High Potassium Intake Research Articles

Nutrition Concerns of Insufficient and Excessive Intake of Dietary Minerals in Lactating Women: A Cross-Sectional Survey in Three Cities of China.

ObjectiveObjectives of this study were 1) to investigate the mineral intake by Chinese lactating women, 2) to explore the dietary source of minerals, and 3) the ratios between different dietary minerals.MethodsA total of 468 lactating women in 5–240 days post-partum participated in this study. Food intakes by participants were measured using one time of 24-hour dietary recall, and minerals from food were calculated based on the Chinese Food Composition Table, second edition.ResultsIn post-partum, women had inadequate food intake. 81.0% of women’s daily intake of dairy products was lower than 300g, and 97.1% of women’s daily intake of salt over 6g. For mineral intake, there were 81.8%, 59.0%, 47.6%, 45.7% and 66.8% of women’s calcium, magnesium, iron, zinc and selenium intake lower than the estimated average requirement, respectively, and 91.7% of women’s excessive intake of sodium. The calcium/phosphorus and sodium/potassium ratios were 0.41±0.26/1 and 3.13±2.89/1, respectively. Considering the dietary sources of minerals, 27.3%, 25.3% and 30.1% of iron, zinc and calcium were from animal-based food, respectively, and 60.3%, 66.1% and 58.0% of iron, zinc and calcium were from plant-based food, respectively. The phosphorus-protein ratio was 0.014±0.003/1. Lactation stage was associated with nutrient intake. Women within 30 days post-partum and the ones who live in Guangzhou had a significantly lower intake of certain minerals, while women with a high education experience had a high intake of calcium, potassium, iron and zinc. Productive age, whether obese or not, and delivery ways were not associated with mineral intakes (P all >0.05).ConclusionChinese women in three studied cities had an inappropriate food intake and resulted in both insufficient and excessive intakes of certain minerals.

Balancing Sodium and Potassium: Estimates of Intake in a New Zealand Adult Population Sample.

Dietary intakes of sodium and potassium are important determinants of blood pressure. We assessed sodium and potassium intake in a cross-sectional survey which included a random sample of New Zealand Adults aged 18 to 64 years from two New Zealand cities: Dunedin and Wellington. Participants completed a short questionnaire, had height, weight and blood pressure measured, and collected a 24 h urine sample. Mean 24 h sodium excretion was 3386 mg/day (95% CI 3221, 3551): 3865 mg/day for men and for 2934 mg/day women. Mean 24 h potassium excretion was 2738 mg/day (95% CI 2623, 2855): 3031 mg/day for men and 2436 mg/day for women. Mean sodium:potassium ratio was 1.32 (95% CI 1.26, 1.39); 1.39 for men and 1.26 for women. Sodium intake was higher among younger people, men, those with a higher BMI and higher potassium excretion. Potassium excretion was higher among older people, men and those with a higher sodium excretion. New Zealand adults have high sodium intakes and low potassium intakes compared to recommended levels. This is likely to adversely affect population blood pressure levels as well as incidence of cardiovascular disease. A comprehensive public health programme to reduce dietary sodium intake and increase intake of fruit and vegetables is warranted.

Salt Loading on QT Dispersion and the Protective Role of Potassium Supplement in Normotensive Adults

QT interval dispersion (QTd) has been suggested to reflect the heterogeneity of myocardial repolarization and widely used in hypertension, coronary heart disease, arrhythmia, evaluation of a drug and so on. The aim of this study was to investigate the effects of dietary sodium intake on QTd and T peak -T end interval (Tp-Te) in normotensive healthy adults and the protective effect of dietary potassium. Sixty-four normotensive subjects aged 20~60 were selected and involved in a 3-week test in chronic salt loading and potassium supplementation, including baseline survey (baseline phase) for 3 d, low-salt diet (3g/day, NaCl, low-salt phase), high-salt diet (18g/day, salt loading phase) and high-salt with potassium supplementation diet (4.5g/day, KCl, salt and potassium supplement phase) each for 7 d. Blood pressure was measured and ECG was recorded at the last day of each phase, QT interval, QTd, corrected QTd (QTcd) and Tp-Te were measured and calculated. QTd, QTcd and Tp-Te at low-salt phase were less than those at baseline phase (QTd, 45.6±7.6ms vs. 52.1±9.4ms; QTcd, 53.4±8.4ms vs. 62.9±10.1ms; Tp-Te, 75.2±8.2ms vs. 85.0±9.6ms, P±0.05); QTcd and Tp-Te after salt loading were greater than those at low-salt phase (QTcd, 62.3±7.9ms vs. 53.4±8.4ms; Tp-Te, 84.7±10.0ms vs. 75.2±8.2ms, P<0.05); compared with those at salt loading phase, QTd, QTcd and Tp-Te were all reduced by large doses of oral potassium supplementation(QTd, 42.6±8.3ms vs. 53.4±9.1ms; QTcd, 52.2±6.2ms vs. 62.3±7.9ms; Tp-Te, 75.1± 8.5ms vs. 84.7±10.0ms, P±0.05). Salt loading increases blood pressure and prolongs QTd, QTcd and Tp-Te, while potassium supplementation reduces the influences of high salt on QTd, QTcd and Tp-Te, suggesting that high potassium intake may decrease the heterogeneity of cardiac repolarization and prevent arrhythmia by shortening repolarization time.

