Decrease In Salt Intake Research Articles

Salt reduction attempts in workers after specific food service facility guidance provided by a public health center: A case study at a worksite in Kawagoe City, Saitama Prefecture

Objective The Kawagoe City Public Health Center implemented a project to reduce salt intake through specific food service facility guidance in workplace cafeterias. Here, we report the study results.Methods The target worksite was company A, with approximately 270 employees, located in Kawagoe City, Saitama Prefecture. There were 214 participants (approximately 80%). The project was conducted from November 2019 to November 2021. The long-term goal was to decrease the number of hypertensive cases in the city. Project outcomes included decreased salt intake, urinary sodium/potassium ratio, and average blood pressure. The project aimed to improve the cafeteria menu, focusing on salt reduction by offering Smart Meals® and reducing the salt equivalents in all menus. The project output indicators included reduced amount of salt in cafeteria menu items, increased frequency of cafeteria use, increased positive evaluations of the cafeteria, and increased daily awareness of the need for salt reduction. Spot urine samples, blood pressure measurements, and self-administered questionnaire data were collected during annual physical examinations. The amount of salt in the cafeteria menu was evaluated by receiving monthly data from the food service company to which company A outsourced its cafeteria operations.Results The analysis included 102 individuals with complete data from to 2019-2021. Estimated salt intake (g/day) from spot urine decreased from 10.3±2.1 in 2019 to 9.8±2.4 in 2020 and 9.5±2.0 in 2021 (P=0.003). Systolic blood pressure (mmHg) decreased from 114.7±12.5 in 2019 to 111.7±12.1 in 2020 and 110.6±12.0 in 2021 (P=0.010). Compared to 2019, changes in dietary salt equivalents in cafeteria menus in 2020 and 2021decreased for set meals A and B, curries, and noodles (P<0.001).Conclusion We offered Smart Meals® and reduced salt equivalents in all workplace cafeteria menus. After 1-2 years, employees' salt intake and blood pressure levels were lower. These results provide implications for the implementation of food environment improvements in public health centers and other local government agencies to promote the Health Japan 21 (third term) strategy.

Formulation of novel low-sodium salts using potassium salts and dietary polysaccharide

Potassium citrate (KC) and potassium lactate (KL) are considered as salt replacers due to their saltiness, processing advantages, and health benefits. However, the obvious bitter taste associated with these compounds has limited their use in salt substitutes. Despite this challenge, little attention has been paid to improving their sensory properties. This study provided evidence that dietary polysaccharide carrageenan can effectively mask the bitterness of KC and KL by specifically binding K+ and forming double helix chains. A highly accurate prediction model was then established for the saltiness and bitterness of low-sodium salts using mixture design principles. Three low-sodium salt formulas containing different potassium salts (KC, KL, KCl), NaCl, and carrageenan were created based on the prediction model. These formulas exhibited favorable saltiness potencies (>0.85) without any noticeable odor, preserving the sensory characteristics of high-sodium food products like seasoning powder while significantly reducing their sodium content. This research provides a promising approach for the food industry to formulate alternative low-sodium products with substantially reduced sodium content, potentially contributing to decreased salt intake.

Progress in Multisensory Synergistic Salt Reduction.

Excessive salt intake, primarily from sodium chloride prevalent in modern food processing, poses a significant public health risk associated with hypertension, cardiovascular diseases and stroke. Researchers worldwide are exploring approaches to reduce salt consumption without compromising food flavor. One promising method is to enhance salty taste perception using multisensory synergies, leveraging gustatory, olfactory, auditory, visual, tactile and trigeminal senses to decrease salt intake while preserving food taste. This review provides a comprehensive overview of salt usage in foods, mechanisms of salty taste perception and evaluation methods for saltiness. Various strategies for reducing salt consumption while maintaining food flavor are examined, with existing salt reduction methods' advantages and limitations being critically analyzed. A particular emphasis is placed on exploring the mechanisms and potential of multisensory synergy in salt reduction. Taste interactions, olfactory cues, auditory stimulation, visual appearance and tactile sensations in enhancing saltiness perception are discussed, offering insights into developing nutritious, appealing low-sodium foods. Furthermore, challenges in current research are highlighted, and future directions for effective salt reduction strategies to promote public health are proposed. This review aims to establish a scientific foundation for creating healthier, flavorful low-sodium food options that meet consumer preferences and wellness needs.

