Abstract
BackgroundCurrent evidence regarding the prognostic relevance of urinary sodium-to-potassium ratio (Na-to-K ratio), as an indicator of diet quality is limited. This study was conducted to investigate whether urinary Na-to-K ratio could be related to habitual dietary patterns, in a general population.MethodsThis study was conducted in the framework of the Tehran Lipid and Glucose Study (2014–2017) on 1864 adult men and women. Urinary Na and K concentrations were measured in the morning spot urine samples. Dietary intakes of the participants were assessed using a validated 147-item Food Frequency Questionnaire (FFQ) and major dietary patterns were obtained using principal component analysis. Mediterranean dietary pattern and Dietary Approaches to Stop Hypertension (DASH) score, were also calculated. Multivariable-adjusted linear regression was used to indicate association of dietary patterns and urinary Na-to-K ratio.ResultsMean (± SD) age of participants was 43.7 ± 13.9 years and 47% were men. Mean (± SD) urinary Na, K and the ratio was 139 ± 41.0 and 57.9 ± 18.6 mmol/L, 2.40 ± 0.07, respectively. Higher urinary Na-to-K ratio (> 2.37 vs. < 1.49) was related to lower intakes of vegetables (282 vs. 321 g/day), low-fat dairy (228 vs. 260 g/day) and fruits (440 vs. 370 g/day). Western dietary pattern was related to higher urinary Na-to-K ratio (β = 0.06; 95% CI 0.01, 0.16). Traditional dietary pattern, Mediterranean and DASH diet scores were inversely associated with urinary Na-to-K ratio (β = − 0.14; 95% CI − 0.24, − 0.11, β = − 0.07; 95% CI − 0.09, − 0.01, β = − 0.12; 95% CI − 0.05, − 0.02, respectively).ConclusionsSpot urinary Na-to-K ratio may be used as a simple and inexpensive method to monitor diet quality in population-based epidemiological studies.
Highlights
Current evidence regarding the prognostic relevance of urinary sodium-to-potassium ratio (Na-to-K ratio), as an indicator of diet quality is limited
Excessive dietary intakes of sodium (Na) along with insufficient potassium (K) intakes are related to risk of developing cardiometabolic disorders [1, 2]
We aimed to investigate whether spot urinary Na-to-K ratio could be related to habitual dietary patterns, and how the index can be used as an indicator of diet quality among a general population
Summary
Current evidence regarding the prognostic relevance of urinary sodium-to-potassium ratio (Na-to-K ratio), as an indicator of diet quality is limited. This study was conducted to investigate whether urinary Na-to-K ratio could be related to habitual dietary patterns, in a general population. Excessive dietary intakes of sodium (Na) along with insufficient potassium (K) intakes are related to risk of developing cardiometabolic disorders [1, 2]. Measurement of Na and K in 24-h urine is the gold standard method to estimate their dietary intakes, low feasibility in populationbased studies and incomplete collections, resulting in underestimation of NA–K intakes, is the major limitation of the method [13]. There are a number of studies suggested spot urinary Na and K as a simple, non-invasive, useful and alternative method to 24-h urine estimation in populations [14, 15]
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