Abstract

Objective: Salt restriction and potassium (K) intake can lower blood pressure (BP) and reduce the risk for cardiovascular (CV) diseases. However, it is still unclear which approaches are most effective in changing diet behavior. We evaluated the impact of two education prevention programs in promoting healthy eating habits in the general population. Design and method: A total of 311 adults (20–70 years) responsible for acquiring and making their meals were randomly assigned to one of the 2 multi-component educational programs (intervention and healthy lifestyle) during 12 weeks, consisting in face-to-face sessions, e-learning and telephone contacts. The healthy lifestyle program was an integrated approach addressing healthy food and lifestyle habits, including increase in K intake, while intervention was based on education and motivation strategies for reducing salt consumption. Training and clinical evaluation sessions occurred every 4 weeks and 24-h urine samples were collected at beginning and after 12 weeks. Results: 269 subjects completed the study (71% women, mean age of 45 years). Groups were similar (mean values) at baseline: weight 75 Kg, BMI 27 kg/m2, waist 86 cm, salt intake 9.2 g/d, K+ 1.9 g/d and BP 116/74 mmHg. After 12 weeks the intake per week of vegetables and legumes doubled, while consumption increased of fruits and fish (50%) and of shellfish (30%) along with reduction of salty (6%) and processed foods (20%). After 12 weeks clinical improvements were similarly observed with both programs: reduction of BP by 2/2 ± 11/7 mmHg P < 0.01, body weight by 0.3 ± 2.1 Kg, P = 0.007) and Na/K ratio by 0.05 ± 0.36, P = 0.027). Benefits were greater in subjects eating salt above mean (from 10.3 g/d salt/d salt intake reduced by 0.6 ± 1.5 g/d; P = 0.001), eating K+ bellow the median (from 2.1 g/d K intake increased 0.1 ± 0.2 g/d; P < 0.001) and with BP above 130/85 mmHg (from 136/88, BP reduced 6/5 ± 14/8 mmHg P = 0.001). Conclusions: Both education programs showed a positive impact in weight, salt and K+ intakes and BP. Subjects with higher BP and / or salt intake were those who benefited most from these dietary approaches.

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