RETRACTED: Urinary sodium or potassium excretion and blood pressure in adults of Shandong province, China: preliminary results of the SMASH project

The aim of the study was to estimate the urinary electrolyte excretion and assess the relationship between dietary sodium or potassium intake and blood pressure within a population of 18-69 adults in Shandong province, China. Random samples of 2184 adults enrolled in the Shandong and Ministry of Health Action on Salt reduction and Hypertension project were collected from 20 countries or districts. Electrolyte intake was estimated by 24-hour urine collections, and urinary volume or creatinine was measured to estimate the accuracy of the collection. Anthropometry was measured with standard procedures. Regression analysis was used to assess the relationship between electrolyte excretion and blood pressure. The mean sodium excretion was 241.8 ± 7.9 mmol among men and 222.3 ± 7.9 mmol among women, respectively. The 24-hour average potassium excretion was 39.9 ± 0.9 and 41.8 ± 1.1 mmol, respectively. Some resident and geographic differences were found for 24-hour urinary electrolyte. Regression analysis showed increments of 1.15 mm Hg in systolic blood pressure and 0.67 mm Hg in diastolic blood pressure per gram increment in urinary sodium excretion. For each increment of 1-g potassium excretion per day, there was a decrement of 0.81 mm Hg in systolic blood pressure and 0.76 mm Hg in diastolic blood pressure. The highest blood pressure was observed in the group with lowest potassium and the highest sodium excretion, which was 13.6 mm Hg in systolic blood pressure and 7.3 mm Hg in diastolic blood pressure difference from group with highest potassium excretion and lowest sodium excretion (P < .0001 for interaction). The Shandong and Ministry of Health Action on Salt reduction and Hypertension project results show a substantially higher sodium excretion and a lower potassium excretion than recommended in Shandong adults. The sodium or potassium intake is positively association with blood pressure. These results support the recommended approaches to lower the risk of hypertension, including lower sodium intake, higher potassium intake, and prevention and control of obesity.

Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group.

Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group.

Intakes of magnesium, potassium, and calcium and the risk of stroke among men.

Intakes of magnesium, potassium, and calcium have been inversely associated with the incidence of hypertension, a known risk factor for stroke. However, only a few studies have examined intakes of these cations in relation to risk of stroke. The aim of this study was to investigate whether high intake of magnesium, potassium, and calcium is associated with reduced stroke risk among men. We prospectively examined the associations between intakes of magnesium, potassium, and calcium from diet and supplements, and the risk of incident stroke among 42 669 men in the Health Professionals Follow-up Study, aged 40 to 75 years and free of diagnosed cardiovascular disease and cancer at baseline in 1986. We calculated the hazard ratio of total, ischemic, and haemorrhagic strokes by quintiles of each cation intake, and of a combined dietary score of all three cations, using multivariate Cox proportional hazard models. During 24 years of follow-up, 1547 total stroke events were documented. In multivariate analyses, the relative risks and 95% confidence intervals of total stroke for men in the highest vs. lowest quintile were 0·87 (95% confidence interval, 0·74-1·02; P, trend = 0·04) for dietary magnesium, 0·89 (95% confidence interval, 0·76-1·05; P, trend = 0·10) for dietary potassium, and 0·89 (95% confidence interval, 0·75-1·04; P, trend = 0·25) for dietary calcium intake. The relative risk of total stroke for men in the highest vs. lowest quintile was 0·74 (95% confidence interval, 0·59-0·93; P, trend = 0·003) for supplemental magnesium, 0·66 (95% confidence interval, 0·50-0·86; P, trend = 0·002) for supplemental potassium, and 1·01 (95% confidence interval, 0·84-1·20; P, trend = 0·83) for supplemental calcium intake. For total intake (dietary and supplemental), the relative risk of total stroke for men in the highest vs. lowest quintile was 0·83 (95% confidence interval, 0·70-0·99; P, trend = 0·04) for magnesium, 0·88 (95% confidence interval, 0·75-4; P, trend = 6) for potassium, and 3 (95% confidence interval, 79-09; P, trend = 84) for calcium. Men in the highest quintile for a combined dietary score of all three cations had a multivariate relative risk of 0·79 (95% confidence interval, 0·67-0·92; P, trend = 0·008) for total stroke, compared with those in the lowest. A diet rich in magnesium, potassium, and calcium may contribute to reduced risk of stroke among men. Because of significant collinearity, the independent contribution of each cation is difficult to define.

