Daily Dietary Sodium Intake Research Articles

Dietary Sodium and Potassium Intakes and Kidney Stone Prevalence: The National Health and Nutrition Examination Survey 2011-2018.

The associations between dietary sodium intake (DSI), dietary potassium intake (DPI), and kidney stone disease (KSD) are not clear. We examined The National Health and Nutrition Examination Survey 2011-2018 to determine the independent associations between daily DSI, DPI, DSI/DPI, and KSD prevalence. In total, 19,405 participants were included for analysis, of which 1,895 had KSD. Higher DSI was not associated with increased odds of KSD in regression analysis when DSI was modeled as a continuous variable (OR = 0.99, 95% CI: 0.99-1.00, p = 0.2), or when comparing highest quartile of DSI to lowest quartile (OR = 0.84, 95% CI: 0.68-1.04, p = 0.1). Unlike DSI, higher DPI was strongly associated with reduced odds of KSD in regression analysis when DPI was modeled as a continuous variable (OR = 0.99, 95% CI: 0.99-0.99, p = 0.02), or when comparing highest quartile of DPI to lowest quartile (OR = 0.75, 95% CI: 0.60-0.94, p = 0.01). Lastly, higher DSI/DPI was also strongly associated with increased odds of KSD in regression analysis when DSI/DPI was modeled as a continuous variable (OR = 1.1, 95% CI: 1.01-1.20, p = 0.03), or when comparing highest quartile of DPI to lowest quartile (OR = 1.30, 95% CI: 1.10-1.70, p = 0.008). All the observed relationships were independent of total calorie intake. In conclusion, both lower DPI and higher DSI/DPI are associated with an increased risk of KSD. Future prospective studies are needed to clarify these causal relationships.

Association between Eating Habits and Sodium Intake among Chinese University Students.

(1) Background: Insufficient evidence exists regarding the dietary habits that may contribute to high sodium intake among college students in China. This cross-sectional study aimed to investigate the dietary sodium intake of college students in Hunan and its association with their dietary habits. (2) Methods: In total, 585 university students from Hunan were recruited for this study. The sodium Food Frequency Questionnaire (sodium-FFQ) and dietary habits were assessed. (3) Results: Excluding cooking salt and high-sodium seasonings, the daily dietary sodium intake among college students in Changsha, Hunan Province, was 1183.74 (563.38, 2054.86) mg/day. A vast majority (89%) of college students reported eating outside of school at least once a week, and approximately one-third (34%) ordered takeaways at least once a week. After adjusting for confounding factors, the associations between the frequency of eating out and ordering takeaways with college students' sodium intake remained significant. (4) Conclusions: The findings indicate that excessive dietary sodium intake among college students in Hunan is a growing concern. College students who frequently eat out and order takeaways tend to have a higher sodium intake. Future research should focus on identifying the main sources of dietary sodium and developing interventions that promote healthy dietary habits among college students.

Application of different spatial interpolation methods in sodium intake estimation

The spatial interpolation method was used to estimate the intake of sodium in the areas without dietary sodium intake data. The data of dietary sodium consumption in this study are from the 2010-2012 China National Nutrition and Health Surveillance(CNNHS), the CNNHS was carried out on stratified multistage systematic clustered random sampling method with proportional to the population to form a representative sample of China as a whole, including 150 survey site. Dietary data was collected through face-to-face interview, based on a combination of three consecutive days of 24-h recalls combined with a household food weighting method, a total of 48 826 participants aged 20 years old and more were recruited in this study. The average sodium intake among 150 survey sites were calculated according to data of the CNNHS 2010-2012. The accuracy of spatial analysis techniques, such as Inverse Distance Weight, Ordinary Kriging, Cooperative Kriging method and Regression Kriging Interpolation method, was compared in the estimation of dietary sodium intake. The spatial analysis method with the highest accuracy was used to estimate the daily dietary sodium intake of each district and county in China, and then the dietary sodium intake of each province was calculated according to the population weight. The average sodium intake among Chinese adults was 5. 18 g, among which the average intake of men is 5. 33 g and that of women was 5. 03 g. Comparing the accuracy of four spatial analysis method in estimating dietary sodium intake, it was found that the Regression Kriging Interpolation method was superior to the other three methods, with root mean square error and mean absolute error of 0. 54 and 0. 44. The Regression Kriging Interpolation method was used to estimate the dietary sodium intake in different regions of China, the estimated national dietary sodium intake by population weighted calculation was 5. 17 g/d, the estimated national dietary sodium intake was 5. 33 g/d for men and 5. 01 g/d for women. The difference rate between the measured and estimated dietary sodium intake for all age groups was not more than 10%. Shandong Province, Tianjin City and Hebei Province had the highest sodium intake, which was 5. 98 g/d, 5. 83 g/d and 5. 82 g/d, respectively. Guizhou Province had the lowest sodium intake, with an estimated intake value of 4. 27 g/d. The spatial interpolation method can be used to estimate the intake of sodium, and the accuracy of Regression Kriging Interpolation method is higher than other spatial interpolation method.

