NAFLD, defined by the hepatic steatosis index (HSI) and the fatty liver index (FLI), were assessed through multivariable logistic regression models. SETTING Communities in the USA from 2007 to 2014. PARTICIPANTS Men and women aged 20 years and older. RESULTS A total of 11 022 participants were included in the HSI-defined NAFLD analysis, and a subsample of 5320 participants was included in the FLI-defined NAFLD analysis. Compared with the lowest quartile of Na intake, the highest quartile had a multivariate-adjusted OR and 95 % CI of 1·46 (1·29, 1·65) for NAFLD as defined by HSI, and 1·41 (1·18, 1·69) for NAFLD as defined by FLI. This association was, to some degree, attenuated but remained significant after adjusting for several related metabolic parameters, including BMI, hypertension, hypercholesterolaemia, and diabetes. CONCLUSIONS Findings from the current study indicate that dietary Na intake is positively associated with NAFLD in US adults.
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Zanetti D, Bergman H, Burgess S, Assimes TL, Bhalla V, Ingelsson E. Urinary Albumin, Sodium, and Potassium and Cardiovascular Outcomes in the UK Biobank: Observational and Mendelian Randomization Analyses. Hypertension 2020; 75:714-722. [PMID: 32008434 PMCID: PMC8032218 DOI: 10.1161/hypertensionaha.119.14028] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Supplemental Digital Content is available in the text. Urinary biomarkers are associated with cardiovascular disease, but the nature of these associations is not well understood. We performed multivariable-adjusted regression models to assess associations of random spot measurements of the urine sodium-potassium ratio (UNa/UK) and urine albumin adjusted for creatinine with cardiovascular risk factors, cardiovascular disease, and type 2 diabetes mellitus (T2D) in 478 311 participants of the UK Biobank. Further, we assessed the causal relationships of these kidney biomarkers, used as proxies for kidney function, with cardiovascular outcomes using the 2-sample Mendelian randomization approach. In observational analyses, UNa/UK showed significant inverse associations with atrial fibrillation, coronary artery disease, ischemic stroke, lipid-lowering medication, and T2D. In contrast, urine albumin adjusted for creatinine showed significant positive associations with atrial fibrillation, coronary artery disease, heart failure, hemorrhagic stroke, lipid-lowering medication, and T2D. We found a positive association between UNa/UK and albumin with blood pressure (BP), as well as with adiposity-related measures. After correcting for potential horizontal pleiotropy, we found evidence of causal associations of UNa/UK and albumin with BP (β systolic BP ≥2.63; β diastolic BP ≥0.85 SD increase in BP per SD change in UNa/UK and urine albumin adjusted for creatinine; P≤0.04), and of albumin with T2D (odds ratio=1.33 per SD change in albumin, P=0.02). Our comprehensive study of urinary biomarkers performed using state-of-the-art analyses of causality mirror and extend findings from randomized interventional trials which have established UNa/UK as a risk factor for hypertension. In addition, we detect a causal feedback loop between albumin and hypertension, and our finding of a bidirectional causal association between albumin and T2D reflects the well-known nephropathy in T2D.
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Affiliation(s)
- Daniela Zanetti
- From the Division of Cardiovascular Medicine, Department of Medicine (D.Z., T.L.A., E.I.), Stanford University School of Medicine, CA.,Stanford Cardiovascular Institute (D.Z., T.L.A., E.I.), Stanford University, CA.,Stanford Diabetes Research Center (D.Z., E.I.), Stanford University, CA
| | - Helene Bergman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden (H.B.)
| | - Stephen Burgess
- MRC Biostatistics Unit (S.B.), University of Cambridge, United Kingdom.,Department of Public Health and Primary Care (S.B.), University of Cambridge, United Kingdom
| | - Themistocles L Assimes
- From the Division of Cardiovascular Medicine, Department of Medicine (D.Z., T.L.A., E.I.), Stanford University School of Medicine, CA.,Stanford Cardiovascular Institute (D.Z., T.L.A., E.I.), Stanford University, CA.,Palo Alto VA Health Care System, CA (T.L.A.)
