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Modou N, Motoula Latou LN, Maimouna T, Dia AD, Seck SM. Dietary salt intake and kidney function in rural Senegalese populations: a cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:97. [PMID: 38926879 PMCID: PMC11210187 DOI: 10.1186/s41043-024-00542-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/23/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION High salt intake is a major risk factor for hypertension and its complications such as chronic kidney disease (CKD) and cardiovascular diseases. The present study aimed to determine level of sodium consumption and its relation with kidney function in the rural populations of Ferlo (centre of Senegal). SUBJECTS AND METHODS We performed a cross-sectional study including 400 volunteers aged > 18 years. Clinical, biological and dietary data were collected during household visits. Daily sodium intake was measured in the 24 h-urine outpout and CKD was defined as eGFR < 60 ml/min. Linear regression analysis was used to assess association between sodium intake and covariates. RESULTS Mean age was 46.42 ± 15.60 and sex-ratio was 1.05. Prevalence of hypertension, CKD and overweight were 21.5, 11.7 and 20.5%, respectively. The median daily salt intake was 11.7 g with interquartile range of 14.8 g. Only 11.25% of participants consumed less than 5 g/day. After multivariate analysis, high salt intake was associated with age > 60 years, overweight and CKD. However, gender and hypertension were not significantly associated with salt intake. Industrial broths (91.5%) and bread (85%) represented the main sources of dietary salt. CONCLUSION This study revealed high levels of daily salt intake contrasting with low potassium intakes in the majority of participants. Participants with CKD, overweight and age > 60 years presented higher salt consumption. Stategies to reduce salt consumption are urgently needed to reduce burden of CKD in rural Senegalese populations.
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Affiliation(s)
- Ndongo Modou
- Nephrology and Dialysis, Regional Hospital of Kedougou, Kedougou, Senegal
| | | | - Toure Maimouna
- Department of Physiology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal
| | - Amadou Diop Dia
- Nephrology Department, Faculty of Health Sciences, University Gaston Berger, Route de Ngalléle, BP 234, Sanar, Saint-Louis, Senegal
| | - Sidy Mohamed Seck
- Nephrology Department, Faculty of Health Sciences, University Gaston Berger, Route de Ngalléle, BP 234, Sanar, Saint-Louis, Senegal.
- IRL-3189 ESS/UGB/CNRS/UCAD/CNRST/USTB, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal.
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Renzetti S, Gennings C, Calza S. A weighted quantile sum regression with penalized weights and two indices. Front Public Health 2023; 11:1151821. [PMID: 37533534 PMCID: PMC10392701 DOI: 10.3389/fpubh.2023.1151821] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/02/2023] [Indexed: 08/04/2023] Open
Abstract
Background New statistical methodologies were developed in the last decade to face the challenges of estimating the effects of exposure to multiple chemicals. Weighted Quantile Sum (WQS) regression is a recent statistical method that allows estimating a mixture effect associated with a specific health effect and identifying the components that characterize the mixture effect. Objectives In this study, we propose an extension of WQS regression that estimates two mixture effects of chemicals on a health outcome in the same model through the inclusion of two indices, one in the positive direction and one in the negative direction, with the introduction of a penalization term. Methods To evaluate the performance of this new model we performed both a simulation study and a real case study where we assessed the effects of nutrients on obesity among adults using the National Health and Nutrition Examination Survey (NHANES) data. Results The method showed good performance in estimating both the regression parameter and the weights associated with the single elements when the penalized term was set equal to the magnitude of the Akaike information criterion of the unpenalized WQS regression. The two indices further helped to give a better estimate of the parameters [Positive direction Median Error (PME): 0.022; Negative direction Median Error (NME): -0.044] compared to the standard WQS without the penalization term (PME: -0.227; NME: 0.215). In the case study, WQS with two indices was able to find a significant effect of nutrients on obesity in both directions identifying sodium and magnesium as the main actors in the positive and negative association, respectively. Discussion Through this work, we introduced an extension of WQS regression that improved the accuracy of the parameter estimates when considering a mixture of elements that can have both a protective and a harmful effect on the outcome; and the advantage of adding a penalization term when estimating the weights.
