Moderate Sodium Research Articles

Effect of high dietary sodium on bone turnover markers and urinary calcium excretion in Korean postmenopausal women with low bone mass

High salt intake is a well-recognized risk factor of osteoporosis for its modulating effect on calcium metabolism. To understand the effect of dietary sodium on bone turnover, we evaluated the association between urinary sodium excretion and bone turnover markers in Korean postmenopausal women with low bone mass. A retrospective review of medical records at a single institution identified 537 postmenopausal women who were first diagnosed with osteopenia or osteoporosis between 2008 and 2013. Subjects were stratified by low (<2 g/day, n=77), moderate (2-4.4 g/day, n=354) and high (⩾4.4 g/day, n=106) sodium excretion. A 24-h urine was collected to estimate sodium, calcium and creatinine. Bone turnover markers and calciotropic hormones were measured in serum. Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry. Sodium intake was positively associated with urinary sodium excretion (P=0.006, r=0.29). Bone turnover markers were significantly higher in the moderate-to-high urinary sodium excretion group (⩾2 g/day) than in the low urinary sodium excretion group (<2 g/day); CTX-I (C-telopeptides of type I collagen) was 21.3% higher (P=0.001) and osteocalcin (OC) was 15.7% higher (P=0.004). Calciotropic hormones and BMD were not significantly different across the sodium excretion groups. High urinary sodium excretion (⩾2 g/day) increased bone turnover markers in Korean postmenopausal women, suggesting that excessive sodium intake might accelerate bone turnover.

Dietary sodium restriction: a neglected therapeutic opportunity in chronic kidney disease.

Restriction of dietary sodium is recommended at a population level as well as for groups at high cardiovascular risk, and chronic kidney disease (CKD). This review addresses recent evidence for the protective effect of dietary sodium restriction in CKD patients specifically. Sodium intake in CKD populations is generally high, and often above population average. Recent data demonstrated that moderately lower sodium intake in CKD patients is associated with substantially better long-term outcome of renin-angiotensin-aldosterone system (RAAS)-blockade, in diabetic and nondiabetic CKD, related to better effects of RAAS-blockade on proteinuria, independent of blood pressure. This is in line with better short-term efficacy of RAAS-blockade during moderate sodium restriction in diabetic and nondiabetic CKD. This effect of sodium restriction is likely mediated by its effects on volume status. Sustainable sodium restriction can be achieved by approaches on the basis of behavioral sciences. Moderate restriction of dietary sodium can substantially improve the protective effects of RAAS-blockade in CKD, by specific renal effects apparent from proteinuria reduction. The latter precludes straightforward extrapolation of data from nonrenal populations to CKD. Concerns regarding the adverse effects of a very low sodium intake should not distract from the protective effects of moderate sodium restriction. Prospective studies should assess the efficacy and sustainability of different strategies to target high sodium intake in CKD, along with measures at population level. http://links.lww.com/CONH/A14.

Adherence to a moderate sodium restriction diet in outpatients with cirrhosis and ascites: a real-life cross-sectional study.

A moderate sodium restriction diet should be indicated in patients with cirrhosis and ascites. Nevertheless, there is a lack of specific investigation on its correct application. To evaluate the adherence of patients with cirrhosis and ascites to a moderately low-salt diet and the impact on intake of total calories and serum sodium concentration. A total of 120 outpatients with cirrhosis and ascites were interviewed with a pre-established questionnaire. A quantitative assessment of nutrient and salt intake was performed. A moderately low-salt diet was followed by 37 patients (Group A). Of the 83 patients who did not follow the diet (Group B), 54 thought that they were following it. The mean daily sodium intake was 79.5 ± 5.5 mmol/day (Group A) and 205.9 ± 14.1 mmol/day (Group B), P < 0.0001. The adherence to diet was related to the severity of cirrhosis, and was higher among candidates for liver transplantation and in patients followed through the Care Management Program. Patients of Group A had reduced the mean daily calorie intake by 20% compared with Group B patients (P < 0.0005), while there was no difference on the occurrence of hyponatraemia. This study shows a poor adherence of patients with cirrhosis and ascites to a moderate dietary sodium restriction. Adherence to a diet seems to increase with the worsening of liver disease, probably because of the reduction of alternative therapeutic options. In addition, a deficiency in the educational process can lead the patient to follow a sodium-reduced diet by means of dangerous tools, such as reducing the overall daily food intake.