| | - Vivek Bhalla
- Division of Nephrology, Department of Medicine (V.B.), Stanford University School of Medicine, CA
| | - Erik Ingelsson
- From the Division of Cardiovascular Medicine, Department of Medicine (D.Z., T.L.A., E.I.), Stanford University School of Medicine, CA.,Stanford Cardiovascular Institute (D.Z., T.L.A., E.I.), Stanford University, CA.,Stanford Diabetes Research Center (D.Z., E.I.), Stanford University, CA
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Sarebanhassanabadi M, Mirhosseini SJ, Mirzaei M, Namayandeh SM, Soltani MH, Salehi-Abargouei A. The association between a dietary habits score and the risk of metabolic syndrome: A cohort study. Clin Nutr 2020; 39:282-290. [DOI: 10.1016/j.clnu.2019.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 01/02/2019] [Accepted: 02/04/2019] [Indexed: 02/02/2023]
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36
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van den Berg EH, Gruppen EG, Blokzijl H, Bakker SJ, Dullaart RP. Higher Sodium Intake Assessed by 24 Hour Urinary Sodium Excretion Is Associated with Non-Alcoholic Fatty Liver Disease: The PREVEND Cohort Study. J Clin Med 2019; 8:jcm8122157. [PMID: 31817623 PMCID: PMC6947413 DOI: 10.3390/jcm8122157] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/30/2019] [Accepted: 12/04/2019] [Indexed: 01/05/2023] Open
Abstract
A higher sodium intake is conceivably associated with insulin resistant conditions like obesity, but associations of non-alcoholic fatty liver disease (NAFLD) with a higher sodium intake determined by 24 hours (24 h) urine collections are still unclear. Dietary sodium intake was measured by sodium excretion in two complete consecutive 24 h urine collections in 6132 participants of the Prevention of Renal and Vascular End-Stage Disease (PREVEND) cohort. Fatty Liver Index (FLI) ≥60 and Hepatic Steatosis Index (HSI) >36 were used as proxies of suspected NAFLD. 1936 (31.6%) participants had an FLI ≥60, coinciding with the increased prevalence of type 2 diabetes (T2D), metabolic syndrome, hypertension and history of cardiovascular disease. Sodium intake was higher in participants with an FLI ≥60 (163.63 ± 61.81 mmol/24 h vs. 136.76 ± 50.90 mmol/24 h, p < 0.001), with increasing incidence in ascending quartile categories of sodium intake (p < 0.001). Multivariably, an FLI ≥60 was positively associated with a higher sodium intake when taking account for T2D, a positive cardiovascular history, hypertension, alcohol intake, smoking and medication use (odds ratio (OR) 1.54, 95% confidence interval (CI) 1.44–1.64, p < 0.001). Additional adjustment for the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) diminished this association (OR 1.30, 95% CI 1.21–1.41, p < 0.001). HSI >36 showed similar results. Associations remained essentially unaltered after adjustment for body surface area or waist/hip ratio. In conclusion, suspected NAFLD is a feature of higher sodium intake. Insulin resistance-related processes may contribute to the association of NAFLD with sodium intake.
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Affiliation(s)
- Eline H. van den Berg
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (E.G.G.)
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands;
- Correspondence: ; Tel.: +31-50-3616161
| | - Eke G. Gruppen
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (E.G.G.)
- Department of Nephrology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands;
| | - Hans Blokzijl
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands;
| | - Stephan J.L. Bakker
- Department of Nephrology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands;
| | - Robin P.F. Dullaart
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, 9700RB Groningen, The Netherlands; (E.G.G.)
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The Effect of a Low Glycemic Index Pulse-Based Diet on Insulin Sensitivity, Insulin Resistance, Bone Resorption and Cardiovascular Risk Factors during Bed Rest. Nutrients 2019; 11:nu11092012. [PMID: 31461862 PMCID: PMC6770095 DOI: 10.3390/nu11092012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 12/16/2022] Open
Abstract
We determined the effects of a low glycemic-index pulse-based diet (i.e., containing lentils, chick peas, beans, and split peas) compared to a typical hospital diet on insulin sensitivity assessed by the Matsuda index from the insulin and glucose response to a two-hour oral glucose tolerance test, insulin resistance assessed by the homeostatic model assessment of insulin resistance (HOMA-IR), bone resorption assessed by 24 h excretion of urinary n-telopeptides(Ntx) and cardiovascular risk factors (blood lipids, blood pressure, arterial stiffness and heart rate variability) during bed rest. Using a randomized, counter-balanced cross-over design with one-month washout, six healthy individuals (30 ± 12 years) consumed the diets during four days of bed rest. The Matsuda index, HOMA-IR, urinary Ntx and cardiovascular risk factors were determined at baseline and after the last day of bed rest. Compared to the typical hospital diet, the pulse-based diet improved the Matsuda index (indicating increased insulin sensitivity; baseline to post-bed rest: 6.54 ± 1.94 to 6.39 ± 2.71 hospital diet vs. 7.14 ± 2.36 to 8.75 ± 3.13 pulse-based diet; p = 0.017), decreased HOMA-IR (1.38 ± 0.54 to 1.37 ± 0.50 hospital diet vs. 1.48 ± 0.54 to 0.88 ± 0.37 pulse-based diet; p = 0.022), and attenuated the increase in Ntx (+89 ± 75% hospital diet vs. +33 ± 20% pulse-based diet; p = 0.035). No differences for changes in cardiovascular risk factors were found between the two diet conditions, with the exception of decreased diastolic blood pressure during day three of bed rest in the pulse-based versus hospital diet (61 ± 9 vs. 66 ± 7 mmHg; p = 0.03). A pulse-based diet was superior to a hospital diet for maintaining insulin sensitivity, preventing insulin resistance, attenuating bone resorption and decreasing diastolic blood pressure during four days of bed rest.