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Affiliation(s)
- Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Stefano Calza
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
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Takemoto N, Millman J, Uema T, Yamakawa F, Okamoto S, Mori M, Mori H, Nakamura K, Yamori Y, Masuzaki H. Analysis of spot urine biomarkers and association with body weight in Japanese elementary schoolchildren. Eur J Pediatr 2022; 181:3879-3888. [PMID: 36097199 PMCID: PMC9546969 DOI: 10.1007/s00431-022-04604-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/17/2022] [Accepted: 08/29/2022] [Indexed: 11/24/2022]
Abstract
UNLABELLED Childhood obesity is rapidly increasing worldwide and is largely the consequence of adoption of unhealthy diets excessive in calories and salt (NaCl) as well as devoid in pivotal micronutrients such as potassium (K) and magnesium (Mg). Education-based programs aiming to encourage healthy food knowledge and behaviors are crucial at a young age, and for this purpose, convenient ways to assess daily dietary intake are warranted. We therefore attempted to evaluate the dietary intake of Okinawan schoolchildren in Japan by analyzing a series of biomarkers in morning spot urine samples and explore whether these biomarkers correlate with body weight and a series of metabolic parameters. We enrolled 98 third-grade elementary schoolchildren in Okinawa, Japan. Morning spot urine samples were collected and analyzed using high-performance liquid chromatography (HPLC) to assess dietary intake. We found that estimated daily NaCl intake was higher in obese/overweight children as compared to healthy-weight children (p = 0.0001). There was also a significant positive correlation between body mass index (BMI) and NaCl intake (Spearman) (ρ = 0.45, p < 0.0001) and a negative correlation between BMI and Mg/Cr (ρ = -0.27, p = 0.01). Furthermore, Na/K ratio was higher in samples collected on Monday (weekend) as compared to samples collected on Thursday or Friday (weekday) (p < 0.0001). CONCLUSION Via the use of morning spot urine analyses, our results show that NaCl intake was associated with obesity, and Mg excretion negatively correlated with BMI in Japanese schoolchildren, highlighting the potential role of these micronutrients in maintaining a healthy body weight. WHAT IS KNOWN •Overweight and obesity are largely due to excessive consumption of calories and positively correlated with salt (NaCl) intake. •Spot urine methods are convenient for assessing the nutritional needs and targeting prevention programs in children. WHAT IS NEW •Utilizing morning spot urine analyses, estimated NaCl intake is positively correlated and Mg/Cr negatively correlated with BMI in Okinawan schoolchildren. •As estimated via morning spot urine samples, a greater proportion of children likely exceeds the recommended NaCl intake on the weekend as compared to weekday.
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Affiliation(s)
- Nozomi Takemoto
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Jasmine Millman
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
| | - Tsugumi Uema
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
| | - Fusae Yamakawa
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Shiki Okamoto
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Mari Mori
- Department of Health Management, School of Health Studies, Tokai University, Kanagawa, Japan
| | - Hideki Mori
- Institute for World Health Development, Mukogawa Women's University, Hyogo, Japan
| | - Koshi Nakamura
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yukio Yamori
- Institute for World Health Development, Mukogawa Women's University, Hyogo, Japan
| | - Hiroaki Masuzaki
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
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Yoo BM, Kim M, Kang MJ. Association between childhood obesity and familial salt intake: analysis of data from Korean National Health and Nutrition Examination Survey, 2014-2017. Endocr J 2021; 68:1127-1134. [PMID: 33907059 DOI: 10.1507/endocrj.ej21-0111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
High salt intake is known as a risk factor of childhood obesity. As family members share not only genes but also their diet habit, parents' salt intake may affect to their children's obesity. In this study, we investigated correlations between childhood obesity and parents' or children's sodium intakes based on a nationwide survey data. From the Korean National Health and Nutrition Examination Survey data from 2014 to 2017, 802 boys and 657 girls aged 10-18 years, and their parents were included. BMI z-score and 24-hour urinary sodium excretion, which is estimated through Tanaka's equation, were used to examine associations between obesity and sodium intakes. The BMI status and the prevalence of obesity between children and their parents showed strong positive correlations in both sexes (all p < 0.001). The urinary sodium excretion between children and their parents showed positive correlations in both sexes (all p < 0.05). Children with higher urinary sodium excretion showed higher BMI (in both sexes, p < 0.001) and higher parental obesity compared to those with lower urinary sodium excretion, however, statistical significances of the latter relationship were varied by sex. In conclusion, our study suggests close relationship between childhood obesity and their sodium intakes, which also correlate well with parental BMIs and diet behavior. Therefore, parental education and active participation could be crucial in regulating childhood obesity.