PP.29.06

Objective: Reducing sodium intake and increasing potassium intake are established essential measures for the prevention of cardiovascular diseases and hypertension. Sodium intake in East Asian populations is still higher in the world. However, there were few reports on the characteristics of individuals with high sodium intake or low potassium intake. The aim of this study is to investigate factors related to urinary sodium and potassium excretion in a representative Japanese population from the National Health and Nutrition Survey. Design and method: This is a cross-sectional study of 2,761 men and women (1,179 men and 1,582 women, aged 20 and older) (the NIPPON DATA2010), who participated in the National Health and Nutrition Survey of Japan conducted in 2010 by the Ministry of Health, Labour and Welfare. They participated from 300 randomly selected districts from all-over Japan. Estimated 24-hour urinary sodium (Na) and potassium (K) excretion was calculated using Tanaka's formula (Tanaka T. et al. J Hum Hypertens. 2002; 16: 97–103) from casual urinary mineral concentration. In order to investigate the association of factors with urinary Na, K and casual urine Na/K ratio, multiple linear regression analysis was performed. Results: Means of estimated 24-hour urine mineral excretions were; Na 176 mmol/day and 172 mmol/day, K 42 mmol/day and 41 mmol/day, and Na/K ratio 3.62 and 3.66 (geometric mean) for men and women, respectively. In men, current smoking was positively associated with urinary Na excretion (ß = 7.121, p = 0.018) and log-transformed Na/K ratio (ß = 0.189, p < 0.001) while it was inversely associated with urinary K excretion (ß = -1.412, p = 0.021) after adjusting for confounding factors. In both men and women, high education status was positively associated with urinary K excretion (men; ß = 2.242, p = 0.001, women; ß = 1.651, p = 0.009) and inversely associated with log-transformed Na/K ratio, (men; ß = -0.136, p = 0.005, women; ß = -0.175, p < 0.001) after adjusting for confounding factors. Conclusions: Non smoking and high education status was independently associated with lower sodium and higher potassium intake estimated using casual urine in general Japanese men and women.

Is Nutrient Adequacy Linked to Physical Activity Level in Healthy Young Adults?

Both physical activity (PA) and diet are important contributors to health and well-being but there is limited information on the interaction of these behaviors and whether the association differs by weight category. PURPOSE: To evaluate the association between physical activity (PA) and dietary intake in young, normal weight and overweight/obese adults. METHODS: The cross-sectional analysis includes 412 adults (27.6±3.8 years, 48% male) with valid dietary and PA data. Height (cm) and weight (kg) were measured with participants in surgical scrubs and bare feet. BMI was calculated (kg/m2) and used to differentiate between normal weight (BMI<25) and overweight/obese (BMI≥25). Multiple 24-hr dietary recalls (24HR) were administered over a period of 14 days and nutrient intake was calculated as the average of at least two 24HR. Total daily energy expenditure (TDEE) was assessed over a period of 10 days with the BodyMedia armband during the time period diet recalls were administered. Resting metabolic rate (RMR) was measured via indirect calorimetry after a 12 hour overnight fast and at least 24 hours abstention from exercise. Physical activity level (PAL=TDEE/RMR) was calculated and used to stratify groups (PAL 1<1.60, 1.6≤PAL 2<1.9, PAL 3≥1.9). RESULTS: A majority of participants (>60%) met macronutrient recommendations (% of calories/day). Conformance with micronutrient recommendations varied between 3% and 99%. Macronutrient intake did not differ between activity groups but a higher PAL was associated with higher fiber intake. In normal weight participants, higher PAL was associated with the higher intakes of minerals (except calcium, iron, and zinc), thiamin, riboflavin, niacin, vitamin B12, and choline (p for trend <0.05). In the overweight/obese group, higher PAL was associated with the higher intakes of potassium, sodium, copper, and niacin (p for trend <0.05). CONCLUSIONS: Higher PA is associated with increased fiber and micronutrient intake in normal weight and overweight/obese young adults. An active lifestyle, therefore, may provide additional benefits beyond those directly attributed to PA.

