Salt Intake In People Research Articles

The effect of educational intervention on salt intake of people at risk of high blood pressure: application of the theory of planned behavior

The effect of educational intervention on salt intake of people at risk of high blood pressure: application of the theory of planned behavior

A Mobile Health Salt Reduction Intervention for People With Hypertension: Results of a Feasibility Randomized Controlled Trial.

BackgroundA high-salt diet is a risk factor for hypertension and cardiovascular disease; therefore, reducing dietary salt intake is a key part of prevention strategies. There are few effective salt reduction interventions suitable for delivery in the primary care setting, where the majority of the management and diagnosis of hypertension occurs.ObjectiveThe aim of this study is to assess the feasibility of a complex behavioral intervention to lower salt intake in people with elevated blood pressure and test the trial procedures for a randomized controlled trial to investigate the intervention’s effectiveness.MethodsThis feasibility study was an unblinded, randomized controlled trial of a mobile health intervention for salt reduction versus an advice leaflet (control). The intervention was developed using the Behavior Change Wheel and comprised individualized, brief advice from a health care professional with the use of the SaltSwap app. Participants with an elevated blood pressure recorded in the clinic were recruited through primary care practices in the United Kingdom. Primary outcomes assessed the feasibility of progression to a larger trial, including follow-up attendance, fidelity of intervention delivery, and app use. Secondary outcomes were objectively assessed using changes in salt intake (measured via 24-hour urine collection), salt content of purchased foods, and blood pressure. Qualitative outcomes were assessed using the think-aloud method, and the process outcomes were evaluated.ResultsA total of 47 participants were randomized. All progression criteria were met: follow-up attendance (45/47, 96%), intervention fidelity (25/31, 81%), and app use (27/31, 87%). There was no evidence that the intervention significantly reduced the salt content of purchased foods, salt intake, or blood pressure; however, this feasibility study was not powered to detect changes in secondary outcomes. Process and qualitative outcomes demonstrated that the trial design was feasible and the intervention was acceptable to both individuals and practitioners and positively influenced salt intake behaviors.ConclusionsThe intervention was acceptable and feasible to deliver within primary care; the trial procedures were practicable, and there was sufficient signal of potential efficacy to change salt intake. With some improvements to the intervention app, a larger trial to assess intervention effectiveness for reducing salt intake and blood pressure is warranted.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 20910962; https://www.isrctn.com/ISRCTN20910962

Hypertension, cardiovascular disease, and nocturia: a systematic review of the pathophysiological mechanisms.

Nocturia significantly impairs quality of life, especially in the elderly population, and urinary retention is a main target of treatment for urologists. In addition to nocturia, cardiovascular diseases are common in the elderly population, and a systematic review showed that hypertension and heart failure are often associated with nocturia. One possible pathogenic mechanism underlying the development of hypertension is an increase in blood pressure due to excessive salt intake in people with high-salt sensitivity. From Guyton's natriuretic curve, we can infer that salt-sensitive hypertensive patients who consume too much salt do not excrete salt during the daytime and are forced to excrete salt at night, resulting in increased urine production and nocturia. In patients with heart failure, the nocturnal supine position leads to an increase in central fluid volume due to an increase in venous return from the periphery, and the secretion of natriuretic peptide is stimulated by the stretching of the atria and ventricles. Thus, natriuresis due to hypertension and hydrodiuresis due to heart failure may cause nocturia, which can effectively be treated by the administration of thiazide diuretics and loop diuretics in the morning, respectively. Because cardiovascular diseases, such as hypertension and heart failure, can cause nocturia and because the treatment methods differ depending on the cause, it is necessary to pay close attention to nocturia in the management of lifestyle-related diseases, such as cardiovascular disease.

Effect of dietary sodium restriction on blood pressure in type 2 diabetes: A meta-analysis of randomized controlled trials

AimsAlthough current guidelines recommend reduction of salt intake in patients with diabetes, the benefits of reducing salt intake in people with type 2 diabetes mellitus (T2DM) lack clear evidence. Therefore, we performed a meta-analysis of available randomized controlled trials (RCTs) of sodium restriction and blood pressure (BP) in patients with T2DM. Data synthesisWe performed a systematic search of the online databases that evaluated the effect of dietary sodium restriction on BP in patients with T2DM. Sodium intake was expressed by 24 h urinary sodium excretion (UNaV). Q statistics and I2 were used to explore between-study heterogeneity. A random-effects model was used in the presence of significant heterogeneity; otherwise, a fixed-effects model was applied. Eight RCTs with 10 trials (7 cross-over and 3 parallel designs) were included in the meta-analysis. Compared with ordinary sodium intake, dietary sodium restriction significantly decreased UNaV (weighted mean difference, WMD: −38.430 mmol/24 h; 95% CI: −41.665 mmol/24 h to −35.194 mmol/24 h). Sodium restriction significantly lowered systolic BP (WMD: −5.574 mm Hg; 95% CI: −8.314 to −2.834 mm Hg; I2 = 0.0%) and diastolic BP (WMD: −1.675 mm Hg; 95% CI: −3.199 to −0.150 mm Hg; I2 = 0.0%) with low heterogeneity among the studies. No publication bias was found from Begg's and Egger's tests. ConclusionsSodium restriction significantly reduces SBP and DBP in patients with T2DM.