Does daily self-monitoring of urinary sodium to potassium ratio decrease salt intake?

Does daily self-monitoring of urinary sodium to potassium ratio decrease salt intake?

Croatian Action on Salt and Health (CRASH): On the Road to Success-Less Salt, More Health.

The World Health Organization recommends adjusting salt intake as a part of the nine global targets to reduce premature mortality from non-communicable chronic diseases as a priority and the most cost-effective intervention. In 2006, the main aim of the Croatian Action on Salt and Health was to decrease salt intake by 16% because of its critical intake and consequences on human health. We have organized educative activities to increase awareness on salt harmfulness, define food categories of prime interest, collaborate with industries and determine salt intake (24 h urine sodium excretion). It was determined that the proportion of salt in ready-to-eat baked bread should not exceed 1.4%. In the period 2014-2022, salt in semi-white bread was reduced by 14%, 22% in bakery and 25% in the largest meat industry. Awareness of the harmfulness of salt on health increased from 65.3% in 2008 to 96.9% in 2023 and salt intake was reduced by 15.9-1.8 g/day (22.8% men, 11.7% women). In the last 18 years, a significant decrease in salt intake was achieved in Croatia, awareness of its harmfulness increased, collaboration with the food industry was established and regulatory documents were launched. However, salt intake is still very high, underlying the need for continuation of efforts and even stronger activities.

Integrating Groove Massage in Dietary Management Plans for Mild Hypertension: A Clinical Study

Hypertension is a substantial risk factor for cardiovascular diseases and has conventionally been managed with medication and dietary modifications. This study aimed to investigate the efficacy of incorporating groove massage into dietary management regimens for patients with moderate hypertension. This randomized controlled trial included 110 participants with moderate hypertension. The patients were divided into two groups: an intervention group and a control group, with 55 patients in each group. The primary outcomes assessed during the eight-week duration were differences in body mass index, systolic and diastolic blood pressure, and physical activity levels. After eight weeks, the patients in the intervention group had a substantially lower body mass index (–1.2 kg/m²) than those in the control group (–0.4 kg/m²). Patients in the intervention group had considerably decreased systolic and diastolic blood pressure (–5 and –3 mmHg, respectively) than those in the control group (–2 and –1 mmHg, respectively). Patients in the intervention group had substantially increased physical activity levels (20%) than those in the control group (10%). Patients in the intervention group had considerable improvements in dietary practices, as evidenced by increased consumption of fruits and vegetables and decreased salt intake.

Barriers and Facilitators to Risk Reduction of Cardiovascular Disease in Hypertensive Patients in Nigeria.

In Sub-Saharan Africa (SSA), the prevalence of hypertension is increasing due to many factors like rapid population growth, globalization, stress, and urbanization. We aimed to characterize the perceptions of cardiovascular disease (CVD) risk among individuals with hypertension living in Nigeria and identify barriers and facilitators to optimal hypertension management. This cross-sectional survey study was conducted at a large teaching hospital in Lagos, Nigeria. We used a convenient sample of males and females, aged 18 or older, with a diagnosis of hypertension who presented for outpatient visits in the cardiology, nephrology, or family medicine clinics between November 1 and 30, 2020. A semiquantitative approach was utilized with a survey consisting of closed and open-ended questionnaires focused on patient knowledge, perceptions of CVD risk, and barriers and facilitators of behavioral modifications to reduce CVD risk. There were 256 subjects, and 62% were female. The mean age was 58.3 years (standard deviation (SD) = 12.6). The mean duration of the hypertension diagnosis was 10.1 years. Most participants were quite knowledgeable about hypertension; however, we observed some knowledge gaps, including a belief that too much "worrying or overthinking" was a major cause of hypertension and that an absence of symptoms indicated that hypertension was under control. Barriers to hypertension management include age, discomfort or pain, and lack of time as barriers to exercise. Tasteless meals and having to cook for multiple household members were barriers to decreasing salt intake. Cost and difficulty obtaining medications were barriers to medication adherence. Primary facilitators were family support or encouragement and incorporating lifestyle modifications into daily routines. We identified knowledge gaps about hypertension and CVD among our study population. These gaps enable opportunities to develop targeted interventions by healthcare providers, healthcare systems, and local governments. Our findings also help in the promotion of community-based interventions that address barriers to hypertension control and promote community and family involvement in hypertension management in these settings.