Reclamation of highly calcareous saline-sodic soil using low quality water and phosphogypsum

The efficiency of two amendments in reclaiming saline sodic soil using moderately saline (EC) and moderate sodium adsorption ratio (SAR) canal water was investigated. Phosphogypsum (PG) and reagent grade calcium chloride were applied to packed sandy loam soil columns and leached with canal water (SAR = 4, and EC = 2.16 dS m−1). Phosphogypsum was mixed with top soil prior to leaching at application rates of 5, 10, 15, 20, 25, 35, 40 Mg ha−1, whereas calcium chloride was dissolved directly in water at equivalent rates of 4.25, 8.5, 12.75, 17.0, 21.25, 29.75, and 34 Mg ha−1, respectively. Both amendments efficiently reduced soil salinity and sodicity. Calcium chloride removed 90 % of the total Na and soluble salts whereas PG removed 79 and 60 %, respectively. Exchangeable sodium percentage was reduced by 90 % in both amendments. Results indicated that during cation exchange reactions most of the sodium was removed when effluent SAR was at maximum. Phosphogypsum has lower total costs than calcium chloride and as an efficient amendment an application of 30 Mg ha−1 and leaching with 4 pore volume (PV) of canal water could be recommended to reclaim the studied soil.

What level of sodium intake worsens renal outcomes?

What level of sodium intake worsens renal outcomes?

Sodium Intake and Renal Outcomes: A Systematic Review

Sodium intake is an important determinant of blood pressure; therefore, reduction of intake may be an attractive population-based target for chronic kidney disease (CKD) prevention. Most guidelines recommend sodium intake of < 2.3 g/day, based on limited evidence. We reviewed the association between sodium intake and renal outcomes. We reviewed cohort studies and clinical trials, which were retrieved by searching electronic databases, that evaluated the association between sodium intake/excretion and measures of renal function, proteinuria, or new need for dialysis. Of 4,337 reviewed citations, seven (n = 8,129) were eligible, including six cohort studies (n = 7,942) and one clinical trial (n = 187). Four studies (n = 1,787) included patients with CKD. All four cohort studies reported that high intake (> 4.6 g/day) was associated with adverse outcomes (vs. moderate/low), while none reported an increased risk with moderate intake (vs. low). Three studies (n = 6,342) included patients without CKD. Two cohort studies (n = 6,155) reported opposing directions of association between low (vs. moderate) sodium intake and renal outcomes, and one clinical trial (n = 187) reported a benefit from low intake (vs. moderate) on proteinuria but an adverse effect on serum creatinine. Available, but limited, evidence supports an association between high sodium intake (> 4.6g/day) and adverse outcomes. However, the association with low intake (vs. moderate) is uncertain, with inconsistent findings from cohort studies. There is urgent need to clarify the long-term efficacy and safety of currently recommended low sodium intake in patients with CKD.

Adherence to a moderate sodium restriction diet in outpatients with cirrhosis and ascites: A real life cross-sectional study

Background: A moderate sodium restriction diet should be indicated in patients with cirrhosis and ascites. Nevertheless, there is a lack of specific investigation on its correct application.

Enhancing lipid production of the marine diatom Chaetoceros gracilis: synergistic interactions of sodium chloride and silicon

Silicon deficiency is a lipid-promoting stress for many oleaginous diatoms. Literature reports suggest that re- duced salinity in seawater, a primary component of which is sodium chloride, may inhibit metabolism of silicon in marine diatoms. We hypothesized that lowering sodium chloride be- low ocean levels may thus be effective in creating silicon stress and enhancing lipid productivity. We examined the interacting effects of silicon supply (0.05, 0.1, 0.2, and 0.8 mM) and sodium chloride concentration (50, 100, and 400 mM) on growth and lipid production in Chaetoceros gracilis. This was done in batch culture to facilitate the application of severe stress. Low levels of either sodium chloride or silicon resulted in at least 50 % increases in lipid content. The synergy of simultaneous, moderate sodium chlo- ride and silicon stress resulted in lipid content up to 73 % of dry mass and lipid productivity of 1.7 g m −2 day −1 ;w ith a daily integrated photosynthetic photon flux of 17.3 mol photons m −2 day −1 , the efficiency of lipid synthesis was thus 0.1 gm ol −1 of photons. Decreased silicon also resulted in a 5 % shift inlipid chain lengthfrom C18toC16fatty acids. We observed a strong sodium chloride/silicon interaction on total and ash-free dry mass densities that arose because low sodium chloride concentrations were inhibitory to growth, but the inhibition was overcome with excessive silicon supply. This observation suggests that low levels of sodium chlo- ride may have affected metabolism of silicon. The findings of this study can be used to enhance lipid production in oleaginous marine diatoms.