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Affiliation(s)
- Byung Min Yoo
- Department of Pediatrics, Hallym University College of Medicine, 1, Hallymdaehak-gil, Chuncheon-si, Gangwon-do 24252, Republic of Korea
| | - Mijin Kim
- Department of Pediatrics, Hallym University College of Medicine, 1, Hallymdaehak-gil, Chuncheon-si, Gangwon-do 24252, Republic of Korea
| | - Min Jae Kang
- Department of Pediatrics, Hallym University College of Medicine, 1, Hallymdaehak-gil, Chuncheon-si, Gangwon-do 24252, Republic of Korea
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Kang M, Choi SY, Jung M. Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data. Clin Exp Pediatr 2021; 64:443-458. [PMID: 33445834 PMCID: PMC8426097 DOI: 10.3345/cep.2020.01655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 12/11/2022] Open
Abstract
In Korea, several national cross-sectional surveys monitor the diet, nutritional status, and health status of children. This continual dedicated national surveillance system contributes to the identification of nutritional and health issues, establishment of public health policies, and development of nutrition recommendations. This paper provides recent information about the Korea National Health and Nutrition Examination Survey and the Korean Youth Risk Behavior Web-based Survey and describes key nationwide survey findings published in the last 5 years on infant feeding practices and the dietary intake and nutritional status of Korean infants, children, and adolescents. There have been increasing trends in children, and teenagers who skip breakfast, eat fast food, consume sugary drinks, have vitamin D deficiency, and are obese. This review will inform pediatricians, nutritionists, and other health care practitioners who track children's growth and development. It may also help researchers and policymakers identify diet-related policies and strategies for chronic disease prevention in Korean infants, children, and adolescents.
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Affiliation(s)
- Minji Kang
- BK21 FOUR Education and Research Team for Sustainable Food & Nutrition, Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University School of Medicine, Busan, Korea
| | - Minyoung Jung
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University School of Medicine, Busan, Korea
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Pre-Pregnancy Diet Quality Is Associated with Lowering the Risk of Offspring Obesity and Underweight: Finding from a Prospective Cohort Study. Nutrients 2021; 13:nu13041044. [PMID: 33804865 PMCID: PMC8063840 DOI: 10.3390/nu13041044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/11/2021] [Accepted: 03/20/2021] [Indexed: 12/16/2022] Open
Abstract
Maternal diet plays a critical role in epigenetic changes and the establishment of the gut microbiome in the fetus, which has been associated with weight outcomes in offspring. This study examined the association between maternal diet quality before pregnancy and childhood body mass index (BMI) in offspring. There were 1936 mothers with 3391 children included from the Australian Longitudinal Study on Women’s Health (ALSWH) and the Mothers and their Children’s Health (MatCH) study. Maternal dietary intakes were assessed using a semi-quantitative and validated 101-item food-frequency questionnaire (FFQ). The healthy eating index (HEI-2015) score was used to explore preconception diet quality. Childhood BMI was categorized as underweight, normal, overweight, and obese based on sex and age-specific BMI classifications for children. Multinomial logistic regression with cluster-robust standard errors was used for analyses. Greater adherence to maternal diet quality before pregnancy was associated with a lower risk of offspring being underweight after adjustment for potential confounders, highest vs. lowest quartile (relative risk ratio (RRR) = 0.68, 95% confidence interval (CI): 0.49, 0.96). Higher adherence to preconception diet quality was also inversely linked with the risk of childhood obesity (RRR = 0.49, 95% CI: 0.24, 0.98). This association was, however, no longer significant after adjusting for pre-pregnancy BMI. Sodium intake was significantly associated with decreased risk of childhood overweight and obesity (RRR = 0.18, 95% CI: 0.14, 0.23) and (RRR = 0.21, 95% CI: 0.17, 0.26), respectively. No significant association was detected between preconception diet quality and offspring being overweight. This study suggests that better adherence to maternal diet quality before pregnancy is associated with a reduced risk of childhood underweight and obesity.