Role of Dietary Management and Physical Activity in Control of Hypertension in Rural Areas of Punjab-A Cross-sectional Study

Introduction: As reported by WHO, hypertension is the third ‘killer’ disease, accounting for one in every eight deaths worldwide. Many modifiable and non-modifiable risk factors are found to be associated with the disease. The present study aims to determine the role of dietary management and physical activity in the control of hypertension in a given population. Material and Methods: A cross-sectional study was conducted that. Study included all hypertensive patients (290) from the field practice area of a tertiary care institute. A self-constructed, pretested questionnaire was used to enquire about the socio- demographic factors and other risk factors associated with hypertension. The data was analyzed using SPSS 23 and valid conclusions were drawn by using the chi-square test. Results: Out of 290 patients, 204 (70.3%) were females and 86 (29.7%) were males. Univariate analysis identified decreased salt intake, decreased fatty food consumption, physical activity, stress management, and spiritual help as highly significant factors affecting hypertension. On multivariate analysis, physical activity, stress management and spiritual help were found to be significant. Conclusion: The study showed that physical activity, stress management and spiritual help were significantly associated with hypertension control among the elderly. Measures should be taken to create awareness about lifestyle modifications in the control of hypertension.

PS-P14-1: EFFECT OF MONOSODIUM GLUTAMATE ON DIETARY SALT REDUCTION IN FEMALE STUDENTS FROM EAST AND SOUTHEAST ASIA: AN INTERNATIONAL COMPARISON

Objective: High sodium intake is a leading dietary risk factor for mortality, especially in China, Japan, and Thailand. Salt reduction is imperative in East and Southeast Asia. The use of umami (glutamate) can effectively decrease salt intake while maintaining food palatability. However, it is unclear whether different eating habits and lifestyles among various nationalities influence the effect of glutamate. This study compared the effects of monosodium glutamate (MSG) on the saltiness and palatability of low-salt solutions among students from East and Southeast Asia. Design and method: A total of 77 female students, stratified into four groups by nationality (from Japan [N = 28], China [N = 17], South Korea [N = 15], and Southeast Asia [Vietnam, Malaysia, and Thailand, N = 17]), tasted 0.3, 0.6, and 0.9% NaCl solutions with or without 0.3% MSG to evaluate saltiness and palatability. Saltiness and palatability were assessed using a visual analog scale. Then, the participants were asked for their height (cm), weight (kg), length of stay in Japan (for international students only), and degree of sodium intake. We analyzed the within-group and intergroup differences in ratings of saltiness and palatability. Results: Among the 77 participants (mean age of 21.6 years), only the 0.3% NaCl solution with MSG showed significantly higher saltiness and palatability ratings than those without MSG. The 0.6%, and 0.9% NaCl solutions with MSG showed significantly higher palatability ratings than solutions without MSG. The 0.6% NaCl solution with MSG had the highest palatability rating of the six solutions. The saltiness ratings for each NaCl solution with or without MSG differed significantly by their nationality (p &lt; 0.05), except for the 0.9% NaCl solution without MSG. The saltiness rating was lowest in the Southeast Asian group. Participants in the Japan, China, and Southeast Asia groups rated the palatability of 0.3% NaCl solution as significantly higher with MSG than without MSG (all p &lt; 0.05). In this regard, a higher but non-significant trend was noted in the South Korean group (p = 0.074). There was no intergroup difference in palatability in the six solutions (p &gt; 0.05). Conclusions: Adding an appropriate amount of umami ingredients improved the palatability of low-salt solutions, regardless of the difference in salty taste rating by their nationality. It was clarified that the utilization of umami is effective for salt reduction in East and Southeast Asia, where excessive salt intake is a major issue.

Estimation of the Effect of Salt-Intake Reduction on Cardiovascular Mortality Decline between 1950 and 2017 in Japan: A Retrospective Simulation Study.

In Japan, a decrease in cardiovascular mortality has coincided with reduced population salt intake since the 1950s. The purpose of this study was to quantify the effect of reduced population salt intake on the long-term trends of cardiovascular mortality. Using government statistics and epidemiological study results in people of 20–69 years old from 1950 to 2017, including the National Health and Nutrition Survey, we developed a system dynamics model of age-specific cardiovascular mortality and salt intake. We estimated the period and cohort effects on mortality and calibrated the model for the historical mortality rate. We then simulated the counterfactual scenario of no decrease in salt intake to estimate the reduction in cardiovascular deaths associated with decreased mean salt intake. Compared with the base run and calibrated to the actual data, approximately 298,000 and 118,000 excess deaths were observed in men and women, respectively, assuming no change in salt intake over the entire period. The model suggests that the decline in salt intake since the 1950s has contributed to a non-negligible reduction in cardiovascular mortality.

