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Del Pinto R, Agabiti Rosei C, Di Guardo A, Giannattasio C, Izzo R, Mazza A, Pucci G, Sarzani R, Tocci G, Veglio F, Volpe M, Grassi G, Muiesan ML, Ferri C. Prevalence, Clustering, and Current Management of Cardiovascular Risk Factors Upon First Referral to Hypertension Specialists: the APPROACH Study. High Blood Press Cardiovasc Prev 2024:10.1007/s40292-024-00650-4. [PMID: 38780831 DOI: 10.1007/s40292-024-00650-4] [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: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Several observational studies have been conducted to assess the prevalence of cardiovascular risk factors in hypertensive patients; however, none has yet investigated prevalence, clustering, and current management of cardiovascular risk factors upon first referral to hypertension specialists, which is the aim of the present study. METHODS Consecutive adult outpatients with essential/secondary hypertension were included at the time of their first referral to hypertension specialists at 13 Italian centers in the period April 2022-2023 if they had at least one additional major cardiovascular risk factor among LDL-hypercholesterolemia, type 2 diabetes, and cigarette smoking. Prevalence, degree of control, and current management strategies of cardiovascular risk factors were assessed. RESULTS A total of 255 individuals were included, 40.2% women and 98.4% Caucasian. Mean age was 60.3±13.3 years and mean blood pressure [BP] was 140.3±17.9/84.8±12.3 mmHg). Most participants were smokers (55.3%), had a sedentary lifestyle (75.7%), suffered from overweight/obesity (51%) or high LDL-cholesterol (41.6%), had never adopted strategies to lose weight (55.7%), and were not on a low-salt diet (57.4%). Only a minority of patients reported receiving specialist counseling, and 27.9% had never received recommendations to correct unhealthy lifestyle habits. Nearly 90% of individuals with an estimated high/very high cardiovascular risk profile did not achieve recommended LDL-cholesterol targets. CONCLUSIONS In patients with hypertension, both pharmacological and lifestyle therapeutic advice are yet to improve before referral to hypertension specialists. This should be considered in the primary care setting in order to optimize cardiovascular risk management strategies.
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Affiliation(s)
- Rita Del Pinto
- Department MeSVA, Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, University of L'Aquila, San Salvatore Hospital, 67100, L'Aquila, Italy
- Case Western Reserve University School of Medicine, Department of Pathology, Cleveland, OH, USA
| | | | - Antonino Di Guardo
- Center for the Prevention and Treatment of Arterial Hypertension Alessandro Filippi, Mascalucia, Catania, Italy
| | | | | | - Alberto Mazza
- ESH Excellence Hypertension Centre, Department of Internal Medicine, Santa Maria della Misericordia General Hospital, Rovigo, Italy
| | - Giacomo Pucci
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, Hypertension Excellence Centre, IRCCS INRCA, Ancona, Italy
| | - Giuliano Tocci
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Franco Veglio
- Internal Medicine Division and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
- IRCCS San Raffaele Rome, Rome, Italy
| | | | | | - Claudio Ferri
- Department MeSVA, Unit of Internal Medicine and Nephrology, Center for Hypertension and Cardiovascular Prevention, University of L'Aquila, San Salvatore Hospital, 67100, L'Aquila, Italy.
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Aswathy S, Shyamalagowri S, Hari S, Kanimozhi M, Meenambiga SS, Thenmozhi M, Karthiyayini R, Suresh D, Manjunathan J. Comparative studies on the cultivation, yield, and nutritive value of an edible mushroom, Pleurotus tuber-regium (Rumph. ex Fr.) Singer, grown under different agro waste substrates. 3 Biotech 2024; 14:123. [PMID: 38562248 PMCID: PMC10981651 DOI: 10.1007/s13205-024-03968-x] [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: 08/02/2023] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
In the present study, Pleurotus tuber-regium (Rumph. ex Fr.) Singer collected from Keeriparai forest of Kanyakumari district, South India was cultivated using environmentally benign, low-cost agricultural waste residues (paddy straw, sugarcane bagasse, rice husk, and sawdust) as growth substrates. The main goal of this study was to assess the cultivation, yield, and nutritional value of P. tuber-regium fruiting bodies grown under different growth substrates. Spawn running time and time for primordia formation were found to be shorter in mushroom growing with paddy straw substrate compared to sawdust and sugarcane bagasse. A quick spawn run time was observed in paddy straw substrate (12 ± 1 day) followed by sugarcane bagasse (15 ± 1 day) and sawdust (23 ± 1 day). The primordia was well developed in the macrofungus grown with paddy straw substrate on 18 ± 1 day followed by sugarcane bagasse (22 ± 1 day) and sawdust (32 ± 1 day). Significantly higher yield of fruiting bodies with increased contents of protein and carbohydrate and low level of fat was obtained when P. tuber-regium was cultivated with paddy straw substrate. While, cultivation of P. tuber-regium in sawdust and sugarcane bagasse resulted in increased contents of K, Na, Ca, and Mg along with highest energy value. On the other hand, rice husk did not support the cultivation of this macrofungus. Therefore, it is of significant interest to initiate the commercial production of this macrofungus so as to fight against the problems of malnutrition found in few African and south Asian countries.
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Affiliation(s)
- S. Aswathy
- Department of Biotechnology, Vel’s Institute of Science, Technology and Advanced Studies (VISTAS), Chennai, TN 600044 India
| | - S. Shyamalagowri
- Department of Botany, Pachaiyappa’s College, Chennai, TN 600030 India
| | - Sowmya Hari
- Department of Bioengineering, School of Engineering, Vel’s Institute of Science, Technology and Advanced Studies (VISTAS), Chennai, TN 600044 India
| | - M. Kanimozhi
- Department of Plant Biology and Plant Biotechnology, Ethiraj College for Women, Chennai, TN 600008 India
| | - S. S. Meenambiga
- Department of Bioengineering, School of Engineering, Vel’s Institute of Science, Technology and Advanced Studies (VISTAS), Chennai, TN 600044 India
| | - M. Thenmozhi
- Department of Biotechnology, Vel’s Institute of Science, Technology and Advanced Studies (VISTAS), Chennai, TN 600044 India
| | - R. Karthiyayini
- Department of Botany, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, TN 641043 India
| | - D. Suresh
- Department of Microbiology, Vel’s Institute of Science, Technology and Advanced Studies (VISTAS), Chennai, TN 600044 India
| | - J. Manjunathan
- Department of Biotechnology, Vel’s Institute of Science, Technology and Advanced Studies (VISTAS), Chennai, TN 600044 India
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Gruber S, Stasi E, Pion AB, Steiner R, Erlic Z, Bornstein SR, Sudano I, Reincke M, Beuschlein F. Unawareness of Primary Aldosteronism as a Common Cause of Hypokalemia - Insights from the IPAHK+ Trial (Incidence of Primary Aldosteronism in Patients with Hypokalemia). Horm Metab Res 2024; 56:300-307. [PMID: 37924818 DOI: 10.1055/a-2204-3163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2023]
Abstract
Hypokalemia plays an important role in the diagnosis and management of primary aldosteronism (PA). While the hypokalemic variant of the disease accounts for about one third of all cases, little is known about the incidence of PA in hypokalemic populations. The IPAHK+ study is an epidemiological, cross-sectional trial to provide evidence on the incidence of PA in hypokalemic patients from a university hospital outpatient population. Recruitment of outpatients with hypokalemia≤3 mmol/l is carried out on a continuous referral-basis through an automated data delivery system. Up to an interim data closure, 66 patients underwent the study protocol. The mean age of the participants was 52.9±1.5 years with an equal sex ratio of 1:1 women to men, a mean potassium value of 2.78±0.31 mmol/l [1.8;3.0] and a prevalence of arterial hypertension of 72.7%. PA was diagnosed in 46.6% of all participants, all of whom had a history of hypertension. Incidence of PA increased continuously with decreasing potassium levels with proportions of 26.7%, 50% and 57.1% in the subgroups of 3.0 mmol/l (n=15), 2.8-2.9 mmol/l (n=22) and≤2.7 mmol/l (n=21), respectively. Prior to testing, 59.1% of all patients presented at least with one plausible other cause of hypokalemia. The incidence of PA in the investigated outpatient population was more than 4 out of 10 and inversely correlated with baseline potassium levels. Moderate or severe hypokalemia, regardless of its cause, should therefore prompt evaluation for PA in hypertensive individuals. Normotensive hypokalemic PA was not observed in this cohort.
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Affiliation(s)
- Sven Gruber
- Department for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Evangelia Stasi
- Department for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Antonio Boan Pion
- Department for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Regula Steiner
- Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
| | - Zoran Erlic
- Department for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Stefan R Bornstein
- Department for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
- Department of Medicine, Carl Gustav Carus, University of Dresden, Dresden, Germany
| | - Isabella Sudano
- University Heart Center, Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Martin Reincke
- Medizinische Klinik Innenstadt, Klinikum der Universität München, München, Germany
| | - Felix Beuschlein
- Department for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
- Medizinische Klinik Innenstadt, Klinikum der Universität München, München, Germany
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Goldie FC, Brady AJB. New National Institute for Health and Care Excellence guidance for hypertension: a review and comparison with the US and European guidelines. Heart 2024; 110:399-401. [PMID: 37935572 DOI: 10.1136/heartjnl-2022-322118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 10/13/2023] [Indexed: 11/09/2023] Open
Abstract
The UK National Institute for Health and Care Excellence (NICE) guidance for hypertension management has recently been updated. This review article summaries the main recommendations in NICE guidelines, and compares them with the American and European guidelines. NICE and the European Society of Cardiology (ESC) recommend diagnosing hypertension at a higher level than the American College of Cardiology/American Heart Association (ACC/AHA). NICE treats to less stringent targets than both the ACC/AHA and the ESC, while using similar, although non-combination pill based, treatment regimens.
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Affiliation(s)
- Fraser C Goldie
- Cardiology, University Hospital Hairmyres, East Kilbride, UK
- Cardiology, Glasgow Royal Infirmary, Glasgow, UK
| | - Adrian J B Brady
- Department of Medical Cardiology, Glasgow Royal Infirmary Department of Cardiology, Glasgow, UK
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Min HK, Sung SA, Jung JY, Oh YK, Lee KB, Park SK, Oh KH, Ahn C, Lee SW. Relationship between urinary potassium excretion, serum potassium levels and cardiac injury in non-dialysis chronic kidney disease: KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD). Br J Nutr 2024; 131:429-437. [PMID: 37694674 DOI: 10.1017/s0007114523002064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Although the cardiovascular benefits of an increased urinary potassium excretion have been suggested, little is known about the potential cardiac association of urinary potassium excretion in patients with chronic kidney disease. In addition, whether the cardiac association of urinary potassium excretion was mediated by serum potassium levels has not been studied yet. We reviewed the data of 1633 patients from a large-scale multicentre prospective Korean study (2011-2016). Spot urinary potassium to creatinine ratio was used as a surrogate for urinary potassium excretion. Cardiac injury was defined as a high-sensitivity troponin T ≥ 14 ng/l. OR and 95 % (CI for cardiac injury were calculated using logistic regression analyses. Of 1633 patients, the mean spot urinary potassium to creatinine ratio was 49·5 (sd 22·6) mmol/g Cr and the overall prevalence of cardiac injury was 33·9 %. Although serum potassium levels were not associated with cardiac injury, per 10 mmol/g Cr increase in the spot urinary potassium to creatinine ratio was associated with decreased odds of cardiac injury: OR 0·917 (95 % CI 0·841, 0·998), P = 0·047) in multivariate logistic regression analysis. In mediation analysis, approximately 6·4 % of the relationship between spot urinary potassium to creatinine ratio and cardiac injury was mediated by serum potassium levels, which was not statistically significant (P = 0·368). Higher urinary potassium excretion was associated with lower odds of cardiac injury, which was not mediated by serum potassium levels.
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Affiliation(s)
- Hyang Ki Min
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Su Ah Sung
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Ji Yong Jung
- Department of Internal Medicine, Graduate School of Medicine, Gachon University, Incheon, Republic of Korea
| | - Yun Kyu Oh
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Kyu Beck Lee
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Biomedical Science, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Curie Ahn
- Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea
| | - Sung Woo Lee
- Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University, Seoul, 11759, Republic of Korea
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Toft U, Riis NL, Jula A. Potassium - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10365. [PMID: 38370111 PMCID: PMC10870975 DOI: 10.29219/fnr.v68.10365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 06/15/2022] [Accepted: 11/10/2023] [Indexed: 02/20/2024] Open
Abstract
Potassium (K) is an essential mineral that is necessary for normal cell and membrane function and for maintaining both fluid balance and acid-base balance. Potassium is furthermore very important for normal excitation, for example in nerves and muscle. It is widely available in several food products, with the most important dietary sources being potatoes, fruits, vegetables, cereal and cereal products, milk and dairy products, and meat and meat products. Potassium deficiency and toxicity is rare in healthy people, but dietary potassium is associated with other health outcomes. Results from observational studies have shown that a potassium intake above 3500 mg/day (90 mmol/day) is associated with a reduced risk of stroke. Similarly, intervention studies provide evidence that this level of potassium intake has a beneficial effect on blood pressure, particularly among persons with hypertension and in persons with a high sodium intake (>4 g/day, equivalent to >10 g salt/day).
