Abstract
Despite the well-known benefits of the Mediterranean Diet (MedDiet), data on the sodium intake is scarce. This study aimed to quantify the association between sodium excretion and the adherence to the MedDiet in the elderly. A representative sample of 1500 Portuguese adults (≥65 years) was assessed (1321 were eligible for the present analysis). A 24 h urine sample was collected and analysed for creatinine and sodium. Excessive sodium intake was defined as above 2000 mg/day. The adherence to the MedDiet was assessed by the PREDIMED. A binary logistic regression model was conducted to evaluate the association between urinary sodium excretion and the adherence to the MedDiet. Odds Ratios (OR) and respective 95% Confidence Intervals (95% CI) were calculated. Excessive sodium excretion was observed in 80.0% of men and 91.5% of women whereas a high adherence to the MedDiet was reported by 42.2% of women and 46.4% of men. After adjusting for confounders, excessive sodium excretion was associated with a high adherence to the MedDiet in men (OR = 1.94; 95% CI: 1.03–3.65) but not in women. These results show that the MedDiet can be an important source of sodium and highlight the need for implementing strategies to reduce sodium intake when following a MedDiet.
Highlights
The Mediterranean Diet (MedDiet) is characterized by the predominance of foods of plant origin such as vegetables, fruit, bread, potatoes, beans, nuts, and seeds; olive oil as the main source of fat; dairy products; and fish, poultry, and eggs, consumed in low to moderate amounts instead of red meat, and wine consumed in low to moderate amounts, usually with meals [1]
Excessive sodium excretion was observed in 80.0% of men and 91.5% of women, whereas a high adherence to the MedDiet was reported by 42.2% of women and 46.4% of men
It was shown that high MedDiet adherence was associated with a higher likelihood of exhibiting higher sodium excretion in males, supporting the hypothesis that salt added during cooking is an important source of sodium, since the foods present in the Mediterranean dietary pattern are not important sources of intrinsic sodium and the consumption of processed foods in the MedDiet is expected to be low
Summary
The Mediterranean Diet (MedDiet) is characterized by the predominance of foods of plant origin such as vegetables, fruit, bread, potatoes, beans, nuts, and seeds; olive oil as the main source of fat; dairy products (mainly cheese and yogurt); and fish, poultry, and eggs, consumed in low to moderate amounts instead of red meat, and wine consumed in low to moderate amounts, usually with meals [1]. In the present study which included a representative sample of Portuguese older adults, the median daily sodium excretion was slightly lower, at 3368 mg, which corresponds to 8.4 g of salt [14]. This issue is of particular importance in Portugal since the overall prevalence of hypertension in adults was 36.0% in 2015, the estimate is much higher among individuals older than 64 years, for whom a prevalence of 71.3% was reported [15]
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