Longitudinal effects of dietary sodium and potassium on blood pressure in adolescent girls.

Identification of risk factors early in life for the development of high blood pressure is critical to the prevention of cardiovascular disease. To study prospectively the effect of dietary sodium, potassium, and the potassium to sodium ratio on adolescent blood pressure. The National Heart, Lung, and Blood Institute's Growth and Health Study is a prospective cohort study with sites in Richmond, California; Cincinnati, Ohio; and Washington, DC. Participants included 2185 black and white girls initially aged 9 to 10 years with complete data for early-adolescent to midadolescent diet and blood pressure who were followed up for 10 years. The first examination visits were from March 1987 through February 1988 and follow-up continued until February 1999. Longitudinal mixed models and analysis of covariance models were used to assess the effect of dietary sodium, potassium, and the potassium to sodium ratio on systolic and diastolic blood pressures throughout adolescence and after 10 years of follow-up, adjusting for race, height, activity, television/video time, energy intake, and other dietary factors. Mean dietary sodium and potassium intakes and the mean potassium to sodium ratio in individuals aged 9 to 17 years. To eliminate potential confounding by energy intake, energy-adjusted sodium and potassium residuals were estimated. Mean systolic and diastolic blood pressures throughout adolescence and at the end of follow-up (individuals aged 17-21 years). Sodium intakes were classified as less than 2500 mg/d (19.4% of participants), 2500 mg/d to less than 3000 mg/d (29.5%), 3000 mg/d to less than 4000 mg/d (41.4%), and 4000 mg/d or more (9.7%). Potassium intakes ranged from less than 1800 mg/d (36.0% of participants) to 1800 mg/d to less than 2100 mg/d (26.2%), 2100 mg/d to less than 2400 mg/d (18.8%), and 2400 mg/d or more (19.0%). There was no evidence that higher sodium intakes (3000 to <4000 mg/d and ≥4000 mg/d vs <2500 mg/d) had an adverse effect on adolescent blood pressure and longitudinal mixed models showed that those consuming 3500 mg/d or more had generally lower diastolic blood pressures compared with individuals consuming less than 2500 mg/d (P = .18). However, higher potassium intakes were inversely associated with blood pressure change throughout adolescence (P < .001 for systolic and diastolic) and at the end of follow-up (P = .02 and P = .05 for systolic and diastolic, respectively). While the potassium to sodium ratio was also inversely associated with systolic blood pressure (P = .04), these effects were generally weaker compared with effects for potassium alone. In this study of adolescent girls, consumption of 3500 mg/d of sodium or more had no adverse effect on blood pressure. The beneficial effects of dietary potassium on both systolic and diastolic blood pressures suggest that consuming more potassium-rich foods during childhood may help suppress the adolescent increase in blood pressure.

High sodium and low potassium intake among Italian children: relationship with age, body mass and blood pressure.

BackgroundHypertension is the leading cause of death in developed countries and reduction of salt intake is recommended as a key preventive measure.ObjectiveTo assess the dietary sodium and potassium intakes in a national sample of Italian children and adolescents and to examine their relationships with BMI and blood pressure (BP) in the framework of the MINISAL survey, a program supported by the Italian Ministry of Health.Population and MethodsThe study population included 1424 healthy subjects (766 boys, 658 girls) aged 6-18 years (mean age: 10.1±2.9) who were consecutively recruited in participating National Health Service centers in 10 Italian regions. Electrolyte intake was estimated from 24 hour urine collections tested for completeness by the concomitant measurement of creatinine content. Anthropometric indices and BP were measured with standardized procedures.ResultsThe average estimated sodium intake was 129 mmol (7.4 g of salt) per day among boys and 117 mmol (6.7 g of salt) among girls. Ninety-three percent of the boys and 89% of the girls had a consumption higher than the recommended age-specific standard dietary target. The estimated average daily potassium intakes were 39 mmol (1.53 g) and 36 mmol (1.40 g), respectively, over 96% of the boys and 98% of the girls having a potassium intake lower than the recommended adequate intake. The mean sodium/potassium ratio was similar among boys and girls (3.5 and 3.4, respectively) and over 3-fold greater than the desirable level. Sodium intake was directly related to age, body mass and BP in the whole population.ConclusionsThe Italian pediatric population is characterized by excessive sodium and deficient potassium intake. These data suggest that future campaigns should focus on children and adolescents as a major target in the framework of a population strategy of cardiovascular prevention.