Daily dietary sodium intake in elite and amateur basketball and volleyball athletes

Daily dietary sodium intake in elite and amateur basketball and volleyball athletes

Reduced-Sodium Lunches Are Well-Accepted by Uninformed Consumers Over a 3-Week Period and Result in Decreased Daily Dietary Sodium Intakes: A Randomized Controlled Trial

BackgroundProcessed foods are major contributors to excessive sodium intake in Western populations. We investigated the effect of food reformulation on daily dietary sodium intake. ObjectiveTo determine whether uninformed consumers accept reduced-sodium lunches and to determine the effect of consuming reduced-sodium lunches on 24-hour urinary sodium excretion. DesignA single-blind randomized controlled pretest-posttest design with two parallel treatment groups was used. Participants/settingParticipants chose foods in an experimental real-life canteen setting at the Restaurant of the Future in Wageningen, the Netherlands, from May 16 until July 1, 2011. InterventionAfter a run-in period with regular foods for both groups, the intervention group (n=36) consumed foods with 29% to 61% sodium reduction (some were partially flavor compensated). The control group (n=38) continued consuming regular foods. Main outcome measuresOutcomes for assessment of acceptance were the amount of foods consumed, energy and sodium intake, remembered food liking, and intensity of sensory aspects. Influence on daily dietary sodium intake was assessed by 24-hour urinary sodium excretion. Statistical analyses performedBetween and within-subject comparisons were assessed by analysis of covariance. ResultsEnergy intake and amount consumed of each food category per lunch remained similar for both groups. Compared with the control group, the intervention group’s sodium intake per lunch was significantly reduced by –1,093 mg (adjusted difference) (95% CI –1,285 to –901), equivalent to 43 mmol sodium. Remembered food liking, taste intensity, and saltiness were scored similarly for almost all of the reduced-sodium foods compared with the regular foods. After consuming reduced-sodium lunches, compared with the control group, intervention participants’ 24-hour urinary sodium excretion was significantly lower by –40 mEq (adjusted difference) (95% CI –63 to –16) than after consuming regular lunches, and this reflects a decreased daily sodium intake of 1 g. ConclusionsComparing the two treatment groups, consumption of reduced-sodium foods over a 3-week period was well accepted by the uninformed participants in an experimental real-life canteen setting. The reduced-sodium foods did not trigger compensation behavior during the remainder of the day in the intervention group compared with the control group, as reflected by 24-hour urinary sodium excretion. Therefore, offering reduced-sodium foods without explicitly informing consumers of the sodium reduction can contribute to daily sodium intake reduction.

Hypertension prevalence, awareness, treatment, and control and sodium intake in Shandong Province, China: baseline results from Shandong-Ministry of Health Action on Salt Reduction and Hypertension (SMASH), 2011.

