Salty Food Intake Research Articles

The intake of food and nutrient by the elderly with chronic disease in the Seoul area

This study was carried out in order to investigate the status of food and nutrient intakes depending on the types of chronic disease of the elderly at welfare centers in Seoul. The total number of subjects was 299 elderly over the age of 60 (82 men and 217 women); they were grouped by the disease status: normal, cardiovascular disease (CVD), diabetes mellitus (DM) and arthritis patients groups. The dietary intakes were obtained by a 24-hour recall and analyzed by CAN-Pro 4.0; they were then compared with the dietary reference intakes for the Korean (KDRIs). In the results of anthropometric data according to chronic disease, the waist circumference of the normal group in males and females was lower than the other groups; in particular, the normal female group showed a lower level of waist-hip ratio, body mass index (BMI) and body fat % than those of the other groups. The arthritis group showed a higher intake of milk products than the other groups (p ＜ 0.05); consequently, calcium intake was significantly higher than that of the other groups (p ＜ 0.001). Vitamin A intake in the arthritis group was significantly higher than the intake in the normal and DM groups (p ＜ 0.01). Normal and arthritis groups showed significantly higher intake of zinc and copper than the CVD group (p ＜ 0.01). In general, about 80% of the subjects in this study revealed insufficient intakes of riboflavin, vitamin C, calcium, dietary fiber, vitamin D, biotin and potassium, compared with the estimated average requirement (EAR) or adequate intake (AI). However, sodium intake of all groups was higher than the AI of KDRIs. In conclusion, nutrient intake, according to the chronic disease, showed significant difference in some of the micronutrients, vitamin A, Ca, Zn and Cu. Therefore, we suggest that dietary guidelines, such as reducing the intake of salty foods and sweet drinks and increasing the intake of foods with sufficient calcium, vitamin D and vitamin C, are necessary to the improvement of eating habits for the elderly.

Association between Habitual Dietary Salt Intake and Risk of Gastric Cancer: A Systematic Review of Observational Studies

Purpose. Systematic reviews of case-control and prospective studies showed a positive association between habitual salt intake and gastric cancer. Given new studies published thereafter, we carried out a meta-analysis to assess the association between dietary salt intake and gastric cancer. Methods. Case-control studies and cohort studies published between January 1992 and January 2012 on PubMed and Embase were searched. We quantified associations between salt intake and gastric cancer with meta-analysis. Results. Eleven studies (7 case controls and 4 cohorts) finally were included in the meta-analysis (total population: n = 2076498; events: n = 12039). The combined odds ratio showed significantly positive association between high salt intake and gastric cancer compared with low salt intake (OR = 2.05, 95% CI [1.60, 2.62]; P < 0.00001). In subgroup meta-analysis, findings were slightly different when analyses were restricted to salty food intake (OR = 2.41, 95% CI [2.08, 2.78]; P < 0.00001) as well as in Asia (OR = 1.27 95% CI [1.22, 1.32]; P < 0.00001). There was no evidence that sample size, exposure assessment substantially influenced the estimate of effects. Conclusions. The systemic review supports the hypothesis that dietary salt intake is positively associated with the risk of gastric cancer.

Food based dietary guidelines (FBDGs) development and promotion in Thailand.

Dietary guidelines based on 5 food groups was used as a main nutrition education tool until 1996 when food based dietary guidelines (FBDGs) were promoted after 2 years of formulation and development. These FBDGs for the general population were designed to promote desirable and culturally acceptable eating behavior. The nine qualitative guidelines of Thai FBDGs include: 1. eat a variety of foods from each of the five food groups and maintain proper weight, 2. eat adequate rice, or alternate carbohydrate, 3. eat plenty of vegetables and fruits regularly, 4. eat fish, lean meats, eggs, legumes and pulses regularly, 5. drink sufficient amount of milk every day, 6. take moderate amounts of fat, 7. avoid excessive intake of sweet and salty foods, 8. eat clean and uncontaminated foods, and 9. avoid or reduce consumption of alcoholic beverages. In 1998, the quantitative part of Thai FBDGs or food guide model was established as "Nutrition Flag" after rigorous test for understanding and acceptability among consumers. Promotion and dissemination of the Thai FBDGs have been carried out at national and community levels through basic health, agricultural and educational services and training activities, as well as periodic campaigning via multiple communication channels and media. Recently in 2009, the FBDGs for infant and preschool children were introduced to replace the previous infant and young child feeding guidelines. There has been no formal evaluation on the impact of promotion of the Thai FBDGs but some periodic testing of knowledge and practices have shown positive results.