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Zhou L, Stamler J, Chan Q, Van Horn L, Daviglus ML, Dyer AR, Miura K, Okuda N, Wu Y, Ueshima H, Elliott P, Zhao L. Salt intake and prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States: the INTERMAP Study. Am J Clin Nutr 2019; 110:34-40. [PMID: 31111867 PMCID: PMC6599742 DOI: 10.1093/ajcn/nqz067] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 03/29/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Several studies have reported that dietary salt intake may be an independent risk factor for overweight/obesity, but results from previous studies are controversial, reflecting study limitations such as use of a single spot urine or dietary recall to estimate daily salt intake rather than 24-h urine collections, and population samples from only a single country or center. OBJECTIVE The aim of this study was to use data from the International Study of Macro-/Micro-nutrients and Blood Pressure (INTERMAP Study) to explore the relation between dietary salt intake estimated from 2 timed 24-h urine collections and body mass index (BMI; in kg/m2) as well as prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States. METHODS Data were from a cross-sectional study of 4680 men and women aged 40-59 y in Japan (n = 1145), China (n = 839), the United Kingdom (n = 501), and the United States (n = 2195). General linear models were used to obtain the regression coefficients (β) of salt intake associated with BMI. Multivariable logistic regression models were used to determine the ORs and 95% CIs of overweight/obesity associated with a 1-g/d higher dietary salt intake. RESULTS After adjustment for potential confounding factors including energy intake, salt intake 1 g/d higher was associated with BMI higher by 0.28 in Japan, 0.10 in China, 0.42 in the United Kingdom, and 0.52 in the United States, all P values < 0.001. Salt intake 1 g/d higher was associated with odds of overweight/obesity 21% higher in Japan, 4% higher in China, 29% higher in the United Kingdom, and 24% higher in the United States, all P values < 0.05. CONCLUSIONS Salt intake is positively associated with BMI and the prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States. This association needs to be further confirmed in well-designed prospective studies with repeated dietary and BMI measurements.This trial was registered at clinicaltrials.gov as NCT00005271.
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Affiliation(s)
- Long Zhou
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jeremiah Stamler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois, Chicago, IL
| | - Alan R Dyer
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Yangfeng Wu
- School of Public Health and Clinical Research Institute, Peking University, Beijing, China
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Liancheng Zhao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Negi PC, Sondhi S, Merwaha R, Asotra S. Prevalence and risk determinants of metabolic syndrome in obese worksite workers in hill city of Himachal Pradesh, India. Indian Heart J 2019; 71:45-51. [PMID: 31000182 PMCID: PMC6477127 DOI: 10.1016/j.ihj.2019.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 12/25/2018] [Accepted: 01/20/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE We report prevalence and risk factors of metabolic syndrome (MS) in the obese workforce of organized sector in hill city of Himachal Pradesh (HP), India. METHODS The cross-sectional survey study of employees of organized sectors in Shimla city of HP, India, was conducted to collect data of demographics, health behavior, psychosocial factors, anthropometry, blood pressure, and blood chemistry to measure blood glucose and lipid profile in fasting state in 3004 employees using validated tools. Out of 3004 subjects screened, data of 418 subjects with body mass index of ≥30 are analyzed to estimate the prevalence of MS and its risk determinants. The association of demographics, health behavior, and psychosocial factors as the risk determinants were analyzed using multivariable logistic regression modeling. RESULTS MS was prevalent in 57.6% [95% confidence interval (CI): 52.8%-62.3%]. The central obesity (odds ratio: 10.6, 95% CI: 2.32-48.4) and consumption of frequent or daily alcohol (odds ratio: 1.94, 95% CI: 1.05-3.59),and extra salt (odds ratio: 3.34, 95% CI: 1.09-10.2) were independent risk factors for MS. The consumption of tobacco, vegetables, sugar-sweetened drinks, physical inactivity, and psychosocial factors had no significant association with MS in obese population. CONCLUSIONS MS is highly prevalent among obese employees of organized sector. The consumption of alcohol and extra salt were major behavioral risk factors for MS and therefore have important implications in behavioral modifications for prevention of MS among obese employees in organized sectors.