Trends in dietary salt sources in Japanese adults: data from the 2007-2019 National Health and Nutrition Survey.

Identifying trends in dietary salt sources is essential for effectively reducing salt/Na intake. This study aimed to examine the trends in dietary salt sources among Japanese adults using the 2007-2019 National Health and Nutrition Survey data collected from 95581 adults aged ≥ 20 years. Dietary intake was estimated using the 1-d household-based dietary record. Foods reported as potential sources of salt intake in Japan and other countries were categorised into twenty-one groups. Salt intake for each food group was adjusted using the density method based on the energy intake. Trends in dietary salt intake based on food sources by sex and age groups (20-39 years, 40-59 years and ≥ 60 years) were analysed using the Joinpoint Regression Program. Salt intake for each age group in both men and women decreased from 2007 (5·3 g/1000 kcal-6·4 g/1000 kcal) to 2019 (4·9 g/1000 kcal-5·6 g/1000 kcal). The major dietary source of salt continued to be seasonings such as soya sauce and soyabean paste (approximately 70 %). Salt intake from seasonings decreased over time in adults aged ≥ 40 years but did not change in those aged 20-39 years. Additionally, a decreasing salt intake from unprocessed fish and shellfish and an increasing salt intake from unprocessed meat were observed across all age categories for both sexes. This study demonstrated that a strategy targeting different age groups may be needed to reduce salt consumption from seasonings among the Japanese population. Further studies on salt content in seasonings and continued monitoring of trends in dietary salt sources are required.

Modeling the Progression of Hypertensive Kidney Disease in African Americans

Chronic kidney disease (CKD) is associated with the progressive functional loss of nephrons and hypertension (HTN). Several clinical studies demonstrate calcium channel blocker (CCB) therapy mitigates the decline in renal function in humans with essential HTN, but there are few long‐term clinical studies that determine the impact of CCBs in patients with hypertensive CKD. African Americans (AA) have a faster progression to end stage renal disease as compared to the white population which may be partially explained by factors such as salt‐sensitive blood pressure (BP) and greater prevalence of uncontrolled HTN. Observational studies demonstrate BP to be a strong independent risk factor for CKD progression, yet intense BP lowering in AA does not diminish the renal function decline any more than standard therapy. The African American Study of Kidney Disease and Hypertension (AASK) trial suggests AA with proteinuric CKD may have detrimental responses to CCB as compared to an angiotensin converting enzyme (ACE) inhibitor. Therefore, using a large physiological model, we set out to replicate the AASK trial findings and predict the roles of the renin‐angiotensin system, salt intake, and intensive antihypertensive therapy in a virtual population during CCB therapy. Our current mathematical model, HumMod, is a large physiological simulator that is comprised of key systems that play an integral role in BP control such as neural, endocrine, circulatory, and renal systems. All of the parameters (n=335) that control these systems were randomly varied and resulted in over 3,000 unique models that we define as a virtual population. We calibrated this virtual population to patient level data from the AASK trial (BP and glomerular filtration rate [GFR] before and after 3 years of amlodipine). After matching the virtual population to individual level data, the virtual population (n=140) was associated with statistically similar BP and GFR before and after CCB therapy (Figure) as well as similar increases in glomerular damage. Baseline factors such as elevated single nephron GFR and increased tubuloglomerular feedback were correlated with greater declines in renal function and increased glomerulosclerosis after 3 years of CCB. Interestingly, when looking at the models with severe CKD (&lt;35 mL/min), glomerulosclerosis and angiotensin II significantly increased with CCB despite significant falls in mean BP (‐7 ± 7 mmHg). Adding an ACE inhibitor decreased angiotensin II levels and abrogated the increase in glomerulosclerosis while further decreasing BP (‐12 ± 9 mmHg). Decreasing salt intake in addition to the CCB+ACE inhibitor therapy further benefited systemic and glomerular pressures but significantly decreased overall GFR independent of any glomerular damage. Finally, all antihypertensive therapies were associated with significant decreases in left ventricular mass. These data suggest the current clinical markers of renal function such as eGFR may not fully reflect the actual progression of CKD, especially with intensive antihypertensive treatment. Our simulation also supports that angiotensin system inhibitors are renoprotective and cardioprotective when combined with CCB therapy in African American CKD patients.