Effect of Salt Intake and Potassium Supplementation on Urinary Renalase and Serum Dopamine Levels in Chinese Adults

Objective: The aim of our study was to assess the effects of altered salt and potassium intake on urinary renalase and serum dopamine levels in humans. Methods: Forty-two subjects (28-65 years of age) were selected from a rural community of northern China. All subjects were sequentially maintained on a low-salt diet for 7 days (3.0 g/day of NaCl), a high-salt diet for an additional 7 days (18.0 g/day of NaCl), and a high-salt diet with potassium supplementation for a final 7 days (18.0 g/day of NaCl + 4.5 g/day of KCl). Results: Urinary renalase excretions were significantly higher during the high-salt diet intervention than during the low-salt diet. During high-potassium intake, urinary renalase excretions were not significantly different from the high-salt diet, whereas they were significantly higher than the low-salt levels. Serum dopamine levels exhibited similar trends across the interventions. Additionally, a significant positive relationship was observed between the urine renalase and serum dopamine among the different dietary interventions. Also, 24-hour urinary sodium excretion positively correlated with urine renalase and serum dopamine in the whole population. Conclusions: The present study indicates that dietary salt intake and potassium supplementation increase urinary renalase and serum dopamine levels in Chinese subjects.

Consumption of kimchi, a salt fermented vegetable, is not associated with hypertension prevalence

BackgroundThe aim of this study was to investigate the association between hypertension and kimchi, a salt-fermented vegetable, intake. MethodsThis study was based on the data from the Korea National Health and Nutrition Examination Survey conducted in 2007, 2008, 2009, 2010, 2011, and 2012. In the final analysis, a total of 20,114 Korean adults (men = 7,815, women = 12,299) was included. Daily energy, nutrient, and kimchi intake were assessed using 24-hour dietary recall. The odds ratios for hypertension, according to groups of quintiles of kimchi consumption by gender, were assessed using logistic regression and multivariable models. ResultsOut of 20,114 participants, 11.3% were newly diagnosed as having hypertension. Although participants with higher consumption of kimchi were more likely to have an older age, higher blood pressure, and a higher BMI, as well as higher consumption of calories and sodium, there was no significant difference in the distribution of prevalence of hypertension across quintiles of kimchi consumption in men and women. In multivariate models by gender, higher consumption of kimchi was not associated with a higher prevalence of hypertension (odds ratio = 0.87; 95% confidence interval = 0.70–1.08 for ≥216.5 g/day vs. <39.2 g/day; p for trend = 0.7532, in men; odds ratio = 1.04; 95% CI = 0.80–1.34 for ≥145.1 g/day vs. < 19.5 g/day; p for trend = 0.2875, in women). ConclusionHigh consumption of kimchi was not associated with an increased prevalence of hypertension in humans. Our results suggested that high potassium intake due to high consumption of kimchi may have helped neutralize the effect of elevated sodium intake on blood pressure levels.

Low sodium and high potassium intake for cardiovascular prevention: evidence revisited with emphasis on challenges in sub-Saharan Africa.

Reduction in dietary salt intake and increase in potassium intake can make a major contribution to the prevention and control of hypertension and consequential cardiovascular disease, especially in sub-Saharan Africa (SSA) where prevalence rates are highest. African populations are going through a westernization of their traditional eating patterns, with a shift towards a US/Western-style diet, which contains an excessive amount of salt. Currently, the mean sodium intake in SSA populations is far above the recommended daily allowance. Besides, potassium intake is low, and, particularly, the supply of fruits and vegetables that are important sources of potassium is insufficient to meet current and growing population needs in SSA countries. Context-relevant strategies are needed for population-wide sodium intake reduction and increase in potassium intake.

Abstract 5060: Dietary sodium, potassium and fluid intake and clear cell renal cell cancer: heterogeneous effects by DNA methylation of genes involved in renal salt homeostasis