IntroductionIn China, population-based blood pressure levels and prevalence of hypertension are increasing. Meanwhile, sodium intake, a major risk factor for hypertension, is high. In 2011, to develop intervention priorities for a salt reduction and hypertension control project in Shandong Province (population 96 million), a cross-sectional survey was conducted to collect information on sodium intake and hypertension prevalence, awareness, treatment, and control.MethodsComplex, multistage sampling methods were used to select a provincial-representative adult sample. Blood pressure was measured and a survey conducted among all participants; condiments were weighed in the household, a 24-hour dietary recall was conducted, and urine was collected. Hypertension was determined by blood pressure measured on a single occasion and self-reported use of antihypertension medications.ResultsOverall, 23.4% (95% confidence interval [CI], 20.9%–26.0%) of adults in Shandong were estimated to have hypertension. Among those classified as having hypertension, approximately one-third (34.5%) reported having hypertension, approximately one-fourth (27.5%) reported taking medications, and one-seventh (14.9%) had their blood pressure controlled (<140/<90 mm Hg). Estimated total average daily dietary sodium intake was 5,745 mg (95% CI, 5,428 mg–6,063 mg). Most dietary sodium (80.8%) came from salt and high-salt condiments added during cooking: a sodium intake of 4,640 mg (95% CI, 4,360 mg–4,920 mg). The average daily urinary sodium excretion was 5,398 mg (95% CI, 5,112 mg–5,683 mg). ConclusionHypertension and excessive sodium intake in adults are major public health problems in Shandong Province, China.

The effect of dietary salt restriction on hypertension in peritoneal dialysis patients.

To investigate the effect of dietary salt restriction on blood pressure levels, total sodium removal, and hydration status of peritoneal dialysis (PD) patients. Thirty-one stable PD patients who consulted a renal dietitian monthly for dietary recommendations, including restricted salt intake <5 g/day, and education about hypertension and hypervolemia were included in this study. Baseline and third month clinical and laboratory findings, bioelectrical impedance analysis results, and urinary and peritoneal sodium removal values were recorded. The mean age of the patients was 47.6 years and the mean time on PD was 39.6 months. The mean total sodium removal decreased slightly from 139.4 ± 69.1 to 136.2 ± 64.8 mmol/day (P > 0.05) for the whole sample, and from 164.3 ± 70.9 to 154.2 ± 72.3 mmol/day (P > 0.05) for the hypertensive subgroup (n: 17). Systolic blood pressure (from 134.3 ± 20.1 to 127.2 ± 19.5 mmHg, P: 0.01), diastolic blood pressure (from 83.2 ± 12.0 to 77.4 ± 10.5 mmHg, P: 0.01) and total body water (from 39.2 ± 10.9 to 38.3 ± 9.3 L, P: 0.04) decreased significantly. We demonstrated that even a little reduction in daily dietary sodium intake caused significant decreases in blood pressure levels and fluid overload.

Abstract 152: Daily Dietary Sodium Intake and Advice on Dietary Sodium among Heart Failure Patients in the Community

Objective: Little is known about the sodium intake of heart failure (HF) patients in the community. We used data from the Measuring Disparities in Chronic Conditions Study to examine the receipt of advice on dietary sodium and its relationship with sodium intake among adults in a large urban county. Method: We recruited adults in King County, WA using a home-address based sample as well as sampling from health facilities using medical record billing codes for key cardiovascular conditions. Survey questions addressed past medical history as well as receipt of advice and behavior related to dietary sodium. Diet history was assessed using the National Cancer Institute Diet History Questionnaire II (DHQ) for intake in the past year. We also compared responses and estimated sodium intake for those who did and did not report a diagnosis of HF. As a sensitivity analysis, we repeated our analysis using the subset of individuals who had a medical record with an ICD9 code for HF in the previous two years. Result: Our results are based on 3357 respondents from the address-based sample and 3477 from the medical record-based sample. The DHQ was completed by 940 and 1291 of these respondents, respectively. HF was reported by 290 respondents (median age 66 years, 57% male, 6.6% black race, 85% from medical record sample, 43% with a DHQ). Among those reporting a diagnosis of HF, 61% (112 of 183) reported being advised to decrease dietary sodium and 37% (67 of 183) reported being told to buy food items labeled as low salt. These rates were 30% (755 of 2515) and 13% (337 of 2515) respectively among individuals without reported HF. Estimated daily dietary sodium intake over the prior year was lower among those with HF completing a DHQ if they reported receiving counseling (mean 2.5 vs 2.8 gm if advised to cut down on salt and 2.3 vs 2.8 gm if advised to buy low salt labeled products). However, these differences were not statistically significant. Only 65% of respondents with HF (183 of 282) said they buy low salt labeled foods and 26% (61 of 290) reported eating processed, fast, or canned food at least 5 times in the prior month. Overall mean estimated daily dietary sodium intake over the prior year was 2.7 gm for respondents both with and without HF. Results were similar for those with an ICD9 code for HF. Conclusion: Our findings revealed that a large percentage of HF patients report no receipt of medical advice to reduce dietary sodium or purchase foods labeled as low salt. Moreover, the dietary intake of salt was similar for HF patients and the general population. These results point to a need for dietary interventions in HF that are both widely adopted and can actually change behavior.

