Difference In Salt Intake Research Articles

Usefulness of Dietary Salt Restriction in Kidney Transplant Recipients: Analysis of Blood Pressure Levels Depending on the Differences in the Levels of Salt Intake

Sodium retention causes post-transplant hypertension, and sodium restriction is recommended in kidney transplantation recipients. We investigated the changes in salt intake and age-specific differences in salt intake over the post-transplant periods and considered what guidance is important for salt reduction tailored to individual recipients. We calculated salt intake for 38 recipients who underwent kidney transplantation from August 2013 to August 2018 using Tanaka's equation and extracted their blood pressure (BP) levels. The rate of achieving the desired level of salt intake (<6 g/d) was 7.9%. The average salt intake was 7.8 ± 1.4 g. Average BP by salt intake was as follows: <6 g/d, 109/71 mm Hg; 6 to <7 g/d, 127/84 mm Hg; 7 to <8 g/d, 124/79 mm Hg, 8 to <9 g/d, 130/73 mm Hg; 9 to <10 g/d, 133/83 mm Hg; and >10g/d, 137/81 mm Hg. Awareness of the need for salt restriction diminishes as time passes after transplantations, leading to increased salt uptake; therefore, regular guidance for keeping salt intake low is necessary for patients to maintain the awareness of salt restriction. The recipients with higher salt intake had higher blood pressure, suggesting the need for managing salt reduction. Dietary counseling showed a short-term efficacy for reducing sodium intake and clinically relevant BP improvement in renal allograft recipients.

Knowledge, Attitudes, and Behavior Towards Salt Intake and Association With 24-hour Urinary Sodium Excretion in an Adult Population Cohort in Uruguay

ObjectivesTo examine the association between knowledge, attitudes and behavior towards salt use and its consumption estimated by urinary sodium excretion in a population adult cohort from Uruguay (Genotype Phenotype and Environment of Hypertension Study - GEFA-HT-UY). MethodsParticipants [n = 243; age 18–89y (min-max); 61.9% women], provided a single 24-hour urine sample validated according to volume and creatinine excretion. A questionnaire describing knowledge, attitudes and behaviors (KAB) was adapted from the WHO/PAHO protocol for population level sodium determination where participants answered on a range of scales. Anthropometric and blood pressure measurements were also taken. Associations between KAB categories and estimated salt intake were examined by general linear models, adjusted for sex, age tertiles and body mass index (BMI) categories. ResultsConsidering all participants, 35.8% were hypertensive (77% on antihypertensive treatment). Systolic/diastolic blood pressure was 125.6 ± 23.4/79.7 ± 9.9 mmHg, with no difference between sexes. Estimated salt intake was 7.8 ± 3.6 g (3116 ± 1433 mg sodium), higher in men (8.9 ± 3.9 g) compared to women (7.3 ± 3.3 g) (P = 0.0013). Salt intake decreased with age tertiles (P = 0.0001), and increased with BMI categories (P = 0.0067). The majority (88.5%) of participants acknowledge that a high salt diet may cause serious health problems, 92.2% were unaware of WHO salt intake recommendation (<5 g/d) and 78.6% had intake over that limit. Only 12.4% considered they consumed “too much salt”. Although 74.7% reported that limiting salt intake was important for their health, only 56% reported taking regular actions to control its intake. No difference in salt intake was found between participants who considered they use salt “too much” (8.5 ± 0.62 g), “the right amount” (7.9 ± 0.28 g), or “too little” (7.6 ± 0.52 g) (P = 0.56). However, those who reported following a healthy diet had 1.4g lower salt intake than those who reported not doing so (P = 0.016). There was no difference in salt intake between those who reported using/not using salt when cooking (P = 0.65), and adding/not adding salt to food at table (P = 0.087). ConclusionsNo associations were found between knowledge, attitudes and behaviors towards salt use and intake. Perceived salt consumption underestimated salt intake. Funding SourcesCSIC, ANII, Uruguay.

