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Armas AJM, Aranda JAE, Arcos HS, Arellano FL, Arguelles CBL, Arreza AMM, Arriza MAG, Ascan CKA, Torres GCS. Assessing Dietary Salt Intake and Pilot-Testing a Home-Based Intervention to Lower Salt Intake Among Filipino College Students. J Community Health Nurs 2024; 41:57-72. [PMID: 37943282 DOI: 10.1080/07370016.2023.2277839] [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: 11/10/2023]
Abstract
PURPOSE To assess the knowledge, attitude, and behaviors related to dietary salt intake and develop a home-based intervention that helps lower salt intake among Filipino college students. DESIGN Two-phase program development study utilizing descriptive and quasi-experimental design. METHODS Phase 1 determined the knowledge, attitude, and behaviors alongside the frequency of dietary salt intake of a consecutive sample (n = 118). Phase 2 involved the development and pilot-testing of a home-based intervention wherein a random sample (n = 35) selected from Phase 1 joined for pilot-testing. The study was conducted from October - November 2021 and utilized valid and reliable measures to test the knowledge, attitude, and behavior of the participants. FINDINGS Initial assessment showed knowledge regarding health risks of high salt intake and positive attitude toward health-promoting behaviors. Post-intervention showed improvement in attitude (p = 0.0004) and behavior (p = 0.001) related to dietary salt intake alongside health literacy (p = 0.036). There was no significant change in knowledge (p = 0.054). CONCLUSION The home-based intervention involving the use of health education materials is successful in improving dietary salt intake patterns. CLINICAL EVIDENCE Community health nurses may utilize home-based interventions to help develop health-promoting behaviors among young adults.
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Souza DS, Santos BI, Costa BM, Santos DM, Aragão LGS, Pires LV, Vieira DAS, Freire ARS, Barbosa KBF. Food frequency questionnaire for foods high in sodium: Validation with the triads method. PLoS One 2023; 18:e0288123. [PMID: 37399199 DOI: 10.1371/journal.pone.0288123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 06/20/2023] [Indexed: 07/05/2023] Open
Abstract
This study aimed to validate a food frequency questionnaire for foods high in sodium (FFQ-FHS) in a population aged ≥18 years and to test its reproducibility. This cross-sectional study included 50 individuals (≥18 years) of both sexes. In addition to the FFQ-FHS, four 24-h dietary recalls (24hRs) were conducted and a socioeconomic and lifestyle questionnaire was administered. Two 24-h urinary excretions were collected for sodium analysis, and anthropometry was performed. For validation, the triad method was applied using the validity coefficient (ρ). For reproducibility, the intraclass correlation coefficient (ICC), 95% confidence interval, kappa coefficient, and Bland-Altman plots were used to check for agreement. The Kolmogorov-Smirnov test was used to verify the data distribution. The validity coefficients for daily energy-adjusted sodium intake were high for the 24hR (ρRAI = 0.85) and weak for the FFQ-FHS (FFQAI = 0.26) and biomarker (ρBAI = 0.20). The ICC values were 0.68 for unadjusted sodium and 0.54 for energy-adjusted sodium intake. The weighed Kappa scores were 0.49 (p<0.01) and 0.260 (p = 0.02) for unadjusted and adjusted sodium intake, respectively. Although the FFQ-FHS is reproducible, it is not valid for the assessment of sodium intake and cannot be the sole instrument used for this purpose.
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Affiliation(s)
- Diana S Souza
- Department of Nutrition, Federal University of Sergipe, São Cristóvão, Brazil
| | - Bianca I Santos
- Department of Nutrition, Federal University of Sergipe, São Cristóvão, Brazil
| | - Brenda M Costa
- Department of Nutrition, Federal University of Sergipe, São Cristóvão, Brazil
| | - Dalila M Santos
- Department of Nutrition, Federal University of Sergipe, São Cristóvão, Brazil
| | - Laryssa G S Aragão
- Department of Nutrition, Federal University of Sergipe, São Cristóvão, Brazil
| | - Liliane V Pires
- Department of Nutrition, Federal University of Sergipe, São Cristóvão, Brazil
| | - Diva A S Vieira
- Department of Nutrition, Federal University of Sergipe, São Cristóvão, Brazil
| | - Analícia R S Freire
- Department of Nutrition, Federal University of Sergipe, São Cristóvão, Brazil
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Koracevic G, Micic S, Stojanovic M, Zdravkovic M. A Need for Improvement in the Definition of Resistant Arterial Hypertension. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:803. [PMID: 37109761 PMCID: PMC10145005 DOI: 10.3390/medicina59040803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
With the medical and social importance of resistant arterial hypertension (HTN) in mind, we had three goals in this paper: to study the definitions of resistant HTN in the guidelines on the topic, to analyze them, and to suggest some improvements. We found (at least) eleven insufficiencies in the definition of resistant HTN: (1) different blood pressure (BP) values are used for diagnoses; (2) the number of BP measurements is not specified; (3) the time-frame for the definition is not obtained; (4) it fails to provide normal or target or controlled BP values; (5) secondary HTN is not currently defined as true resistant HTN, but as apparently treatment-resistant HTN; (6) the definition usually directly incorporates BP cut-offs for systolic BP (sBP) and diastolic BP (dBP) making the diagnosis temporary; (7) stress is not included in the exclusion strategy for resistant HTN; (8) there is potentially a need to introduce a category of recovered resistant HTN; (9) to what degree do healthy lifestyle measures have to be fulfilled to consider it as sufficient to change the diagnosis from "apparent treatment-resistant HTN" to the "resistant HTN"; (10) sBP values normal-for-the-age for 61 and 81 year old patients in some guidelines fulfill the criterion for resistant HTN; (11) it probably ought to read "In the absence of contraindications and compelling indications…" in the others. We believe that it is better to use the phrase "above the target BP" for the definition of (treatment) resistant HTN, because the whole story of resistant HTN is related to non-responders to antihypertensive treatment. Therefore, as we treat to target and not to normal values, it is appropriate to define resistant HTN as an insufficiency to reach the target BP values. Moreover, the definition of (treatment) resistant HTN should not be universal for every patient with HTN, but it should be age-related: (treatment) resistant HTN is elevated BP over the target/normal BP values. Using this modification, there will be no need to automatically change the definition of resistant HTN when we change the BP targets in the future.