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Hernandez-Leon SG, Sarabia Sainz JAI, Ramos-Clamont Montfort G, Huerta-Ocampo JÁ, Ballesteros MN, Guzman-Partida AM, Robles-Burgueño MDR, Vazquez-Moreno L. Nanoproteomic Approach for Isolation and Identification of Potential Biomarkers in Human Urine from Adults with Normal Weight, Overweight and Obesity. Molecules 2021; 26:1803. [PMID: 33806905 PMCID: PMC8004714 DOI: 10.3390/molecules26061803] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 12/11/2022] Open
Abstract
In this work, previously synthesized and characterized core-shell silica nanoparticles (FCSNP) functionalized with immobilized molecular bait, Cibacron blue, and a porous polymeric bis-acrylamide shell were incubated with pooled urine samples from adult women or men with normal weight, overweight or obesity for the isolation of potential biomarkers. A total of 30 individuals (15 woman and 15 men) were included. FCSNP allowed the capture of a variety of low molecular weight (LMW) proteins as evidenced by mass spectrometry (MS) and the exclusion of high molecular weight (HMW) proteins (>34 kDa) as demonstrated by SDS-PAGE and 2D SDS-PAGE. A total of 36 proteins were successfully identified by MS and homology database searching against the Homo sapiens subset of the Swiss-Prot database. Identified proteins were grouped into different clusters according to their abundance patterns. Four proteins were found only in women and five only in men, whereas 27 proteins were in urine from both genders with different abundance patterns. Based on these results, this new approach represents an alternative tool for isolation and identification of urinary biomarkers.
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Affiliation(s)
- Sergio G. Hernandez-Leon
- Centro de Investigación en Alimentación y Desarrollo A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, col. La Victoria, Hermosillo, Sonora 83304, Mexico; (S.G.H.-L.); (G.R.-C.M.); (M.N.B.); (A.M.G.-P.); (M.d.R.R.-B.)
| | - Jose Andre-i Sarabia Sainz
- Departamento de Investigación en Física, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Col. Centro, Hermosillo, Sonora 83190, Mexico;
| | - Gabriela Ramos-Clamont Montfort
- Centro de Investigación en Alimentación y Desarrollo A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, col. La Victoria, Hermosillo, Sonora 83304, Mexico; (S.G.H.-L.); (G.R.-C.M.); (M.N.B.); (A.M.G.-P.); (M.d.R.R.-B.)
| | - José Ángel Huerta-Ocampo
- CONACyT-Centro de Investigación en Alimentación y Desarrollo A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, col. La Victoria, Hermosillo, Sonora 83304, Mexico;
| | - Martha Nydia Ballesteros
- Centro de Investigación en Alimentación y Desarrollo A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, col. La Victoria, Hermosillo, Sonora 83304, Mexico; (S.G.H.-L.); (G.R.-C.M.); (M.N.B.); (A.M.G.-P.); (M.d.R.R.-B.)
| | - Ana M. Guzman-Partida
- Centro de Investigación en Alimentación y Desarrollo A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, col. La Victoria, Hermosillo, Sonora 83304, Mexico; (S.G.H.-L.); (G.R.-C.M.); (M.N.B.); (A.M.G.-P.); (M.d.R.R.-B.)