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Affiliation(s)
- P C Negi
- Chandar Kant Research Associate II MRU, IGMC Shimla, HP, India.
| | - Sachin Sondhi
- Chandar Kant Research Associate II MRU, IGMC Shimla, HP, India
| | - Rajeev Merwaha
- Chandar Kant Research Associate II MRU, IGMC Shimla, HP, India
| | - Sanjeev Asotra
- Chandar Kant Research Associate II MRU, IGMC Shimla, HP, India
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Gao P, Yan Z, Zhu Z. The role of adipose TRP channels in the pathogenesis of obesity. J Cell Physiol 2019; 234:12483-12497. [PMID: 30618095 DOI: 10.1002/jcp.28106] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 12/07/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Peng Gao
- Department of Hypertension and Endocrinology Center for Hypertension and Metabolic Diseases, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension Chongqing China
| | - Zhencheng Yan
- Department of Hypertension and Endocrinology Center for Hypertension and Metabolic Diseases, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension Chongqing China
| | - Zhiming Zhu
- Department of Hypertension and Endocrinology Center for Hypertension and Metabolic Diseases, Daping Hospital, Third Military Medical University, Chongqing Institute of Hypertension Chongqing China
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Zhao L, Cogswell ME, Yang Q, Zhang Z, Onufrak S, Jackson SL, Chen TC, Loria CM, Wang CY, Wright JD, Terry AL, Merritt R, Ogden CL. Association of usual 24-h sodium excretion with measures of adiposity among adults in the United States: NHANES, 2014. Am J Clin Nutr 2019; 109:139-147. [PMID: 30624582 PMCID: PMC6500904 DOI: 10.1093/ajcn/nqy285] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/19/2018] [Indexed: 12/19/2022] Open
Abstract
Background Both excessive sodium intake and obesity are risk factors for hypertension and cardiovascular disease. The association between sodium intake and obesity is unclear, with few studies assessing sodium intake using 24-h urine collection. Objectives Our objective was to assess the association between usual 24-h sodium excretion and measures of adiposity among US adults. Methods Cross-sectional data were analyzed from a sample of 730 nonpregnant participants aged 20-69 y who provided up to 2 complete 24-h urine specimens in the NHANES 2014 and had data on overweight or obesity [body mass index (kg/m2) ≥25] and central adiposity [waist circumference (WC): >88 cm for women, >102 cm for men]. Measurement error models were used to estimate usual sodium excretion, and multiple linear and logistic regression models were used to assess its associations with measures of adiposity, adjusting for sociodemographic, health, and dietary variables [i.e., energy intake or sugar-sweetened beverage (SSB) intake]. All analyses accounted for the complex survey sample design. Results Unadjusted mean ± SE usual sodium excretion was 3727 ± 43.5 mg/d and 3145 ± 55.0 mg/d among participants with and without overweight/obesity and 3653 ± 58.1 mg/d and 3443 ± 35.3 mg/d among participants with or without central adiposity, respectively. A 1000-mg/d higher sodium excretion was significantly associated with 3.8-units higher BMI (95% CI: 2.8, 4.8) and a 9.2-cm greater WC (95% CI: 6.9, 11.5 cm) adjusted for covariates. Compared with participants in the lowest quartile of sodium excretion, the adjusted prevalence ratios in the highest quartile were 1.93 (95% CI: 1.69, 2.20) for overweight/obesity and 2.07 (95% CI: 1.74, 2.46) for central adiposity. The associations also were significant when adjusting for SSBs, instead of energy, in models. Conclusions Higher usual sodium excretion is associated with overweight/obesity and central adiposity among US adults.