Sodium density and obesity; the Korea National Health and Nutrition Examination Survey 2007–2010

It is unclear whether the amount of sodium consumed and the degree of saltiness of food is associated with obesity. We examined the association between sodium intake and obesity using the concept of sodium density. This study included 5025 children (7-18 years) and 20586 adults (≥ 19 years) who participated in the Korean National Health and Nutrition Examination Survey(KNHANES), 2007-2010. We defined sodium density(mg/g) as the ratio of daily dietary sodium intake (mg/day) and daily food weight consumed (g/day). We examined the association between sodium density and obesity, and abdominal obesity in children and adults. The overall prevalences of obesity and abdominal obesity were 31.4 and 24.5%, respectively, in adults and 4.5 and 6.5%, respectively, in children. The multivariate-adjusted odds ratio (OR) for obesity in adults with the highest quintile of sodium density compared with the lowest quintile was 1.18 (95% confidence interval (CI), 1.04-1.35), and a significant dose-response association (P for trend=0.002) was observed. The OR for abdominal obesity in adults with the highest quintile of sodium density was not statistically significant after adjusting for confounding factors, but showed a significant dose-response association (P for trend=0.043). In children, OR values for obesity and abdominal obesity in the highest quintile of sodium density were 1.78 (95% CI, 1.13-2.80) and 2.13 (95% CI, 1.16-3.91), respectively, and both showed significant dose-response associations (P for trend <0.001). Our results indicate that high sodium intake may be a potential risk factor for weight gain independent of calorie intake.

High-Dose Torasemide is Equivalent to High-Dose Furosemide with Hypertonic Saline in the Treatment of Refractory Congestive Heart Failure

A randomised, double-blind study was performed to evaluate the effects of the combination of high-dose torasemide and hypertonic saline solution (HSS) infusion versus high-dose furosemide (frusemide) and HSS in the treatment of refractory New York Heart Association class IV congestive heart failure (CHF). Eighty-four patients (55 males, 29 females) with refractory CHF, aged 55-84 years, with an ejection fraction <35%, serum creatinine <2 mg/dL, blood urea nitrogen </=60 mg/dL, a reduced urinary volume and a low natriuresis, were randomised to two groups. Group 1 (27 males, 15 females) received an intravenous infusion of furosemide 500mg plus HSS (150mL of 1.4-4.6% sodium chloride) twice daily in 30 minutes. Group 2 (28 males, 14 females) received torasemide 200mg twice daily plus HSS during a period lasting 4-8 days. Physical examination, measurement of bodyweight, blood pressure, heart rate, evaluation of signs of CHF, and serum and urinary parameters were controlled daily during hospitalisation. Chest x-ray, ECG and echocardiogram were obtained at entry, during hospitalisation and at discharge. During the treatment and after discharge the daily dietary sodium intake was 120 mmol, with a fluid intake of 1.0-1.5L in both groups. Bodyweight and 24-hour urinary volume, serum and urinary laboratory parameters, until reaching a compensated state, were controlled daily, when intravenous furosemide and torasemide were replaced with oral furosemide administration only (250-500mg twice daily). After discharge the double-blind design was discontinued and the subsequent period was an open-label study with furosemide only; the patients were followed up as outpatients weekly for the first 3 months and subsequently once a month. Baseline clinical characteristics of patients were similar in both groups. A significant increase in daily diuresis and natriuresis was observed in both groups. No difference was observed in serum sodium or potassium. Bodyweight was reduced in both groups. Blood pressure values decreased, and heart rate was corrected to normal values in both groups. In the follow-up period (12 +/- 3.9 months), 17 patients were re-admitted to the hospital for heart failure. Thirteen patients died during follow-up. We conclude that high-dose torasemide is equivalent to high-dose furosemide in the treatment of refractory CHF.