The Salt Swap intervention to reduce salt intake in people with high blood pressure: protocol for a feasibility randomised controlled trial

BackgroundHigh salt intake is a risk factor for hypertension and cardiovascular disease. Reducing salt intake has been shown to reduce blood pressure. Despite population-level interventions, including product reformulation and public awareness campaigns, adult salt consumption in the UK still exceeds recommendations; this is primarily due to salt consumed in processed and pre-packaged foods. Moderate or high-intensity dietary advice to encourage individuals to reduce their salt intake has been shown to be effective at reducing blood pressure, but evidence of the effectiveness of interventions that are suitable for delivery at scale in routine primary care is scarce. This feasibility trial investigates a complex behavioural change intervention to reduce dietary salt intake and blood pressure by encouraging individuals to purchase lower-salt foods when grocery shopping.MethodsThis randomised controlled trial will test the feasibility of a novel intervention to reduce salt intake, and the trial procedures to assess its effectiveness. We will recruit participants through UK general practices and randomise 40 participants with high blood pressure, in a 2:1 allocation to receive either the Salt Swap intervention or a control information leaflet. The primary outcomes relate to the criteria for progression to a large-scale trial. These include follow-up rates at 6 weeks, fidelity of intervention delivery and use of the intervention mobile app. Secondary outcomes include the effect of the intervention on the salt content of purchased foods (grams per 100 g), urinary sodium excretion assessed through 24-hour urine samples and blood pressure. Trial process measures will be collected and qualitative assessment will provide insights into participant engagement with the intervention content and perceived barriers to and facilitators of salt reduction dietary behavioural change.DiscussionIf the outcomes indicate the trial is feasible and there is evidence that behavioural change may result in salt reduction, we will proceed to a definitive trial to test the effectiveness of the intervention to lower blood pressure. If successful, this intervention approach could be applied not only to people with high blood pressure, but also to the wider population with normal blood pressure in whom dietary salt intake exceeds recommendations.Trial registrationISRCTN, 20910962. Registered on 5 April 2017.

What are the benefits and harms of altered dietary salt intake in people with chronic kidney disease?

What are the benefits and harms of altered dietary salt intake in people with chronic kidney disease?

Salt Restriction in Diabetes.

There are no long-term interventions examining the effects of salt reduction in people with diabetes, and these are urgently required. Sodium reduction is controversial as it appears that an intake below 2.5g and above 6g/day of salt is associated with increased cardiovascular disease risk. However, pre-existing illness leading to a lower salt intake may confound the findings. Only a few studies have prospectively collected data on the sodium intake and excretion of people with diabetes and examined hard end points. In addition, future studies need to collect more data on food intake as well as coexistent illnesses to address potential confounding. The World Health Organization recommends a reduction to less than 5g/day salt in adults. Given that the available evidence suggests that the salt intake of people with type 2 diabetes is generally well above 6g/day it seems reasonable to ensure individuals with diabetes have an intake below 6g/day. However, such recommendations need to be individualized.

Possible deleterious hormonal changes associated with low-sodium diets.

The average salt intake of people in Canada, the United States, and Europe is about 3,400 mg of sodium per day, which exceeds the recommended intake levels set by various health organizations. The World Health Organization recommends a worldwide reduction of sodium intake to less than 2,000 mg per day. Most research to date has focused on the negative effects of high-sodium intake; however, little information is available on the metabolic effects of low-sodium intakes. This review focuses on the hormonal changes associated with low-sodium diets, especially the hormones involved in metabolism and cardiovascular and renal function. Based largely on rodent studies, low-sodium diets have been associated with changes in glycemic control, energy metabolism, cardiovascular disease risk, cholesterol concentrations, inflammation, and functioning of the renin-angiotensin-aldosterone system. Overall, research has revealed mixed results regarding the impact of dietary sodium intake on various hormones. Further research is required to assess the effects of sodium reduction on hormones and their associated pathways in order to determine the likelihood of any unintended effects.