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Affiliation(s)
- Ulla Toft
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Nanna Louise Riis
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Antti Jula
- Department of Clinical Medicine, University of Turku, Turku, Finland
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Sadanaga T, Hirota S. Association between sodium-to-potassium ratio in spot urine and hospitalization due to heart failure in high-risk Japanese patients. IJC HEART & VASCULATURE 2024; 50:101334. [PMID: 38234681 PMCID: PMC10792732 DOI: 10.1016/j.ijcha.2023.101334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/10/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024]
Abstract
Background In Japanese cardiovascular (CV) high-risk patients, the ESPRIT (Evaluation of Sodium Intake for the Prediction of Cardiovascular Events in Japanese High-risk Patients) study showed that high sodium excretion (≥4.0 g/day) was associated with a composite CV events of heart failure (HF) hospitalization, acute coronary syndrome, cerebrovascular events, and CV deaths. In this context, the sodium-to-creatinine (Na/Cr) ratio in spot urine was found to be significantly associated with HF hospitalizations. Since a stable potassium balance plays a particularly relevant role for CV patients, this post-hoc study was designed to investigate the extent to which consideration of the sodium-to-potassium (Na/K) ratio represents a better predictor of HF hospitalizations in the ESPRIT study population. Methods This is a post-hoc analysis of a previously reported ESPRIT study (n = 520, 60 HF hospitalizations). Results Receiver operating curve analysis yielded optimal Na/K ratio cut-off value of 2.9 for detecting HF hospitalization. Kaplan-Meier curve showed that high Na/K ratio in spot urine was associated with increased HF hospitalization (p < 0.001). Cox proportional hazards model analysis revealed that high Na/K ratio was associated with HF hospitalization with a hazard ratio of 2.97 (confidence interval: 1.67-5.61). An association between high Na/K ratio and HF hospitalization remained after adjustments for Na/Cr ratio in spot urine or the use of diuretics. Conclusion The Na/K ratio in spot urine is associated with HF hospitalization in high-risk Japanese patients.
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Bjørnsbo KS, Brøns C, Aadahl M, Kampmann FB, Friis Bryde Nielsen C, Lundbergh B, Wibaek R, Kårhus LL, Madsen AL, Hansen CS, Nørgaard K, Jørgensen NR, Suetta C, Kjaer M, Grarup N, Kanters J, Larsen M, Køber L, Kofoed KF, Loos R, Hansen T, Linneberg A, Vaag A. Protocol for the combined cardiometabolic deep phenotyping and registry-based 20-year follow-up study of the Inter99 cohort. BMJ Open 2024; 14:e078501. [PMID: 38286704 PMCID: PMC10826573 DOI: 10.1136/bmjopen-2023-078501] [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: 08/04/2023] [Accepted: 01/03/2024] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION The population-based Inter99 cohort has contributed extensively to our understanding of effects of a systematic screening and lifestyle intervention, as well as the multifactorial aetiology of type 2 diabetes (T2D) and cardiovascular disease. To understand causes, trajectories and patterns of early and overt cardiometabolic disease manifestations, we will perform a combined clinical deep phenotyping and registry follow-up study of the now 50-80 years old Inter99 participants. METHODS AND ANALYSIS The Inter99 cohort comprises individuals aged 30-60 years, who lived in a representative geographical area of greater Copenhagen, Denmark, in 1999. Age-stratified and sex-stratified random subgroups were invited to participate in either a lifestyle intervention (N=13 016) or questionnaires (N=5264), while the rest served as a reference population (N=43 021). Of the 13 016 individuals assigned to the lifestyle intervention group, 6784 (52%) accepted participation in a baseline health examination in 1999, including screening for cardiovascular risk factors and prediabetic conditions. In total, 6004 eligible participants, who participated in the baseline examination, will be invited to participate in the deep phenotyping 20-year follow-up clinical examination including measurements of anthropometry, blood pressure, arterial stiffness, cardiometabolic biomarkers, coronary artery calcification, heart rate variability, heart rhythm, liver stiffness, fundus characteristics, muscle strength and mass, as well as health and lifestyle questionnaires. In a subsample, 10-day monitoring of diet, physical activity and continuous glucose measurements will be performed. Fasting blood, urine and faecal samples to be stored in a biobank. The established database will form the basis of multiple analyses. A main purpose is to investigate whether low birth weight independent of genetics, lifestyle and glucose tolerance predicts later common T2D cardiometabolic comorbidities. ETHICS AND DISSEMINATION The study was approved by the Medical Ethics Committee, Capital Region, Denmark (H-20076231) and by the Danish Data Protection Agency through the Capital Region of Denmark's registration system (P-2020-1074). Informed consent will be obtained before examinations. Findings will be disseminated in peer-reviewed journals, at conferences and via presentations to stakeholders, including patients and public health policymakers. TRIAL REGISTRATION NUMBER NCT05166447.
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Affiliation(s)
- Kirsten Schroll Bjørnsbo
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Mette Aadahl
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Freja Bach Kampmann
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Camilla Friis Bryde Nielsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Bjørn Lundbergh
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Line Lund Kårhus
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Anja Lykke Madsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Kirsten Nørgaard
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Charlotte Suetta
- Institute of Sports Medicine, Department of Orthopedic Surgery and Department of Geriatrics and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Michael Kjaer
- Institute of Sports Medicine, Department of Orthopedic Surgery and Department of Geriatrics and Palliative Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Jørgen Kanters
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Center of Physiological Research, University of California, San Francisco, CA, USA
| | - Michael Larsen
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology and Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Klaus Fuglsang Kofoed
- Department of Clinical Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology and Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ruth Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Allan Vaag
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Lund University Diabetes Center, Malmö, Sweden
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
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Martín-Riobóo E, Turégano-Yedro M, Banegas JR. Evidence on the use of alternative substances and therapies in hypertension. HIPERTENSION Y RIESGO VASCULAR 2024; 41:40-57. [PMID: 38123388 DOI: 10.1016/j.hipert.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Review of some of the best-known biological and non-biological complementary/alternative therapies/medicines (CAM) and their relationship with blood pressure (BP) and hypertension (HT). SEARCH STRATEGY Narrative review assessing a recent series of systematic reviews, meta-analyses, and clinical trials published in recent years, focusing on the effects of CAM on BP and HT. SELECTION OF STUDIES We searched EMBASE, MEDLINE, Cochrane Library and Google Scholar, obtaining a total of 4336 articles, finally limiting the search to 181 after applying filters. SYNTHESIS OF RESULTS Some studies on biological therapies show some usefulness in BP reduction with an adequate benefit-risk balance, although there is a scarcity of high-quality trials that support these results. Some mind-body therapies have shown hypothetical benefit; in contrast, others lack robust evidence. CONCLUSIONS Although some therapies present a reasonable risk-benefit ratio, they should in no case replace pharmacological treatment when indicated.
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Affiliation(s)
- E Martín-Riobóo
- Especialista en Medicina Familiar y Comunitaria, UGC Poniente, Distrito Sanitario Córdoba-Guadalquivir, Córdoba, IMIBIC, Hospital Reina Sofía Córdoba, Spain.
| | - M Turégano-Yedro
- Especialista en Medicina Familiar y Comunitaria, Centro de Salud Casar de Cáceres, Cáceres, Spain
| | - J R Banegas
- Especialista en Medicina Preventiva y Salud Pública, Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz y CIBERESP, Madrid, Spain
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10
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Kissock KR, Garrett GS, Mkambula P, Bullen JD, Trieu K, Fisher LJ, Paige E, Gary MS, Neal B. Switching the World's Salt Supply-Learning from Iodization to Achieve Potassium Enrichment. Adv Nutr 2024; 15:100148. [PMID: 37977326 PMCID: PMC10730351 DOI: 10.1016/j.advnut.2023.100148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/23/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023] Open
Abstract
Sodium is an essential dietary component, but excess sodium intake can lead to high blood pressure and an increased risk of cardiovascular disease. Many national and international bodies, including the World Health Organization, have advocated for population-wide sodium reduction interventions. Most have been unsuccessful due to inadequate sodium reduction by food industry and difficulties in persuading consumers to add less salt to food. Recent research highlights potassium-enriched salt as a new, feasible, acceptable, and scalable approach to reducing the harms caused by excess sodium and inadequate potassium consumption. Modeling shows that a global switch from regular salt to potassium-enriched salt has the potential to avert millions of strokes, heart attacks, and premature deaths worldwide each year. There will be many challenges in switching the world's salt supply to potassium-enriched salt, but the success of universal salt iodization shows that making a global change to the manufacture and use of salt is a tractable proposition. This in-depth review of universal salt iodization identified the importance of a multisectoral effort with strong global leadership, the support of multilateral organizations, engagement with the salt industry, empowered incountry teams, strong participation of national governments, understanding the salt supply chain, and a strategic advocacy and communication plan. Key challenges to the implementation of the iodization program were costs to government, industry, and consumers, industry concerns about consumer acceptability, variance in the size and capabilities of salt producers, inconsistent quality control, ineffective regulation, and trade-related regulatory issues. Many of the opportunities and challenges to universal salt iodization will likely also be applicable to switching the global salt supply to iodized and potassium-enriched salt.
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Affiliation(s)
- Katrina R Kissock
- The George Institute for Global Health, University of New South Wales, New South Wales, Australia.
| | | | | | - James D Bullen
- The George Institute for Global Health, University of New South Wales, New South Wales, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, New South Wales, Australia
| | - Laura J Fisher
- The George Institute for Global Health, University of New South Wales, New South Wales, Australia
| | - Ellie Paige
- The George Institute for Global Health, University of New South Wales, New South Wales, Australia; National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Bruce Neal
- The George Institute for Global Health, University of New South Wales, New South Wales, Australia; School of Public Health, Imperial College London, United Kingdom
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11
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Tsehay EG, Emire SA, Admassu H, Gebeyehu TA. Nutritional composition and phytochemical content of wild edible tuber ( amorphophallus abyssinicus) crop. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2023. [DOI: 10.1080/10942912.2023.2197176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Affiliation(s)
- Eden Genetu Tsehay
- Chemical Engineering Department, College of Biological and Chemical Engineering, Addis Ababa Science and Technology University, Addis Ababa, Ethiopia
- Biotechnology and Bioprocess Center of Excellence, Addis Ababa Science and Technology University, Addis Ababa, Ethiopia
| | - Shimelis Admassu Emire
- Food Engineering Graduate Program, School of Chemical and Bio Engineering, Addis Ababa Institute of Technology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Habtamu Admassu
- Biotechnology and Bioprocess Center of Excellence, Addis Ababa Science and Technology University, Addis Ababa, Ethiopia
- Department of Food Process Engineering, College of Biological and Chemical Engineering, Addis Ababa Science and Technology University, Addis Ababa, Ethiopia
| | - Teshome Assefa Gebeyehu
- Food Science and Nutrition laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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12
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Groenland EH, Vendeville JPAC, Bots ML, Visseren FLJ, Musson REA, Spiering W. Validation of spot urine in estimating 24-h urinary sodium, potassium and sodium-to-potassium ratio during three different sodium diets in healthy adults. Blood Press 2023; 32:2170868. [PMID: 36752063 DOI: 10.1080/08037051.2023.2170868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
PURPOSE To evaluate the validity of spot urine assay methods in estimating the 24-h urinary sodium, potassium and sodium-to-potassium ratio during three different sodium diets. MATERIALS AND METHODS Twelve healthy volunteers were asked to adhere to 3 dietary sodium targets (3.3-5.0g/day,<3.3 g/day and >5.0 g/day) for three consecutive weeks and to measure salt excretion daily in spot urine samples using a self-monitoring device. On day 7 of each week, 24-h urine was collected to compare measured with estimated 24-h salt excretion (by the Kawasaki, Tanaka and INTERSALT equations). RESULTS Correlation coefficients relating measured and estimated 24-h sodium excretion were low and not significant for Kawasaki and INTERSALT and moderate for the Tanaka equation (τ 0.56-0.64,p<.05). Bland-Altman plots showed considerable differences between estimated and measured sodium excretion across all salt diets. Over 40% of the participants showed an absolute difference between measured and estimated 24-h sodium of more than 1000 mg/day. The correlation coefficients between 24-h and spot Na/K ratio were 0.67, 0.94 and 0.85(p<.05), and mean differences were 0.59, 0.06 and 0.48 for the intermediate, low and high sodium diets, respectively. CONCLUSION These findings do not support estimation of individual 24-h salt excretion from spot urine by the Kawasaki, Tanaka, or INTERSALT formula. Plain language summaryAccurate monitoring of salt intake is essential to improve BP control. At present, measurement of sodium and potassium excretion in multiple non-consecutive 24-h urinary collections is considered the gold standard for measuring dietary sodium intake. However, this method is burdensome, time-consuming and error prone.Therefore, we assessed and compared the validity of three formula-based approaches to estimate 24-h urinary sodium and potassium excretion and the Na/K ratio from spot urine samples measured by a self-monitoring device under three different sodium diets using 24-h urine collections as the reference.We conclude that use of three commonly used equations that estimate 24-h urinary sodium and potassium excretion result in substantial bias, poor precision and poor accuracy and are therefore not recommended. The Na/K ratio based on multiple casual urine samples may be a useful, low-burden, low-cost alternative method to 24-h urine collection for monitoring daily salt intake.
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Affiliation(s)
- Eline H Groenland
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jean-Paul A C Vendeville
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Ruben E A Musson
- Department of Clinical Chemistry and Haematology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Wilko Spiering
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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13
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Winsløw U, Sakthivel T, Zheng C, Philbert B, Vinther M, Frandsen E, Iversen K, Bundgaard H, Jøns C, Risum N. The effect of increased plasma potassium on myocardial function; a randomized POTCAST substudy. Int J Cardiovasc Imaging 2023; 39:2097-2106. [PMID: 37470856 PMCID: PMC10673982 DOI: 10.1007/s10554-023-02914-x] [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: 02/05/2023] [Accepted: 06/30/2023] [Indexed: 07/21/2023]
Abstract
Plasma potassium (p-K) in the high-normal range has been suggested to reduce risk of cardiovascular arrythmias and mortality through electrophysiological and mechanical effects on the myocardium. In this study, it was to investigated if increasing p-K to high-normal levels improves systolic- and diastolic myocardial function in patients with low-normal to moderately reduced left ventricular ejection fraction (LVEF). The study included 50 patients (mean age 58 years (SD 14), 81% men), with a mean p-K 3.95 mmol/l (SD 0.19), mean LVEF 48% (SD 7), and mean Global Longitudinal Strain (GLS) -14.6% (SD 3.1) patients with LVEF 35-55% from "Targeted potassium levels to decrease arrhythmia burden in high-risk patients with cardiovascular diseases trial" (POTCAST). Patients were given standard therapy and randomized (1:1) to an intervention that included guidance on potassium-rich diets, potassium supplements, and mineralocorticoid receptor antagonists targeting high-normal p-K levels (4.5-5.0 mmol/l). Echocardiography was done at baseline and after a mean follow-up of 44 days (SD 18) and the echocardiograms were analyzed for changes in GLS, mechanical dispersion, E/A, e', and E/e'. At follow-up, mean difference in changes in p-K was 0.52 mmol/l (95%CI 0.35;0.69), P<0.001 in the intervention group compared to controls. GLS was improved with a mean difference in changes of -1.0% (-2;-0.02), P<0.05 and e' and E/e' were improved with a mean difference in changes of 0.9 cm/s (0.02;1.7), P = 0.04 and ? 1.5 (-2.9;-0.14), P = 0.03, respectively. Thus, induced increase in p-K to the high-normal range improved indices of systolic and diastolic function in patients with low-normal to moderately reduced LVEF.