A Comprehensive Management System for Heart Failure Improves Clinical Outcomes and Reduces Medical Resource Utilization

The effectiveness of heart failure management in clinical practice is limited by physicians' suboptimal utilization of effective medications, patients' poor adherence to dietary sodium limitation and optimal drug therapy, and the lack of systematic monitoring of patients after hospitalization. The present study evaluated the feasibility and safety of MULTIFIT, a physician-supervised, nurse-mediated, home-based system for heart failure management that implements consensus guidelines for pharmacologic and dietary therapy using a nurse manager to enhance dietary and pharmacologic adherence and to monitor clinical status by frequent telephone contact. Fifty-one patients with the clinical diagnosis of heart failure were followed for 138 ± 44 days. Daily dietary sodium intake fell by 38%, from 3,393 to 2,088 mg (p = 0.0001); average daily medication doses increased significantly (lisinopril: 17 to 23 mg, p < 0.001; hydralazine: 140 to 252 mg, p = 0.01). Functional status and exercise capacity improved significantly (p = 0.01). Compared with the 6 months before enrollment and normalized for variable follow-up, the frequency of general medical and cardiology visits declined by 23% and 31%, respectively (both p < 0.03); emergency room visits for heart failure and for all causes declined 67% and 53%, respectively (both p < 0.001). Hospitalization rates for heart failure and for all causes declined 87% and 74%, respectively (p = 0.001), compared with the year before enrollment. The MULTIFIT system enhanced the effectiveness of pharmacologic and dietary therapy for heart failure in clinical practice, improving clinical outcomes and reducing medical resource utilization.

Borderline hypertensive autosomal dominant polycystic kidney disease patients have enhanced production of renal dopamine. Normalization of renal haemodynamics by DOPA infusion

In autosomal dominant polycystic kidney disease (ADPKD) the pathophysiology of hypertension, which is frequently observed before loss of renal function, is not well understood. We investigated intrarenal dopamine, the renin-angiotensin-aldosterone system (RAAS), and plasma endothelin in relation to sodium homeostasis as potential hypertensive factors in this disease. Eight borderline hypertensive ADPKD patients with (near) normal renal function and seven matched healthy control subjects were investigated at three levels of daily dietary sodium intake: 150, 50 and 450 mmol. In the 450-mmol sodium intake period we studied the effects of renally formed dopamine by infusing its precursor DOPA (DOPAi.v., 7 micrograms kg-1 min-1). In the 50-mmol sodium intake period we studied the influence of the RAAS by administering enalaprilate (42 micrograms kg-1), followed by angiotensin II (12 ng kg-1 min-1) intravenously. GFR and ERPF were measured by continuous infusion of inulin and PAH. At all levels of sodium intake sodium balances were equal, but daily urinary excretions of dopamine and DOPA were higher (P < 0.01) in the ADPKD patients than in the controls. Renal vascular resistance, filtration fraction and blood pressure were higher in the ADPKD patients (all P < 0.05) while plasma renin activity was similar. DOPAi.v. normalized renal haemodynamics and increased plasma endothelin in ADPKD patients (all P < 0.05), while stimulation of natriuresis was equal in both groups. Enalaprilate increased plasma endothelin in the ADPKD patients and only partially normalized renal haemodynamics. In borderline hypertensive ADPKD patients: (1) urinary dopamine excretion is increased at all levels of sodium intake, suggesting that this may be needed to maintain sodium balance; (2) stimulation of renal dopamine production is able to normalize renal haemodynamics, making dopamine receptor agonism a potential therapeutic option; (3) the activity of the RAAS is not clearly enhanced; (4) renal vasodilatation increases plasma endothelin levels.

The lack of benefit of modest sodium restriction in the institutionalized elderly.

Modest restriction of sodium intake is commonly prescribed in hypertensive or fluid-retaining states in the elderly. In recent years this intervention is generally adjunctive to pharmacologic therapy. Its utility was tested by comparison of baseline serum urea nitrogen (BUN) and creatinine levels, weight, and mean blood pressure with these determinations six months after the daily dietary sodium intake was changed from 2 g to 4 g in 38 institutionalized elderly persons. No difference was discernible. In elderly persons in institutions, where diuretic therapy is common and the validity of diagnoses is not tested daily, the modest restriction of sodium intake may accomplish little more than reducing the palatability of food.