Determinación de sodio urinario como marcador bioquímico para estimar la ingesta de sal en trabajadores del Ministerio de Salud Pública y Bienestar Social, Paraguay

RESUMEN En América Latina, 13% de todas las muertes y 5,1% de los años de vida ajustados por discapacidad se deben a la hipertensión. El exceso de sodio en la dieta puede incrementar aproximadamente un 30% el riesgo de hipertensión. El objetivo fue determinar la concentración de sodio en orina de 24 de horas para estimar la ingesta de sal en trabajadores del Ministerio de Salud Pública y Bienestar Social (MSPBS). Estudio transversal, en trabajadores de 25 a 64 años (n = 397) del MSPBS en Asunción-Paraguay en el 2014. La información sociodemográfica y económica, así como los factores de riesgo de enfermedades cardiovasculares, se evaluaron mediante un cuestionario validado y desarrollado por la OMS. Los niveles de sodio y potasio en orina de 24 horas se midieron usando un protocolo estandarizado. La mediana de la ingesta diaria de sal fue de 13,7 g. La mediana de la excreción de sodio en orina de 24 horas fue de 239 mEq, superando el valor de excreción de sodio recomendado en un 20%. Los hombres tuvieron una excreción de sodio en orina de 24 horas más alta que las mujeres tanto en el grupo de 25 a 44 años (251 mEq / 24 horas frente a 218 mEq/ 24 horas) como en el grupo de 45 a 64 años (266 mEq / 24 horas frente a 233 mEq / 24 horas) de los participantes del estudio. En conclusión, la ingesta de sal fue notablemente superior a la recomendada por la OMS (<5g/d).

ABSTRACT In Latin America, 13% of all deaths and 5.1% of disability-adjusted life years are due to hypertension. An excess of sodium in the diet may increase the risk of hypertension by 30%. The objective was to determine the 24-hour urine sodium concentration to estimate salt intake in employees of the Paraguayan Ministry of Public Health and Social Welfare (MSPBS). Cross-sectional study in 25-64 years-old employees (n=397) of the Ministry of Public Health and Social Welfare in Asuncion-Paraguay in 2014. Socio-demographic and -economic information as well as risk factors of cardiovascular diseases were assessed using a questionnaire validated and developed by the WHO. Sodium and potassium levels in the 24-hour urine were measured using a standardized protocol. The median salt intake per day was 13.7 g. The median of 24-hour urine sodium excretion was 239 mEq, exceeding the recommended sodium excretion value by 20%. Men had a higher 24-hour urine sodium excretion than women in both the 25-44 years-old group (251 mEq/24 hours vs. 218 mEq/24 hours) and the 45-64 years-old segment of the study participants (266 mEq/24 hours vs. 233 mEq/24 hours). In conclusion, salt intake was remarkably higher than recommended by WHO (<5g/d).

Sodium found in processed cow milk and estimated intake by infants

Abstract Objective: To determine the sodium concentration in cow milk available for sale and to estimate its consumption by infants up to 6 months of age. Methods: Sodium level was determined by flame emission spectrophotometry in eight different lots of five brands of liquid ultra-high temperature milk and three brands of powdered milk. To estimate sodium consumption via cow milk, orientations for exceptional situations when neither breastfeeding nor infant formula is possible were considered. Inferential statistics were performed and results were compared with critical parameters at a 5% significance level. Results: The mean sodium content per portion found in liquid milk (162.5 ± 16.2) mg/200 mL was higher than that in powdered milk (116.8 ± 3.0) mg/26 g. Estimated sodium consumption by infants through powdered milk varied from 149.8 to 224.7% of adequate intake, and via liquid milk can be more than 500% of the adequate intake, reaching 812.4% of it if dilution is not applied. Seven of the eight brands of milk studied had declared, on their labels, that the sodium content was 13-30% lower than that found in chemical analysis. Conclusion: Liquid and powdered whole cow milk have high sodium content, and the content per portion is higher in liquid milk than in powdered milk. The estimated consumption of sodium through these products can far exceed the adequate intake for infants from 0 to 6 months old, even when the recommended dilution and maximum daily volumes are followed.