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Affiliation(s)
- Ulrik Winsløw
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark.
| | - Tharsika Sakthivel
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Chaoqun Zheng
- Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
| | - Berit Philbert
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Michael Vinther
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Emil Frandsen
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Kasper Iversen
- Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Jøns
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Niels Risum
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
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14
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Tse YH, Tuet CY, Lau KK, Tse HF. Dietary modification for prevention and control of high blood pressure. Postgrad Med J 2023; 99:1058-1067. [PMID: 37286197 DOI: 10.1093/postmj/qgad021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 06/09/2023]
Abstract
Hypertension (HT) remains the leading cause of cardiovascular and premature death around the world. Diet is one of the important factors that contributes to the development of HT. We review the current evidence of how different dietary factors may influence blood pressure (BP) and consequent development of HT. There is evidence that BP is positively associated with higher consumption of sodium, alcohol, animal-based protein such as red meat, low-quality carbohydrates such as sugar-sweetened beverages, and saturated fatty acids. On the contrary, other dietary constituents have BP-lowering effects. These include potassium, calcium, magnesium, yogurt, eggs, plant-based proteins such as soy and legumes, mono- and polyunsaturated fatty acids, and high-quality carbohydrates such as whole grain and fruits. Dietary fibre is unrelated to BP lowering, possibly due to the different mechanisms of various types of fibre. The effects of caffeine, hibiscus tea, pomegranate, and sesame on BP are also unclear as evidence is hard to assess due to the varying concentrations and different types of drinks used in studies. Implementing dietary changes such as the Dietary Approaches to Stop Hypertension (DASH diet) or adopting a Mediterranean diet has been shown to reduce and control BP. Although the effect of diet on BP control has been established, the optimal amount of each dietary component and consequent ability to devise a personalized diet for HT prevention and BP control for different populations still require further investigation.
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Affiliation(s)
- Yiu-Hei Tse
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Choi-Yee Tuet
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kui-Kai Lau
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Hung-Fat Tse
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Center for Translational Stem Cell Biology, Hong Kong, China
- Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China
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15
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Basdeki ED, Karatzi K, Arnaoutis G, Makrilakis K, Liatis S, Cardon G, De Craemer M, Iotova V, Tsochev K, Tankova T, Kivelä J, Wikström K, Rurik I, Radó S, Miguel-Berges ML, Gimenez-Legarre N, Moreno-Aznar L, Manios Y. A lifestyle pattern characterised by high consumption of sweet and salty snacks, sugar sweetened beverages and sedentary time is associated with blood pressure in families at risk for type 2 diabetes mellitus in Europe. The Feel4Diabetes Study. J Hum Nutr Diet 2023; 36:1564-1575. [PMID: 36719056 DOI: 10.1111/jhn.13145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Individuals from families at high-risk for type 2 diabetes mellitus (T2DM) are also at high risk for hypertension (HTN) and cardiovascular disease. Studies identifying lifestyle patterns (LPs) combining dietary, physical activity or sedentary variables and examining their possible role with respect to developing blood pressure (BP) are limited. The present study aimed to examine the association of different LPs with BP levels in families at high risk for T2DM in Europe. METHODS In total, 1844 adults (31.6% males) at high-risk for T2DM across six European countries were included in this cross-sectional study using data from the baseline assessment of the Feel4Diabetes Study. BP measurements and dietary and physical activity assessments were conducted, and screen times were surveyed. LPs were revealed with principal component analysis of various data regarding diet, physical activity, screen time and smoking. RESULTS Three LPs were identified. LP3 (high consumption of sweet and salty snacks, sugar sweetened soft drinks and juices, and high amount of screen time) was positively associated with diastolic BP (B, 0.52; 95% confidence interval = 0.05-0.99) and the existence of HTN (odds ratio = 1.12; 95% confidence interval = 1.00-1.25). Participants in the highest tertile of LP3 spent mean 3 h of screen time, consumed 1.5 portions of sweet and/or salty snacks and 1 L of soft drinks on a daily basis, were associated with 12% higher risk of HTN. CONCLUSIONS Focusing on the combination of eating and lifestyle behaviours may more accurately identify, and therefore guide preventive measures tailored to the specific needs of high-risk populations.
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Affiliation(s)
- Eirini D Basdeki
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Athens, Greece
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - Giannis Arnaoutis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Athens, Greece
| | - Konstantinos Makrilakis
- National and Kapodistrian University of Athens Medical School, First Department of Propaedeutic Medicine, Laiko General Hospital, Athens, Greece
| | - Stavros Liatis
- National and Kapodistrian University of Athens Medical School, First Department of Propaedeutic Medicine, Laiko General Hospital, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Marieke De Craemer
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Violeta Iotova
- Departemnt of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- Departemnt of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia, Sofia, Bulgaria
| | - Jemina Kivelä
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Wikström
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Sándorné Radó
- Faculty of Health, Doctoral School of Health Science, University of Debrecen, Debrecen, Hungary
| | - María L Miguel-Berges
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Natalia Gimenez-Legarre
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Luis Moreno-Aznar
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre(Agro-Health), Heraklion, Greece
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Valmorbida JL, Baratto PS, Leffa PS, Sangalli CN, Silva JA, Vitolo MR. Consumption of ultraprocessed food is associated with higher blood pressure among 6-year-old children from southern Brazil. Nutr Res 2023; 116:60-68. [PMID: 37354762 DOI: 10.1016/j.nutres.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/26/2023]
Abstract
Ultraprocessed foods (UPF) consumption plays a critical role in the development of chronic diseases, but evidence of their effect on children's health is limited. We hypothesized that the consumption of UPF can influence blood pressure levels in 6-year-old children. This study is a secondary analysis of a randomized field trial in Brazil that is registered at clinicaltrial.gov (NCT00635453). Dietary intake was obtained using 2 multiple-pass 24-hour recalls when 305 children were 3 and 6 years old. We classified foods according to the NOVA system and determined the percentage of total energy intake derived from ultraprocessed foods. We collected anthropometric measures from and evaluated systolic and diastolic blood pressures of 6-year-old children. Linear regression analysis was used to assess the association between UPF consumption and blood pressure levels. UPF represented 40.3% (interquartile range, 34.1-48.5) of the total energy intake at 3 years and 45.2% (interquartile range, 41.5-53.2) at 6 years. The adjusted linear regression analyses showed that systolic blood pressure was associated with UPF consumption at 6 years (P = .05), birth weight (P = .02), waist circumference (P < .01), and physical activity (P = .04), whereas diastolic blood pressure was associated with UPF consumption at 3 and 6 years (P = .01 and P < .01, respectively), birth weight (P = .05), and waist circumference (P < .01). Our data suggest that UPF consumption played a role in increasing 6-year-old children's blood pressure. These results reinforce the importance of effective strategies to prevent the excessive consumption of UPF in childhood.
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Affiliation(s)
- Julia L Valmorbida
- Graduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil; Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil.
| | - Paola S Baratto
- Graduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil; Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil
| | - Paula S Leffa
- Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil
| | - Caroline N Sangalli
- Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil
| | - Janilson A Silva
- Nutrition Department, University Center of João Pessoa, João Pessoa/PB, 58053-000, Brazil
| | - Marcia R Vitolo
- Graduate Program in Pediatrics, Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil; Nutrition Research Group (NUPEN), Federal University of Health Sciences of Porto Alegre, Porto Alegre/RS, 90050-170, Brazil
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Peña-Jorquera H, Cid-Jofré V, Landaeta-Díaz L, Petermann-Rocha F, Martorell M, Zbinden-Foncea H, Ferrari G, Jorquera-Aguilera C, Cristi-Montero C. Plant-Based Nutrition: Exploring Health Benefits for Atherosclerosis, Chronic Diseases, and Metabolic Syndrome-A Comprehensive Review. Nutrients 2023; 15:3244. [PMID: 37513660 PMCID: PMC10386413 DOI: 10.3390/nu15143244] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
Atherosclerosis, chronic non-communicable diseases, and metabolic syndrome are highly interconnected and collectively contribute to global health concerns that reduce life expectancy and quality of life. These conditions arise from multiple risk factors, including inflammation, insulin resistance, impaired blood lipid profile, endothelial dysfunction, and increased cardiovascular risk. Adopting a plant-based diet has gained popularity as a viable alternative to promote health and mitigate the incidence of, and risk factors associated with, these three health conditions. Understanding the potential benefits of a plant-based diet for human health is crucial, particularly in the face of the rising prevalence of chronic diseases like diabetes, hypertension, dyslipidemia, atherosclerosis, and cancer. Thus, this review focused on the plausible advantages of consuming a type of food pattern for the prevention and/or treatment of chronic diseases, emphasizing the dietary aspects that contribute to these conditions and the evidence supporting the benefits of a plant-based diet for human health. To facilitate a more in-depth analysis, we present separate evidence for each of these three concepts, acknowledging their intrinsic connection while providing a specific focus on each one. This review underscores the potential of a plant-based diet to target the underlying causes of these chronic diseases and enhance health outcomes for individuals and populations.
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Affiliation(s)
- Humberto Peña-Jorquera
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Viña del Mar 2530388, Chile
| | - Valeska Cid-Jofré
- Centro de Investigación Biomédica y Aplicada (CIBAP), Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Santiago 9160019, Chile
| | - Leslie Landaeta-Díaz
- Facultad de Salud y Ciencias Sociales, Universidad de las Américas, Santiago 7500975, Chile
- Núcleo en Ciencias Ambientales y Alimentarias, Universidad de las Américas, Santiago 7500975, Chile
| | - Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
| | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, Centre for Healthy Living, University of Concepción, Concepción 4070386, Chile
| | - Hermann Zbinden-Foncea
- Laboratorio de Fisiología del Ejercicio y Metabolismo, Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago 7500000, Chile
- Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Gerson Ferrari
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Av. Pedro de Valdivia 425, Providencia 7500912, Chile
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 9170022, Chile
| | - Carlos Jorquera-Aguilera
- Escuela de Nutrición y Dietética, Facultad de Ciencias, Universidad Mayor, Santiago 8580745, Chile
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Viña del Mar 2530388, Chile
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Martins VM, Ziegelmann PK, Ferrari F, Bottino LG, Lucca MB, Corrêa HLR, Blum GB, Helal L, Fuchs SC, Fuchs FD. Thiazide diuretics alone or combined with potassium-sparing diuretics to treat hypertension: a systematic review and network meta-analysis of randomized controlled trials. J Hypertens 2023; 41:1108-1116. [PMID: 37016911 PMCID: PMC10241430 DOI: 10.1097/hjh.0000000000003436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/03/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND The magnitude of blood pressure (BP)-lowering effects and decrease of the adverse effects of thiazide diuretics provided by potassium-sparing diuretics remain uncertain. The aim of this study was to compare the BP-lowering efficacy and the incidence of adverse effects of high (T+) and low-dose (T-) thiazide diuretics, alone or combined with high (PS+) or low-dose (PS-) potassium-sparing diuretics in patients with primary hypertension. METHODS A systematic literature search was performed in PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, Web of Science, Scopus and LILACS. Randomized double-blind placebo or active-controlled trials (RCT) with 3 weeks to 1 year of follow-up were included. Sample size, mean and standard deviation from baseline, follow-up and change from baseline values were extracted by two independent reviewers. Pairwise random effect models and Bayesian network meta-analysis models were used to compare the effects of treatments. The risk of bias in individual studies was assessed using the Rob 1.0 tool. The primary outcome was the mean difference in office SBP. Secondary outcomes were the mean difference in biochemical parameters and the incidence of nonmelanoma skin cancer. RESULTS Two hundred and seventy-six double-blind RCTs involving 58 807 participants (mean age: 55 years; 45% women) were included. All treatment groups were more effective than placebo in lowering BP, with mean differences (MDs) of change from baseline ranging from -7.66 mmHg [95% credible interval (95% CrI), -8.53 to -6.79] for T- to -12.77 mmHg (95% CrI, -15.22 to -10.31) for T+PS-. T+ alone or combined with potassium-sparing was more effective in reducing BP than T-. The surface under the cumulative ranking curve (SUCRA) estimated ranking showed that the best effectiveness in lowering SBP was found for T+PS- (0.69), T+PS+ (0.65) and T+ (0.54). Compared with placebo, all treatments (except T-PS-) were associated with more potassium reduction and T+ compared with all other treatments and T- when compared with T-PS-. Compared with placebo, all active treatments (except T+PS+) showed higher elevations of uric acid. The increase of plasma glucose promoted by thiazides alone was reduced by potassium-sparing agents. CONCLUSION Thiazides with potassium-sparing diuretics are associated with increased BP-lowering efficacy compared with thiazides alone while minimizing hypokalaemia and hyperglycaemia. These findings demonstrate that thiazide and potassium-sparing diuretic combination is preferable to thiazide alone in treating hypertension.