| | - María del Refugio Robles-Burgueño
- Centro de Investigación en Alimentación y Desarrollo A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, col. La Victoria, Hermosillo, Sonora 83304, Mexico; (S.G.H.-L.); (G.R.-C.M.); (M.N.B.); (A.M.G.-P.); (M.d.R.R.-B.)
| | - Luz Vazquez-Moreno
- Centro de Investigación en Alimentación y Desarrollo A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, col. La Victoria, Hermosillo, Sonora 83304, Mexico; (S.G.H.-L.); (G.R.-C.M.); (M.N.B.); (A.M.G.-P.); (M.d.R.R.-B.)
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Donfrancesco C, Lo Noce C, Russo O, Minutoli D, Di Lonardo A, Profumo E, Buttari B, Iacone R, Vespasiano F, Vannucchi S, Onder G, Galletti F, Galeone D, Bellisario P, Gulizia MM, Giampaoli S, Palmieri L, Strazzullo P. Trend of salt intake measured by 24-h urine collection in the Italian adult population between the 2008 and 2018 CUORE project surveys. Nutr Metab Cardiovasc Dis 2021; 31:802-813. [PMID: 33546949 DOI: 10.1016/j.numecd.2020.10.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/09/2020] [Accepted: 10/20/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS The WHO Global Action Plan for the Prevention of non-communicable diseases (NCDs) recommends a 30% relative reduction in mean population salt/sodium intake. The study assessed the trend in the habitual salt intake of the Italian adult population from 2008 to 2012 to 2018-2019 based on 24-h urinary sodium excretion, in the framework of the CUORE Project/MINISAL-GIRCSI/MENO SALE PIU' SALUTE national surveys. METHODS AND RESULTS Data were from cross-sectional surveys of randomly selected age and sex-stratified samples of resident persons aged 35-74 years in 10 (out of 20) Italian Regions distributed in North, Centre and South of the Country. Urinary sodium and creatinine measurements were carried out in a central laboratory. The analyses included 942 men and 916 women examined in 2008-2012, and 967 men and 1010 women examined in 2018-2019. The age-standardized mean daily population salt (sodium chloride) intake was 10.8 g (95% CI 10.5-11.1) in men and 8.3 g (8.1-8.5) in women in 2008-2012 and respectively 9.5 g (9.3-9.8) and 7.2 g (7.0-7.4) in 2018-2019. A statistically significant (p<0.0001) salt intake reduction was thus observed over 10 years for both genders, and all age, body mass index (BMI) and educational classes. CONCLUSIONS The average daily salt intake of the Italian general adult population remains higher than the WHO recommended level, but a significant reduction of 12% in men and 13% in women has occurred in the past ten years. These results encourage the initiatives undertaken by the Italian Ministry of Health aimed at the reduction of salt intake at the population level.