Association between salt taste sensitivity threshold and blood pressure in healthy individuals: a cross-sectional study

ABSTRACT BACKGROUND: Hypertension is an important public health problem. Overweight and high salt intake are risk factors for its development. OBJECTIVE: To evaluate the association between salt taste sensitivity threshold (STST) and blood pressure (BP) in healthy adults. DESIGN AND SETTING: Cross-sectional study conducted in a private institution. METHODS: 104 healthy adults (aged 18-59 years) were evaluated. Sociodemographic, clinical and dietary data were collected. Nutritional status and BP were assessed using body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). STST was assessed using graded saline solutions with sodium chloride concentrations ranging from 0.228 to 58.44 g/l. Identification of salty taste in solutions ≥ 3.652 g/l was used as the cutoff point for high STST. RESULTS: Participants with high STST presented higher daily average intakes for energy (2017.4 ± 641.5 versus 1650.5 ± 357.7 kcal/day; P = 0.01) and sodium (3070.2 ± 1195.1 versus 2435.2 ± 963.6 mg/day; P = 0.01) and higher BMI (P = 0.008) and WC (P = 0.002). After adjustment for age, sex, sodium and potassium intake, WC and family history of hypertension, the averages for SBP and DBP in subjects with high STST were higher than in those with normal STST (SBP: 138.2 ± 1.7 versus 119.7 ± 0.9 mmHg; P < 0.001; DBP: 81.2 ± 1.9 versus 75.1 ± 1.0 mmHg; P = 0.008). CONCLUSION: High STST was associated with elevated blood pressure in healthy adults, regardless of other risk factors for hypertension.

Prevalence of Undiagnosed Hypertension and Its Associated Factors Among the University Staff

@#Introduction: Hypertension is a public health concern that is associated with heart disease. This study aims to investigate the prevalence of undiagnosed hypertension and its associated factors among the staff in a private university in Selangor, Malaysia. Methods: 100 respondents participated in this cross-sectional study. Blood pressure, Body Mass Index (BMI), percentage body fat (%BF), visceral fat rating (VFR), and waist circumference (WC) were measured. Questionnaires regarding knowledge, attitude, and practice (KAP) of salt diet validated from WHO/PAHO and Food Frequency Questionnaires regarding sodium intake validated from IPH Malaysia were administered. Statistical data was analysed using SPSS. Results: The prevalence of undiagnosed hypertension was 24%. About 66% of the participants had excessive sodium intake. The mean sodium intake was 2869.43±930.75mg/d. Simple linear regression showed that BMI. %BF, VFR, and WC were significantly correlated with systolic blood pressure (SBP). Age and sodium intake were not correlated with SBP. After controlling all the variables in multiple linear regression, VFR remained as a significant contributor to SBP (adjusted R2=0.419, F=18.833, p=<0.001). Soy sauce, omelette, fried rice, and nasi lemak were the main contributors of sodium intake. A lack of knowledge on the negative impacts of high salt diet was significantly associated with high dietary sodium intake (>2400mg/d). Conclusion: Our study found a high prevalence of undiagnosed hypertension among the private university staff. The association between VFR and SBP is an important finding for community study. Increased awareness on the excessive salt consumed and its association with health is needed to reduce the sodium intake.

Conocimiento, barreras y factores asociados al consumo de sodio en pacientes con hipertensión arterial / Knowledge, barriers and factors associated with sodium intake in hypertensive patients

Introducción: la ingesta de sodio en pacientes con hipertensión arterial (HTA) podría estar influenciada por variables sociodemográficas, clínicas, conocimientos y barreras percibidas por los mismos al momento de realizar un plan alimentario controlado en sodio. Objetivos: analizar la asociación entre la ingesta diaria de sodio y las barreras percibidas para realizar un plan alimentario controlado en sodio, el nivel de conocimientos sobre productos con alto contenido en sodio, sexo, edad, índice de masa corporal y tiempo de diagnóstico en pacientes con hipertensión arterial. Adicionalmente, determinar la proporción de conocimiento inadecuado sobre productos alimentarios con alto contenido en sodio. Materiales y método: se estimó la ingesta de sodio en 156 pacientes a partir de un registro alimentario y un cuestionario de frecuencia de consumo; el nivel de conocimientos y las barreras se determinaron a través de cuestionarios de elaboración propia. Resultados: la ingesta promedio de sodio fue de 4228 mg (IC95%= 3892 ­ 4563 mg), equivalente a 10,57g de sal. La ingesta de sodio se correlacionó negativamente con la edad (r= -0,26; p=0,001) y positivamente con el índice de masa corporal (r=0,3; p=0,000) y con las barreras percibidas (r=0,4; p=0,000). A su vez, la ingesta de sodio fue significativamente mayor (p=0,025) en quienes presentaron un conocimiento inadecuado. Según el análisis multivariado, el score final de barreras, sexo e índice de masa corporal podrían explicar alrededor del 30% de la variabilidad de la ingesta de sodio en pacientes hipertensos. Conclusiones: La HTA es una problemática vinculada al estilo de vida actual, por lo que su abordaje debería tener en cuenta los condicionantes y determinantes que influyen cada paciente(AU)