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Affiliation(s)
| | - Patrícia K. Ziegelmann
- Graduate Program in Cardiology and Cardiovascular Sciences
- Graduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul
| | - Filipe Ferrari
- Graduate Program in Cardiology and Cardiovascular Sciences
| | - Leonardo G. Bottino
- Graduate Program in Cardiology and Cardiovascular Sciences
- INCT PREVER, Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS Brazil
| | - Marcelo B. Lucca
- Graduate Program in Cardiology and Cardiovascular Sciences
- INCT PREVER, Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS Brazil
| | | | - Gabriela B. Blum
- INCT PREVER, Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS Brazil
| | - Lucas Helal
- Graduate Program in Cardiology and Cardiovascular Sciences
- Center for Journalology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Sandra C. Fuchs
- Graduate Program in Cardiology and Cardiovascular Sciences
- Graduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul
- INCT PREVER, Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS Brazil
| | - Flávio D. Fuchs
- Graduate Program in Cardiology and Cardiovascular Sciences
- INCT PREVER, Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS Brazil
- Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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Kumar A, Gupta K, Islam Apu MA, Abrol GS, Tomer V. Effect of household processing on nutritional and antinutritional composition, mineral-mineral ratios, and functional properties of Colocasia leaves. Heliyon 2023; 9:e17137. [PMID: 37383195 PMCID: PMC10293681 DOI: 10.1016/j.heliyon.2023.e17137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/08/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023] Open
Abstract
Colocasia leaves are high in nutrients and other phytochemicals but their utilization remains limited due to a lack of awareness. Higher content of anti-nutritional factors like oxalic and tannic acid in Colocasia leaves limit nutrient availability. In the present study, the effect of four household procedures viz. soaking (8-12 h), microwave heating (2-6 min), cooking (30-60 min), and blanching (1-3 min), followed by sun drying, was studied on the nutritional, antinutritional and functional properties of Colocasia leaves. A significant increase in crude fibre (25.7%-29.65%), and protein (4.33-15.6%) content was found in all the treatments except for the microwave treatment. A significant decrease in fat (5.7-31.4%), ash (20.34-28.22%), oxalic acid (27.07-35.32%), and tannic acid (up to 96%) was also found in various treatments. Among the minerals, a significant increase was reported for calcium (up to 16.38%), and iron (up to 5.9%). The highest mineral retention was found in soaked samples. The soaked and cooked samples also had a higher Ca: Mg ratio. A significant change in functional properties was also found. FTIR peaks suggested no significant qualitative effect occurred on phytochemical or physicochemical characteristics. Cluster analysis showed that cooking was second to soaking in terms of overall quality which were most comparable to the control. Cooking efficiently reduced the antinutritional factors, however, a significant loss of nutrients and functional properties was also observed. Therefore, the soaking of Colocasia leaves for 8-10 h is recommended as the best practice before their food applications.
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Affiliation(s)
- Ashwani Kumar
- Department of Food Technology and Nutrition, Lovely Professional University, Phagwara, Punjab, 144411, India
- Department of Postharvest Technology, Rani Lakshmi Bai Central Agricultural University, Jhansi, 284003, India
| | - Kritika Gupta
- Department of Food Technology and Nutrition, Lovely Professional University, Phagwara, Punjab, 144411, India
- Department of Nutrition and Hospitality Management, University of Mississippi, Oxford, 38677, USA
| | - Md. Aminul Islam Apu
- Department of Nutrition and Hospitality Management, University of Mississippi, Oxford, 38677, USA
| | - Ghan Shyam Abrol
- Department of Postharvest Technology, Rani Lakshmi Bai Central Agricultural University, Jhansi, 284003, India
| | - Vidisha Tomer
- VIT School of Agricultural Innovations and Advanced Learning, Vellore Institute of Technology, Vellore, 632014, India
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20
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Kou C, Zhao X, Fan X, Lin X, Wang Q, Yu J. Dietary sodium/potassium intake and cognitive impairment in older patients with hypertension: Data from NHANES 2011-2014. J Clin Hypertens (Greenwich) 2023. [PMID: 37183770 DOI: 10.1111/jch.14667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/26/2023] [Accepted: 04/30/2023] [Indexed: 05/16/2023]
Abstract
This study aimed to assess the relationship between dietary sodium/potassium intake and cognition in elderly individuals with hypertension. We designed a cross-sectional study based on the 2011-2014 National Health and Nutrition Examination Survey (NHANES) 2011-2014. A multivariable-logistic regression analysis was performed to analyze the relationship between sodium/potassium intake and cognitive impairment. Restricted cubic spline (RCS) based on regression analysis to assess the nonlinear dose-response relationship between dietary sodium intake and cognitive performance. Out of the 2276 participants included in this study, 1670 patients had hypertension. Compared with the lowest quartile of dietary sodium intake, the lowest weighted odds ratio of cognitive impairment in DSST was observed in Q4 (OR = 0.45, 0.29-0.70), and a similar trend was observed in AFT (OR = 0.34, 0.18-0.65). After adjusting the covariates, the lowest weighted multivariable-adjusted OR of cognitive impairment in DSST were also observed in Q4 (OR = 0.47, 0.26-0.84) compared with the lowest quartile of dietary sodium intake. The RCS results showed that dietary sodium intake was U-shaped and associated with the risk of cognitive impairment in the DSST (Pnon-linearity = 0.0067). In addition, no significant association was observed between dietary potassium intake and different dimensions of cognitive performance. In conclusion, excessively high and low low dietary sodium were associated with impairment of specific processing speed, sustained attention, and working memory for elderly patients with hypertension in the United States. However, no association was observed between dietary potassium intake and cognition.
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Affiliation(s)
- Chengkun Kou
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xu Zhao
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xin Fan
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xin Lin
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Qiongying Wang
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Jing Yu
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
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21
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Iddrisu AK, Besing Karadaar I, Gurah Junior J, Ansu B, Ernest DA. Mixed effects logistic regression analysis of blood pressure among Ghanaians and associated risk factors. Sci Rep 2023; 13:7728. [PMID: 37173375 PMCID: PMC10182051 DOI: 10.1038/s41598-023-34478-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
Blood pressure (BP) control is a global health issue with an increase in BP beyond the normal BP leading to different stages of hypertension in humans and hence the need to identify risk factors of BP for efficient and effective control. Multiple BP measurement have proven to provide BP readings close to the true BP status of the individual. In this study, we used multiple BP measurement data on 3809 Ghanaians to determine risk factors associated with BP. The data were obtained from World Health Organization study on Global AGEing and Adult Health. We defined high blood pressure (HBP) as [Formula: see text] 130/80 mmHg or normal as [Formula: see text] 130/80 mmHg. We provide summary statistics and also used the Chi-Square test to assess significance of association between HBP versus risk factors of HBP. The aim of this study is to identify risk factors of BP using the mixed effects logistic regression model. Data were analyzed using R version 4.2.2. The results showed that the risk of high blood pressure (HBP) decreases across the three measurement periods. There is reduced risk (OR = 0.274, 95% CI = 0.2008, 0.405) of HBP among male participants relative to female participants. The risk (OR = 2.771, 95% CI = 1.8658, 4.1145) of HBP increased by 2.771-folds among those who are 60 years and above relative to those below the age of 60 years. Those whose work involves/requires vigorous exercise has 1.631-fold increase in the risk (OR = 1.631, 95% CI = 1.1151, 2.3854) of HBP relative to those whose work does not involve vigorous exercise. There is approximately 5-folds increased in the risk (OR = 4.896, 95% CI = 1.9535, 12.2268) of among those who have ever been diagnosed with diabetes. The results also revealed high risk (OR = 1.649, 95%CI = 1.1108, 2.4486) of HBP among those who have formal education. The risk (OR = 1.009, 95% CI = 1.0044, 1.0137) of HBP increases with increasing weight and a reduced risk (OR = 0.996, 95% CI = 0.9921, 0.9993) of HBP with increasing height. We found that sad experience, either mild, moderate or severe, is associated with a reduced risk of HBP. Those who have vegetable servings at least 2 cups per day have increased risk of HBP and those who have fruits servings at least 2 cups per day is associated with a reduced risk of HBP, however this is not statistically significant. To achieve success in BP control, programs should be designed with the aim of reducing weight, educate those with formal eduction on issues relating to HBP. Those whose work requires vigorous exercise are recommended to have regular check-ups to ensure that pressure build-up in the lungs is cleared. SBP is lower for women at young age but continue to increase after menopause as their BP increase becomes salt-sensitive. Hence there is need to give more attention to menopausal women so as to improve BP. Both young and old individuals are recommended to practice regular exercise since this has shown to reduce risk of being overweight or becoming diabetic and reduces the risk of HBP at yong age and old age. Also, to improve blood pressure control, programs for management of blood pressure or hypertension should focus more short stature individuals since such people are more likely to experience HBP.
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Affiliation(s)
- Abdul-Karim Iddrisu
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana.
| | | | - Joseph Gurah Junior
- Department of Mathematics and ICT, St. Ambrose College of Education, Dormaa-Akwamu, Ghana
| | - Bismark Ansu
- Department of Mathematics and ICT, St. Ambrose College of Education, Dormaa-Akwamu, Ghana
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22
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Yamanaka N, Itabashi M, Fujiwara Y, Nofuji Y, Abe T, Kitamura A, Shinkai S, Takebayashi T, Takei T. Relationship between the urinary Na/K ratio, diet and hypertension among community-dwelling older adults. Hypertens Res 2023; 46:556-564. [PMID: 36522425 DOI: 10.1038/s41440-022-01135-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 11/10/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022]
Abstract
The association between the urinary sodium (Na)/potassium (K) ratio and hypertension is well recognized. We investigated whether the urinary Na/K ratio might be associated with hypertension in community-dwelling older adults and whether the association was influenced by habitual dietary patterns. We enrolled a total of 684 older adults (mean age, 76.8 years) and conducted health examinations at Kusatsu, Japan, in 2021. The urinary Na/K ratio was found to be independently associated with systolic blood pressure (SBP) (p < 0.0001), years of education (p = 0.0027), number of cohabitants (p = 0.0175), estimated glomerular filtrate rate (eGFR) (p = 0.0244), and Geriatric Depression Scale short-version (GDS15) score (p = 0.0366). In addition, an unsupervised hierarchical clustering analysis revealed a spectrum of habitual dietary patterns for higher and lower values of the urinary Na/K ratio. The decision tree indicated that the urinary Na/K ratio was associated with the history of milk consumption. A positive history of daily milk consumption predicted a mean urinary Na/K ratio of 2.8, and a negative history of daily milk consumption predicted a mean urinary Na/K ratio of 3.3. Furthermore, the frequency of fruit and vegetable consumption also predicted the urinary Na/K ratio. The relationship between the urinary Na/K ratio and hypertension was influenced by the frequency of consumption of milk, fruits, and vegetables in the subjects. This finding might be due to the influence of education and/or depression. The results suggested the importance of nutritional education in the development of hypertension.
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Affiliation(s)
- Noriko Yamanaka
- Departments of Nephrology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.,Research Team for Social Participation and Community Health, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.,Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Mitsuyo Itabashi
- Departments of Nephrology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Takashi Takei
- Departments of Nephrology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
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23
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The Effects of Fenugreek Seed Consumption on Blood Pressure: A Systematic Review and Meta-analysis of Randomized Controlled Trials. High Blood Press Cardiovasc Prev 2023; 30:123-133. [PMID: 36763260 DOI: 10.1007/s40292-023-00565-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Cardiovascular diseases (CVDs) are growing health issues worldwide. Hypertension (HTN) is one of the most common among CVDs in all populations. Fenugreek has recently been the center of multiple investigations. AIM In this systematic review and meta-analysis, we aimed at gathering and summing up the existing literature regarding the impact of fenugreek seed on systolic blood pressure (SBP) and diastolic blood pressure (DBP). METHODS All major databases (MEDLINE, Cochrane library, EMBASE, and Web of Science) were searched from inception up to 28 June 2022. Relevant randomized controlled trials (RCTs) meeting the inclusion criteria were included and the required data was extracted. The pooled effects were reported as weighted mean differences (WMDs). I-squared test was used to detect between-study heterogeneities. Subgroup analyses were conducted to find sources of heterogeneities. P-values < 0.05 were considered as statistically significant. RESULTS Six RCTs including a total of 373 participants were included in the final meta-analysis. Fenugreek seed supplementation significantly reduced SBP (WMD: 3.46 mmHg, 95% CI - 6.33, - 0.59, P=0.018), but not DBP (WMD: 3.19 mmHg; 95% CI, - 5.82 to 12.21, P=0.488). Subgroup analyses showed that fenugreek seed administered in dosages ≥ 15 g/day and durations ≤ 12 weeks significantly reduced SBP and DBP. CONCLUSION Supplementation with fenugreek seed, especially in dosages ≥ 15 g/day and durations ≤ 12 weeks, might play a role in reducing SBP, but not DBP. However, further investigations are warranted to ensure the clinical relevance of these findings.
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24
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Rezende-Alves K, Hermsdorff HHM, Miranda AEDS, Bressan J, Mendonça RDD, de Oliveira FLP, Pimenta AM. Effects of minimally and ultra-processed foods on blood pressure in Brazilian adults: a two-year follow up of the CUME Project. J Hypertens 2023; 41:122-131. [PMID: 36453655 DOI: 10.1097/hjh.0000000000003311] [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: 12/03/2022]
Abstract
AIM To assess the association of food consumption according to degree of processing with changes in systolic (SBP) and diastolic (DBP) blood pressure in adult participants of a Brazilian cohort. METHODS Longitudinal study with 2496 adult participants of the Cohort of Universities of Minas Gerais (CUME Project). Food consumption was categorized by food groups according to degree of processing following the NOVA grading system: unprocessed/minimally processed foods/culinary ingredients (U/MPF&CI), processed foods (PFs) and ultra-processed foods (UPFs). unprocessed/minimally processed foods/culinary ingredients (U/MPF&CI), processed foods (PFs) and ultra-processed foods (UPFs). Changes in SBP and DBP were categorized (decreased, maintained, increased). Independent associations between exposure and outcomes were verified using multiple generalized ordered logistic models adjusted for potential confounders. RESULTS After a two-year follow-up, the consumption of U/MPF&CI (% daily caloric intake) reduced the chance of increasing DBP (P for trend = 0.014), with a more evident effect among participants within the 5th quintile of this food group (odds ratio (OR) = 0.55; 95% confidence interval (CI): 0.34-0.97]. On the other hand, the consumption of UPFs (% daily caloric intake) raised the chance of increasing DBP (P for trend = 0.005) and was more evident among participants within the quintiles of higher consumption (4th quintile - OR = 1.97; 95% CI: 1.25-3.10; 5th quintile - OR = 1.79; 95% CI = 1.12-2.86). No associations were found between food consumption according to degree of processing and changes in SBP. CONCLUSION Higher consumption of U/MPF&CI and UPFs were independently associated to lower and greater chances of increased DBP in adult participants from CUME Project.