Abstract 12447: Early-Stage, Community-Based Design Process to Understand User Needs for Hypertension Management mHealth Intervention: The WIRED-L Study

Background: Black Americans and older adults have high rates of hypertension and face unique barriers to managing their blood pressure. Using a community-based participatory design approach, we sought out to understand such barriers and determinants for engaging in a healthy lifestyle to inform the development of a wearables-based mHealth intervention. Methods: As part of the Wearables In Reducing risk and Enhancing Daily Life-style (WIRED-L) study, we performed semi-structured discovery interviews of hypertensive adults in Flint and Ann Arbor, MI that relied on the capability, opportunity and motivation behavior (COM-B) framework focusing on 2 behaviors: 1) increase physical activity and 2) decrease salt intake. A rapid analysis approach was used to analyze interview data. Transcripts were used as artifacts for the subsequent empathy mapping session, attended by academic partners and community participants, to contextualize the discovery interviews. Results were compared across study sites. Results: We conducted 9 discovery interviews (Flint = 4 Black people; Ann Arbor = 3 White and 2 Asian people). Physical capability (i.e. pain and disability) and automatic motivation (i.e. habits and drive) were barriers for physical activity, while psychological capability (i.e. understanding), automatic and reflective motivations (i.e. plans and evaluations) were barriers for healthy eating. From empathy mapping that included 12 stakeholders, the primary insight for the Flint user group was a desire to decrease salt intake, but practical constraints exist (e.g., unhealthy foods are the cheaper option, and price is an important factor in health decisions). In the Ann Arbor user group, participants were comfortable with navigating technology and had environments more conducive for physical activity. Conclusion: User groups faced different challenges to maintaining a healthy lifestyle. To reduce hypertension disparities, our design will focus on the barriers that were more prevalent among the Flint population. Our results suggest reducing racial disparities in hypertension will require addressing all phases of mHealth intervention development.

Intervention to decrease salt intake inadequacy using a control device to monitor and control salt use when cooking at home – iMC SALT preliminary results

Abstract Introduction Excessive salt intake is one of the greatest risks to public health, making urgent to propose measures to reduce its intake and bring great benefits to reduce cardiovascular diseases risk. In the Portuguese population, the main source of salt consumption is the salt that is added during food preparation and cooking meals. Purpose The main aim of this study was to assess whether an intervention using a dosing salt device (Salt Control H) in food preparation and cooking has beneficial effects in salt intake. Methods This was a two-arm randomized controlled trial. A total of 88 workers from a public university (50% female; mean age 47.2±11.4 years), were randomly assigned to a intervention (I; n=42) or a control group (C; n=46). The intervention was delivered by health professionals in an occupational medicine setting, asking participants to use a salt control device that delivers the maximum amount of salt to add in food preparation and cooking, according to the number and age of the persons who will consume the meal, during 8 weeks. Primary outcome was the 24-hour urinary sodium excretion (Na24), validated by creatinine coefficient, and secondary outcome was 24-h urinary sodium-to-potassium ratio (Na/K24). Parametric tests were used to assess differences between urinary data stratified by C or I group and Mann-Whitney to evaluate differences between stratified groups according to meet WHO daily recommendations of intake. Results At baseline, there was no significant differences in mean Na24 (C: 3145.5±1420.1 and I:3268.7±1159.8 mg/d, p=0.096) and Na/K24 (C: 2.0±0.9 and I: 2.1±0.8 mg/d, p=0.792) between the two groups. After 8 weeks intervention, a Na24 and Na/K24 non statistically significant decrease was observed in the I group (to 3094.1±1391 and 2.0±0.8 mg/d), as opposed to the C group (to 3262.5±1527.0 and 2.2±0.9 mg/d). The proportion of participants from I group that present Na&amp;lt;2000 mg/d increased (from 17 to 29%) as the proportion of participants that present Na/K24 &amp;lt;1 (from 0 to 12%) without significant differences from C group (p=0.214 for Na &amp;lt;2000 mg/d and p=0.383 for Na/K24 &amp;lt;1). Conclusion The Salt Control H measurement device showed promising results to increase adherence to daily salt intake recommendations. The device is a useful and practical tool for educating individuals about dietary salt doses to add to meals cooked at home. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Fundação para a Ciência e Tecnologia Figure 1