Introduction: sodium intake in patients with diagnosed hypertension could be influenced by socio-demographic and clinical variables, knowledge and barriers perceived at the moment of adopting a sodiumcontrolled diet plan. Objectives: to analyze association between daily sodium intake and barriers perceived to carry out a controlled-sodium diet plan, the level of knowledge about products with high sodium content, sex, age, body mass index (BMI) , and time since diagnosis in hypertensive patients. Additionally, to determine the proportion of inadequate knowledge about food products with high sodium content. Materials and methods: sodium intake was estimated in 156 patients from a food registry and a food frequency questionnaire; the level of knowledge and the barriers were determined through self-developed questionnaires. Results: the average sodium intake was 4228 mg (95% CI = 3892 - 4563 mg), equivalent to 10.57g of salt. Sodium intake correlated negatively with age (r = -0.26; p = 0.001) and positively with body mass index (r = 0.3; p = 0.000) and with perceived barriers (r = 0.4; p = 0.000). In addition, sodium intake was significantly higher (p = 0.025) in those who presented inadequate knowledge. As specified by the multivariate analysis, the final barrier score, sex and BMI could explain 30% of the variability of sodium intake in hypertensive patients. Conclusion: hypertension is a health problem related to current lifestyle, so approaches towards it should take into account the conditionings and determinants that influence on each patient(AU)

Effect of dietary sodium intake on residual renal function in patients undergoing peritoneal dialysis: a prospective study of 33 cases / 南方医科大学学报

OBJECTIVE@#To explore the impact of dietary sodium-intake on residual renal function in patients undergoing peritoneal dialysis (PD).@*METHODS@#Thirty-three patients on PD with stable dialysis were regularly followed up for 12 months. The daily sodium intake of the patients was calculated based on the 3-day dietary record. Based on the mean daily sodium intake, the patients enrolled were divided into low-salt group (sodium intake≤3.0 g/day, 19 patients) and high-salt group (sodium intake>3.0 g/day, 14 patients). The baseline data of the patients were recorded, and the indicators of residual renal function and peritoneal function were regularly tested. The patients were followed-up at 3-month intervals, and their urine volume, peritoneal ultrafiltration volume and other clinical indicators were recorded and the biochemical indexes were detected to evaluate the changes in the residual renal function and peritoneal function.@*RESULTS@#There was a positive correlation between the total sodium excretion and dietary sodium intake in these patients (=0.536, =0.0013), and sodium excretion by dialysis was positively correlated with their sodium intake (=0.901, =0.000). Regression analysis suggested that the total sodium excretion was correlated with dietary sodium intake (β=0.416, 95% : 0.170-0.666; < 0.0018); sodium excretion by dialysis was associated with dietary sodium intake (β=0.489, 95% : 0.395-0.582; < 0.001). The residual renal function was reduced by 17.48±11.22 L /(w·1.73 m) in the low-salt group, as compared to 30.20±18.30 L /(w·1.73 m) in the high-salt group (=0.032). The reduction in the residual renal function was correlated with sodium intake in the PD patients (=0.409, =0.018). Multivariate regression analysis showed that sodium intake was an independent factor contributing to the reduction of residual renal function (β=14.646, 95% CI 7.426-21.866, < 0.001).@*CONCLUSIONS@#Sodium excretion by PD in patients with continuous ambulatory PD is positively correlated with their dietary sodium intake, which contribute to the decrease of residual renal function. A high dietary sodium intake may accelerate the reduction of residual renal function in these patients.

Designing optimized food intake patterns for Korean adults using linear programming (II): adjustment of the optimized food intake pattern by establishing stepwise intake goals of sodium / 한국영양학회지