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Affiliation(s)
- Goran Koracevic
- Department for Cardiovascular Diseases, Clinical Center Nis, 18000 Nis, Serbia;
- Faculty of Medicine, University of Nis, 18000 Nis, Serbia
| | - Sladjana Micic
- Clinic for Nephrology, University Clinical Center Nis, 18000 Nis, Serbia;
| | - Milovan Stojanovic
- Faculty of Medicine, University of Nis, 18000 Nis, Serbia
- Institute for Treatment and Rehabilitation Niska Banja, 18000 Nis, Serbia
| | - Marija Zdravkovic
- University Hospital Medical Center Bezanijska Kosa, 11000 Belgrade, Serbia;
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Bertinato J, Gaudet J, De Silva N, Mohanty S, Qiao C, Herod M, Gharibeh N, Weiler H. Iodine Status of Mother-Infant Dyads from Montréal, Canada: Secondary Analyses of a Vitamin D Supplementation Trial in Breastfed Infants. J Nutr 2022; 152:1459-1466. [PMID: 35218192 PMCID: PMC9178965 DOI: 10.1093/jn/nxac047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/16/2022] [Accepted: 02/22/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Most pregnant or lactating women in Canada will not meet iodine requirements without iodine supplementation. OBJECTIVES To assess the iodine status of 132 mother-infant pairs based on secondary analyses of a vitamin D supplementation trial in breastfed infants from Montréal, Canada. METHODS Maternal iodine status was assessed using the breastmilk iodine concentration (BMIC). Singleton, term-born infants were studied from 1-36 months of age. Usual (adjusted for within-person variation) iodine intakes were estimated from urinary iodine and creatinine concentrations. Iodine status was assessed using median urinary iodine concentrations (UICs) and by estimating inadequate intakes by the cut-point method using a proposed Estimated Average Requirement for infants 0-6 months of age (72 μg/d). RESULTS At 1, 3, and 6 months of age, 70%, 63%, and 3% of infants, respectively, were exclusively breastfed. From 1-36 months of age (n = 82-129), the median UICs were ≥100 μg/L (range, 246-403 μg/L), which is the cutoff for adequate intakes set by the WHO for children <2 years. Almost all (98%-99%) infants at 1 and 2 months, 2 and 3 months, and 3 and 6 months of age had usual creatinine-adjusted iodine intakes ≥ 72 μg/d. The median BMIC was higher (P < 0.001) at 1 month compared to 6 months of lactation [1 month, 198 μg/kg (IQR, 124-274; n = 105) and 6 months, 109 μg/kg (IQR, 67-168; n = 78)]. At 1 and 6 months, 96% and 79% of mothers, respectively, had a BMIC ≥ 60 μg/kg, the lower limit of a normal reference range. The percentages of mothers that used a multivitamin-mineral (MVM) supplement containing iodine were 90% in pregnancy and 79% and 59% at 1 and 6 months of lactation, respectively. CONCLUSIONS The iodine status of infants was adequate throughout infancy. These results support a recommendation that all women who could become pregnant, who are pregnant, or who are breastfeeding take a daily MVM supplement containing iodine.