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Affiliation(s)
| | | | - Ornella Russo
- Federico II University of Naples Medical School, Naples, Italy
| | | | | | | | | | - Roberto Iacone
- Federico II University of Naples Medical School, Naples, Italy
| | | | | | | | | | | | | | - Michele M Gulizia
- National Hospital of High Relevance and Specialization "Garibaldi", Catania, Italy; Heart Care Foundation, Florence, Italy
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Chailimpamontree W, Kantachuvesiri S, Aekplakorn W, Lappichetpaiboon R, Sripaiboonkij Thokanit N, Vathesatogkit P, Kunjang A, Boonyagarn N, Sukhonthachit P, Chuaykarn N, Sonkhammee P, Khunsaard P, Nuntapanich P, Charoenbut P, Thongchai C, Uttarachai A, Kwankhoom W, Rattanakanahutanon F, Ruangchai K, Yanti N, Sasang N, Bunluesin S, Garg R. Estimated dietary sodium intake in Thailand: A nationwide population survey with 24-hour urine collections. J Clin Hypertens (Greenwich) 2021; 23:744-754. [PMID: 33420751 PMCID: PMC8678751 DOI: 10.1111/jch.14147] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 01/21/2023]
Abstract
Thailand has committed to reducing population sodium intake by 30% by 2025. However, reliable nationally representative data are unavailable for monitoring progress toward the goal. We estimated dietary sodium consumption using 24‐hour urinary analyses in a nationally representative, cross‐sectional population‐based survey. We selected 2388 adults (aged ≥ 18 years) from the North, South, North‐east, Central Regions, and Bangkok, using multi‐stage cluster sampling. Mean sodium excretion was inflated by 10% to adjust for non‐urinary sources. Multivariate logistic regression was performed to assess factors associated with sodium consumption ≥ 2000 mg. Among 1599 (67%) who completed urine collection, mean age was 43 years, 53% were female, and 30% had hypertension. Mean dietary sodium intake (mg/day) was 3636 (±1722), highest in South (4108 ± 1677), and lowest in North‐east (3316 ± 1608). Higher sodium consumption was independently associated with younger age (Adjusted Odds Ratio (AOR) 2.81; 95% Confidence interval (CI): 1.53‐5.17; p = .001); higher education (AOR 1.79; 95% CI: 1.19‐2.67; p = .005), BMI ≥ 25 (AOR 1.55; 95% CI: 1.09‐2.21; p=.016), and hypertension (AOR 1.58; 95% CI: 1.02‐2.44; p = .038). Urine potassium excretion was 1221 mg/day with little variation across Regions. Estimated dietary sodium consumption in Thai adults is nearly twice as high as recommended levels. These data provide a benchmark for future monitoring.
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Affiliation(s)
- Worawon Chailimpamontree
- Division of Nephrology, Department of Medicine, Chandrubeksa hospital, Nakhon Pathom, Thailand.,Thai low salt network, Nephrology Society of Thailand, Bangkok, Thailand
| | - Surasak Kantachuvesiri
- Thai low salt network, Nephrology Society of Thailand, Bangkok, Thailand.,Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Raweewan Lappichetpaiboon
- Thai low salt network, Nephrology Society of Thailand, Bangkok, Thailand.,Department of Nutrition, Fort Nawamintharachini Hospital, Chon Buri, Thailand
| | | | - Prin Vathesatogkit
- Division of Cardiology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ananthaya Kunjang
- Thai low salt network, Nephrology Society of Thailand, Bangkok, Thailand
| | | | - Penmat Sukhonthachit
- Faculty of Science and Technology, Songkhla Rajabhat University, Songkhla, Thailand
| | - Narinphop Chuaykarn
- Faculty of Liberal Arts, Rajamangala University of Technology Srivijaya, Songkhla, Thailand
| | | | - Payong Khunsaard
- Faculty of Public Health, Chiang Rai College, Chiang Rai, Thailand
| | | | - Pattaraporn Charoenbut
- Faculty of Public Health, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
| | - Comsun Thongchai
- Faculty of Public Health, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
| | - Apinya Uttarachai
- Faculty of Public Health, Valaya Alongkorn Rajabhat University under the Royal Patronage, Pathum Thani, Thailand
| | - Wisrut Kwankhoom
- Faculty of Science and Technology, Valaya Alongkorn Rajabhat University under the Royal Patronage, Pathum Thani, Thailand
| | - Fuangfah Rattanakanahutanon
- Faculty of Public Health, Valaya Alongkorn Rajabhat University under the Royal Patronage, Pathum Thani, Thailand
| | - Krich Ruangchai
- Faculty of Public Health, Valaya Alongkorn Rajabhat University under the Royal Patronage, Pathum Thani, Thailand