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Affiliation(s)
- Lixia Zhao
- National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA,IHRC, Inc., Atlanta, GA,Address correspondence to LZ (e-mail: )
| | - Mary E Cogswell
- National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA
| | - Quanhe Yang
- National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA
| | - Zefeng Zhang
- National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA
| | - Stephen Onufrak
- National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA
| | - Sandra L Jackson
- National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA
| | - Te-Ching Chen
- National Center for Health Statistics, CDC, Hyattsville, MD
| | | | - Chia-Yih Wang
- National Center for Health Statistics, CDC, Hyattsville, MD
| | | | - Ana L Terry
- National Center for Health Statistics, CDC, Hyattsville, MD
| | - Robert Merritt
- National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA
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Brey CW, Akbari-Alavijeh S, Ling J, Sheagley J, Shaikh B, Al-Mohanna F, Wang Y, Gaugler R, Hashmi S. Salts and energy balance: A special role for dietary salts in metabolic syndrome. Clin Nutr 2018; 38:1971-1985. [PMID: 30446179 DOI: 10.1016/j.clnu.2018.10.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/20/2018] [Accepted: 10/28/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Dietary salts sodium (Na+), potassium (K+), magnesium (Mg2+), and calcium (Ca2+) are important in metabolic diseases. Yet, we do not have sufficient understanding on the salts global molecular network in these diseases. In this systematic review we have pooled information to identify the general effect of salts on obesity, insulin resistance and hypertension. AIMS To assess the roles of salts in metabolic disorders by focusing on their individual effect and the network effect among these salts. METHODS We searched articles in PubMed, EMBASE and Google Scholar. We selected original laboratory research, systematic reviews, clinical trials, observational studies and epidemiological data that focused on dietary salts and followed the preferred reporting items for systematic review in designing the present systematic review. RESULTS From the initial search of 2898 studies we selected a total of 199 articles that met our inclusion criteria and data extraction. Alterations in metabolic pathways associated with the sensitivity of sodium, potassium, magnesium and calcium may lead to obesity, hypertension, and insulin resistance. We found that the results of most laboratory research, animal studies and clinical trials are coherent but some research outcome are either inconsistent or inconclusive. CONCLUSION Important of salts in metabolic disorder is evident. In order to assess the effects of dietary salts in metablic diseases, environmental factors, dietary habits, physical activity, and the microbiome, should be considered in any study. Although interest in this area of research continues to grow, the challenge is to integrate the action of these salts in metabolic syndrom.
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Affiliation(s)
| | - Safoura Akbari-Alavijeh
- Laboratory of Developmental Biology, Center for Vector Biology, Rutgers University, 180 Jones Avenue, New Brunswick, NJ, 08901, USA
| | - Jun Ling
- Department of Basic Sciences, Geisinger Commonwealth School of Medicine, 525 Pine Street, Scranton, PA, 18509, USA
| | - Jordan Sheagley
- Department of Basic Sciences, Geisinger Commonwealth School of Medicine, 525 Pine Street, Scranton, PA, 18509, USA
| | - Bilal Shaikh
- Laboratory of Developmental Biology, Center for Vector Biology, Rutgers University, 180 Jones Avenue, New Brunswick, NJ, 08901, USA
| | | | - Yi Wang
- Laboratory of Developmental Biology, Center for Vector Biology, Rutgers University, 180 Jones Avenue, New Brunswick, NJ, 08901, USA
| | - Randy Gaugler
- Laboratory of Developmental Biology, Center for Vector Biology, Rutgers University, 180 Jones Avenue, New Brunswick, NJ, 08901, USA
| | - Sarwar Hashmi
- Laboratory of Developmental Biology, Center for Vector Biology, Rutgers University, 180 Jones Avenue, New Brunswick, NJ, 08901, USA; Rutgers Center for Lipid Research, New Jersey Institute for Food, Nutrition, & Health, Rutgers University, USA.
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Park YM, Kwock CK, Park S, Eicher-Miller HA, Yang YJ. An association of urinary sodium-potassium ratio with insulin resistance among Korean adults. Nutr Res Pract 2018; 12:443-448. [PMID: 30323912 PMCID: PMC6172169 DOI: 10.4162/nrp.2018.12.5.443] [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: 04/02/2018] [Revised: 07/05/2018] [Accepted: 09/20/2018] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was conducted to investigate the effects of sodium-potassium ratio on insulin resistance and sensitivity in Korean adults. SUBJECTS/METHODS Subjects were 3,722 adults (1,632 men and 2,090 women) aged 40-69 years participating in the Korean genome and epidemiology study_Ansan and Ansung study. Insulin resistance was assessed using homeostasis model assessment of insulin resistance (HoMA-IR) and fasting insulin, and insulin sensitivity was assessed by using the quantitative insulin sensitivity check index (QUICKI). The 24-h urinary sodium and potassium excretion were estimated from spot urinary samples using the Tanaka formula. The generalized linear model was applied to determine the association between urinary sodium-potassium ratio and insulin resistance. RESULTS HoMA-IR (P-value = 0.029, P-trend = 0.008) and fasting insulin (P-value = 0.017, P-trend = 0.005) levels were positively associated with 24-h estimated urinary sodium-potassium ratio in the multivariable model. QUICKI was inversely associated with 24-h estimated urinary sodium-potassium ratio in all models (P-value = 0.0002, P-trend < 0.0001 in the multivariate model). CONCLUSION The present study suggests that high sodium-potassium ratio is related to high insulin resistance and low insulin sensitivity. Decreasing sodium intake and increasing potassium intake are important for maintaining insulin sensitivity. Further studies are needed to confirm these findings in longitudinal studies.