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Affiliation(s)
| | | | | | - Josefina Bressan
- Department of Nutrition and Health, Federal University of Viçosa, Brazil
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25
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Catheter-based adrenal ablation: an alternative therapy for patients with aldosterone-producing adenoma. Hypertens Res 2023; 46:91-99. [PMID: 36229523 DOI: 10.1038/s41440-022-01034-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 02/03/2023]
Abstract
Unilateral adrenalectomy is the standard treatment for patients with aldosterone-producing adenoma (APA), but it lacks an option for patients with APA who refuse or are not suitable for surgery. In this study, we studied whether catheter-based adrenal ablation for APA is comparable to adrenalectomy. A total of 2185 hypertensive patients were screened, and 112 patients with APA were recruited and counselled on the treatment options. Fifty-two patients opted for catheter-based adrenal ablation, and 60 opted for adrenalectomy. Clinical and biochemical outcomes were assessed at 6 months after treatment. Factors associated with hypertension remission and the advantages and limitations of this approach were evaluated. According to the primary aldosteronism surgical outcome (PASO) criteria, complete and partial clinical success was achieved in 21 (40.4%) and 23 (44.2%) patients in the ablation group vs. 33 (55.0%) and 23 (38.3%) patients in the adrenalectomy group, respectively. Complete and partial biochemical success was achieved in 30 (57.7%) and 17 (32.7%) patients in the ablation group vs. 51 (85.0%) and 5 (8.3%) patients in the adrenalectomy group, respectively. The complete clinical success rate was not (P > 0.05), but the complete biochemical success rate was significantly different between the two groups (P < 0.01). Factors associated with adrenal ablation-mediated hypertension remission were hypertension duration and serum potassium level at baseline. Compared with surgery, adrenal ablation requires a shorter operating time and time to resume physical activity. Catheter-based adrenal ablation may be an alternative and feasible option for APA patients unwilling to receive surgical treatment.
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26
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Ohseto H, Ishikuro M, Obara T, Murakami K, Onuma T, Noda A, Takahashi I, Matsuzaki F, Ueno F, Iwama N, Kikuya M, Metoki H, Sugawara J, Kuriyama S. Dietary calcium intake was related to the onset of pre-eclampsia: The TMM BirThree Cohort Study. J Clin Hypertens (Greenwich) 2022; 25:61-70. [PMID: 36579409 PMCID: PMC9832228 DOI: 10.1111/jch.14606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 12/30/2022]
Abstract
This study aimed to explore the relationship between dietary electrolyte intake and the prevalence of hypertensive disorders of pregnancy (HDP) subtypes. Our analysis included 19 914 pregnant women from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. A food frequency questionnaire was used to estimate dietary calcium, potassium, sodium, and magnesium intakes. HDP was determined based on the medical records during regular antenatal care. Logistic regression analysis assessed the relationship between dietary electrolytes intake quintiles, and HDP subtypes with adjustment for basic characteristics. Dietary electrolyte intakes were applied for the prediction model. Of the cohort, 547 participants delivered with pre-eclampsia (PE), 278 with superimposed PE (SP), and 896 with gestational hypertension (GH). PE was associated with low crude calcium intake (odds ratio of the first quintile [<251 mg/day] to the fifth quintile [>623 mg/day] and 95% confidence interval, 1.31 [1.00-1.70]) and P for trend was .02. SP was not associated with any nutritional intake; however, the combined outcome of PE and SP was related to low crude calcium and potassium and energy-adjusted calcium, potassium, and magnesium intakes (P for trend, .01, .048, .02, .04, and .02, respectively). The same tendency was observed for GH. A prediction model that included crude calcium and potassium intakes performed better than a model without them. In conclusion, low dietary calcium, potassium, and magnesium were associated with higher HDP subtypes prevalence. The prediction model implied that crude calcium and potassium intakes might play a critical role in PE and SP pathogenesis.
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Affiliation(s)
- Hisashi Ohseto
- Tohoku University Graduate School of MedicineSendaiJapan
| | - Mami Ishikuro
- Tohoku University Graduate School of MedicineSendaiJapan,Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Taku Obara
- Tohoku University Graduate School of MedicineSendaiJapan,Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan,Tohoku University HospitalSendaiJapan
| | - Keiko Murakami
- Tohoku University Graduate School of MedicineSendaiJapan,Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Tomomi Onuma
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Aoi Noda
- Tohoku University Graduate School of MedicineSendaiJapan,Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan,Tohoku University HospitalSendaiJapan
| | | | - Fumiko Matsuzaki
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Fumihiko Ueno
- Tohoku University Graduate School of MedicineSendaiJapan,Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Noriyuki Iwama
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan,Tohoku University HospitalSendaiJapan
| | - Masahiro Kikuya
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan,Teikyo University School of MedicineTokyoJapan
| | - Hirohito Metoki
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan,Faculty of MedicineTohoku Medical and Pharmaceutical UniversitySendaiJapan
| | - Junichi Sugawara
- Tohoku University Graduate School of MedicineSendaiJapan,Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan,Tohoku University HospitalSendaiJapan
| | - Shinichi Kuriyama
- Tohoku University Graduate School of MedicineSendaiJapan,Tohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan,International Research Institute of Disaster ScienceTohoku UniversitySendaiJapan
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Effect of 4-Week Consumption of Soy Kori-tofu on Cardiometabolic Health Markers: A Double-Blind Randomized Controlled Cross-Over Trial in Adults with Mildly Elevated Cholesterol Levels. Nutrients 2022; 15:nu15010049. [PMID: 36615709 PMCID: PMC9824620 DOI: 10.3390/nu15010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Kori-tofu is a frozen soy tofu, and soy consumption is associated with positive effects on cardiometabolic health markers. We aimed to assess the potential of Kori-tofu to improve cardiometabolic health outcomes in humans by repetitive daily consumption. In a double-blind randomized controlled cross-over trial, 45 subjects aged 40-70 years with (mildly) elevated cholesterol levels, received a four week Kori-tofu intervention or whey protein control intervention with a four week wash-out period in between. Cardiometabolic biomarkers were measured before and after both interventions. A significant decrease in total, low-density lipids (LDL), and high-density lipids (HDL) cholesterol, Hemoglobin A1c (HbA1c), fructosamine and systolic blood pressure was observed within the Kori-tofu intervention. However, many of these findings were also observed in the control intervention. Only adiponectin changes were different between treatments but did not change significantly within interventions. Improvements in cardiometabolic markers within the Kori-tofu intervention point toward potential beneficial health effects. Due to the lack of significant effects as compared to control, there is, however, currently no substantiating evidence to claim that Kori-tofu has beneficial effects on cardiometabolic health.
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28
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Vulin M, Magušić L, Metzger AM, Muller A, Drenjančević I, Jukić I, Šijanović S, Lukić M, Stanojević L, Davidović Cvetko E, Stupin A. Sodium-to-Potassium Ratio as an Indicator of Diet Quality in Healthy Pregnant Women. Nutrients 2022; 14:nu14235052. [PMID: 36501082 PMCID: PMC9737568 DOI: 10.3390/nu14235052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
This study aimed to investigate diet quality in healthy pregnant women based on the Na-to-K ratio from 24 h urine sample and food frequency questionnaire (FFQ), to compare dietary micro- and macronutrient intake with current nutritional recommendations (RDA), and to investigate whether gestational weight gain (GWG) is associated with Na-to-K ratio and diet quality during pregnancy in general. Sixty-four healthy pregnant women between 37 and 40 weeks of gestation participated in the study. Participants' GWG, body composition, molar 24 h urine Na-to-K ratio, and FFQ data on average daily total energy, food groups, and micro-/macronutrient intake were obtained. A Na-to-K ratio of 2.68 (1.11-5.24) does not meet nutrition quality and is higher than the WHO recommendations due to excessive sodium and insufficient potassium intake. FFQ Na-to-K ratio was associated with a higher daily intake of soups, sauces, cereals, fats, and oils and a low intake of fruit and non-alcoholic beverages. A total of 49% of pregnant women exhibited excessive GWG, which was attributed to the increase in adipose tissue mass. GWG was not associated with total energy but may be the result of insufficient physical activity during pregnancy. Daily intake of vitamin D, vitamin E, folate, niacin, riboflavin, calcium, iron, and zinc was suboptimal compared to RDA.
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Affiliation(s)
- Martina Vulin
- Department of Obstetrics and Gynecology, University Hospital Osijek, HR-31000 Osijek, Croatia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
| | - Lucija Magušić
- Department of Obstetrics and Gynecology, University Hospital Osijek, HR-31000 Osijek, Croatia
| | - Ana-Maria Metzger
- Department of Obstetrics and Gynecology, University Hospital Osijek, HR-31000 Osijek, Croatia
| | - Andrijana Muller
- Department of Obstetrics and Gynecology, University Hospital Osijek, HR-31000 Osijek, Croatia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
| | - Ines Drenjančević
- Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
- Scientific Center of Excellence for Personalized Health Care, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
| | - Ivana Jukić
- Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
- Scientific Center of Excellence for Personalized Health Care, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
| | - Siniša Šijanović
- Department of Obstetrics and Gynecology, University Hospital Osijek, HR-31000 Osijek, Croatia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
| | - Matea Lukić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
| | - Lorena Stanojević
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
| | | | - Ana Stupin
- Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
- Scientific Center of Excellence for Personalized Health Care, Josip Juraj Strossmayer University of Osijek, HR-31000 Osijek, Croatia
- Correspondence:
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Jung H, Lee G, Lim K, Shin S. Association of milk consumption with management and incidence of hypertension among South Korean adults: A prospective analysis of the health examinees study cohort. Nutr Metab Cardiovasc Dis 2022; 32:2515-2525. [PMID: 36175315 DOI: 10.1016/j.numecd.2022.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND AIMS Studies have revealed a positive relationship between milk consumption and hypertension. However, few researchers have investigated the association between milk consumption and changes in blood pressure (BP) in South Korean adults. Therefore, we examined the association between milk intake and the management and risk of hypertension in South Korean adults. METHODS AND RESULTS Participants were selected from the Health Examinees study. The definition of hypertension was based on the guidelines of the Korean Society of Hypertension. The participants were divided into three groups according to changes between baseline and follow-up BP data. Milk consumption was assessed using food frequency questionnaires. In both men and women, the higher milk consumption group had increased odds of trends of BP improvement (OR: 1.249, 95% CI: 1.043-1.496, p for trend: 0.2271 in men; OR: 1.147, 95% CI: 1.014-1.297, p for trend: 0.0293 in women) and decreased odds of trends of worsening (OR: 0.861, 95% CI: 0.756-0.980, p for trend: <0.0001 in men, OR: 0.866, 95% CI: 0.794-0.943, p for trend: 0.0010 in women) compared to those of the non-consumption group. In the prospective study, milk intake was inversely associated with hypertension risk (HR: 0.900, 95% CI: 0.811-0.999, p for trend: 0.0076 in men; HR: 0.879, 95% CI: 0.814-0.949, p for trend: 0.0002 in women). CONCLUSION Increased intake of milk was inversely related to the risk of increased BP, with a decreased risk of hypertension events.
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Affiliation(s)
- Hyein Jung
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea
| | - Geongu Lee
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea
| | - Kyungjoon Lim
- Faculty of Medicine and Health, School of Medical Science, University of Sydney, NSW 2006, Australia
| | - Sangah Shin
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, South Korea.
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Avocado consumption is associated with a reduction in hypertension incidence in Mexican women. Br J Nutr 2022; 129:1976-1983. [PMID: 35979778 DOI: 10.1017/s0007114522002690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Avocado is a fruit rich in dietary fibre, potassium, Mg, mono and PUFA and bioactive phytochemicals, which are nutritional components that have been associated with cardiovascular health. Yet, despite the boom in avocado consumption, we lack evidence on its association with CVD risk in the general population. To estimate the prospective association between avocado consumption and incident hypertension in Mexican women, we estimated the association in participants from the Mexican Teachers’ Cohort who were ≥ 25 years, free of hypertension, CVD and cancer at baseline (n 67 383). We assessed baseline avocado consumption with a semi-quantitative FFQ (never to six or more times per week). Incident hypertension cases were identified if participants self-reported a diagnosis and receiving treatment. To assess the relation between categories of avocado consumption (lowest as reference) and incident hypertension, we estimated incidence rate ratios (IRR) and 95 % CI using Poisson regression models and adjusting for confounding. We identified 4002 incident cases of hypertension during a total of 158 706 person-years for a median follow-up of 2·2 years. The incidence rate of hypertension was 25·1 cases per 1000 person-years. Median avocado consumption was 1·0 (interquartile range: 0·23, 1·0) serving per week (half an avocado). After adjustment for confounding, consuming 5 + servings per week of avocado was associated with a 17 % decrease in the rate of hypertension, compared with non- or low consumers (IRR = 0·83; 95 % CI: 0·70, 0·99; Ptrend = 0·01). Frequent consumption of avocado was associated with a lower incidence of hypertension.