Association of Single Nucleotide Polymorphisms in Salt Taste Receptor Genes With Dietary Salt Intake and Blood Pressure Among Iranian Adults Population

ObjectivesSo far, few researches has examined how genetic variation in salt taste receptors affects food intake in Iranian population. Thus, in this study, we aimed to investigate associations of single nucleotide polymorphisms (SNPs) in salt taste receptors genes with dietary salt intake and blood pressure. MethodsThis cross-sectional study was carried out among 116 randomly selected adults aged 18 years and over in Isfahan city, Iran. Subjects with diabetes insipidus, renal insufficiency, a special dietary regimen, fasting or menstruating on the day of sampling, using diuretics and oral contraceptives or pregnant and lactating women as well as participants who had incomplete 24-h urine collection were excluded. A 24-h urine collection and blood pressure measurement were done. Whole blood was collected to extract DNA and measure SNP rs239345 in the ENaC and rs224534, rs4790151 and rs8065080 in the TRPV1 gene. ResultsHomozygous carriers of the T allele for rs239345 were found to consume significantly more sodium (4414.7 ± 1943.8 mg/day) compared to the AA genotype (3887.4 ± 1709.1 mg/day). Further, they also had higher diastolic blood pressure compared to subjects with the AA genotype (81.3 ± 9.7 vs. 75.3 ± 8.3 mmHg). Compared to subjects with the CC genotype, those with homozygous carriers of the T allele for rs8065080 in the TRPV1 had higher sodium intake (3592.6 ± 1645.2 mg/day vs. 4604.2 ± 2013.5 mg/day) and systolic blood pressure (118.1 ± 11.3 mmHg vs. 123.4 ± 11.5 mmHg). No differences were found in dietary sodium intake and blood pressure with the rs224534 and rs4790151 SNPs. ConclusionsThese findings suggest that genetic variation in the ENaC and TRPV1 genes may contribute to inter-individual differences in salt intake and blood pressure. Funding SourcesThe National Institute for Medical Research Development (NIMAD) was funded this study via grant number of 977,549.

Estimation of dietary salt intake in adult residents in Anhui province, 2019

Objective: Based on the data of the baseline survey of hypertension and sodium intake monitoring in Anhui province in 2019, the salt intake in adult residents was estimated. Methods: Multi-stage stratified cluster random sampling was used to select participants aged 18-69 years, questionnaire survey and related measurements were conducted. Salt intake in participants with different characteristics were estimated with complex sample and linearization of Taylor series based on design and the correlation between salt intake and blood pressure, waist circumference and BMI were tested by linear regression. Results: A total of 1 500 participants were included. The overall salt intake was 9.14 g/d, which was 9.84 g/d in men and 8.47 g/d in women (P<0.05). The differences in salt intake across different subgroups were significant (P<0.05). Univariate linear regression analysis showed that salt intake was positively correlated with SBP, DBP, waist circumference and BMI (P<0.05), while multivariate linear regression analysis (adjusted for other factors) only showed a positive correlation between salt intake and BMI (β=0.053,95%CI: 0.028-0.078, P<0.05). Conclusion: The dietary salt intake in adult residents in Anhui was higher than WHO recommendation, suggesting that public health education need to be taken to reduce salt intake.

Frequency of alcohol drinking modifies the association between salt intake and albuminuria: a 1-year observational study.

Albuminuria is an important risk factor for end-stage kidney disease and cardiovascular mortality. This 1-year observational study aimed to assess the effect modification of alcohol drinking on the association between salt intake and albuminuria. Overall, 448 employees at a pharmaceutical company in Japan who underwent annual health checkups in both 2017 and 2018 were evaluated. The main exposure of interest was drinking frequency at their first checkups categorized as rarely, occasionally, and daily. To assess the association between the changes in salt intake and albuminuria, the differences in salt intake estimated from single-spot urine specimens and the urinary albumin-to-creatinine ratio (UACR) between 2017 and 2018 were calculated for each subject. A multivariable-adjusted linear regression model showed a significant association between ∆salt intake and ∆Log UACR (per 1 g/day of ∆salt intake, adjusted ß 0.16 [95% confidence interval 0.14, 0.19]) and an effect modification between drinking frequency and ∆salt intake (P for interaction = 0.088). The association between ∆salt intake and ∆Log UACR was enhanced by drinking frequency in a dose-dependent manner (per 1 g/day of ∆salt intake, adjusted ß 0.13 [0.06, 0.19], 0.16 [0.12, 0.20], and 0.20 [0.13, 0.27] in rare, occasional, and daily drinkers, respectively). In conclusion, the results of the present study indicated that salt-induced albuminuria was enhanced in subjects with higher drinking frequency, suggesting that salt restriction may have a stronger renoprotective effect in subjects with higher drinking frequency.