Abstract Introduction: Sodium, potassium and fluid play a key role in renal salt homeostasis. We showed that sodium intake is associated with higher renal cell cancer (RCC) risk. Promoter CpG island methylation, leading to silencing of tumor suppressor genes, may also affect RCC carcinogenesis. We investigated whether associations between sodium, potassium and fluid intake and RCC risk differed for RCC subtypes defined by promoter methylation of genes involved in renal salt homeostasis. Methods: The Netherlands Cohort Study (NLCS) with case-cohort design included 120,852 subjects aged 55-69 years. Diet was measured with a food frequency questionnaire. After 20.3 years of follow-up, paraffin-embedded tumor blocks from 454 incident RCC cases were collected, of which 80% had clear cell (cc) histology. Methylation-specific PCR was used to analyze promoter CpG island methylation in tumor DNA. Genes involved in renal salt homeostasis were of interest if exhibiting 1) promoter CpG island methylation in ccRCC cell lines and not in normal kidney tissue in a genome-wide methylation screen (MBD-affinity massive parallel sequencing) and 2) ccRCC-specific down-regulation in public expression data. We identified ARHGDIG, ATP1A1, SCNN1B and SLC8A3 as candidate genes, which were then combined into a methylation sum score and categorized representing no (0 genes methylated), low (1 gene methylated) and high (≥2 genes methylated) methylation. Cox regression analyses were stratified accordingly and included 4,439 subcohort members and 348 ccRCC cases. Results: ARHGDIG, ATP1A1, SCNN1B and SLC8A3 were methylated in 22.7%, 16.4%, 42.2% and 5.5% of ccRCC tumors. High sodium intake increased overall ccRCC risk [HR(95%CI): 1.42(1.06-1.89)] regardless of methylation status (P-heterogeneity = 0.69). High potassium intake was differently associated with ccRCC risk (P-heterogeneity = 0.02); ccRCC risk was lower for tumors without methylation [HR(95%CI): 0.59(0.36-0.98)], but higher for tumors with high methylation [HR(95%CI): 1.50(0.89-2.52)]. For fluid intake, HRs similarly differed across the methylation subtypes, but heterogeneity was not significant (P-heterogeneity = 0.45). Individual gene analyses showed that SCNN1B was most indicative of the heterogeneous effects. Discussion: Our findings indicate for the first time a joint influence of diet and epigenetics to determine ccRCC risk. By investigating specific dietary intakes and DNA methylation in selected genes we provide a biological rational for the role of renal salt homeostasis in the development of ccRCC. In particular, we show that, besides sodium intake, also potassium and fluid intake may be implicated in ccRCC etiology, when the epigenetic environment is considered. Further exploration of the temporal relationship and exact pathological pathway is however warranted. Citation Format: Ivette A. G. Deckers, Piet A. van den Brandt, Manon van Engeland, Patricia M. M. B. Soetekouw, Marcella M. L. L. Baldewijns, András P. Keszei, Leo J. Schouten. Dietary sodium, potassium and fluid intake and clear cell renal cell cancer: heterogeneous effects by DNA methylation of genes involved in renal salt homeostasis. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5060. doi:10.1158/1538-7445.AM2014-5060

Potassium intake and risk of stroke in women with hypertension and nonhypertension in the Women's Health Initiative.

Dietary potassium has been associated with lower risk of stroke, but there are little data on dietary potassium effects on different stroke subtypes or in older women with hypertension and nonhypertension. The study population consisted of 90 137 postmenopausal women aged 50 to 79 at enrollment, free of stroke history at baseline, followed up prospectively for an average of 11 years. Outcome variables were total, ischemic, and hemorrhagic stroke, and all-cause mortality. Incidence was compared across quartiles of dietary potassium intake, and hazard ratios were obtained from Cox proportional hazards models after adjusting for potential confounding variables, and in women with hypertension and nonhypertension separately. Mean dietary potassium intake was 2611 mg/d. Highest quartile of potassium intake was associated with lower incidence of ischemic and hemorrhagic stroke and total mortality. Multivariate analyses comparing highest to lowest quartile of potassium intake indicated a hazard ratio of 0.90 (95% confidence interval, 0.85-0.95) for all-cause mortality, 0.88 (95% confidence interval, 0.79-0.98) for all stroke, and 0.84 (95% confidence interval, 0.74-0.96) for ischemic stroke. The effect on ischemic stroke was more apparent in women with nonhypertension among whom there was a 27% lower risk with hazard ratio of 0.73 (95% confidence interval, 0.60-0.88), interaction P<0.10. There was no association with hemorrhagic stroke. High potassium intake is associated with a lower risk of all stroke and ischemic stroke, as well as all-cause mortality in older women, particularly those who are not hypertensive.

Association of the neighborhood retail food environment with sodium and potassium intake among US adults.