Attitudes and beliefs of health risks associated with sodium intake in diabetes

Background: Despite good evidence that reducing sodium intake can reduce blood pressure (BP), salt intake in people with type 1 diabetes (T1DM) or type 2 diabetes (T2DM) remains high. The purpose of this study was to describe the knowledge and beliefs of health risks associated with a high salt diet in adults with diabetes. Methods: Men and women with T1DM (n = 27; age 38 ± 16 years) or T2DM (n = 124; age 60 ± 11 years) were recruited. Results: Nine (6.0%) respondents knew the correct maximum daily recommended upper limit for salt intake. Thirty-six (23.9%) participants were not concerned with the amount of salt in their diet. Most participants knew that a diet high in salt was related to high BP (88.1%) and stroke (78.1%) and that foods such as pizza (80.8%) and bacon (84.8%) were high in salt. Fewer than 30% of people knew that foods such as white bread, cheese and breakfast cereals are high in salt (white bread 28.5%, cheese 29.1%, breakfast cereals 19.9%) and 51.0% correctly ranked three different nutrition information panels based on the sodium content. Label reading and purchase of low salt products was used by 60–80% of the group. Estimated average 24 hour urinary sodium excretion was 169 ± 32 mmol/24 h in men and 115 ± 27 mmol/24 h in women. Conclusion: Label reading and purchase of low salt products was used by the majority of the group but their salt excretion was still high. Men who used label reading had a lower salt intake. Other strategies to promote a lower sodium intake such as reducing sodium in staple foods such as bread need investigation.

Sodium and potassium intake of urban dwellers: nothing changed in Yazd, Iran.

To assess the daily salt intake of people aged 20-74 years based on the 24-hour urinary sodium excretion in urban population of Yazd, a population-based cross-sectional study was conducted. This is a substudy of Yazd Healthy Heart Project in Iran. From 2004 to 2005, two thousand people of the urban population of Yazd city, aged 20-74 years, were enrolled in the main study. Overall, 219 volunteer participants of 20-70 years were enrolled in this substudy. Sample frame was the household numbers according to the database of Yazd City Health Services. Calcium, phosphorus, sodium, potassium, and creatinine were measured in the urine samples collected from the participants over a 24-hour period. Sodium content in urine over 24 hours was 171.7 +/- 82.9 mmol/day in males and 127.8 +/- 56.1 mmol/day in females (p < 0.0001) while potassium content was 49.4 +/- 23.2 mmol/day in males and 41.5 +/- 25.1 mmol/day in females (p = 0.2). Estimated average daily salt (NaCl) intake was 10.0 +/- 4.8 g/day in males and 7.5 +/- 3.3 g/day in females (p < 0.0001). Only one participant had the ideal Na/K ratio of less than one. Na/K ratios greater than one and less than two were seen in 11.3% (n = 24), and a ratio equal to or greater than 2 was observed in 82.3% (n = 118) of the participants. The average Na/K ratio was 3.69 +/- 1.58. Unlike many developed countries where sodium intake declined over the past few decades, the daily sodium intake in Yazd is high, and daily potassium intake is low. This is similar to what was observed four decades ago in an area not far from Yazd. Efforts must be directed towards health promotion interventions to increase public awareness to reduce sodium intake and increase potassium intake.

Relación costo-utilidad de la disminución del consumo de sal y su efecto en la incidencia de enfermedades cardiovasculares en Argentina

Estimate the cost-utility ratio of an intervention to reduce dietary salt intake in people over the age of 35 in Argentina. The intervention consisted of reducing salt content in food by 5% to 25%. A simulation model was used to measure the impact of policies on heart disease in order to predict incidence, prevalence, mortality, and cost trends for heart and cerebrovascular disease in the population aged 35 - 84. The intervention modeled the impact and costs of a 3-gram reduction in dietary salt intake by reducing the amount of salt in processed food and salt added to food by the participants themselves over a 10-year period. Changes in event occurrence during this period and gains in quality-adjusted life years (QALY) were estimated in high- and low-impact scenarios. The intervention generated a net savings of US$ 3 765 million and a gain of 656 657 QALYs in the high-impact scenario and a savings of US$ 2 080 million and 401 659 QALY in the low-impact scenario. The result would be reductions in the incidence of heart disease (24.1%), acute myocardial infarction (21.6%), and stroke (20.5%), as well as in mortality from heart disease (19.9%) and all causes (6.4%). Benefits were observed for all age groups and both genders. Implementing this strategy to reduce salt intake would produce a very positive health impact, both in QALY gains and savings in economic resources.

High salt meals in staff canteens of salt policy makers: observational study

Objective To assess the salt content of hot meals served at the institutions of salt policy makers in the Netherlands.Design Observational study.Setting 18 canteens at the Department of Health, the...