Mean dietary salt intake in Nepal: A population survey with 24‐hour urine collections

High salt (sodium chloride) intake raises blood pressure and increases the risk of developing hypertension, a major risk factor for cardiovascular disease. Little is known about salt intake in Nepal, and no study has estimated salt consumption from 24-hour urinary sodium excretion. Participants (n=451) were recruited from the Community-Based Management of Non-Communicable Diseases in Nepal(COBIN) cohort in 2018. Salt intake was estimated by analyzing 24-hour urinary sodium excretion. Multivariate linear regression was used to estimate differences in salt intake. The mean (±SD) age and salt intake were 49.6 (±9.8)years and 13.3 (±4.7)g/person/d, respectively. Higher salt intake was significantly associated with male gender (β for female=-2.4; 95% CI: -3.3, -1.4) and younger age (β10years =-1.4; 95% CI: -1.4, -0.5) and higher BMI (β=0.1; 95% CI: 0.0, 0.2). A significant association was also found between increase in systolic blood pressure and higher salt intake (β=0.3; 95% CI: 0.0, 0.7). While 55% reported that they consumed just the right amount of salt, 98% were consuming more than the WHO recommended salt amount (<5g/person/d). Daily salt intake in this population was over twice the limit recommended by the WHO, suggesting a substantial need to reduce salt intake in this population. It also supports the need of global initiatives such as WHO's Global Hearts Initiative SHAKE technical package and Resolves to Save Lives for sodium reduction in low- and middle-income countries like Nepal.

SODIUM AND POTASSIUM INTAKE IN RURAL POPULATION

Objective: Our aim was to determine trends in salt and potassium intake in general rural population during the 7.5 years of follow-up and to analyze differences in results obtained using various equations. Design and method: Out of 1582 subjects (random rural sample) enrolled in ENAH study conducted in 2008–2010, 739 were invited for the second visit in 2015 and 377 subjects with reliable both urine samples (urine creatinine in normal ranges) were included in further analyses s (80m 297w; average age 52 ± 13.5). Blood pressure was measured three times (Omron M6) and mean values were calculated. Fasting blood and first morning (spot) urine samples were collected. Sodium and potassium were determined using Tanaka, Kawasaki and Intersalt equations. Potassium intake was further adjusted for intestinal intake (77%) and renal excretion (92%). Optimal, normal, high normal BP, untreated and treated hypertension (HT) were diagnosed in 20.9%, 15.3%, 12.9%, 19.1% and 31.5%, respectively. Results: There were no differences in basal and follow up values of salt and potassium intake (Tanaka: 10.4 ± 2.4 vs. 10.1 ± 2.3; 2.2 ± 0.6 vs.1.9 0.4, respectively, p>0.05) or Na/K ratio (4.3 ± 0.1 vs, 4.6 0.9). Salt intake > 10 g/day and potassium > 3.5 g/day were detected in 56.5% and 3.2%, respectively. Significant difference in salt intake was observed only between OBP and treated HT. The same trends were found using all equations. However, significant differences in salt and potassium intake were observed using different equations (particularly between genders). Conclusions: High salt and inadequately low potassium intake with poor Na/K ratio were found in rural population with no positive trends in 7.5 years of follow-up. Obtained differences in salt and potassium intake using different equations is important finding underlining that method (equation) used in particular study should be taken into account when comparing results among various studies.