Bilan métabolique et prise en charge médicale de la lithiase : une mise au point du CLAFU

This text summarizes the CLAFU first-line screening guidelines for renal stone disease patients. We have focused on the useful information provided by renal stone analysis and also the identification of relevant stone risk factors detected in a 24-hour urine collection. Indeed, evaluation of water, sodium and protein intake may be easily achieved in a current clinical setting and allows a useful pedagogic tool for patients' advices and follow-up: daily diuresis above 2000 mL, calcium intake between 800 mg and 1 g/day, a moderate daily sodium and proteins restricted diet (<9 g and <1.2 g/kg per day respectively). General therapeutical principles are reviewed, including circumstances requiring specialized management.

Hydration status and fluid and sodium balance in elite Canadian junior women’s soccer players in a cool environment

Dehydration can impair mental and on-field performance in soccer athletes; however, there is little data available from the female adolescent player. There is a lack of research investigating fluid and electrolyte losses in cool temperatures. Therefore, the purpose of this study was to investigate the pretraining hydration status, fluid balance, and sweat sodium loss in 34 female Canadian junior elite soccer athletes (mean age ± SD, 15.7 ± 0.7 years) in a cool environment. Data were collected during two 90 min on-field training sessions (9.8 ± 3.3 °C, 63% ± 12% relative humidity). Prepractice urine specific gravity (USG), sweat loss (pre- and post-training body mass), and sweat sodium concentration (regional sweat patch method) were measured at each session. Paired t tests were used to identify significant differences between training sessions and Pearson's product moment correlation analysis was used to assess any relationships between selected variables (p ≤ 0.05). We found that 45% of players presented to practice in a hypohydrated state (USG > 1.020). Mean percent body mass loss was 0.84% ± 0.07% and sweat loss was 0.69 ± 0.54 L. Although available during each training session, fluid intake was low (63.6% of players consumed <250 mL). Mean sweat sodium concentration was 48 ± 12 mmol·L⁻¹. Despite low sweat and moderate sodium losses, players did not drink enough to avoid mild fluid and sodium deficits during training. The findings from this study highlights the individual variations that occur in hydration management in athletes and thus the need for personalized hydration guidelines.

Biosynthetically intriguing chlorinated lipophilic metabolites from geographically distant tropical marine cyanobacteria.

Five new vinylchlorine-containing metabolites, the lipoamides janthielamide A and kimbeamides A-C and the ketide-extended pyranone kimbelactone A, have been isolated from collections of marine cyanobacteria made in Curaçao and Papua New Guinea. Both janthielamide A and kimbeamide A exhibited moderate sodium channel blocking activity in murine Neuro-2a cells. Consistent with this activity, janthielamide A was also found to antagonize veratridine-induced sodium influx in murine cerebrocortical neurons. These lipoamides represent the newest additions to a relatively rare family of marine cyanobacterial-derived lipoamides and a new structural class of compounds exhibiting neuromodulatory activities from marine cyanobacteria.

A moderate-sodium DASH-type diet improves mood in postmenopausal women

ObjectiveWe compared the effect on mood of a moderate sodium Dietary Approaches to Stop Hypertension-type diet, which included lean red meat (vitality diet [VD]), with a healthy diet (HD; decreased fat and increased wholegrain breads and cereal). MethodsIn a randomized, parallel intervention study, postmenopausal women were assigned to the VD or HD for 14 wk. Mood was measured every 2 wk by the Profile of Mood States. Dietary adherence was assessed using 24-h urine collections. Data were analyzed using one-way between-groups multivariate analysis of variance and correlations. ResultsForty-six subjects completed the VD and 49 completed the HD. The two groups showed an improvement in anger, confusion, depression, fatigue, tension, vigor, and the Profile of Mood States global score over the length of the intervention (P < 0.01 for time), but there was a significant diet group by time effect for anger (P < 0.05), such that anger improved more in the VD compared with the HD group. For the two groups combined, urinary sodium excretion was associated with the Profile of Mood States global score, such that a low sodium intake was associated with a better mood (r = 0.267, P < 0.05). In addition, red meat consumption (a component of the VD) was associated with a decrease in depression (r = −0.21, P < 0.05) and an increase in fruit consumption was associated with a decrease in confusion (r = −0.26, P < 0.05). ConclusionIn addition to the health benefits of a moderate-sodium Dietary Approaches to Stop Hypertension diet on blood pressure and bone health, this diet had a positive effect on improving mood in postmenopausal women.