PURPOSE: The Dietary Reference Intakes for Koreans (KDRIs) suggest that the goal for the intake of sodium should be less than 2,000 mg, which is thought to be infeasible to achieve when eating the typical Korean diet. This study aimed to obtain the new intake goals for sodium with improved feasibility to achieve, and also to design optimized food intake patterns for Korean adults by performing linear programming. METHODS: The data from a one day 24-hour dietary recall of the 2010 ~ 2014 Korea National Health and Nutrition Survey were used to quantify food items that Korean adults usually consumed. These food items were categorized into seven groups and 24 subgroups. The mean intakes and intake distributions of the food groups and the food subgroups were calculated for eight age (19 ~ 29, 30 ~ 49, 50 ~ 64, and over 65 years old) and gender (male and female) groups. A linear programming model was constructed to minimize the difference between the optimized intakes and the mean intakes of the food subgroups while meeting KDRIs for energy and 13 nutrients, and not exceeding the typical quantities of each of the food subgroups consumed by the respective age and gender groups. As an initial solution of the linear programming, the optimized intake of seasonings, including salt, was calculated as 0 g for all the age and gender groups when the sodium constraint was inserted not to exceed 2,000 mg. Therefore, the sodium constraint was progressively increased by 100 mg until the optimized intake of seasoning was obtained as the values closest to the 25(th) percentile of the intake distribution of seasonings for the respective age and gender groups. RESULTS: The optimized food intake patterns were mathematically obtained by performing linear programming when the sodium constraint values were 3,600 mg, 4,500 mg, 4,200 mg, 3,400 mg, 2,800 mg, 3,100 mg, 3,100 mg, and 2,500 mg for the eight age and gender groups. CONCLUSION: The optimized food intake patterns for Korean adults were designed by performing linear programming after increasing the sodium constraint values from 2,000 mg to 2500 ~ 4,500 mg according to the age and gender groups. The resulting patterns suggest that current diets should be modified to increase the intake of vegetables for all the groups, milk/dairy products for the female groups, and fruits for the female groups except for the females aged 50 ~ 64 years.

Consumo excesivo de sal e hipertensión arterial: Implicaciones para la salud pública / Excessive consumption of salt and hypertension: Implications for public health

Resumen La sal es necesaria para el buen funcionamiento del organismo, pero el aumento excesivo de su ingesta está produciendo incremento en la incidencia de hipertensión arterial (HTA), la que constituye el principal factor de riesgo de muerte en el mundo, y el segundo de discapacidad por enfermedad cardiaca y accidente cerebrovascular. El objetivo de este trabajo fue revisar, desde una perspectiva actual, las relaciones existentes entre el consumo de sal (CNS) y la salud pública, haciendo énfasis en la HTA, así como en las políticas existentes encaminadas a reducir su sobreuso. Múltiples estudios señalan que la reducción del CNS en la población es una de las medidas más eficaces. Sin embargo, la adición de sal durante el cocinado no es el único problema, ya que la mayor cantidad proviene de los alimentos preparados o precocinados. Por tanto, la lucha contra el consumo excesivo de sal debe concebirse como una actividad permanente de los servicios médicos, con el apoyo constante de las autoridades públicas y la colaboración de las industrias alimentarias, a través de reducir o eliminar la adición de sal de los preparados, siguiendo las recomendaciones científicas emitidas en los últimos años.

Abstract Salt is necessary for the proper functioning of the organism, but the excessive use of it in feeding has increased the incidence of arterial hypertension (AHT), which constitutes the main risk factor of death in the world, and the second of disability due to heart disease and brain strokes. The aim of this work was to review, from a current perspective, the relationships between salt consumption (SCN) and public health, with emphasis on AHT, as well as in the existing policies aimed at reducing its overuse. Multiple studies indicate that the reduction of SCN is one of the most effective measures. However, the addition of salt during cooking is not the only problem, since the greatest amount of salt comes from precooked foods. Therefore, the fight against excessive SCN should be conceived as a permanent activity of medical services, with the constant support of public authorities, and collaboration of food industries by reducing or eliminating salt addition from prepared meals, following the scientific recommendations issued in recent years.

The influence of salt intake on the course of experimental toxoplasmosis in outbred or inbred mouse strains

Many environmental factors contribute to an effective immune response against Toxoplasma gondii (Tg) infection, among which diet is important in triggering the immune response of the host to infection. Emerging reports suggest that salt intake undermines the regulatory mechanisms mediated by innate and adaptive immune cells. Unfortunately, the impact of an Intermediate Salt Diet (ISD) on the pathogenesis and immune response to toxoplasmosis remains unclear. The purpose of this study was to evaluate the susceptibility profile to an ISD (NaCl 2%) of two mouse strains (outbred Swiss and inbred C57BL6) infected by the ME49 strain of Tg. Our data confirm an antagonistic susceptibility to oral Tg infection among the two mouse strains. Sodium intake induced the highest mortality in C57BL6 compared to Swiss mice in the infected groups. A simultaneous ISD with the infection did not induce significant differences in body weight in either mouse strains. Both mouse strains showed an antagonistic response to a sodium intake diet on the number of parasite brain cysts. An increased number of brain cysts in C57BL6 ISD-Tg animals were noted while Swiss ISD-Tg animals presented a decrease in the number of brain cysts compared to NSD-Tg (Normal Salt Diet) for both mouse strains. Furthermore, sodium intake caused a significant reduction in the specific humoral immune response against Tg in inbred C57BL6 mice. Thus, our data reveal that an ISD affects the humoral immune response in the murine model and influences the course of Tg infection.