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Starck C, Blumfield M, Abbott K, Cassettari T, Wright J, Duve E, Barclay AW, Fayet-Moore F. Methodology for the Review and Update of Nutrient Criteria Underpinning Front-of-Pack Labeling: Application to the Glycemic Index Symbol. Front Nutr 2022; 9:867349. [PMID: 35757261 PMCID: PMC9218624 DOI: 10.3389/fnut.2022.867349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background Nutrient criteria underlying front-of-pack food labeling programs can play an important role in improving dietary intakes. Currently, no methodology for the development or update of nutrient criteria has been published, nor the methods used by food regulatory bodies. The scientific publication of methodology outlining the development and update of nutrient criteria underpinning front-of-pack food labeling programs highlighting healthier food choices is needed. Objective To develop and provide a globally applicable and transparent methodology for researchers to follow when reviewing existing or developing new nutrient criteria for front-of-pack labeling. Methods The Nutrient Criteria Methodology involved five phases: Phase I, the development of guiding principles; Phase II, collection of information for subsequent phases, including a pre-scope of the literature and selection of food composition database(s) for modeling; Phase III, literature review of all possible nutrients relevant to the nutrient criteria; Phase IV, database modeling to set quantitative limits for each selected nutrient; Phase V, assessment of the criteria against an established nutritional quality assessment tool. As an example, the methodology was applied to the update of the GI Symbol Product Eligibility and Nutrient Criteria (PENC). Results A comprehensive and replicable methodology, based on best practice protocols and ensuring both scientific credibility and practicality of use by industry, was developed. Application of the five phases of the methodology to the GI Symbol PENC highlighted the ability of the methodology to uncover nutritional measures currently missing in many nutrient criteria for front-of-pack food labeling programs and other national food labeling systems, such as glycemic load and the unsaturated to saturated fat ratio. Foods achieving the PENC had a higher Health Star Rating than foods not achieving the PENC. Conclusion Our Nutrient Criteria Methodology can be applied to the development and update of global nutrient criteria underpinning front-of-pack food labeling programs. Further research into the implementation of additional nutritional measures found to be important for human health is recommended, with the goal of the prevention of diet-related disease.
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Affiliation(s)
- Carlene Starck
- Nutrition Research Australia, Sydney, NSW, Australia.,Riddet Institute, Massey University, Palmerston North, New Zealand
| | | | - Kylie Abbott
- Nutrition Research Australia, Sydney, NSW, Australia
| | | | - Jutta Wright
- Nutrition Research Australia, Sydney, NSW, Australia
| | - Emily Duve
- Nutrition Research Australia, Sydney, NSW, Australia
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Prediction Tool to Estimate Potassium Diet in Chronic Kidney Disease Patients Developed Using a Machine Learning Tool: The UniverSel Study. Nutrients 2022; 14:nu14122419. [PMID: 35745151 PMCID: PMC9228360 DOI: 10.3390/nu14122419] [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] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 02/06/2023] Open
Abstract
There is a need for a reliable and validated method to estimate dietary potassium intake in chronic kidney disease (CKD) patients to improve prevention of cardiovascular complications. This study aimed to develop a clinical tool to estimate potassium intake using 24-h urinary potassium excretion as a surrogate of dietary potassium intake in this high-risk population. Data of 375 adult CKD-patients routinely collecting their 24-h urine were included to develop a prediction tool to estimate potassium diet. The prediction tool was built from a random sample of 80% of patients and validated on the remaining 20%. The accuracy of the prediction tool to classify potassium diet in the three classes of potassium excretion was 74%. Surprisingly, the variables related to potassium consumption were more related to clinical characteristics and renal pathology than to the potassium content of the ingested food. Artificial intelligence allowed to develop an easy-to-use tool for estimating patients' diets in clinical practice. After external validation, this tool could be extended to all CKD-patients for a better clinical and therapeutic management for the prevention of cardiovascular complications.
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Ström E, Östgren CJ, Nystrom FH, Wijkman MO. Associations between fruit consumption and home blood pressure in a randomly selected sample of the general Swedish population. J Clin Hypertens (Greenwich) 2022; 24:723-730. [PMID: 35499960 PMCID: PMC9180314 DOI: 10.1111/jch.14491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
Frequent fruit consumption has been associated with lower office blood pressure. Less is known about associations between fruit consumption and home blood pressure. Our aim was to study the correlation between consumption of specific fruits and home blood pressure in a large randomly selected study population. The main outcome was systolic home blood pressure. Home blood pressure measurements were performed with calibrated oscillometric meters during seven consecutive days. Means for all available measurements were used. Validated food frequency questionnaires were used for estimating frequency of fruit consumption. The specified fruits were bananas, apples/pears and oranges/citrus fruit. Complete case analysis regarding fruit consumption, office‐ and home blood pressure measurements and other relevant variables was performed in 2283 study participants out of 2603 available. Multivariable linear regression analysis was performed. There were statistically significant associations between consumption of all fruit types and lower systolic home blood pressure unadjusted (p for trend; bananas, apples/pears and oranges/citrus fruit p < .001). The numerical differences between most and least frequent consumption of fruit were for bananas ‐2.7 mm Hg, apples/pears ‐3.9 mm Hg and for oranges/citrus fruit ‐3.4 mm Hg. When adjusted for covariates, both consumption of apples/pears and oranges/citrus fruit had an independent statistically significant association with lower blood pressure (p = .048 resp. p = .009). Future controlled interventional studies are needed to evaluate the effect of specific fruit on home blood pressure.
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Affiliation(s)
- Edvin Ström
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Carl Johan Östgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Fredrik H Nystrom
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Magnus O Wijkman
- Department of Internal Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
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Elarbaoui M, Jafri A, Elkardi Y, Makhlouki H, Ellahi B, Derouiche A. Sodium and potassium intakes assessed by 24-h urine among Moroccan University students in Casablanca, Morocco: Cross-sectional study. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Analytical application of MIL-53 (Al) for the extraction of pesticides from fruit juices following their preconcentration through dispersive liquid-liquid microextraction. TALANTA OPEN 2022. [DOI: 10.1016/j.talo.2022.100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Hiremath S, Fergusson D, Knoll G, Ramsay T, Kong J, Ruzicka M. Diet or additional supplement to increase potassium intake: protocol for an adaptive clinical trial. Trials 2022; 23:147. [PMID: 35164833 PMCID: PMC8845348 DOI: 10.1186/s13063-022-06071-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 01/31/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
High blood pressure is the leading cause of cardiovascular disease worldwide. The prevalence of high blood pressure is steadily rising as the population grows amongst older adults with the ageing population. Therapeutical treatments are widely available to decrease blood pressures, in addition to many lifestyle options, such as dietary changes and exercise. There is a marked preference amongst patients, as reiterated by Hypertension Canada, for more research into non-therapeutic methods for controlling blood pressure or to reduce the burden of taking many pills to control high blood pressure. Indeed, effective options do exist, especially with diet, specifically decreasing sodium and increasing potassium intake. Current public health outreach primarily focusses on sodium intake, even though potassium intake remains low in the Western world. Excellent data exist in published research that increasing potassium intake, either via dietary modification or supplements, reduces blood pressure and reduces risk of cardiovascular outcomes such as stroke. However, the advice most often provided by medical professionals is to ‘eat more fruits and vegetables’ which has little impact on patient outcomes.
Methods
We propose to do a clinical trial in two stages with an adaptive trial design. In the first stage, participants with high blood pressure and proven low potassium intake (measured on the basis of a 24-h urine collection) will get individually tailored dietary advice, reinforced by weekly supportive phone/email support. At 4 weeks, if there has not been a measured increase in potassium intake, participants will be prescribed an additional potassium supplement. Testing will be conducted again at 8 weeks, to confirm the efficacy of the potassium supplement. Final measurements will be planned at 52 weeks to observe and measure the persistence of the effect of diet or additional supplement. Concurrent measurements of sodium intake, blood pressure, participant satisfaction, and safety measures will also be done.
Discussion
The results of the study will help determine the most effective method of increasing potassium intake, thus reducing blood pressure and need for blood pressure-lowering medicines, and at the same time potentially increasing participant satisfaction. The current guidelines recommend changes in diet, not a potassium supplement, to increase potassium intake; hence, the two-stage design will only add supplements if the most rigorous dietary advice does not work.
Trial registration
This study has been registered on ClinicalTrials.govNCT03809884. Registered on January 18, 2019
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Taladrid D, de Celis M, Belda I, Bartolomé B, Moreno-Arribas MV. Hypertension- and glycaemia-lowering effects of a grape-pomace-derived seasoning in high-cardiovascular risk and healthy subjects. Interplay with the gut microbiome. Food Funct 2022; 13:2068-2082. [PMID: 35107113 DOI: 10.1039/d1fo03942c] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose: Grape pomace (GP) is a winery by-product rich in polyphenols and dietary fibre. Some recent results suggest that GP-derived extracts could be promising additives in food, specially recommended for low-salt diets. The hypothesis tested in this paper is that the regular consumption of GP-derived seasonings could help in the control of hypertension and glycaemia. Methods: A randomized intervention study (6 weeks) was performed in high-risk cardiovascular subjects (n = 17) and in healthy subjects (n = 12) that were randomly allocated into intervention (2 g day-1 of GP seasoning) or control (no seasoning consumed) groups. Blood samples, faeces, urine and blood pressure (BP) were taken at the baseline and at the end of the intervention. Faecal samples were analysed for microbiota composition (16S rRNA gene sequencing) and microbial-derived metabolites (short chain fatty acids and phenolic metabolites). Results: Among the clinical parameters studied, BP and fasting blood glucose significantly decreased (p < 0.05) after the seasoning intervention, but not for the control group. Notably, application of a novel approach based on ASV (Amplicon Sequence Variant) co-occurrence networks allowed us to identify some bacterial communities whose relative abundances were related with metadata. Conclusion: Our primary findings suggest that GP-seasoning may help in the modulation of cardiometabolic risk factors, mainly in the early stages. Furthermore, it evidences modulation of gut microbiota and functional bacterial communities by grape pomace, which might mediate the cardiometabolic effects of this by-product.
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Affiliation(s)
- Diego Taladrid
- Institute of Food Science Research (CIAL), CSIC-UAM, C/Nicolás Cabrera 9, 28049 Madrid, Spain.
| | - Miguel de Celis
- Department of Genetics, Physiology and Microbiology, Complutense University of Madrid, 28040-Madrid, Spain
| | - Ignacio Belda
- Department of Genetics, Physiology and Microbiology, Complutense University of Madrid, 28040-Madrid, Spain
| | - Begoña Bartolomé
- Institute of Food Science Research (CIAL), CSIC-UAM, C/Nicolás Cabrera 9, 28049 Madrid, Spain.
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Guo X, Zhang M, Li C, Zhang X, Zhao Z, Huang Z, Deng X, Wang L. Association Between Urinary Sodium and Potassium Excretion and Blood Pressure Among Non-Hypertensive Adults — China, 2018−2019. China CDC Wkly 2022; 4:522-526. [PMID: 35812699 PMCID: PMC9257692 DOI: 10.46234/ccdcw2022.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/29/2022] [Indexed: 11/14/2022] Open
Abstract
What is already known about this topic? High sodium and low potassium in 24 h urinary excretion were associated with elevated blood pressure. What is added by this report? With increasing body mass index levels, decreasing unit urinary sodium excretion was more effective in reducing systolic and diastolic blood pressure, and increasing unit urinary potassium excretion was more effective in reducing diastolic blood pressure. What are the implications for public health practice? Reducing sodium and increasing potassium intake was more effective in reducing blood pressure in overweight and obese non-hypertensive adults compared to underweight and normal weight adults.
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Affiliation(s)
- Xiaohui Guo
- Division of NCD and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
- Tianjin Nankai District Center for Disease Control and Prevention, Tianjin, China
| | - Mei Zhang
- Division of NCD and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Chun Li
- Division of NCD and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Xiao Zhang
- Division of NCD and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Zhenping Zhao
- Division of NCD and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Zhengjing Huang
- Division of NCD and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Xiaoqing Deng
- Division of NCD and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
| | - Limin Wang
- Division of NCD and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, China CDC, Beijing, China
- Limin Wang,
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Cheteu Wabo TM, Wu X, Sun C, Boah M, Ngo Nkondjock VR, Kosgey Cheruiyot J, Amporfro Adjei D, Shah I. Association of dietary calcium, magnesium, sodium, and potassium intake and hypertension: a study on an 8-year dietary intake data from the National Health and Nutrition Examination Survey. Nutr Res Pract 2022; 16:74-93. [PMID: 35116129 PMCID: PMC8784264 DOI: 10.4162/nrp.2022.16.1.74] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/17/2020] [Accepted: 05/11/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND/OBJECTIVES There has been an increased interest in determining calcium magnesium, sodium, and potassium's distinct effects on hypertension over the past decade, yet they simultaneously regulate blood pressure. We aimed at examining the association of dietary calcium, magnesium, sodium, and potassium independently and jointly with hypertension using National Health and Nutrition Examination Survey data from 2007 to 2014. MATERIALS/METHODS The associations were examined on a large cross-sectional study involving 16684 US adults aged>20 years, using multivariate analyses with logistical models. RESULTS Sodium and calcium quartiles assessed alone were not associated with hypertension. Potassium was negatively associated with hypertension in the highest quartile, 0.64 (95% confidence interval [CI], 0.48–0.87). When jointly assessed using the high and low cut-off points, low sodium and corresponding high calcium, magnesium, and potassium intake somewhat reduced the odds of hypertension 0.39 (95% CI, 0.20–0.76). The sodium-to-potassium ratio was positively associated with hypertension in the highest quartile1.50 (95% CI, 1.11–2.02). When potassium was adjusted for sodium intake and sodium-to-potassium ratio assessed among women, increased odds of hypertension were reported in the highest quartile as 2.02 (95% CI, 1.18–3.34) and 1.69 (95% CI, 1.12–2.57), respectively. The association of combined minerals on hypertension using dietary goals established that men meeting the reference intakes for calcium and exceeding for magnesium had reduced odds of hypertension 0.51 (95% CI, 0.30–0.89). Women exceeding the recommendations for both calcium and magnesium had the lower reduced odds of 0.30 (95% CI, 0.10–0.69). CONCLUSIONS Our results suggest that the studied minerals' association on hypertension is stronger when jointly assessed, mostly after gender stratification. As compared to men, women increased their risk of hypertension even with a low sodium intake. Women would also reasonably reduce their risk of developing hypertension by increasing calcium and magnesium intake. In comparison, men would somewhat be protected from developing hypertension with calcium intake meeting the dietary goals and magnesium exceeding the nutritional goals.