Estimation of Salt Consumption from 24-hour Urine Collection in a Nepalese Population (P18-084-19)

ObjectivesHigh salt (sodium chloride) intake is associated with an increased risk of hypertension, which is a major risk factor for cardiovascular diseases. Current consumption of salt in Nepal is unknown. The objective of this study was to estimate average salt intake in a Nepalese population from 24-hr urine collection in a population-based survey. MethodsParticipants (n = 499) were recruited from the Community-Based Management of Non-Communicable Diseases in Nepal (COBIN) cohort in the peri-urban area of Pokhara municipality from July to December 2018. The modified version of STEPS survey of non-communicable diseases (NCD) risk factors was administered. Salt intake was estimated from a single 24-hr urine collection. Multivariate linear regression was used to estimate differences in salt intake (g) associated with a variety of factors including demographics, lifestyle, health care, and health literacy. ResultsMean (SD) age was 50.0 (9.7) years; mean salt intake was 13.0 (4.8) g/person/d. Male gender, younger age, and higher body mass index were significantly associated with higher salt intake (Table). Although 55% of respondents thought that they consumed just the right amount of salt, 96% were consuming more than the WHO-recommended level of less than 5 g/d. Almost half of the respondents reported that they consumed processed food containing high amounts of salt. In multivariate analyses, systolic blood pressure was 0.4 mmHg (95% CI: 0.05, 0.7) higher per 1-gram increase in salt intake. ConclusionsDaily intake of salt in this Napalese population was over twice the WHO recommended upper limit, indicating a substantial need to reduce salt across the entire population. Community-based interventions for behavior modification through health education and dietary counseling may be effective in this population where salt is added during cooking. Still, interventions targeting the marketing, availability, and labeling of processed foods is also important, as intake of processed foods was also commonplace in Nepal. Funding SourcesPHI through financial support from Centers for Disease Control and Prevention (CDC), USA; Jayanti Memorial Trust (JMT), Nepal; Nepal Development Society (NEDS), Nepal. Supporting Tables, Images and/or Graphs▪

Factors Related to Salt-Reduction Cognizance and Salt Intake in Women Aged 40-59 Years: Characteristics of Guardians of Medical University Students

In our previous study in which we aimed to clarify the factors related to salt intake in women aged 40-59 years, salt intake was found to be not related to salt-reduction cognizance. The aim of this research was to clarify factors related to salt intake in those who were cognizant of the importance of reducing their salt intake. Two hundred and forty-seven female guardians (effective rate, 32.2%) in a medical university, aged 40-59 years old, participated in this study. The participants were divided into three groups according to their salt-reduction cognizance. There was no significant difference in salt intake between the three groups who were salt-reduction cognizant. Intakes of potassium (mg/1,000 kcal), vegetables, and fruits were higher in those who were cognizant of the importance of reducing their salt intake. The frequencies of consuming stewed foods, miso soup, and vinegared and marinated dishes were also higher. Those who were salt-reduction cognizant were knowledgeable about salt consumption, had experienced making low-salt dishes, used low-sodium seasoning, and made light-tasting dishes by regulating ingredients when cooking. However, when it came to eating, there was no difference in the percentage of those who left most of the broth when eating noodle soups and the frequency with which they added seasoning in terms of salt-reduction cognizance. Salt-reduction cognizant women aged 40-59 years made conscious efforts to use less salt at the time of cooking, but made no efforts when eating, even though they were cognizant of the importance of reducing their salt intake.

FIXED DOSE COMBINATION THERAPY IS ASSOCIATED WITH BETTER BLOOD PRESSURE CONTROL AND LOWER ALBUMINURIA IN REAL-LIFE COHORT DURING 7 YEARS OF FOLLOW UP. ENAH – CROATIAN RURAL STUDY