The effect of different dietary sodium levels on blood electrolytes, growth performance and foot pad dermatitis incidence in turkeys

The objective of this study was to determine the effect of different dietary sodium levels on serum macroelement concentrations, growth performance and incidence of foot pad dermatitis (FPD) in female turkeys raised to six weeks of age. The influence of a lowsodium diet (without additional sodium) and diets supplemented with NaCl to increase sodium content by 0.5, 1.0, 1.5, 2.0 and 2.5 g kg–1 was compared. The dietary electrolyte balance (DEB) was high (242-248 mEq kg–1) due to a high potassium content (11.0 g kg–1). Turkeys fed the low-sodium diet were characterized by significantly lower concentrations of chloride (p=0.002) and phosphorus (p<0.001), and significantly higher magnesium levels (p<0.001), compared with the other groups. The lowest dietary inclusion of sodium (0.5 g kg –1 ) contributed to a significant increase in the body weights of turkeys at six weeks of age (p<0.001), and it improved feed conversion efficiency (p<0.001) in comparison with the low-sodium diet. No significant differences in body weight and feed conversion ratio followed experimental treatments with higher dietary NaCl addition. Diets supplemented with different amounts of sodium had no effect on litter moisture content, whereas the incidence of FPD increased significantly following the addition of dietary sodium at 1.0 g kg–1 to 2.5 g kg–1, compared with the low-sodium diet. The results of our study indicate that moderate sodium supplementation (0.5 g kg–1) of a sodium-deficient diet significantly increased the body weights of young

Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial

Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial

The effect of different dietary sodium levels on blood mineral concentrations and tibia mineralization in turkeys

The objective of this study was to determine the effect of different dietary levels of sodium in diets with and without sodium chloride on mineral metabolism, including blood electrolyte levels and tibia mineralization parameters, in young turkeys (to six weeks of age). The influence of diets with a low (L), medium (M) and high (H) sodium content, at 0.34, 1.34 and 2.82 g/kg respectively, was compared. The content of chloride and potassium in turkey diets (1.7 - 5.9 and 11 g/kg, respectively) was above the recommended levels. The sodium-deficient diet L decreased the serum concentrations of sodium, chloride and phosphorus, and it increased the serum levels of calcium and magnesium in turkeys, compared with groups M and H. Relative to group L, different dietary sodium levels in groups M and H contributed to a similar increase in the body weights of birds (1.06 vs. 1.46 and 1.44 kg, p < 0.001) and in the absolute (4.60 vs. 6.83 and 6.62 g, p < 0.001) and relative tibia weight (0.42 vs. 0.46 and 0.46% body weight, p = 0.031). No significant differences were found between groups with respect to the content of ash, calcium and phosphorus in tibia dry matter. Supplemental sodium increased the bone density index (from 50.6 to 68.4 and 66.3 mg/mm in groups L, M and H, respectively, p < 0.001), the maximum bending moment (from 5.27 to 7.40 and 7.33 N/mm, p = 0.002) and the minimum breaking strength of tibia (from 0.136 to 0.191 and 0.189, p = 0.002). In conclusion, our study indicates that the applied dietary treatment with a moderate sodium level (1.34 g/kg) resulted in a rate of bird growth and tibia mineralization similar to those observed with the treatment with much higher Na content (2.82 g/kg).