Effects of Sodium Intake on the Association between the Salt-Sensitive Gene, Alpha-Adducin 1 (ADD1), and Inflammatory Cytokines in the Prevalence of Children Obesity

OBJECTIVE: To examine the effects of sodium intake on the correlations between the salt-sensitive gene α-adducin 1 (ADD1) and inflammatory cytokines in Korean childhood obesity. METHODS: A total of 2,070 students aged 8–9 years old participated in this study. The anthropometrics, serum biochemistry profile, inflammatory cytokines, and three-day dietary assessment were analyzed according to sex, obesity degree, and ADD1 polymorphism. RESULTS: The obesity prevalence was higher in boys (15.6%) than in girls (11.9%). Boys also showed higher values in anthropometrics; lipid, glucose, and insulin profiles; total calorie intakes, as well as those of sodium and calcium compared with those of the girls. The more obese were boys and girls, the higher were the anthropometrics and the blood levels (total cholesterol, triglyceride, low-density lipoprotein cholesterol, fasting blood sugar, and insulin), but the lower was high-density lipoprotein cholesterol. The obese boys had significantly higher sodium and Na/K intakes, while the obese girls had higher visfatin level and Na/K intake. In addition, an increase in the risk factors for blood pressure and obesity in ADD1 variants was identified. Serum tumor necrosis factor-α(TNF-α) significantly increased with increasing sodium intake in the ADD1 W allele carriers, regardless of sex. The presence of obesity with the ADD1 W allele induced inflammatory accelerators such as TNF-α or C-reactive protein(CRP) with higher sodium intake. CONCLUSION: Obese children with an ADD1w allele can experience a more complex form of obesity than non-obese when exposed to an obesity-inducing environment and need to be controlled sodium intake in the diet.

Role of the central nucleus of the amygdala in regulating the nongenomic effect of aldosterone on sodium intake in rat nucleus tractus solitarius / 南方医科大学学报

<p><b>OBJECTIVE</b>To reveal the nongenomic effect of aldosterone on the regulation of sodium intake in the nucleus tractus solitarius (NTS) and the role of central nucleus of the amygdala (CeA) in regulating this effect.</p><p><b>METHODS</b>Adult male SD rats were divided into four groups and underwent operations to induce bilateral CeA electrolytic lesions (400 μA, 25 s; =28), bilateral sham CeA lesions (=28), unilateral CeA lesions (=28), or unilateral sham CeA lesions (=26). After 3 days of recovery, the rats received implantation of a stainless steel 23-gauge cannula wih two tubes into the NTS followed by a recovery period of 7 days. The rats in each group were then divided into two subgroups for microinjection of aldosterone (50 ng/μL) or control solution in the NTS, and the cumulative intake within 30 min of 0.3 mol/L NaCl solution was recorded for each rat.</p><p><b>RESULTS</b>Bilateral CeA lesions (3 days) eliminated the increased 0.3 mol/L NaCl intake induced by aldosterone microinjected into the NTS (0.3±0.04 mL in CeA lesion group 1.3±0.3 mL in sham lesion group). Unilateral CeA lesion (3 days) reduced aldosterone-induced increase of NaCl intake in the first 15 min ( < 0.05) but not in 15-30 min ( > 0.05). In rats with sham lesions, aldosterone (50 ng/μL) still induced a significant increase in NaCl intake[1.3±0.3 mL 0.25±0.02 mL in the control group; F (3, 224)=24.0, < 0.05].</p><p><b>CONCLUSIONS</b>The regulation of sodium intake by aldosterone is subjected to descending facilitatory modulation by the bilateral CeA, and CeA integrity is essential for aldosterone to execute the nongenomic effect in regulating rapid sodium intake.</p>

Association between Sodium Excretion and Obesity of Adults in Gwangju / 대한지역사회영양학회지