IntroductionHigh sodium intake and low potassium intake, which can contribute to hypertension and risk of cardiovascular disease, may be related to the availability of healthful food in neighborhood stores. Despite evidence linking food environment with diet quality, this relationship has not been evaluated in the United States. The modified retail food environment index (mRFEI) provides a composite measure of the retail food environment and represents the percentage of healthful-food vendors within a 0.5 mile buffer of a census tract.MethodsWe analyzed data from 8,779 participants in the National Health and Nutrition Examination Survey, 2005–2008. By using linear regression, we assessed the relationship between mRFEI and sodium intake, potassium intake, and the sodium–potassium ratio. Models were stratified by region (South and non-South) and included participant and neighborhood characteristics.ResultsIn the non-South region, higher mRFEI scores (indicating a more healthful food environment) were not associated with sodium intake, were positively associated with potassium intake (P [trend] = .005), and were negatively associated with the sodium–potassium ratio (P [trend] = .02); these associations diminished when neighborhood characteristics were included, but remained close to statistical significance for potassium intake (P [trend] = .05) and sodium–potassium ratio (P [trend] = .07). In the South, mRFEI scores were not associated with sodium intake, were negatively associated with potassium intake (P [trend] = < .001), and were positively associated with sodium–potassium ratio (P [trend] = .01). These associations also diminished after controlling for neighborhood characteristics for both potassium intake (P [trend] = .03) and sodium–potassium ratio (P [trend] = .40).ConclusionWe found no association between mRFEI and sodium intake. The association between mRFEI and potassium intake and the sodium–potassium ratio varied by region. National strategies to reduce sodium in the food supply may be most effective to reduce sodium intake. Strategies aimed at the local level should consider regional context and neighborhood characteristics.

1011 High Dietary Potassium Intake As Measured by 24-Hour Urine Collection Is Associated With Lower Risk of Ulcerative Colitis

dl among 84 CD cases (Pdiff=.005) and 20.0 ng/dl among 91 UC cases (Pdiff=.70). Compared to women in the lowest quartile of testosterone the multivariate-adjusted RRs for CD were 0.76 (95% CI, 0.38-1.54) for women in the second quartile; 0.45 (95% CI, 0.20-0.99) for the third quartile; and 0.51 (0.24-1.10) for the highest quartile (Plinear trend = .04). We observed that for every 5 ng/dl increase in testosterone, the risk of CD decreased by 14% (Plinear trend = .03). In contrast, we did not observe any consistent association between prediagnostic testosterone and risk of UC (Plinear trend=.75). We also did not observe any association between plasma levels of SHBG and DHEAS and risk of UC or CD (all Plinear trends > .15). Conclusion: Pre-diagnosis levels of circulating total testosterone are associated with a lower risk of CD but not UC among women. The effect of testosterone in modulating innate immunity may explain this novel finding. In addition, because oral contraceptives decrease levels of endogenous testosterone, our data provides insight into the mechanism by which exogenous hormones may influence risk of CD.

Snacking patterns, diet quality, and cardiovascular risk factors in adults.

BackgroundThe relationship of snacking patterns on nutrient intake and cardiovascular risk factors (CVRF) in adults is unknown. The aim of this study was to examine the associations of snacking patterns with nutrient intake, diet quality, and a selection of CVRF in adults participating in the 2001-2008 National Health and Nutrition Examination Survey.Methods24-hour dietary recalls were used to determine intake and cluster analysis was used to identify the snacking patterns. Height and weight were obtained and the health indices that were evaluated included diastolic and systolic blood pressure, high density lipoprotein-cholesterol, low density lipoprotein cholesterol, triacylglycerides, blood glucose, and insulin.ResultsThe sample was participants (n = 18,988) 19+ years (50% males; 11% African-Americans; 72% white, 12% Hispanic-Americans, and 5% other). Cluster analyses generated 12 distinct snacking patterns, explaining 61% of the variance in snacking. Comparisons of snacking patterns were made to the no snack pattern. It was found that miscellaneous snacks constituted the most common snacking pattern (17%) followed by cakes/cookies/pastries (12%) and sweets (9%). Most snacking patterns were associated with higher energy intakes. Snacking patterns cakes/cookies/pastries, vegetables/legumes, crackers/salty snacks, other grains and whole fruit were associated with lower intakes of saturated fatty acids. Added sugars intakes were higher in the cakes/cookies/pastries, sweets, milk desserts, and soft drinks patterns. Five snack patterns (cakes/cookies/pastries, sweets, vegetable/legumes, milk desserts, soft drinks) were associated with lower sodium intakes. Several snack patterns were associated with higher intakes of potassium, calcium, fiber, vitamin A, and magnesium. Five snacking patterns (miscellaneous snacks; vegetables/legumes; crackers/salty snacks; other grains; and whole fruit) were associated with better diet quality scores. Alcohol was associated with a lower body mass index and milk desserts were associated with a lower waist circumference. No snack patterns were associated with other CVRF studied.ConclusionsOverall, several snacking patterns were associated with better diet quality than those consuming no snacks. Yet, the majority of the snacking patterns were not associated with CVRF. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet along with more nutrient-dense foods to be included in snacks.