Cymatherelactone and cymatherols A− C, polycyclic oxylipins from the marine brown alga Cymathere triplicata

An investigation of the oxylipin chemistry of the temperate brown alga Cymathere triplicata led to the isolation of several secondary metabolites, cymatherelactone ( 1) and cymatherols A− C ( 2– 4), the latter as their methyl ester derivatives ( 5– 7), which contained cyclopentyl, cyclopropyl, epoxide and lactone rings. Their structures were elucidated using a combination of spectroscopic techniques and synthetic chemistry. Cymatherelactone ( 1), as well as R- and S-Mosher’s esters of its seco acid, exhibited moderate sodium channel blocking activity.

Sulphur in the metal poor globular cluster NGC 6397

Sulphur (S) is a non-refractory alpha-element that is not locked into dust grains in the interstellar medium. Thus no correction to the measured, interstellar sulphur abundance is needed and it can be readily compared to the S content in stellar photospheres. Here we present the first measurement of sulphur in the metal poor globular cluster (GC) NGC 6397, as detected in a MIKE/Magellan high signal-to-noise, high-resolution spectrum of one red giant star. While abundance ratios of sulphur are available for a larger number of Galactic stars down to an [Fe/H] of ~ -3.5 dex, no measurements in globular clusters more metal poor than -1.5 dex have been reported so far. We find a NLTE, 3-D abundance ratio of [S/Fe] = +0.52 +/- 0.20 (stat.) +/- 0.08 (sys.), based on the S I, Multiplet 1 line at 9212.8A. This value is consistent with a Galactic halo plateau as typical of other alpha-elements in GCs and field stars, but we cannot rule out its membership with a second branch of increasing [S/Fe] with decreasing [Fe/H], claimed in the literature, which leads to a large scatter at metallicities around -2 dex. The [S/Mg] and [S/Ca] ratios in this star are compatible with a Solar value to within the (large) uncertainties. Despite the very large scatter in these ratios across Galactic stars between literature samples, this indicates that sulphur traces the chemical imprints of the other alpha-elements in metal poor GCs. Combined with its moderate sodium abundance ([S/Na]_NLTE=0.48), the [S/Fe] ratio in this GC extends a global, positive S-Na correlation that is not seen in field stars and might indicate that proton-capture reactions contributed to the production of sulphur in the (metal poor) early GC environments.

Discussion of “The applicability of garnet–orthopyroxene geobarometry in mantle xenoliths”, by Wu C.-M. and Zhao G. (Lithos, v. 125, p. 1–9)

Wu and Zhao (2011) argue that pressures and temperatures for mantle xenoliths are best determined by combining Taylor's (1998) garnet–orthopyroxene barometer and two-pyroxene thermometer. Here we show that this choice may lead to grossly erroneous P–T estimates for some peridotitic compositions and increased scatter around xenolith geotherms. We contend that the Nickel and Green (1985) barometer remains a better choice than the Taylor (1998) barometer for thermobarometry of garnet-facies mantle peridotites and pyroxenites, at least for orthopyroxenes with moderate sodium contents. For highly-sodic orthopyroxene compositions, the reliability of the Nickel and Green (1985) barometer and of its modifications proposed by Carswell and Gibb (1987) and Carswell (1991) still awaits detailed evaluation.

Interaction between Gα12 and Gα13 protein subunits and dopamine receptors in renal proximal tubules

The cells of the renal proximal tubules (RPTs) have high aromatic L-amino-acid decarboxylase activity. Filtered or circulating L-3,4-dihydroxyphenylalanine can be converted to dopamine after uptake into this extraneuronal compartment, without being subsequently converted to norepinephrine.1 Peripheral dopamine has been characterized as an important modulator of both renal sodium excretion and blood pressure by acting directly on renal epithelial ion transport and by modulating the secretion/release of other hormonal/humoral molecules. These hormonal and humoral molecules include aldosterone, catecholamines, renin and vasopressin, each of which contribute to the regulation of sodium homeostasis and blood pressure. In addition, other hormones may interact with dopamine produced in RPTs to increase (for example, atrial natriuretic peptide) or decrease (for example, angiotensin) its inhibitory effect on tubular sodium reabsorption. The actions of endogenous renal dopamine on water and electrolyte transport are modest under euvolemic conditions, but become magnified during moderate sodium excess. Thus, following a moderate acute or chronic sodium load, up to 50% of sodium excretion is mediated by dopamine produced by the RPTs.2

Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial

Objective To compare the effects on proteinuria and blood pressure of addition of dietary sodium restriction or angiotensin receptor blockade at maximum dose, or their combination, in patients with non-diabetic...