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Affiliation(s)
- Yeong Mi Park
- Department of Foods and Nutrition, Dongduk Women's University, 60, Hwarang-ro 13-gil, Seongbuk-gu, Seoul 02748, Korea
| | - Chang Keun Kwock
- Nutrition and Diet Research Group, Korea Food Research Institute, Jeonbuk 55365, Korea
| | - Seyeon Park
- Department of Applied Chemistry, Dongduk Women's University, Seoul 02748, Korea
| | - Heather A Eicher-Miller
- Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN 47907, USA
| | - Yoon Jung Yang
- Department of Foods and Nutrition, Dongduk Women's University, 60, Hwarang-ro 13-gil, Seongbuk-gu, Seoul 02748, Korea.,Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN 47907, USA
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Han SY, Kim NH, Kim DH, Han K, Kim SM. Relationship between urinary sodium-creatinine ratios and insulin resistance in Korean children and adolescents with obesity. J Pediatr Endocrinol Metab 2018. [PMID: 29543590 DOI: 10.1515/jpem-2017-0447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The prevalence of childhood obesity has significantly increased in Korea. This study aimed to use data from the 2010 Korea National Health and Nutrition Examination Survey (KNHANES) to investigate the association between sodium (Na) intake and insulin resistance in children and adolescents with obesity. METHODS The study population consisted of 578 adolescents aged 12-18 years who were enrolled in the 2010 KNHANES. Subjects were classified into the following four groups based on their body mass index (BMI) and homeostatic model assessment-insulin resistance (HOMA-IR) values: normal BMI and HOMA-IR (Group 1), normal BMI and ≥75% HOMA-IR (Group 2), ≥85% BMI and normal HOMA-IR (Group 3) and ≥85% BMI and ≥75% HOMA-IR (Group 4). The groups were further divided into four quartiles (Q1-Q4) based on urinary sodium-creatinine ratios (UNa/Cr) to analyze the association between obesity and metabolic abnormality as a result of increased Na intake. RESULTS There were significant differences among the four groups in terms of abdominal obesity (p<0.000), waist circumference (WC) (p<0.000) blood glucose levels (p<0.000), insulin levels (p<0.000) and UNa/Cr, with Groups 2, 3 and 4 having significantly higher UNa/Cr than Group 1 (p=0.002). In addition, there was a significant positive correlation between UNa/Cr and obesity (Q1=1 vs. Q4=3.23, p=0.019) and metabolic abnormality (Q1=1 vs. Q4=2.25, p=0.167). CONCLUSIONS Increased Na intake showed a positive statistical correlation with insulin resistance and is associated with an increased risk of insulin resistance and other metabolic abnormalities in obese children and adolescents.
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Affiliation(s)
- So Yoon Han
- Department of Family Medicine, Korea University College of Medicine, Korea University, Seoul, Republic of Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea
| | - Do Hoon Kim
- Department of Family Medicine, Korea University College of Medicine, Korea University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Biostatistics, Catholic University College of Medicine, Seoul, South Korea
| | - Seon Mee Kim
- Department of Family Medicine, Korea University College of Medicine, Korea University, Seoul, Republic of Korea
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Willebrand R, Kleinewietfeld M. The role of salt for immune cell function and disease. Immunology 2018; 154:346-353. [PMID: 29465812 DOI: 10.1111/imm.12915] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 12/22/2017] [Accepted: 01/14/2018] [Indexed: 12/27/2022] Open
Abstract
The immune system evolved to protect organisms from invading pathogens. A network of pro- and anti-inflammatory cell types equipped with special effector molecules guarantees efficient elimination of intruders like viruses and bacteria. However, imbalances can lead to an excessive response of effector cells incurring autoimmune or allergic diseases. An interplay of genetic and environmental factors contributes to autoimmune diseases and recent studies provided evidence for an impact of dietary habits on the immune status and related disorders. Western societies underwent a change in lifestyle associated with changes in food consumption. Salt (sodium chloride) is one component prevalent in processed food frequently consumed in western countries. Here we summarize recent advances in understanding the mechanisms behind the effects of sodium chloride on immune cells like regulatory T cells (Tregs) and T helper (TH ) 17 cells and its implication as a risk factor for several diseases.