TRPV4 function in the distal nephron is regulated by dietary potassium and sodium intake (892.2)

It becomes recognized that Ca2+‐permeable TRPV4 channel is predominantly expressed in the distal nephron and its activity is essential for [Ca2+]i elevations in response to increased tubular flow. Here, we probe whether TRPV4 function in the kidney is regulated by dietary intake of major electrolytes. We found that renal TRPV4 expression was increased by high potassium diet (5% K+) and decreased by dietary potassium restriction (0.003 % K+). Saturation of systemic mineralocorticoid status with DOCA had little effect on TRPV4 protein abundance pointing to an aldosterone‐independent nature of this regulation. Increased TRPV4 expression by high potassium intake was associated with significantly augmented [Ca2+]i responses to elevated flow as was detected using Fura‐2 Ca2+ imaging in freshly isolated split‐opened distal nephrons. Furthermore, dietary sodium load (2% Na+) similarly increased renal TRPV4 expression and enhanced flow‐induced [Ca2+]i responses in distal nephron cells. Interestingly, protein levels of other Ca2+‐permeable channel, TRPC3, also expressed in the distal nephron, were not altered by variations in dietary potassium and sodium intake. We conclude that increased ultrafiltrate delivery to the distal nephron as a result of high potassium and sodium intake elicits respective augmentation of TRPV4 expression and therefore enhanced cellular responses to distal tubular flow.Grant Funding Source: DK095029

Abstract MP78: Relationship Between Casual Urinary Sodium/potassium Ratio And 24-h Urinary Sodium/potassium Ratio: The Intersalt Study

Objective: High dietary sodium (Na) and low dietary potassium (K) intakes are associated with adverse blood pressure levels and excess risks of cardiovascular diseases. The Sodium/potassium (Na/K) ratio is a composite index of Na and K. Recently, we found Na/K ratio of casual urine is useful for estimating 24-h urinary Na/K ratio in healthy Japanese participants. However, this finding has not been validated in different ethnic groups. Our aim was to assess the utility across and within populations of casual (spot) urine specimens to estimate 24-h urinary Na/K ratio using data from the International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT). Methods: The INTERSALT study collected standardized data on casual urinary Na and K concentrations, and also on timed 24-h urinary Na and K excretion for 10,079 men and women ages 20-59 years from 52 population samples in 32 countries. Pearson correlation coefficients and agreement quality analysis (by the Bland-Altman method) were computed for Na/K ratio of casual urine against 24-h urinary Na/K ratio. Results: Overall mean value of Na/K ratio in 24-h urine collections was 3.24. 24-h urinary Na/K ratio and Na/K ratio of casual urine across the 52 population samples were highly correlated: r=0.96 (overall), r=0.96 (men), r=0.95 (women), r=0.94 (ages 20-29), r=0.94 (ages 30-39), r=0.95 (ages 40-49) and r=0.95 (ages 50-59). 24-hour urinary Na/K ratio and Na/K of casual urine across the 10,079 individuals had moderately strong correlations: r=0.69 (overall), r=0.70 (men), r=0.68 (women), r=0.58 (white), r=0.47 (black), r=0.81 (Amerindian), r=0.70 (Asian Indian), r=0.64 (east-Asian), r=0.70 (other ethnicities), r=0.58 (with anti-hypertensive medication use) and r=0.72 (without anti-hypertensive medication use). The bias estimate with the Bland-Altman method, defined as the difference between Na/K of 24-h urine collection and casual urine, was approximately 0.4 across both populations and individuals, independent of age, gender and anti-hypertensive medication use across the 52 population samples. Bias estimates across population samples were 0.39 (overall), 0.42 (men), 0.36 (women), 0.32 (ages 20-29), 0.41 (ages 30-39), 0.37 (ages 40-49) and 0.46 (ages 50-59). Bias estimates for the 10,079 individuals were 0.40 (overall), 0.42 (men), 0.37 (women), 0.33 (white), 0.69 (black), 0.04 (Amerindian), 0.22 (Asian Indian), 0.65 (east-Asian), 0.31 (other ethnicities), 0.45 (with anti-hypertensive medication use) and 0.38 (without anti-hypertensive medication use). Conclusions: These findings indicate that casual urine Na/K ratio is a useful, low-burden, low-cost method alternative to 24-h urine collection for estimation of urinary Na/K ratio across populations of various ethnicities. It is also applicable to individual urinary Na/K ratio.