PURPOSE: The aim of this study was to analyze the association between sodium excretion and obesity for healthy adults in the Gwangju area. METHODS: The participants included 80 healthy adults aged 19 to 69 years in Gwangju. The dietary intake and sodium excretion were obtained using the 24-hour recall method and 24 hour urine collection. The participants were classified into two groups according to the amount of urinary sodium excretion: (≤ 141.75 mmol/dL, > 141.75 mmol/dL). RESULTS: After adjusting for sex, age, smoking history, and income, the high excretion of sodium group was significantly higher for weight, body mass index, body fat mass, percent body fat, visceral fat area (VFA), waist circumference, hip circumference, and WHR. The energy and nutrients intake were significant after adjusting for sex, age, smoking history, and income. The LSE group had a significantly higher fat intake and Na/K intake ratio. The HSE group had significantly higher fiber intake, and K intake. As the amount of urinary sodium excretion increased, the risk of obesity before correction was 3.57 (95% CI: 1.13–11.25) times greater, and the risk of obesity of T3 increased significantly by 3.33 times (95% CI: 1.05–10.59). After correcting for sex and age, the obesity risk of T2 increased significantly by 4.23 times (95% CI: 1.11–16.06), and after correcting for sex, age, smoking history, and income, the obesity risk of T2 increased significantly by 6.81 times (95% CI: 1.44–32.19) the risk of obesity. CONCLUSIONS: An association exists between sodium excretion and obesity in Korean adults. In this study, the high excretion of sodium group was obese and the risk of obesity was higher than the low excretion of sodium group.

Association between Sodium Excretion and Obesity of Adults in Gwangju / 대한지역사회영양학회지

PURPOSE: The aim of this study was to analyze the association between sodium excretion and obesity for healthy adults in the Gwangju area. METHODS: The participants included 80 healthy adults aged 19 to 69 years in Gwangju. The dietary intake and sodium excretion were obtained using the 24-hour recall method and 24 hour urine collection. The participants were classified into two groups according to the amount of urinary sodium excretion: (≤ 141.75 mmol/dL, > 141.75 mmol/dL). RESULTS: After adjusting for sex, age, smoking history, and income, the high excretion of sodium group was significantly higher for weight, body mass index, body fat mass, percent body fat, visceral fat area (VFA), waist circumference, hip circumference, and WHR. The energy and nutrients intake were significant after adjusting for sex, age, smoking history, and income. The LSE group had a significantly higher fat intake and Na/K intake ratio. The HSE group had significantly higher fiber intake, and K intake. As the amount of urinary sodium excretion increased, the risk of obesity before correction was 3.57 (95% CI: 1.13–11.25) times greater, and the risk of obesity of T3 increased significantly by 3.33 times (95% CI: 1.05–10.59). After correcting for sex and age, the obesity risk of T2 increased significantly by 4.23 times (95% CI: 1.11–16.06), and after correcting for sex, age, smoking history, and income, the obesity risk of T2 increased significantly by 6.81 times (95% CI: 1.44–32.19) the risk of obesity. CONCLUSIONS: An association exists between sodium excretion and obesity in Korean adults. In this study, the high excretion of sodium group was obese and the risk of obesity was higher than the low excretion of sodium group.

Evaluation of the sodium intake reduction plan for a local government and evidence-based reestablishment of objectives: Case of the Seoul Metropolitan Government / 한국영양학회지

PURPOSE: To identify the effectiveness of policy evaluation, consistent monitoring is necessary. This study aimed to carry out mid-term evaluation of objectives and programs related to comprehensive plans for sodium intake reduction by 2020 for Seoul city and then reestablish the objectives of the sodium intake reduction plans. METHODS: Literature reviews, data analysis, and reviews of expert focus-groups were performed to evaluate objectives, to develop a new goal, and to identify the priority subjects of the sodium intake reduction programs. In order to examine target populations for the programs, awareness and behaviors related to sodium intakes among Seoul citizens were examined by sex, age, and income level using the 2008~2013 Korea National Health and Nutrition Examination Survey data. RESULTS: Current objectives of the sodium intake reduction plan by 2020 for Seoul city were not appropriate, so objectives were reset to 3,600 mg of sodium intake by 2020 among Seoul citizens with 2% reduction per year. Although sodium intake showed a decreasing trend by year, it was still high, especially in men. The sodium intake reduction programs currently in progress have not been assessed at multiple levels across multiple sectors and have only been assessed fragmentarily. For dietary behavior related to sodium intakes by sex, age, and income level, sodium intake was higher in the group with less than 100 g of fruit intake compared to the group with 100 g or more. Subjects aged 30~59 years and the low household income group showed relatively higher sodium intakes. Based on the data analysis and the expert review, the priority subject of the sodium intake reduction programs was determined to be adult men. In terms of a program strategy for sodium intake reduction, multi-level and setting approaches, including work sites, home, and restaurants, were suggested to reduce sodium intakes of the target subject. CONCLUSION: The suggested objectives should be consistently monitored by data analysis, and the determined programs need to be phased in over 5 years.