Factors associated with the salt intake behaviors in women in a high-salt intake setting

PurposeThe high prevalence of hypertension is a significant concern worldwide. A decrease in salt intake is a well-known strategy to control hypertension and reduce the risk of cardiovascular diseases. Little is known about the factors influencing salt intake behaviors in settings such as Iran where consumption of salt is higher than the recommended amount. The purpose of this study was to find out what factors affect three salt intake behaviors among women: adding salt when cooking, adding salt to prepared food at the table and purchasing salty foods.Design/methodology/approachA community-wide cross-sectional survey of 516 women was conducted in Ilam, Iran. Participants were recruited using the cluster random sampling method. The survey included behaviors and variables of an expanded theory of planned behavior. The hypothesized relationships were investigated using structural equation modeling.FindingsPerceived behavioral control (PBC) (p < 0.001) and habit (p = 0.01) appeared to be significant factors of adding salt when cooking. Determinants of adding salt to food at the table were intention (p < 0.001), PBC (p < 0.001), habit (p < 0.001). Also, PBC (p < 0.001), intention (p < 0.001), habit (p < 0.001) were identified as predictors of the purchase of salty foods. The results did not support the moderating role of Hedonic feeling to salt on the relation between intention and behaviors.Originality/valueThis study would be applicable to develop salt reduction interventions. Because altering the hedonic response to food is difficult, the lack of its moderating role could be a promising finding for developing salt reduction interventions.

Strengthening Knowledge to Practice on Effective Salt Reduction Interventions in Low- and Middle-Income Countries.

The objective of this review was to consolidate available published information on the implementation and evaluation of salt reduction interventions in low- and middle-income countries (LMICs). The Science of Salt database (made up of studies identified in a weekly Medline search) was used to retrieve articles related to the implementation of salt reduction interventions from June 2013 to February 2020. Studies that measured the effects of the interventions in LMICs, based on four outcome measures-salt intake; sodium levels in foods; knowledge, attitudes, and behaviours (KABs) towards salt; and blood pressure-were included. Results were summarised overall and according to subgroups of intervention type, duration, sample size, country's income class, and regional classification. The review identified 32 studies, representing 13 upper middle-income and four lower middle-income countries. The main salt reduction interventions were education, food reformulation, and salt substitution; and many interventions were multi-faceted. More studies reported a positive effect of the interventions (decreased salt intake (12/17); lower sodium levels in foods or compliance with agreed targets (6/6); improved KAB (17/19); and decreased blood pressure (10/14)) than a null effect, and no study reported a negative effect of the intervention. However, many studies were of small scale and targeted specific groups, and none was from low-income countries. Consumer education, food reformulation, and salt substitution, either alone or in combination, were effective in their target populations. Supporting scale-up of salt reduction interventions in LMICs is essential to cover broader populations and to increase their public health impact.

Effects of Home-Delivered Meals on Older People’s Protein Intake, Physical Performance, and Health-Related Quality of Life: The Power Meals Randomized Controlled Trial

This trial examined the effectiveness of an 8-week home meal service on protein and other nutrient intake, physical performance (PP) and health related quality of life (HRQoL) among older people living at home (≥65 years; home care clients, caregivers and care recipients). Participants were randomized into three groups; (1) protein-rich meal, snack, and bread (INT1), (2) regular meal (INT2) and (3) control group. Nutrient intake was assessed with 3-day food diaries, PP with Short Physical Performance Battery (SBBP) and HRQoL with 15 dimensional Health-related quality of life instrument. Total of 67 (59.7% women, mean age 78.2 years) participants (n = 22 INT1, n = 24 INT2, n = 21 CG) completed the trial. At baseline, mean protein intake was 0.92 (SD 0.32) g/kg adjusted body weight (aBW)/d. At 8 weeks, protein-rich home meal service in INT1 increased protein intake (+ 0.11 (95%CI −0.01 to 0.21) g/kg aBW/d, 9.4 (95%CI 1.0 to 17.8) g/d) compared to other groups. It also increased calcium intake (+169.9 (95%CI 26 to 314) mg/d) and improved results in Sit-to-Stand Test (-4.8 (95%CI −6.8 to −2.7) sec) in INT1 compared to CG. Both home meal services increased saturated fat intake (INT1; 4.6 (95%CI 1.0–8.2) g/d, INT2;7.8 (95%CI 1.9 to 13.7)g/d) and decreased salt intake (INT1;-2330.9 (95%CI −2998 to -1664) mg/d, INT2; −2371.9 (95%CI −3399 to -1345) mg/d) compared to CG. There was no effect on overall HRQoL.