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Affiliation(s)
- Ralf Willebrand
- VIB Laboratory of Translational Immunomodulation, Center for Inflammation Research, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Markus Kleinewietfeld
- VIB Laboratory of Translational Immunomodulation, Center for Inflammation Research, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
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24-h urinary sodium to potassium ratio and its association with obesity in children and adolescents. Eur J Nutr 2018; 58:947-953. [DOI: 10.1007/s00394-018-1645-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 09/20/2017] [Indexed: 11/25/2022]
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Hasenegger V, Rust P, König J, Purtscher AE, Erler J, Ekmekcioglu C. Main Sources, Socio-Demographic and Anthropometric Correlates of Salt Intake in Austria. Nutrients 2018; 10:E311. [PMID: 29509671 PMCID: PMC5872729 DOI: 10.3390/nu10030311] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/27/2018] [Accepted: 03/02/2018] [Indexed: 01/11/2023] Open
Abstract
Excessive salt intake is known to increase blood pressure and cardiovascular risk. Nevertheless, salt intake exceeds the recommendations in most countries. To face this problem, it is important to identify high consumers as well as the main contributors of salt intake. Overall, data of 2018 adults between 18 and 64 years were analysed to determine the main sources, socio-demographic and anthropometric correlates of salt intake. Dietary intake was assessed from 24-h-recalls, information on socio-demographic characteristics was obtained using a questionnaire and anthropometric data were measured. Salt intake was significantly higher in males than in females. There was a significant positive association between salt intake and body mass index. No significant differences in salt intake were observed for other variables including affluence, educational level, smoking status and physical activity. The main contributor to salt intake were condiments including table salt (32.6%), followed by cereals and cereal products (27.0%), meat and meat products (16.1%) and dairy products (14.0%). These results highlight that specific population groups need to be targeted by public health initiatives and that a reduction in salt intake can only be achieved in tandem with the food producers by the reduction of salt in processed foods.
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Affiliation(s)
- Verena Hasenegger
- Department of Nutritional Sciences, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria.
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Petra Rust
- Department of Nutritional Sciences, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria.
| | - Jürgen König
- Department of Nutritional Sciences, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria.
| | - Anna Elisabeth Purtscher
- Health University of Applied Sciences, Tyrol, Bachelor Programm Dietetics, Innrain 98, 6020 Innsbruck, Austria.
| | - Judith Erler
- Health University of Applied Sciences, Tyrol, Bachelor Programm Dietetics, Innrain 98, 6020 Innsbruck, Austria.
| | - Cem Ekmekcioglu
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
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Elfassy T, Mossavar-Rahmani Y, Van Horn L, Gellman M, Sotres-Alvarez D, Schneiderman N, Daviglus M, Beasley JM, Llabre MM, Shaw PA, Prado G, Florez H, Zeki Al Hazzouri A. Associations of Sodium and Potassium with Obesity Measures Among Diverse US Hispanic/Latino Adults: Results from the Hispanic Community Health Study/Study of Latinos. Obesity (Silver Spring) 2018; 26:442-450. [PMID: 29318759 PMCID: PMC5783725 DOI: 10.1002/oby.22089] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/12/2017] [Accepted: 11/06/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate cross-sectional associations of sodium and potassium with BMI, waist circumference (WC), and body fat and to determine whether the nativity and/or duration of United States (US) residence modified these associations. METHODS Sodium and potassium were derived from 24-hour diet recalls from 16,156 US participants of the 2008 to 2011 Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and from 24-hour urine in 447 HCHS/SOL participants. BMI, WC, and body fat were measured. RESULTS Dietary sodium that was 500 mg/d higher was cross-sectionally associated with a 0.07-kg/m2 higher BMI (P < 0.05) and a 0.18-cm larger WC (P = 0.04). Dietary potassium that was 500 mg/d higher was only associated with lower BMI and smaller WC among those who were foreign-born with 10 + years in the US (-0.13 kg/m2 , P < 0.01 and -0.36 cm, P = 0.01, respectively) and among those who were US-born (-0.62 kg/m2 , P < 0.01 and -1.42 cm, P < 0.01, respectively). Urinary sodium that was 500 mg/d higher was associated with a 0.27-kg/m2 higher BMI (P < 0.01) and 0.54 kg more body fat (P < 0.01). CONCLUSIONS Sodium intake was associated with higher BMI, WC, and body fat. Potassium intake was associated with lower BMI and smaller WC among US-born participants and participants with a longer duration of US residence.