The association between dietary sodium intake and adiposity, inflammation, and hormone markers: A preliminary study / 한국영양학회지

PURPOSE: Excess intake of sodium is a major diet-related risk factor for human diseases including hypertension and cancer as well as obesity and inflammation. However, findings are still controversial, and evidence is lacking in Koreans. Therefore, for better understanding of the role of dietary sodium intake in disease etiology, this study investigated the effects of dietary sodium intake on adiposity, inflammation, and hormones in Koreans. METHODS: A total of 80 males and females joined the study. The general characteristics and dietary intake data were investigated by trained interviewers using a questionnaire and 24-h dietary recall, respectively. For the markers of adiposity, body weight, body mass index, percent of body fat, visceral fat area, and waist and hip circumference were measured. For the inflammation and hormone markers, leptin, adiponectin, insulin, tumor necrosis factor-α, and interleukin-6 were also analyzed. RESULTS: Multivariate linear regression analyses suggested that dietary sodium intake was not associated with adiposity. However, dietary sodium showed a significant association with insulin level: Plasma insulin concentration increased with sodium intake independent of other dietary intake or percent of body fat (β = 0.296, adjusted r² = 0.276, p < 0.01). Other markers for inflammation and hormonal responses were not associated with dietary sodium intake. CONCLUSION: Findings suggested that dietary sodium intake may be a critical modifying factor in the level of plasma insulin. However, it showed a limited effect on obesity and other inflammation markers and hormone levels. These findings should be confirmed in larger, well-designed investigations.

Effects of interaction between SLC12A3 polymorphism, salt-sensitive gene, and sodium intake on risk of child obesity / 한국영양학회지

PURPOSE: Obesogenic environments in children, in particular excessive intake of sodium, generate hypertension, which is a major risk factor for chronic diseases. METHODS: In all, 725 children, 379 boys and 373 girls, aged 8∼9 years were recruited from seven elementary schools in Kuro-ku, Seoul. To evaluate whether or not obesity risk was modulated by salt-sensitive genes, Solute Carrier Familiy 12 member 3 (SLC12A3) was used as the target. After children were assigned into obese (BMI > 85 percentile) or non-obese groups, anthropometry, blood biochemistry, and dietary intakes were measured according to the genotypes GG (wild) or GA+AA (hetero+mutant). RESULTS: Without gender differences, high TG and low HDLc were detected in the obese group compared to the non-obese group. Regardless of obesity, weight gain and blood pressure (BP) increased in the SLC12A3 GA+AA genotype rather than in the GG type. HDLc was associated with obesity risk without genotype difference. Odd ratios for risk of obesity were 15.57 (95% CI 2.192∼110.654), 22.84 (95% CI 1.565∼333.469), and 9.32 (95%CI 1.262∼68.817) in boys and girls with GA+AA genotypes as sodium intake increased above 4,000 mg/day. Dietary calcium, sodium, folate, and vit C were associated with obesity risk according to gender or genotype differences. Since high folate intake reduced obesity risk in only boys with GG type. Risk for overweight and obesity increased in boys with GA+AA genotypes and dietary habits with high sodium and cholesterol and low folate. CONCLUSION: The A allele of SLC12A3 rs11643718 was sensitive to development of obesity in children as sodium intake increased.

Relationship of sodium consumption with obesity in Korean adults based on Korea National Health and Nutrition Examination Survey 2010~2014 / 한국영양학회지

PURPOSE: Excess sodium intake may contribute to the etiology of hypertension and cardiovascular disease risk. World Health Organization (WHO) recommends a daily sodium intake of less than 2 g. The aim of this study was to estimate the association of sodium intake with obesity in Korean adults. METHODS: This study used Dietary intake and Health data on 22,321 subjects aged 30 years and over from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010~2014. Information on dietary intake was obtained by the one day 24-hour recall method in KNHANES, and sodium intake was classified into five groups (< 2,000 mg, 2,000~4,000 mg, 4,000~6,000 mg, 6,000~8,000 mg, ≥ 8,000 mg). Obesity was defined as having a body mass index (BMI) higher than 25 kg/m². Intake of sodium and obesity status were analyzed by logistic regression with SPSS Statistics 23. RESULTS: Men tended to have a higher sodium intake than women (p < 0.001). After adjusting for age, sex, year, daily energy intake, education level, smoking status, drinking status, physical activity, and chronic diseases and comparing the highest sodium intake group (≥ 8,000 mg) with the lowest intake group (< 2,000 mg), the OR of obesity was 1.351 (95% CI: 1.032~1.767) in men. The OR of obesity in the sodium intake group (4,000~6,000 mg) was 1.232 (95% CI: 1.063~1.427) in women. CONCLUSION: Our findings suggest an independent relationship between sodium intake and as increased risk of obesity in Korean adults, implying the necessity for future research on low-sodium diet intervention in relation to obesity.

