Abstract

High sodium and low potassium intakes are associated with increased levels of blood pressure and risk of cardiovascular diseases. Assessment of habitual dietary habits are helpful to evaluate their intake and adherence to healthy dietary recommendations. In this study, we determined sodium and potassium food-specific content and intake in a Northern Italy community, focusing on the role and contribution of adherence to Mediterranean diet patterns. We collected a total of 908 food samples and measured sodium and potassium content using inductively coupled plasma mass spectrometry. Using a validated semi-quantitative food frequency questionnaire, we assessed habitual dietary intake of 719 adult individuals of the Emilia-Romagna region. We then estimated sodium and potassium daily intake for each food based on their relative contribution to the overall diet, and their link to Mediterranean diet patterns. The estimated mean sodium intake was 2.15 g/day, while potassium mean intake was 3.37 g/day. The foods contributing most to sodium intake were cereals (33.2%), meat products (24.5%, especially processed meat), and dairy products (13.6%), and for potassium they were meat (17.1%, especially red and white meat), fresh fruits (15.7%), and vegetables (15.1%). Adherence to a Mediterranean diet had little influence on sodium intake, whereas potassium intake was greatly increased in subjects with higher scores, resulting in a lower sodium/potassium ratio. Although we may have underestimated dietary sodium intake by not including discretionary salt use and there may be some degree of exposure misclassification as a result of changes in food sodium content and dietary habits over time, our study provides an overview of the contribution of a wide range of foods to the sodium and potassium intake in a Northern Italy community and of the impact of a Mediterranean diet on intake. The mean sodium intake was above the dietary recommendations for adults of 1.5–2 g/day, whilst potassium intake was only slightly lower than the recommended 3.5 g/day. Our findings suggest that higher adherence to Mediterranean diet patterns has limited effect on restricting sodium intake, but may facilitate a higher potassium intake, thereby aiding the achievement of healthy dietary recommendations.

Highlights

  • Non-communicable diseases (NCDs) are the leading causes of death worldwide [1]

  • Our findings suggest that higher adherence to Mediterranean diet patterns has limited effect on restricting sodium intake, but may facilitate a higher potassium intake, thereby aiding the achievement of healthy dietary recommendations

  • Adherence to the Italian Mediterranean Index was moderate with approximately 60% of subjects having a score equal or above the median value of 4, and a similar higher proportion of subjects appeared to adhere to Mediterranean–Dietary Approach to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) pattern, with a mean score of 7.5

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Summary

Introduction

Cardiovascular diseases (CVD) still represent the leading cause of death and disability [2], being responsible for more than 35% of all deaths in Italy [3]. The effect of dietary intakes of sodium and potassium on the regulation of blood pressure levels has been widely investigated [8]. A decrease in sodium intake showed an approximately linear association with blood pressure levels [12], cardiovascular diseases [13], and stroke [14], with beneficial effects of sodium reduction in both subjects with and without hypertension [12,15,16]

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