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Affiliation(s)
- Tali Elfassy
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Linda Van Horn
- Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Marc Gellman
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Martha Daviglus
- Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | | | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Pamela A Shaw
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
| | - Hermes Florez
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
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Kim YM, Kim SH, Shim YS. Association of sodium intake with insulin resistance in Korean children and adolescents: the Korea National Health and Nutrition Examination Survey 2010. J Pediatr Endocrinol Metab 2018; 31:117-125. [PMID: 29303781 DOI: 10.1515/jpem-2017-0362] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 11/16/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study aimed to evaluate the relationship between sodium intake and insulin resistance indices. METHODS A total of 718 Korean children and adolescents (411 boys) aged 10-18 years who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) were included in the study. The urinary sodium to urinary creatinine ratio was used as a surrogate for sodium intake. The homeostatic model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI) were used as indices of insulin resistance. RESULTS The mean urinary sodium to urinary creatinine ratio was 11.34 in males and 10.17 in females. The urinary sodium to urinary creatinine ratio was significantly positively correlated with HOMA-IR (r=0.165, p<0.001) and inversely correlated with QUICKI (r=-0.181, p<0.001) in Pearson's correlation analyses. In a multivariate linear regression analysis, the urinary sodium to urinary creatinine ratio was independently and significantly positively associated with HOMA-IR (β=0.073, p=0.018) and significantly inversely associated with QUICKI (β=-0.080, p=0.007) after adjustment for possible confounders. HOMA-IR was independently and significantly positively associated with the urinary sodium to urinary creatinine ratio (β=0.087, p=0.018), whereas QUICKI was independently and significantly negatively associated with the urinary sodium to urinary creatinine ratio (β=-0.097, p=0.009) after controlling for confounders. CONCLUSIONS Our results suggest that sodium intake, as estimated by the urinary sodium to urinary creatinine ratio, may be independently associated with insulin resistance in children and adolescents.
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Affiliation(s)
- Yong Min Kim
- Department of Pediatrics, Hallym University College of Medicine, Seoul, Republic of Korea
| | - So Hyun Kim
- Department of Pediatrics, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Young Suk Shim
- Department of Pediatrics, Hallym University College of Medicine, Seoul, Republic of Korea
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So CH, Jeong HR, Shim YS. Association of the urinary sodium to urinary specific gravity ratio with metabolic syndrome in Korean children and adolescents: The Korea National Health and Nutrition Examination Survey 2010-2013. PLoS One 2017; 12:e0189934. [PMID: 29253859 PMCID: PMC5734790 DOI: 10.1371/journal.pone.0189934] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/05/2017] [Indexed: 11/20/2022] Open
Abstract
Objectives This study aimed to evaluate the association between sodium intake and metabolic syndrome (MetS) in Korean boys. Methods A total of 1,738 boys aged 10–18 years were included in this study from the Korea National Health and Nutrition Examination Survey (KNHANES) during the years 2010–2013. Sodium intake was assessed using the urinary sodium excretion to urinary specific gravity ratio (U-Na to U-SG ratio). Results The median U-Na to U-SG ratio was 133.27 mmol/L (interquartile range: 95.66–178.50 mmol/L). Significant positive associations were found between the U-Na to U-SG ratio and the TG (P = 0.001 for trend) and TG concentrations, and these concentrations were significantly higher in boys with a U-Na to U-SG ratio in the highest quartile compared with those with a ratio in the lowest (P = 0.001) and second (P = 0.033) quartiles, as demonstrated through analysis of covariance (ANCOVA) after adjustment for possible confounders, including age, BMI standard deviation score, ferritin, vitamin D, house income, smoking, alcohol intake, physical activity, season, total intake, total energy intake, protein intake, fat intake, carbohydrate intake, and water intake. Significant inverse associations were found for the U-Na to U-SG ratio with the HDL-C (P = 0.033 for trend) and HDL-C levels, and these values were significantly lower in boys with a ratio in the highest quartile compared with those with a ratio in the second quartile (P = 0.020), as demonstrated through an ANCOVA. Although the trends did not reach statistical significance, a higher U-Na to U-SG ratio tended to be associated with higher SBP (P = 0.086 for trend), DBP (P = 0.063 for trend), and glucose levels (P = 0.099 for trend), as illustrated through ANCOVA. Boys with a ratio in the highest quartile exhibited a 1.73-fold increased risk for elevated TG (95% CI, 1.19–2.51) and a 2.66-fold increased risk for MetS (95% CI, 1.11–6.35) compared with those with a ratio in the lowest quartile, as demonstrated through multivariate logistic regression analyses after adjusting for confounders. Conclusions Our results suggest that high sodium intake may be significantly independently associated with MetS in Korean boys aged 10–18 years.
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Affiliation(s)
- Cheol Hwan So
- Department of Pediatrics, Wonkwang University School of Medicine, Iksan, Republic of Korea
| | - Hwal Rim Jeong
- Department of Pediatrics, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Young Suk Shim
- Department of Pediatrics, Hallym University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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