| | - Nadchar Yanti
- Faculty of Public Health, Valaya Alongkorn Rajabhat University under the Royal Patronage, Pathum Thani, Thailand
| | - Natnapa Sasang
- Faculty of Public Health, Phranakhon Si Ayutthaya Rajabhat University, Phra Nakhon Si Ayutthaya, Thailand
| | | | - Renu Garg
- WHO Country Office for Thailand, Bangkok, Thailand
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Hajek A, Kretzler B, König HH. The Association Between Obesity and Social Isolation as Well as Loneliness in the Adult Population: A Systematic Review. Diabetes Metab Syndr Obes 2021; 14:2765-2773. [PMID: 34168476 PMCID: PMC8216698 DOI: 10.2147/dmso.s313873] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 05/27/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Obesity is associated with adverse health outcomes and can result in feelings of loneliness or social isolation, for example due to stigmatization. These factors are in turn associated with morbidity and mortality. Thus far, a systematic review is lacking with regard to the association between obesity, social isolation and loneliness. Therefore, our aim was to fill this gap in knowledge. MATERIALS AND METHODS Three established electronic databases (PubMed, PsycInfo, as well as CINAHL) were searched. Observational studies examining the link between obesity and loneliness or social isolation were included. Disease-specific samples were excluded. RESULTS In sum, six studies have been included. While some studies point to an association between obesity and increased loneliness levels, it should be acknowledged that findings are mixed. Study quality was quite high. CONCLUSION This systematic review showed that the literature is inconclusive and incomplete. Further research is required to shed further light on these associations. Moreover, studies from countries outside Europe, based on longitudinal data and using objective assessments of obesity, are urgently required. Gender differences should be further explored.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
- Correspondence: André Hajek Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, GermanyTel +49 40 7410 52877Fax +49 40 7410-40261 Email
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
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Naser AM, Rahman M, Unicomb L, Doza S, Selim S, Chaity M, Luby SP, Anand S, Staimez L, Clasen TF, Gujral UP, Gribble MO, Narayan KMV. Past Sodium Intake, Contemporary Sodium Intake, and Cardiometabolic Health in Southwest Coastal Bangladesh. J Am Heart Assoc 2020; 9:e014978. [PMID: 32875927 PMCID: PMC7727005 DOI: 10.1161/jaha.119.014978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background We compared the relationship of past and contemporary sodium (Na) intake with cardiometabolic biomarkers. Methods and Results A total of 1191 participants' data from a randomized controlled trial in coastal Bangladesh were analyzed. Participants provided 24-hour urine Na (24UNa) data for 5 monthly visits. Their fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein, blood pressure, and 24-hour urine protein were measured at the fifth visit. Participants' mean 24UNa over the first 4 visits was the past Na, and 24UNa of the fifth visit was the contemporary Na intake. We estimated the prevalence ratios of elevated cardiometabolic biomarkers and metabolic syndrome across 24UNa tertiles by multilevel logistic regression using participant-, household-, and community-level random intercepts. Models were adjusted for age, sex, body mass index, smoking, physical activity, alcohol consumption, sleep hours, religion, and household wealth. Compared with participants in tertile 1 of past urine Na, those in tertile 3 had 1.46 (95% CI, 1.08-1.99) times higher prevalence of prediabetes or diabetes mellitus, 5.49 (95% CI, 2.73-11.01) times higher prevalence of large waist circumference, and 1.60 (95% CI, 1.04-2.46) times higher prevalence of metabolic syndrome. Compared with participants in tertile 1 of contemporary urine Na, those in tertile 3 had 1.93 (95% CI, 1.24-3.00) times higher prevalence of prediabetes or diabetes mellitus, 3.14 (95% CI, 1.45-6.83) times higher prevalence of proteinuria, and 2.23 (95% CI, 1.34-3.71) times higher prevalence of large waist circumference. Conclusions Both past and contemporary Na intakes were associated with higher cardiometabolic disease risk.