Objective: The aim of this study was to analyze differences in blood pressure (BP) control and albuminuria between subjects treated with fixed dose combination (FCD) and those treated with free components in real-life during the 7 years follow up period. Design and method: Out of 1134 subjects (door-to-door enrollment, participation rate 80%) data on 236 (54 men; 182 women; mena age 63.2 years) treated hypertensives (HT) were analyzed at the end of 7 years of follow-up. At enter 136 of them were already treated HT (group A) and 100 were new-diagnosed HT (group B) who had started with antihypertensive therapy from that moment. Local GP were allowed to tailor antihypertensive therapy during the follow up period. At basal and at the end of follow up BP was measured by physicians who were project collaborators (ESH/ESC guidelines; OmronM6); salt intake (spot urine - Kawasaki equation), eGFR (CKD-Epi) and albumin-to-creatinin ration (ACR mg/g;first morning urine sample) were analyzed in central lab. Pregnant women, terminal ill, bed-ridden patients, those with severe disability, mentally ill or suffering from dementia or at least one limb amputated/immobilized were exclided. Results: At the end of follow up BP controll was achieved in 31.6% and 38% of HT (group A and B, respectively). In both groups, there there were no significnat differences in salt intake, BMI, smoking and the number of used drugs between controlled and uncontrolled subjects (p < 0.05). However, in group A significant increase in FDC prescription was observed ih the controlled vs.uncontrolled subjects (22% vs. 5.5%). BP control was associated with lower ACR in group A (14.9 vs.76.3; p < 0.01) and group B (9.1 vs.24.9; p < 0.05). Conclusions: In this real-life cohort after 7 years of follow-up BP controll was ahived with more drugs but only if used as FDC what was associated with better organoprotection i.e.lower ACR. Overall poor BP control and organoprotection could be improved using more FDC.

Main Sources, Socio-Demographic and Anthropometric Correlates of Salt Intake in Austria.

Excessive salt intake is known to increase blood pressure and cardiovascular risk. Nevertheless, salt intake exceeds the recommendations in most countries. To face this problem, it is important to identify high consumers as well as the main contributors of salt intake. Overall, data of 2018 adults between 18 and 64 years were analysed to determine the main sources, socio-demographic and anthropometric correlates of salt intake. Dietary intake was assessed from 24-h-recalls, information on socio-demographic characteristics was obtained using a questionnaire and anthropometric data were measured. Salt intake was significantly higher in males than in females. There was a significant positive association between salt intake and body mass index. No significant differences in salt intake were observed for other variables including affluence, educational level, smoking status and physical activity. The main contributor to salt intake were condiments including table salt (32.6%), followed by cereals and cereal products (27.0%), meat and meat products (16.1%) and dairy products (14.0%). These results highlight that specific population groups need to be targeted by public health initiatives and that a reduction in salt intake can only be achieved in tandem with the food producers by the reduction of salt in processed foods.

Salt intake and dietary sources of salt on weekdays and weekend days in Australian adults.

To assess if there is a difference in salt intake (24 h urine collection and dietary recall) and dietary sources of salt (Na) on weekdays and weekend days. A cross-sectional study of adults who provided one 24 h urine collection and one telephone-administered 24 h dietary recall. Community-dwelling adults living in the State of Victoria, Australia. Adults (n 598) who participated in a health survey (53·5 % women; mean age 57·1 (95 % CI 56·2, 58·1) years). Mean (95 % CI) salt intake (dietary recall) was 6·8 (6·6, 7·1) g/d and 24 h urinary salt excretion was 8·1 (7·8, 8·3) g/d. Mean dietary and 24 h urinary salt (age-adjusted) were 0·9 (0·1, 1·6) g/d (P=0·024) and 0·8 (0·3, 1·6) g/d (P=0·0017), respectively, higher at weekends compared with weekdays. There was an indication of a greater energy intake at weekends (+0·6 (0·02, 1·2) MJ/d, P=0·06), but no difference in Na density (weekday: 291 (279, 304) mg/MJ; weekend: 304 (281, 327) mg/MJ; P=0·360). Cereals/cereal products and dishes, meat, poultry, milk products and gravy/sauces accounted for 71 % of dietary Na. Mean salt intake (24 h urine collection) was more than 60 % above the recommended level of 5 g salt/d and 8-14 % more salt was consumed at weekends than on weekdays. Substantial reductions in the Na content of staple foods, processed meat, sauces, mixed dishes (e.g. pasta), convenience and takeaway foods are required to achieve a significant consistent reduction in population salt intake throughout the week.