Relationship between thresholds and self-assessed preference for saltiness and sodium intake in young women / 한국영양학회지

PURPOSE: We recruited 118 women in their early 20's to examine the relationship between sodium intake and salty taste thresholds and preference. We also examined the association of salty taste preference with sodium-related dietary behaviors and major dishes contributing to sodium intake. METHODS: Daily sodium intake was estimated using a 127-item dish-frequency questionnaire. Salty taste thresholds and preference were measured using rating scales using water solution of NaCl and a self-administered questionnaire based on a Likert scale, respectively. RESULTS: Salty taste preference showed positive correlation with daily sodium intake and sodium intake-increasing behaviors, and inverse association with sodium intake-decreasing behaviors, including salt and soy sauce use at the table, the frequency of eating out and home delivery of foods, broth consumption of soup, stew or noodle soup, the use of ready-to-serve or processed foods, fresh vegetable intake, and the accommodating attitude toward bland food. Intake of sodium-contributing dishes, including ramen, spicy soft-tofu stew, radish kimchi, and dishes containing kimchi, also showed positive association with salty taste preference. Unexpectedly, detection and recognition thresholds of salty taste showed no association with salty taste preference, sodium intake, and sodium-related dietary behaviors. CONCLUSION: These findings suggest that salty taste preference could reflect sodium intake of individuals rather than thresholds of saltiness, and may be used as a simple and effective proxy for usual sodium intake.

Associations of Obesity and Dyslipidemia with Intake of Sodium, Fat, and Sugar among Koreans: a Qualitative Systematic Review

A qualitative systematic review was performed to identify associations of obesity and dyslipidemia with intake of sodium, fat, and sugar among Koreans. We reviewed 6 Korean research databases (KMbase, KoreaMed, NDSL, DBpia, RISS, KISS) with the keywords “sodium intake,”“fat intake,” and “sugar intake.” Total of 11 studies were investigated in this present study. Of these articles, 7 studies were related to sodium intake, 2 studies had a relation to fat intake, and 2 studies were associated with sugar intake. We indicated general characteristics, concentration of serum lipids, nutrition intake, and statistically significant results. High sodium intake contributed to increased etiology of hypertriglyceridemia, high-density lipoprotein (HDL) hypocholesterolemia, and a risk of being overweight. Fat intake was significantly associated with body fat, low-density lipoprotein (LDL) hypercholesterolemia, and HDL hypocholesterolemia. Sugar intake from coffee drinks and sugar-sweetened beverages contributed to increased HDL hypocholesterolemia and continuous metabolic syndrome score. This qualitative review among Koreans represented that intake of sodium, fat, and sugar has a positive relationship with cause of obesity-related diseases. Especially, this present study has a great significance in terms of considered study that intake of the potentially hazardous nutrients among Koreans has an association with obesity and dyslipidemia. However, further studies such as randomized controlled trials on associations between sodium, fat, and sugar and obesity and dyslipidemia need to be continuously required in order to conduct quantitative systematic reviews and a meta-analysis for Koreans.

Analysis of Sodium Intake via Drugs Used by Hypertensive Inpatients / 中国药房

OBJECTIVE:To investigate sodium intake via drug used by hypertensive inpatients during hospitalization. METH-ODS:290 inpatients with hypertension were collected from vasculocardiology department of our hospital between Jan. and Oct. 2013. The types of sodium-containing drugs and sodium-intake during hospitalization were analyzed statistically. RESULTS:275 pa-tients with hypertension were prescribed 38 sodium-containing drugs(94.8%);82.7% were administered by iv gtt with a average drug treatment course of 6.7 days(average hospitalization days of 6.8 days). Solvent containing sodium such as 0.9% Sodium chlo-ride injection and Creatine phosphate sodium for injection were the most sodium donors. 43.3% patients’sodium intake exceeded upper limit of 2 g/day recommended by WHO. CONCLUSIONS:Hypertensive inpatients are prescribed too much sodium-contain-ing drugs,and less intravenous solutions and less adjuvant medicines should be took to decrease sodium intake. Only when prospec-tive benefit are greater than risk,the patients can be prescribed sodium-containing drug prescription.At the same time,manufacturers should annotate the content of sodium in package inserts,which is convenient for physicians to choose drugs.