Association of Estimated Salt and Miso Intake with the Prevalence of Obesity in People with Type 2 Diabetes: A Cross-Sectional Study.

Fuyuko Takahashi,Masahide Hamaguchi,Ryosuke Sakai,Yoshitaka Hashimoto,Takuro Okamura,Emi Ushigome,Naoko Nakanishi,Akane Miki,Michiaki Fukui,Takafumi Senmaru,Noriyuki Kitagawa,Ayumi Kaji,Yuka Kawate,Saori Majima,Mai Asano,Hiroshi Okada,Masahiro Yamazaki

doi:10.3390/nu13093014

Fuyuko Takahashi, Masahide Hamaguchi + Show 15 more

Open Access

https://doi.org/10.3390/nu13093014

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Abstract

Salt intake is often estimated by the amount of sodium excreted in urine, and miso has been reported to increase it. This cross-sectional study investigated the relationship between obesity and high estimated salt intake with and without habitual miso consumption. Estimates of salt intake (g/day) were calculated using urinary sodium excretion, and a high estimated intake was defined as greater than the median amount of 9.5 g/day. Participants were divided into four groups based on estimated salt intake and miso consumption. Among 300 people, the proportions of obesity were 77.8% (n = 14/18), 40.2% (n = 53/132), 26.0% (n = 33/127), and 34.8% (n = 8/23) in the (+/−), (+/+), (−/+), and (−/−) groups of high estimated salt intake/habitual miso consumption, respectively. Compared with the (+/−) group, the adjusted odds ratios for obesity were 0.07 (95% confidence interval (CI): 0.02–0.26, p < 0.001), 0.16 (95% CI: 0.03–0.76, p = 0.022), and 0.14 (95% CI: 0.04–0.51, p = 0.003) in the (−/+), (−/−), and (+/+) groups, respectively. The presence of obesity was not much higher in people with high estimated salt intake with habitual miso consumption than that in people without. Clinicians should be aware that miso consumption promotes salt excretion, which may lead to an apparently higher estimated salt intake than actual.

Highlights

A high salt intake is known to elevate blood pressure and increase the risk of cardiovascular disease (CVD) [1,2]
A previous study reported that high salt intake, estimated from a questionnaire, was related to an elevated incidence of CVD in people with type 2 diabetes mellitus (T2DM) [6]
Salt intake can be estimated by collecting urine over 24 hours (24 h urine), but, because this is difficult for both researchers and participants, it leads to incomplete data and low survey response rates; spot urine is alternatively used to estimate salt intake [12,13,14], which is recommended by 2019 guidelines for the management of hypertension from the Japanese Society of Hypertension [15]

Summary

Introduction

A high salt intake is known to elevate blood pressure and increase the risk of cardiovascular disease (CVD) [1,2]. For people with type 2 diabetes mellitus (T2DM), many guidelines recommend reducing salt consumption to prevent hypertension [3,4,5]. A previous study reported that high salt intake, estimated from a questionnaire, was related to an elevated incidence of CVD in people with T2DM [6]. Previous studies showed that salt intake, estimated from urinary excretion, is related to the risk of obesity [7,8,9,10,11]. Miso intake was shown to have a preventive effect on hypertension in non-hypertensive Japanese people, miso itself increases dietary salt [19]. We recently revealed an association between miso and low body fat mass [22]

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