The blood pressure-salt sensitivity paradigm: pathophysiologically sound yet of no practical value.

Sodium plays an important pathophysiological role in blood pressure (BP) values and in the development of hypertension, and epidemiological studies such as the Intersalt Study have shown that the increase in BP occurring with age is determined by salt intake. Recently, a meta-analysis of 13 prospective studies has also shown the close relationship between excess sodium intake and higher risk of stroke and total cardiovascular events. However, the BP response to changing salt intake displayed a marked variability, as first suggested by Kawasaki et al. (The effect of high-sodium and low-sodium intakes on blood pressure and other related variables in human subjects with idiopathic hypertension. Am J Med 1978; 64: 193-198) and later by Weinberger et al. (Definitions and characteristics of sodium sensitivity and blood pressure resistance. Hypertension 1986; 8: II127-II134), who recognized the heterogeneity of the BP response to salt and developed the concept of salt sensitivity. We have a large body of evidence in favour of a major role of metabolic and neuro-hormonal factors in determining BP salt sensitivity in association with the effect of genetic variation. There is evidence that salt sensitivity influences the development of organ damage, even independently-at least in part-of BP levels and the occurrence of hypertension. In addition, several observational studies indicate that salt sensitivity is clearly associated with a higher rate of cardiovascular events and mortality, independently of BP levels and hypertension. A cluster of factors with well-known atherogenic potential such as hyperinsulinaemia, dyslipidaemia and microalbuminuria-all known to be prevalent in salt-sensitive hypertension-might at least partially explain the increased cardiovascular risk observed in salt sensitive individuals. The gold standard for the evaluation of BP salt sensitivity is the BP response to a moderate reduction of salt intake for several weeks; nevertheless, these protocols often suffer of poor patient compliance to dietary instructions. To overcome this problem, short-term tests have been proposed that evaluate either large differences in salt intake for a few days or the response to intravenous administration of saline solution and short-acting diuretics. Recently, the use of ambulatory BP measurement has been proposed for the clinical assessment of BP salt sensitivity. Noteworthy, BP salt sensitivity, in whomever or however assessed, behaves as a continuous variable but salt sensitivity is used as a categorical parameter, with salt-sensitive individuals being defined as those with a difference in BP between low- and high-sodium intake >10%, and salt-resistant subjects those in whom BP does not increase or shows an increase <5% under sodium loading. The general conclusion that can and should be drawn from the above considerations is that the paradigm of salt sensitivity, despite its important pathophysiological meaning, is not helpful, so far, to the practising physician in clinical practice nor is it relevant or useful to the design and implementation of a population-based strategy of salt intake reduction; however, further studies are warranted for an accurate assessment of the salt-sensitivity phenotype in clinical practice. In the absence of a population strategy for salt intake reduction, the aim should be the generation of a 'low sodium environment' allowing for a dietary salt intake tailored on true human requirements and not on deleterious lifestyle habits.

High Iodine and Salt Intakes and Obesity do not Modify the Thyroid Function in Mexican Schoolchildren.

Mexico is considered as a nutritional transition country with a high prevalence of overweight and obesity, and recent studies have reported a high iodine intake in children. Both high iodine intake and obesity have been associated with thyroid dysfunction. Our aim was to assess iodine and salt intake and thyroid function in Mexican schoolchildren with normal weight and obesity. A cross-sectional study was performed during 2012-2013 in schoolchildren from Queretaro, Mexico. Six hundred seventy-eight schoolchildren were evaluated to obtain nutrition status, urinary iodine concentration (UIC) and thyroid volume (TVol). The prevalence of overweight and obesity was 47.3%, the median UIC was 428μg/L and TVol was normal in all schoolchildren; however, obese girls had a higher TVol than normal weight at the age of 8, 10 and 12years. A subsample of schoolchildren was divided in 6-8 and 9-12-year-old groups, in order to compare thyroid function (thyrotropin, free T4, and anti-thyroid antibodies); iodine and salt intake were estimated with 24-h urinary samples. No differences in thyroid function were observed in both age groups. In the 6-8-year-old group, obese schoolchildren had higher iodine intake than normal-weight children (415.5 vs. 269.1μg/day, p < 0.05), but no differences in salt intake. In contrast, in the 9-12-year-old group, obese schoolchildren had higher salt intake than normal-weight children (6.2 vs. 3.8g/day, p < 0.05), but no differences in iodine intake. Dietary patterns could explain the differences between both age groups. Further studies are needed to identify the main sources of iodine intake in Mexican populations.