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Affiliation(s)
- Therese Martin Cheteu Wabo
- Department of Nutrition and Food Hygiene, Harbin Medical University, Harbin 150081, China
- Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundéré, Ngaoundéré 454, Cameroon
| | - Xiaoyan Wu
- Department of Nutrition and Food Hygiene, Harbin Medical University, Harbin 150081, China
| | - Changhao Sun
- Department of Nutrition and Food Hygiene, Harbin Medical University, Harbin 150081, China
| | - Michael Boah
- Department of Epidemiology Biostatistics and Disease Control, School of Public Health, University for Development Studies, Tamale TL 1883, Ghana
| | | | | | - Daniel Amporfro Adjei
- Department of Health Services Management, Harbin Medical University, Harbin 150081, China
| | - Imranulllah Shah
- Department of Nutrition and Food Hygiene, Harbin Medical University, Harbin 150081, China
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Salman E, Kadota A, Okami Y, Kondo K, Yoshita K, Okuda N, Nakagawa H, Saitoh S, Sakata K, Okayama A, Chan Q, Elliott P, Stamler J, Ueshima H, Miura K. Investigation of the urinary sodium-to-potassium ratio target level based on the recommended dietary intake goals for the Japanese population: The INTERMAP Japan. Hypertens Res 2022; 45:1850-1860. [PMID: 36344663 PMCID: PMC9659487 DOI: 10.1038/s41440-022-01007-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/20/2022] [Accepted: 07/24/2022] [Indexed: 11/09/2022]
Abstract
Growing epidemiological evidence has shown an association of the urinary sodium (Na) to potassium (K) ratio (Na/K ratio) with blood pressure and cardiovascular diseases. However, no clear cutoff level has been defined. We investigated the cutoff level of the urinary Na/K ratio under different dietary guidelines for Japanese individuals, especially that endorsed by the 2020 revised Japanese Dietary Reference Intakes (DRIs). A population of 1145 Japanese men and women aged 40 to 59 years from the INTERMAP study was examined. Using high-quality standardized data, the averages of two 24 h urinary collections and four 24 h dietary recalls were used to calculate the 24 h urinary and dietary Na/K ratios, respectively. Associations between the urinary and dietary Na/K ratios were tested by sex- and age-adjusted partial correlation. The optimal urinary Na/K ratio cutoff level was determined by receiver operating characteristic (ROC) curves and sex-specific cross tables for recommended dietary K and salt. Overall, the average molar ratio of 24 h urinary Na/K was 4.3. We found moderate correlations (P < 0.001) of the 24 h urinary Na/K ratio with 24 h urinary Na and K excretion (r = 0.52, r = -0.49, respectively) and the dietary Na/K ratio (r = 0.53). ROC curves showed that a 24 h urinary Na/K ratio of approximately 2 predicted Na and K intake that meets the dietary goals of the Japanese DRIs. The range of urinary Na/K ratios meeting the dietary goals of the Japanese DRIs for both Na and K was 1.6‒2.2 for men and 1.7‒1.9 for women. Accomplishing a urinary Na/K ratio of 2 would be desirable to achieve the DRIs dietary goals for both Na and K simultaneously in middle-aged Japanese men and women accustomed to Japanese dietary habits. This observational study is registered at www.clinicaltrials.gov as NCT00005271.
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Affiliation(s)
- Ebtehal Salman
- grid.410827.80000 0000 9747 6806NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan ,grid.471243.70000 0001 0244 1158OMRON Healthcare Co., Ltd, Kyoto, Japan
| | - Aya Kadota
- grid.410827.80000 0000 9747 6806NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Yukiko Okami
- grid.410827.80000 0000 9747 6806NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Keiko Kondo
- grid.410827.80000 0000 9747 6806NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Katsushi Yoshita
- grid.261445.00000 0001 1009 6411Department of Food Science and Nutrition, Graduate School of Human Life Science and Nutrition, Osaka City University, Osaka, Japan
| | - Nagako Okuda
- grid.258797.60000 0001 0697 4728Department of Health Science, Kyoto Prefectural University, Kyoto, Japan
| | - Hideaki Nakagawa
- grid.411998.c0000 0001 0265 5359Medical Research Institute, Kanazawa Medical University, Kanazawa, Japan
| | - Shigeyuki Saitoh
- grid.263171.00000 0001 0691 0855School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Kiyomi Sakata
- grid.411790.a0000 0000 9613 6383Department of Hygiene and Public Health, Iwate Medical University, Yahaba, Japan
| | - Akira Okayama
- grid.272242.30000 0001 2168 5385Department of Non-Communicable Diseases, Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Queenie Chan
- grid.7445.20000 0001 2113 8111Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Paul Elliott
- grid.7445.20000 0001 2113 8111Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Jeremiah Stamler
- grid.16753.360000 0001 2299 3507Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Hirotsugu Ueshima
- grid.410827.80000 0000 9747 6806NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Katsuyuki Miura
- grid.410827.80000 0000 9747 6806NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
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The Effect of Behavioral Changes on the Treatment of Hypertension. Curr Hypertens Rep 2021; 23:43. [PMID: 34820738 DOI: 10.1007/s11906-021-01164-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW Hypertension is one of the leading causes of preventable premature death. RECENT FINDINGS Strongly advocating for lifestyle changes to improve blood pressure control is of paramount importance in the successful management of hypertension. In this review, we will discuss the effect of various behavioral and lifestyle changes and review the evidence to support these changes to improve blood pressure control. These include dietary modifications, alcohol consumption, weight loss, various types of exercise, device-guided breathing, relaxation, and biofeedback techniques.
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Sun N, Jiang Y, Wang H, Yuan Y, Cheng W, Han Q, Yuan H, Yang L, Guo Z, Sun Y, Sun G, Yin X, Wang H, Mu J, Wang J. Survey on sodium and potassium intake in patients with hypertension in China. J Clin Hypertens (Greenwich) 2021; 23:1957-1964. [PMID: 34563099 PMCID: PMC8630600 DOI: 10.1111/jch.14355] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 05/11/2021] [Accepted: 06/04/2021] [Indexed: 11/30/2022]
Abstract
Sodium and potassium intake in hypertensive patients in China is not clear. The authors aimed to investigate the distribution of sodium and potassium intake in hypertensive patients in China, and to analyze the relationship between sodium and potassium intake and blood pressure. The study was performed in 130 hospitals from 23 provinces across China from 2016 to 2019. Finally, 9501 hypertensive patients average aged 54 years were included. 24 h urinary sodium and potassium excretion were measured. Distribution of urinary electrolytes were described according to age, gender and region. The association between urinary electrolytes and blood pressure was analyzed by multivariate linear regression. Hypertensive patients exhibited an average 24 h urinary sodium and potassium excretion of 156.7 ± 81.5 mmol/d and 39.2 ± 20.2 mmol/d (equivalent to sodium chloride of 9.2 g/d, potassium chloride of 2.9 g/d), sodium/potassium ratio (median) of 4.14 (2.92,5.73). Urinary electrolytes were lower in women than men (sodium: 171.1 vs 138.7, p < .05; potassium: 40.3 vs 37.7, p < .05), in the elderly than in the younger (sodium: 168.7 vs 139.9, p < .05; potassium: 39.5 vs. 37.5, p < .05). For every 1 unit of Na/K ratio increase, blood pressure increased by 0.46/0.24 mmHg. Blood pressure was 2.75/1.27 mmHg higher in quartile 4 than quartile 1 of Na/K. It remains high sodium and low potassium for hypertensive patients in China. Decreased sodium, Na/K ratio and increased potassium may help for blood pressure management.
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Affiliation(s)
- Ningling Sun
- Institute of hypertensionPeople's Hospital, Peking UniversityBeijingChina
| | - Yinong Jiang
- The Institute of Hypertension and Heart FailureThe 1st Affiliated Hospital of Dalian Medical UniversityDalianChina
| | - Hongyi Wang
- Institute of hypertensionPeople's Hospital, Peking UniversityBeijingChina
| | - Yifang Yuan
- Institute of hypertensionPeople's Hospital, Peking UniversityBeijingChina
- Department of CardiologyTsinghua Changgung HospitalTsinghua UniversityBeijingChina
| | - Wenli Cheng
- Department of HypertensionBeijing Anzhen Hospital Affiliated to Capital Medical UniversityBeijingChina
| | - Qinghua Han
- Department of CardiologyFirst Hospital of Shanxi Medical UniversityTaiyuanChina
| | - Hong Yuan
- Department of HypertensionThird Xiangya HospitalCentral South UniversityChangshaChina
| | - Li Yang
- Department of GeriatricsYan'an Affiliated Hospital of Kunming Medical UniversityKunmingChina
| | - Zihong Guo
- Hypertension wardFuwai Yunnan Cardiovascular HospitalBeijingChina
| | - Yuemin Sun
- Department of CardiologyTianjin Medical University General HospitalTianjinChina
| | - Gang Sun
- Department of CardiologyThe Second Affiliated Hospital of Baotou Medical CollegeBaotouChina
| | - Xinhua Yin
- Department of CardiologyThe First Affiliated Hospital of Harbin Medical UniversityHarbinChina
| | - Hao Wang
- Department of HypertensionHenan Provincial People's HospitalZhengzhouChina
| | - Jianjun Mu
- Department of cardiologyFirst Hospital of Xi'an Jiaotong UniversityXi'anChina
| | - Jiguang Wang
- Shanghai Institute of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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Gallo LA, Gallo TF, Young SL, Fotheringham AK, Barclay JL, Walker JL, Moritz KM, Akison LK. Adherence to Dietary and Physical Activity Guidelines in Australian Undergraduate Biomedical Students and Associations with Body Composition and Metabolic Health: A Cross-Sectional Study. Nutrients 2021; 13:nu13103500. [PMID: 34684500 PMCID: PMC8538134 DOI: 10.3390/nu13103500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 01/14/2023] Open
Abstract
There is a paucity of data on whether Australian university students are meeting specific nutrient guidelines, and the relationship between diet and physical activity patterns with body composition and metabolic health. In this study, biomedical students from The University of Queensland were recruited (150 males and 211 females, 19–25 years), and nutritional intake (ASA24-Australia) and physical activity levels (Active Australia Survey) quantified. Body composition (height, waist circumference, body mass, BMI, and percentage body fat; BOD POD) and metabolic health (oral glucose tolerance test) were also measured. Median daily energy intake was 6760 kJ in females and 10,338 kJ in males, with more than 30% of total energy coming from energy-dense, nutrient-poor foods. Only 1 in 10 students met fruit or vegetable recommendations, with less than one third meeting recommendations for fibre, calcium, and potassium. Intakes of calcium and iron were particularly low among female students, with only 16% and 6% of students meeting the recommended dietary intake (RDI), respectively. The majority of males and almost half of all females exceeded the suggested dietary target (SDT) for sodium. Sufficient physical activity (≥150 min over ≥5 sessions per week) was met by more than 80% of students. Body composition and blood glucose concentrations were largely normal but an early sign of insulin resistance (HOMA-IR > 2.0), measured in a subset of students, was present in 21% of males and 17% of females. Modest reductions in blood glucose levels and percentage body fat were associated with increasing vigorous activity. Low intakes of fibre, calcium, and potassium could be corrected by increasing fruit, vegetable, and dairy intake, and, among females, health promotion messages focusing on iron-rich foods should be prioritised. While these nutrient deficiencies did not translate into immediate metabolic heath concerns, dietary behaviours can track into adulthood and have lasting effects on overall health.
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Affiliation(s)
- Linda A. Gallo
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD 4072, Australia; (S.L.Y.); (K.M.M.); (L.K.A.)
- Correspondence:
| | - Tania F. Gallo
- North Melbourne Football Club, Arden Street, North Melbourne, VIC 3051, Australia;
| | - Sophia L. Young
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD 4072, Australia; (S.L.Y.); (K.M.M.); (L.K.A.)
| | - Amelia K. Fotheringham
- Mater Research Institute—The University of Queensland, Translational Research Institute, Woolloongabba, QLD 4102, Australia; (A.K.F.); (J.L.B.)
| | - Johanna L. Barclay
- Mater Research Institute—The University of Queensland, Translational Research Institute, Woolloongabba, QLD 4102, Australia; (A.K.F.); (J.L.B.)
| | - Jacqueline L. Walker
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD 4072, Australia;
| | - Karen M. Moritz
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD 4072, Australia; (S.L.Y.); (K.M.M.); (L.K.A.)
| | - Lisa K. Akison
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD 4072, Australia; (S.L.Y.); (K.M.M.); (L.K.A.)
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Yin X, Tian M, Sun L, Webster J, Trieu K, Huffman MD, Miranda JJ, Marklund M, Wu JHY, Cobb LK, Chu H, Pearson SA, Neal B, Liu H. Barriers and Facilitators to Implementing Reduced-Sodium Salts as a Population-Level Intervention: A Qualitative Study. Nutrients 2021; 13:nu13093225. [PMID: 34579109 PMCID: PMC8471368 DOI: 10.3390/nu13093225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/06/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022] Open
Abstract
Widespread use of reduced-sodium salts can potentially lower excessive population-level dietary sodium intake. This study aimed to identify key barriers and facilitators to implementing reduced-sodium salt as a population level intervention. Semi-structured interviews were conducted with key informants from academia, the salt manufacturing industry, and government. We used the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to inform our interview guides and data analysis. Eighteen key informants from nine countries across five World Health Organization regions participated in the study from January 2020 to July 2020. Participants were concerned about the lack of robust evidence on safety for specific populations such as those with renal impairment. Taste and price compared to regular salt and an understanding of the potential health benefits of reduced-sodium salt were identified as critical factors influencing the adoption of reduced-sodium salts. Higher production costs, low profit return, and reduced market demand for reduced-sodium salts were key barriers for industry in implementation. Participants provided recommendations as potential strategies to enhance the uptake. There are presently substantial barriers to the widespread use of reduced-sodium salt but there are also clear opportunities to take actions that would increase uptake.
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Affiliation(s)
- Xuejun Yin
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (X.Y.); (J.W.); (K.T.); (M.D.H.); (J.J.M.); (M.M.); (J.H.Y.W.); (B.N.); (H.L.)
| | - Maoyi Tian
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (X.Y.); (J.W.); (K.T.); (M.D.H.); (J.J.M.); (M.M.); (J.H.Y.W.); (B.N.); (H.L.)