The Effects of Long-Term Nutrition Counseling According to the Behavioral Modification Stages in Patients with Cardiovascular Disease.

Background: the behavioral modification stages (BMS) are widely used; however, there are no reports on long-term nutrition counseling for cardiovascular disease (CVD) according to BMS. Aim: to study the effects of long-term nutrition counseling based on the BMS in patients with CVD. Methods: fifteen patients with CVD who participated in nutrition counseling were enrolled between June 2012 and December 2016. We provided BMS and dietary questionnaires to estimate the stage score (SS), salt intake, and drinking habits (non-drinking group (n = 7)/drinking group (n = 8)), and measured the blood pressure (BP), body mass index (BMI), and biochemical markers before and after hospitalization at 6 months, 1 year, and 1.5 years after leaving the outpatient department (OPD). Results: a significant decreased salt intake and increase in SS were found at 1.5 years. It significantly decreased the BP and salt intake in the non-drinking group at 1.5 years. Conclusions: long-term nutrition counseling according to BMS improved salt intake and BP in the non-drinking group. However, in the drinking group, increased salt intake might weaken the BP improvement. Temperance and low-sodium intake are essential factors that control BP, especially in drinkers.

Modification of Dietary Habits for Prevention of Gout in Japanese People: Gout and Micronutrient Intake or Alcohol Consumption

In Japan, most of gout patients are adults, and the prevalence of gout has increased markedly since the 1960s. This phenomenon is thought to be attributed to the westernization of the Japanese diet since 1955. Monitoring the intake of nutrients and foods in Japanese people is essential in the prevention of gout. The objective of this article is to propose a preventive method for gout through the evaluation of recent dietary habits in Japanese people. In this article, the author suggests the importance of micronutrient (vitamin and mineral) intake and alcohol consumption for prevention of gout in Japanese people referencing the results of clinical research reported. The author used the data of the Comprehensive Survey of Living Conditions in Japan for the number of gout patients (1986-2016) and the data of the National Health and Nutrition Survey in Japan (1946-2017) for the intake of micronutrients. The relationship between the number of gout patients and micronutrient intake in Japanese people was examined. Modification of micronutrient intake for the prevention of gout in Japanese people (especially adults) is suggested as follows: limiting or decreasing salt intake; increase intake of vitamin A, vitamin B₁, vitamin B₂, vitamin B₆, calcium, potassium, magnesium, and zinc; and limiting alcohol consumption.

Study of Epidemiological Factors Affecting Patients of Hypertension Attending Urban Health Training Centre of Community Medicine of Tertiary Care Hospital, Maharashtra

Introduction -Hypertension is a chronic condition causing coronary heart disease, stroke and other vascularcomplications. Aim and objective- To study epidemiological factors affecting patients of hypertensionattending urban health training centre of community medicine department of tertiary care hospital,Maharashtra. Material and Methods- The study was a hospital based observational descriptive studycarried out in urban health training centre of community medicine department of tertiary care hospital fromApril 2016 to September 2016 including all known cases of hypertension which was around 450. Result-Maximum cases were from age group 40-59 years (53.71 %) and 40.77 % were males and 59.23 % werefemales.Whereas 43 % and 14 % of study subjects were having BMI of 25-29.9 and ? 30 respectively, 35% were having family history of hypertension, 72% were having salt intake of > 5 gram, 67% were havingmixed diet, 55 % men were having waist-hip ratio > 0.9 and 67% women were having waist-hip ratio >0.8,45 % of total male subjects and 08 % female subjects were having habit of alcohol intake. Whereas 42 %of total male subjects and 28 % of female subjects were having habit of tobacco intake. Conclusion- Forthe control of hypertension decreased salt intake, physical activity, cessation of habits such as alcohol andtobacco intake and early detection and treatment are need of the hour.