Agreement between 24-hour salt ingestion and sodium excretion in a controlled environment.

Accurately collected 24-hour urine collections are presumed to be valid for estimating salt intake in individuals. We performed 2 independent ultralong-term salt balance studies lasting 105 (4 men) and 205 (6 men) days in 10 men simulating a flight to Mars. We controlled dietary intake of all constituents for months at salt intakes of 12, 9, and 6 g/d and collected all urine. The subjects' daily menus consisted of 27 279 individual servings, of which 83.0% were completely consumed, 16.5% completely rejected, and 0.5% incompletely consumed. Urinary recovery of dietary salt was 92% of recorded intake, indicating long-term steady-state sodium balance in both studies. Even at fixed salt intake, 24-hour urine collection for sodium excretion (UNaV) showed infradian rhythmicity. We defined a ±25 mmol deviation from the average difference between recorded sodium intake and UNaV as the prediction interval to accurately classify a 3-g difference in salt intake. Because of the biological variability in UNaV, only every other daily urine sample correctly classified a 3-g difference in salt intake (49%). By increasing the observations to 3 consecutive 24-hour collections and sodium intakes, classification accuracy improved to 75%. Collecting seven 24-hour urines and sodium intake samples improved classification accuracy to 92%. We conclude that single 24-hour urine collections at intakes ranging from 6 to 12 g salt per day were not suitable to detect a 3-g difference in individual salt intake. Repeated measurements of 24-hour UNaV improve precision. This knowledge could be relevant to patient care and the conduct of intervention trials.

THE IMPACT OF CONTROLLED FLUID AND SALT INTAKE TRAINING IN PATIENTS UNDERGOING HAEMODIALYSIS.

Serious complications can occur when patients have difficulty in adhering to fluid and salt recommendations. This study was designed as an experimental study with the aims of evaluating the effects of controlled fluid and salt intake training on the intra-dialytic process and on the level of patients' knowledge. The factors that had an impact on the training process were also evaluated. The effectiveness of the planned training was evaluated at 0, 1, 3 and 6 months. There were no significant differences in salt intake exceeding 3 g per day (p > 0.05) between the preliminary and final test, although a statistically significant change was observed at months 1 and 3. The effectiveness of the training decreased by the end of the 3rd month. A statistically significant change was obtained prior to and after the training at months 0, 1, 3 and 6 with respect to the rates of daily fluid intake exceeding 1,500 ml, hypovolaemia, hypervolaemia, awareness of salt-rich food and correct calculation of daily fluid intake by the patients. Also a significant reduction was observed in the volume of oedema after the training. The patients' age, gender, marital status and educational background did not have a significant effect on daily salt intake of more than 3 g, daily fluid intake of more than 1,500 ml, and level of knowledge regarding fluid and salt control. The training was effective at some time points in decreasing salt and fluid intake. This training should be repeated at certain intervals for the behavioural changes to become permanent.