- The George Institute for Global Health, Peking University Health Science Center, Beijing 100600, China;
- School of Public Health, Harbin Medical University, Harbin 150081, China
- Correspondence: ; Tel.: +86-(0)451-8750-2881
| | - Lingli Sun
- The George Institute for Global Health, Peking University Health Science Center, Beijing 100600, China;
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (X.Y.); (J.W.); (K.T.); (M.D.H.); (J.J.M.); (M.M.); (J.H.Y.W.); (B.N.); (H.L.)
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (X.Y.); (J.W.); (K.T.); (M.D.H.); (J.J.M.); (M.M.); (J.H.Y.W.); (B.N.); (H.L.)
| | - Mark D. Huffman
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (X.Y.); (J.W.); (K.T.); (M.D.H.); (J.J.M.); (M.M.); (J.H.Y.W.); (B.N.); (H.L.)
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - J. Jaime Miranda
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (X.Y.); (J.W.); (K.T.); (M.D.H.); (J.J.M.); (M.M.); (J.H.Y.W.); (B.N.); (H.L.)
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima 15074, Peru
| | - Matti Marklund
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (X.Y.); (J.W.); (K.T.); (M.D.H.); (J.J.M.); (M.M.); (J.H.Y.W.); (B.N.); (H.L.)
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Public Health and Caring Sciences, Uppsala University, 75236 Uppsala, Sweden
| | - Jason H. Y. Wu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (X.Y.); (J.W.); (K.T.); (M.D.H.); (J.J.M.); (M.M.); (J.H.Y.W.); (B.N.); (H.L.)
| | - Laura K. Cobb
- Resolve to Save Lives, an Initiative of Vital Strategies, New York, NY 10005, USA;
| | - Hongling Chu
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100083, China;
| | - Sallie-Anne Pearson
- Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Bruce Neal
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (X.Y.); (J.W.); (K.T.); (M.D.H.); (J.J.M.); (M.M.); (J.H.Y.W.); (B.N.); (H.L.)
- School of Public Health, Imperial College London, London SW7 2BX, UK
| | - Hueiming Liu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (X.Y.); (J.W.); (K.T.); (M.D.H.); (J.J.M.); (M.M.); (J.H.Y.W.); (B.N.); (H.L.)
- Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Sydney, NSW 2050, Australia
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Ajenikoko A, Ide N, Shivashankar R, Ge Z, Marklund M, Anderson C, Atun A, Thomson A, Henry ME, Cobb LK. Core Strategies to Increase the Uptake and Use of Potassium-Enriched Low-Sodium Salt. Nutrients 2021; 13:nu13093203. [PMID: 34579080 PMCID: PMC8466693 DOI: 10.3390/nu13093203] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022] Open
Abstract
Excess sodium consumption and insufficient potassium intake contribute to high blood pressure and thus increase the risk of heart disease and stroke. In low-sodium salt, a portion of the sodium in salt (the amount varies, typically ranging from 10 to 50%) is replaced with minerals such as potassium chloride. Low-sodium salt may be an effective, scalable, and sustainable approach to reduce sodium and therefore reduce blood pressure and cardiovascular disease at the population level. Low-sodium salt programs have not been widely scaled up, although they have the potential to both reduce dietary sodium intake and increase dietary potassium intake. This article proposes a framework for a successful scale-up of low-sodium salt use in the home through four core strategies: availability, awareness and promotion, affordability, and advocacy. This framework identifies challenges and potential solutions within the core strategies to begin to understand the pathway to successful program implementation and evaluation of low-sodium salt use.
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Affiliation(s)
- Adefunke Ajenikoko
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
| | - Nicole Ide
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
| | - Roopa Shivashankar
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
- Indian Council of Medical Research (ICMR), New Delhi 110029, India
| | - Zeng Ge
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
| | - Matti Marklund
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD 21087, USA; (M.M.); (M.E.H.)
- The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia
| | - Cheryl Anderson
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, CA 92093, USA; (C.A.); (A.A.)
| | - Amy Atun
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, La Jolla, CA 92093, USA; (C.A.); (A.A.)
| | - Alexander Thomson
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
| | - Megan E. Henry
- Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD 21087, USA; (M.M.); (M.E.H.)
| | - Laura K. Cobb
- Resolve to Save Lives, Vital Strategies, New York, NY 10005, USA; (A.A.); (N.I.); (R.S.); (Z.G.); (A.T.)
- Correspondence: ; Tel.: +1-212-500-5729
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46
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Dietary and Lifestyle Modification for the Prevention and Treatment of Hypertension. CURRENT CARDIOVASCULAR RISK REPORTS 2021. [DOI: 10.1007/s12170-021-00683-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vaudin A, Wambogo E, Moshfegh AJ, Sahyoun NR. Sodium and Potassium Intake, the Sodium to Potassium Ratio, and Associated Characteristics in Older Adults, NHANES 2011-2016. J Acad Nutr Diet 2021; 122:64-77. [PMID: 34303635 DOI: 10.1016/j.jand.2021.06.012] [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: 09/22/2020] [Revised: 06/04/2021] [Accepted: 06/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Sodium, potassium, and the balance between these 2 nutrients are associated with hypertension and cardiovascular disease, and prevalence of these conditions increases with age. However, limited information is available on these intakes among older adults. OBJECTIVE Our aim was to explore the socioeconomic and health factors associated with usual sodium and potassium intakes and the sodium to potassium (Na:K) ratio of older adults. DESIGN This was a cross-sectional, secondary analysis of the 2011-2012, 2013-2014, and 2015-2016 National Health and Nutrition Examination Survey. PARTICIPANTS/SETTING This study included the data of 5,104 adults 50 years and older, with at least one reliable 24-hour dietary recall and an estimated glomerular filtration rate ≥60 mL/min/1.73 m2. MAIN OUTCOME MEASURES Sodium and potassium intake, as absolute intake, density (per 1,000 kcal) and ratio of Na:K intake. STATISTICAL ANALYSES We used t tests and χ2 tests to examine significant differences in intakes on a given day by characteristics. Linear and logistic regression models were used to assess associations of socioeconomic and health characteristics with usual sodium and potassium intakes, determined using the National Cancer Institute method. RESULTS Only 26.2% of participants consumed <2,300 mg sodium (16.2% of men and 35.2% of women) and 36.0% of men and 38.1% of women consumed at least 3,400 mg and 2,600 mg of potassium, respectively. Fewer than one-third of participants consumed a Na:K ratio of <1.0. Women, those with lower blood pressure, and those with a lower body mass index were more likely to have a ratio <1.0. CONCLUSIONS Participants consumed too much sodium and not enough potassium, based on current recommendations. A higher Na:K ratio was significantly associated with established risk factors for cardiovascular disease. The study findings suggest that more research on cardiovascular health should include both sodium and potassium, as well as balance between these nutrients.
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Nichols S, Dalrymple N, Prout P, Ramcharitar-Bourne A. Socio-demographic factors in relation to habitual sodium and potassium intakes among adults in Trinidad and Tobago. Nutr Health 2021; 28:453-466. [PMID: 34266341 DOI: 10.1177/02601060211031741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Approximately one-third of adults in Trinidad and Tobago have high blood pressure (hypertension). Excessive consumption of sodium (Na+) is a known risk factor for hypertension. AIM We investigated Na+ and potassium (K+) intakes and their correlates in a multi-ethnic Caribbean population. METHOD Volunteers completed a self-administered questionnaire comprising socio-demographic items, physical activity (PA) and a semiquantitative food frequency questionnaire. Foods eaten were classified by level of processing using the NOVA classification system and analysed for Na+ and K+ levels using appropriate dietary analysis software. The study was approved by the University of the West Indies at Saint Augustine Ethics Committee. RESULTS 11,783 adults participated in the study. Approximately 83.2% of total calories, 79% of Na+ and 40% of K+ was derived from the consumption of highly processed foods. Median daily Na+ and K+ intakes were 2759 mg and 2853 mg, respectively. Na+ intakes showed significant nonlinear increases with age (p < 0.001) and body mass index (BMI) (p < 0.001), and non-linear decreases with educational attainment (p < 0.001). K+ intakes showed significant nonlinear decreases with age (p < 0.001) and BMI (p < 0.001), and linear increases with educational attainment (p < 0.001). Males had higher intakes of Na+ and K+ than females. Na+: K+ was lower among persons participating in moderate to high intensity PA ≥ 150 minutes/week compared to those participating in such activities < 150 minutes/week. CONCLUSION Socio-demographic factors were significantly correlated with Na+ and K+ intakes among participants and must be considered in strategies aimed at achieving healthy intakes of these nutrients.
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Affiliation(s)
- Selby Nichols
- Human Nutrition Group, Department of Agricultural Economics and Extension, University of The West Indies at Saint Augustine, Trinidad and Tobago
| | - Nequesha Dalrymple
- Human Nutrition Group, Department of Agricultural Economics and Extension, University of The West Indies at Saint Augustine, Trinidad and Tobago.,Department of Curriculum and Instruction, Faculty of Education and Humanities, University of Guyana, Turkeyen Campus, Greater Georgetown, Guyana
| | - Patrice Prout
- Human Nutrition Group, Department of Agricultural Economics and Extension, University of The West Indies at Saint Augustine, Trinidad and Tobago
| | - Anisa Ramcharitar-Bourne
- Human Nutrition Group, Department of Agricultural Economics and Extension, University of The West Indies at Saint Augustine, Trinidad and Tobago
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Assessment of Foods Associated with Sodium and Potassium Intake in Japanese Youths Using the Brief-Type Self-Administered Diet History Questionnaire. Nutrients 2021; 13:nu13072345. [PMID: 34371856 PMCID: PMC8308755 DOI: 10.3390/nu13072345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/20/2022] Open
Abstract
The identification of sodium and potassium intake in youths is an important step to preventing the increase of blood pressure in childhood. We examined food intake and estimated mineral intake using a brief-type self-administered diet history questionnaire (BDHQ) to test its validity as a comparison with urinary excretion in Japanese youths. The subjects were 5th and 8th graders (n = 2377), who completed the BDHQ and permitted the use of their overnight urine specimens. Sodium intake was poorly associated with sodium excretion (Rho = 0.048), and the coefficients of dietary potassium and a sodium-to-potassium molar ratio were 0.091–0.130. Higher soybean paste (miso) intake and pickles were significantly associated with higher sodium excretion (p ≤ 0.005). However, these foods were positively associated with potassium excretion (p = 0.002–0.012), and not associated with an excreted sodium-to-potassium ratio. Fruits and dairy products were positively associated (p ≤ 0.048), whereas beverages were negatively associated with potassium excretion (p ≤ 0.004). The association of the sodium-to-potassium ratio was opposite to that of potassium (p ≤ 0.001). The choice of foods, potassium, and the sodium-to-potassium ratio assessed using the BDHQ are available as part of health education for youths, but the assessment of sodium intake in population levels should be carefully conducted.
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50
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Kreutz R, Dobrowolski P, Prejbisz A, Algharably EAEH, Bilo G, Creutzig F, Grassi G, Kotsis V, Lovic D, Lurbe E, Modesti PA, Pappaccogli M, Parati G, Persu A, Polonia J, Rajzer M, de Timary P, Weber T, Weisser B, Tsioufis K, Mancia G, Januszewicz A. Lifestyle, psychological, socioeconomic and environmental factors and their impact on hypertension during the coronavirus disease 2019 pandemic. J Hypertens 2021; 39:1077-1089. [PMID: 33395152 DOI: 10.1097/hjh.0000000000002770] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
SUMMARY The coronavirus disease 2019 (COVID-19) pandemic considerably affects health, wellbeing, social, economic and other aspects of daily life. The impact of COVID-19 on blood pressure (BP) control and hypertension remains insufficiently explored. We therefore provide a comprehensive review of the potential changes in lifestyle factors and behaviours as well as environmental changes likely to influence BP control and cardiovascular risk during the pandemic. This includes the impact on physical activity, dietary patterns, alcohol consumption and the resulting consequences, for example increases in body weight. Other risk factors for increases in BP and cardiovascular risk such as smoking, emotional/psychologic stress, changes in sleep patterns and diurnal rhythms may also exhibit significant changes in addition to novel factors such as air pollution and environmental noise. We also highlight potential preventive measures to improve BP control because hypertension is the leading preventable risk factor for worldwide health during and beyond the COVID-19 pandemic.
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Affiliation(s)
- Reinhold Kreutz
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Berlin, Germany
| | - Piotr Dobrowolski
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
| | - Aleksander Prejbisz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
| | - Engi A E-H Algharably
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Berlin, Germany
| | - Grzegorz Bilo
- Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Felix Creutzig
- Mercator Research Institute on Global Commons and Climate Change
- Technical University Berlin, Berlin, Germany
| | - Guido Grassi
- Clinica Medica, University Milano Bicocca, Milan, Italy
| | - Vasilios Kotsis
- 3rd Department of Internal Medicine Aristotle University Thessaloniki, Hypertension-24 h Ambulatory Blood Pressure Monitoring Center, Papageorgiou Hospital, Thessaloniki, Greece
| | - Dragan Lovic
- Cardiology Department, Clinic for Internal Disease Intermedica, Singidunum University, School of Medicine, Nis, Serbia
| | - Empar Lurbe
- Pediatric Department, Consorcio Hospital General, University of Valencia
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Valencia, Spain
| | - Pietro A Modesti
- Department of Experimental and Clinical Medicine, Universita' degli Studi di Firenze, School of Medicine, Azienda Ospedaliero Universitaria Careggi, Firenze
| | - Marco Pappaccogli
- Hypertension Unit, Division of Internal Medicine, Department of Medical Sciences, University of Turin, Turin, Italy
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique and Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Alexandre Persu
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique and Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jorge Polonia
- Department of Medicine and CINTESIS, Faculty of Medicine, Porto University, Porto, Portugal
| | - Marek Rajzer
- 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension Jagiellonian University Medical College, Kraków, Poland
| | - Philippe de Timary
- Department of Adult Psychiatry, Cliniques Universitaires Saint-Luc and Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria
| | | | - Konstantinos Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Giuseppe Mancia
- Università Milano-Bicocca, Milan
- Policlinico di Monza, Monza, Italy
| | - Andrzej Januszewicz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
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