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Affiliation(s)
| | - Jeremiah Gaudet
- Nutrition Research Division, Bureau of Nutritional Sciences, HPFB (Health Products and Food Branch), Health Canada, Ottawa, Canada
| | - Nimal De Silva
- Department of Earth and Environmental Sciences, University of Ottawa, Ottawa, Canada
| | - Smitarani Mohanty
- Department of Earth and Environmental Sciences, University of Ottawa, Ottawa, Canada
| | - Cunye Qiao
- Bureau of Food Surveillance and Science Integration, HPFB, Health Canada, Ottawa, Canada
| | - Matthew Herod
- Department of Earth and Environmental Sciences, University of Ottawa, Ottawa, Canada
- Canadian Nuclear Laboratories Regulatory Program Division, Directorate of Nuclear Cycle and Facilities Regulation, Canadian Nuclear Safety Commission, Ottawa, Canada
| | - Nathalie Gharibeh
- Nutrition Research Division, Bureau of Nutritional Sciences, HPFB (Health Products and Food Branch), Health Canada, Ottawa, Canada
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, Québec, Canada
| | - Hope Weiler
- Nutrition Research Division, Bureau of Nutritional Sciences, HPFB (Health Products and Food Branch), Health Canada, Ottawa, Canada
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, Québec, Canada
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Bertinato J, Qiao C, L'Abbé MR. Iodine Status of Canadian Children, Adolescents, and Women of Childbearing Age. J Nutr 2021; 151:3710-3717. [PMID: 34313736 DOI: 10.1093/jn/nxab268] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/07/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Adequate iodine intake is important for children and women of childbearing age because iodine is vital for fetal brain development and early life. OBJECTIVE Iodine status of children (n = 1875), adolescents (n = 557), and women of childbearing age (n = 567) was assessed using urinary iodine concentrations (UIC) from duplicate spot samples collected in the Canadian Health Measures Survey, cycle 5 (2016-2017). METHODS Daily iodine intakes were estimated from urinary iodine and creatinine concentrations using a formula based on iodine absorption and predicted 24-h creatinine excretion. Usual UIC and iodine intakes, adjusted for within-person variation, were estimated using the National Cancer Institute method. Iodine status was assessed by 1) comparing median UIC with WHO/UNICEF/ICCIDD reference ranges and 2) estimating the prevalence of inadequate and excessive intakes using the estimated average requirement (EAR) and tolerable upper intake level (UL) cut-point method, respectively. RESULTS Median UIC for males and females 6-11 or 12-19 y old were ≥100 μg/L, the lower cutoff for adequate intakes. For women 20-39 y old, the median UIC of an unadjusted sample was 81 μg/L (95% CI: 67, 95) and for the usual UIC was 108 μg/L (95% CI: 84, 131). The percentage of children 3 y old with iodine intake ≥EAR was 82% (95% CI: 75, 89). The corresponding estimates for males 4-8, 9-13, and 14-18 y old were 93% (95% CI: 88, 97), 91% (95% CI: 87, 96), and 84% (95% CI: 76, 91), respectively. Estimates for females 4-8, 9-13, 14-18, and 19-39 y old were 86% (95% CI: 83, 89), 87% (95% CI: 80, 95), 68% (95% CI: 55, 80), and 68% (95% CI: 59, 76), respectively. For all sex-age groups, 91-100% had iodine intakes ≤UL. CONCLUSIONS Iodine intakes may be insufficient for some women of childbearing age. Public health policies and programs should continue to recommend that all women who could become pregnant, or women who are pregnant or breastfeeding, take a daily multivitamin-mineral supplement containing iodine.
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Affiliation(s)
- Jesse Bertinato
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada.,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
| | - Cunye Qiao
- Bureau of Food Surveillance and Science Integration, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Penniston KL, Knoll T. Diätetische Aspekte der Urolithiasis. Urolithiasis 2021. [DOI: 10.1007/978-3-662-62454-8_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Penniston KL. Diet and Kidney Stones: The Ideal Questionnaire. Eur Urol Focus 2020; 7:9-12. [PMID: 32958415 DOI: 10.1016/j.euf.2020.09.001] [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: 08/14/2020] [Revised: 08/20/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
Diet frequently contributes to patients' urinary stone disease. It is important to determine when this is the case and when it is not, as failure to do so may delay the implementation of other, more appropriate therapies. When diet is thought to be involved, one of two approaches may be taken: (1) provide a general list of all possible dietary factors that influence the risk for all types of stones and let the patient decide which dietary change(s) are needed; or (2) prescribe specific modifications that address each patient's need for change and their personal characteristics (i.e., urinary risk factors, type(s) of stones they have formed, dietary preferences, nutrient needs, etc.). The latter of these approaches is "minimally invasive" and is thus consistent with the goal of other therapies. However, this approach requires a rigorous appraisement of each patient's diet and linkage, when possible, to urinary and other stone risk factors. When the collaboration of a registered dietitian nutritionist or other nutrition professional experienced in dietary assessment is not available, screeners or questionnaires may be useful. Unfortunately, there is no such tool that is validated for identifying dietary stone risk factors. The development of a brief, 40-item, stone-specific food screener is described. While further validation is needed, it may provide the basis for a standardized instrument that could be used more broadly; desired features of such an instrument are described. Patient Summary: Personalized nutrition therapy is useful in mitigating the effects or recurrence risk of many chronic diseases. It is also useful in stone disease, a condition with highly variable risk expression, even among patients who form the same types of stones. A standardized and validated stone-specific dietary assessment tool would be valuable in clinical management and in research studies involving the description of patients' diets and dietary intervention.
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Affiliation(s)
- Kristina L Penniston
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Clinical Nutrition Services, UW Health University Hospital and Clinics, Madison, WI, USA.
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