Abstract 326: Salt Intake, Drinking Behavior, And The Body Corporate

Clinical practice and public health advice on salt consumption relies on the generally accepted notion that accurately collected 24-hour urine collections are valid estimates for salt and fluid intake. Reduced salt intake would also reduce thirst and ingestion of sugary drinks accordingly. To test these widely accepted ideas, we performed two independent ultra-long term salt balance studies lasting 105 and 205 days in 10 men simulating a flight to Mars. We fixed dietary intake of all constituents for months at salt intakes of 6, 9, and 12 grams per day and collected all urine. We controlled all environmental factors for rigorous quantitative comparison of urine volume and salt excretion with daily fluid and salt intake. In 1646 collected 24-hour urine samples, our ten subjects recovered 92% of salt they ingested. Due to infradian rhythmical renal salt excretion, only 781 out of 1646 daily urine samples correctly classified a 3 g difference in salt intake (47%). Reducing salt intake from 12 to 6 g reduced 24-hour cortisone excretion (78.3±19.6 vs. 67.2±19.3 μg/d; P&lt;0.001) and increased water intake by 299 ml/d due to reduced glucocorticoid-driven metabolic water production. Even accurately collected 24-hour urine collections at intakes ranging from 6-12 grams salt per day provide no reliable information on individual salt intake. Reducing salt intake leads to reduced glucocorticoid levels decreased metabolic water production and a counterintuitive increase in fluid intake. Traditional views on fluid and electrolyte homeostasis may lead to misinterpretations in clinical practice, public health research, and policy-decision making.

Fatores associados à adição de sal à refeição pronta

The scope of this research was to investigate the potential differences between men and women in the addition of salt to prepared food. The study included 47,557 individuals aged 18 to 64 participating in the Risk and Protection Factors for Chronic Disease Surveillance System by Telephone Interview carried out in 26 Brazilian state capitals and the Federal District in 2006. Differences between men and women were tested by the chi-square test and the association magnitudes between the dependent and independent variables were estimated by the Odds Ratio obtained by Multiple Logistic Regression analysis. The prevalence of the addition of salt to prepared food was 8.3%, being higher among men (9,8% vs 6,9%, p < 0.01). After adjustment, the addition of salt to prepared food was higher in individuals with self-rated fair to poor health, reporting cardiovascular disease and living in the North of Brazil. Hypertensive individuals reported addition of less salt to prepared food. Educational level was not associated with salt usage. Men add more salt than women. Public health policies aimed at reducing salt intake by the population should take into account the gender differences in salt intake and the factors that contribute to such differences.

Estimation of daily salt intake through a 24-hour urine collection in Pohang, Korea.

There is an established relationship between a high salt diet and public health problems, especially hypertension and cardiovascular disease. We estimated daily salt intake in a group of adults and assessed its association with related variables in Pohang, Korea. We conducted a cross-sectional survey in 2013 with 242 adults. Urine was collected for 24 hr to estimate daily salt intake, and questionnaires about salt preference were administered. The mean daily salt intake was 9.9±4.6 g. There was no difference in salt intake between high systolic blood pressure (SBP) participants and normal SBP participants (10.5±4.7 g/d vs. 9.6±4.3 g/d, P=0.339), but high diastolic blood pressure (DBP) participants reported more salt intake than normal DBP participants (10.4±4.9 g/d vs. 9.7±4.1 g/d, P=0.049). Salt intake and body mass index demonstrated a positive correlation (P=0.001). A preference for Korean soup or stew was associated with high salt intake (P=0.038). Dietary salt intake in Korean adults is still higher than the recommendation from the World Health Organization. More efforts should be made to reduce the salt consumption of Korean adults.

Empirically Derived Dietary Patterns and Hypertension

The association between dietary patterns and hypertension or systolic blood pressure/diastolic blood pressure was described in 27 papers identified between January 2008 and December 2011. The majority were cross-sectional studies (with only two cohort studies). Most of the empirically derived dietary pattern studies in the literature have used factor analysis methods based on dietary data from food frequency questionnaires. There are six studies using national representative samples. The majority of the studies did not assess intake of salt. The difference in salt intake by dietary patterns is not known. “Western,” “meat and alcohol,” and “processed meat” dietary patterns are positively associated either categorically with hypertension or continuously with blood pressure in most studies. While a “vegetable”-rich food pattern is inversely related to hypertension in Western countries, the traditional Asian vegetable-rich food pattern seems not to be protective against hypertension in Asian populations. Posterior dietary pattern approaches can provide useful information in developing dietary guidelines. Further research is needed in this field.