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Affiliation(s)
- Abu Mohd Naser
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
| | - Mahbubur Rahman
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b) Dhaka Bangladesh
| | - Leanne Unicomb
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b) Dhaka Bangladesh
| | - Solaiman Doza
- International Centre for Diarrhoeal Disease ResearchBangladesh (icddr,b) Dhaka Bangladesh
| | - Shahjada Selim
- Department of Endocrinology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh
| | | | - Stephen P Luby
- Division of Infectious Diseases and Geographic MedicineStanford University Stanford CA
| | - Shuchi Anand
- Division of Nephrology School of Medicine Stanford University Stanford CA
| | - Lisa Staimez
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
| | - Thomas F Clasen
- Gangarosa Department of Environmental Health Sciences Rollins School of Public HealthEmory University Atlanta GA
| | - Unjali P Gujral
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
| | - Matthew O Gribble
- Gangarosa Department of Environmental Health Sciences Rollins School of Public HealthEmory University Atlanta GA.,Department of Epidemiology Rollins School of Public HealthEmory University Atlanta GA
| | - K M Venkat Narayan
- Emory Global Diabetes Research Center Hubert Department of Global Health Rollins School of Public HealthEmory University Atlanta GA
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Sakboonyarat B, Pornpongsawad C, Sangkool T, Phanmanas C, Kesonphaet N, Tangthongtawi N, Limsakul A, Assavapisitkul R, Thangthai T, Janenopparkarnjana P, Varodomvitaya P, Dachoviboon W, Laohasara J, Kruthakool N, Limprasert S, Mungthin M, Hatthachote P, Rangsin R. Trends, prevalence and associated factors of obesity among adults in a rural community in Thailand: serial cross-sectional surveys, 2012 and 2018. BMC Public Health 2020; 20:850. [PMID: 32493314 PMCID: PMC7271557 DOI: 10.1186/s12889-020-09004-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/27/2020] [Indexed: 01/17/2023] Open
Abstract
Background Obesity is one principle risk factor increasing the risk of noncommunicable diseases including diabetes, hypertension and atherosclerosis. In Thailand, a 2014 study reported obesity (BMI ≥25 kg/m2) in a Thai population aged ≥15 years was 37.5, 32.9 and 41.8% overall and among males and females, respectively. The study aimed to determine trends in the prevalence of obesity among adults residing in a Thai rural community between 2012 and 2018 and investigate the associations between obesity and behavioral factors. Methods Serial cross-sectional studies were conducted in 2012 and 2018 among adults in Na-Ngam rural community. In 2012 and 2018, all 635 and 627 individuals, respectively, were interviewed using structured questionnaires related to demographics, risk behaviors, comorbidities and arthrometric measurement. Spot urine was collected by participants and obesity was defined as BMI ≥25 kg/m2. The risk factors for obesity were analyzed in the 2018 survey. Results A total of 1262 adults in Na-Ngam rural community were included in the study. The prevalence of obesity was 33.9% in 2012 and 44.8% in 2018 (P < 0.001). The average BMI increased from 23.9 ± 4.2 kg/m2 in 2012 to 25.0 ± 4.52 kg/m2 in 2018 (P < 0.001). Obesity was associated with higher age (AOR 0.99; 95%CI 0.97–0.99), smoking (AOR 0.52; 95%CI 0.28–0.94), instant coffee-mix consumption > 1 cup/week (AOR 1.44; 95%CI 1.02–2.04), higher number of chronic diseases (≥1 disease AOR 1.82; 95%CI 1.01–2.68, > 2 diseases AOR 2.15; 95%CI 1.32–3.50), and higher spot urine sodium level (AOR 1.002; 95%CI 0.99–1.01). Conclusion Our data emphasized that obesity constituted a serious problem among adults residing in a rural community. A trend in significant increase was found regarding the prevalence of obesity and average BMI in the rural community over 6 years. Effective public health interventions should be provided at the community level to reduce BMI. Moreover, modifiable risk factors for obesity should be attenuated to inhibit the progression of metabolic syndrome, noncommunicable diseases and their complications.
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Affiliation(s)
- Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
| | | | | | | | | | | | - Ammiga Limsakul
- Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | | | | | | | | | | | | | | | - Sarawuth Limprasert
- Department of Internal Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Mathirut Mungthin
- Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Panadda Hatthachote
- Department of Physiology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
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