The positive effect of an intervention program on the hypertension knowledge and lifestyles of rural residents over the age of 35 years in an area of China

Hypertension (HTN) is a leading cause of cardiovascular and cerebrovascular diseases. Lifestyle modification may be the preferential approach to prevent and control HTN. The purpose of this study was to evaluate the effects of a community intervention program, which focused on improving the HTN knowledge, diets and lifestyles in a rural Chinese area. The study was carried out in a rural area of the Hubei Province from May 2003 to April 2006. A total of 1632 participants were recruited. Of the participants, 826 from the town of Xiaoxita and 806 from the town of Fenxiang were assigned to the intervention group (group I) and to the control group (group C), respectively. Group I participants underwent an intervention that included HTN education and dietary and lifestyle guidance. Group C participants were not subjected to an intervention. The outcome measures included HTN knowledge, dietary and lifestyle behaviors, and prevalence, awareness, treatment and control rates of HTN. Along with the changes in HTN education (P<0.05), the participants in group I exhibited a significantly greater improvement in dietary habits and lifestyle behaviors, including reducing salty food intake (13.6%), fat intake (22.9%) and alcohol consumption (9.6%), after 3 years in comparison with those in group C (21.7, 31.9 and 18%, respectively). The prevalence of HTN was significantly lower in group I (22.5%) than in group C (36%) after the intervention strategies. The study showed that the implementation of a community intervention program involving HTN education and lifestyle modifications for rural residents is a powerful approach to reduce HTN prevalence and improve long-term health outcomes.

Dietary Behavior Related to Salty Food Intake of Adults Living in a Rural Area according to Saline Sensitivity

This study was conducted to identify behavioral characteristics of salty food intake according to saline sensitivity of adults living in a rural area. Anthropometry and blood pressure were measured and salt intake-related dietary behavior was surveyed by questionnaires through interviews with 402 subjects aged ≥ 40 years in Chungcheongbuk-Do, Korea. The percentages of overweight and obese among the subjects were 37.8% and 3.8% respectively. Mean blood pressure of the subjects was in the normal range, but the distribution of subjects who were normotensive, high normal, and hyper- tensive was 48.7%, 17.7%, and 33.6% respectively. Approximately 27% of all subjects habitually consumed salty food, which was the smallest group, followed by 38.1% normal and 35.1% not-salty food. However, 34.6% of the eldest group of ≥ 65 years consumed salty food. The saline insensitive group showed a higher percentage of irregular meals, overeat- ing, speed-eating, an unbalanced diet, a preference for fried food, and habitual intake of salty foods. These subjects rec- ognized the risk for eating salty food, but they lacked the will to reduce their salty food intake. Compared to spouses and family members, experts such as doctors, nurses, and dieticians were the most influential for reducing the salty food in - take of subjects. Saline sensitive group had relatively better control over salty food intake at every meal, eating out, and even when eating salty food that the spouse preferred. The saline sensitive group ate more frequently vegetables and fruits, whereas the saline insensitive group ate more frequently hot spicy foods. In conclusion, the results suggest that it is nec- essary to establish a social atmosphere toward reducing salt intake at the level of the government and food industry and to set action plans to be available for nutrition education programs to reduce salt intake nationwide. (Korean J Nutr 2011; 44(6): 537 ~ 550)

Risk Factors for Hepatocellular Carcinoma: A Case-Control Study in Belgrade (Serbia)

The objective of this case-control study was to test the existing hypotheses about factors related to the occurrence of hepatocellular carcinoma in the population of Belgrade (Serbia). The investigation was conducted between 2004 and 2007 and consisted of 45 newly diagnosed, histologically confirmed hepatocellular carcinoma patients and 90 individually gender- and age-matched hospital controls. Conditional univariate and multivariate logistic regression analyses were applied. A highly statistically significant association (P = 0.001) was demonstrated between hepatocellular carcinoma and HBsAg positivity and the presence of hepatitis C virus antibodies. Diabetes mellitus was significantly (P = 0.018) associated with an increased risk of hepatocellular carcinoma. A statistically significant inverse association was shown between low parity and the risk of hepatocellular carcinoma (P = 0.033). The risk increased significantly with a longer history of cigarette smoking (P = 0.044), as well as the daily consumption of hard liquor (P = 0.049). A weekly intake of fish (P = 0.003) and yogurt (P = 0.003) and daily intake of boiled vegetables (P = 0.001) were reported more frequently by controls than hepatocellular carcinoma cases. In the current study, a high intake of salty food also significantly increased the risk of hepatocellular carcinoma (P = 0.027). Based on multivariate analysis, the presence of hepatitis C virus antibodies (OR = 24.6, P = 0.001) and duration of smoking > or =25 years (OR = 3.8, P = 0.020) were significantly related to hepatocellular carcinoma, whereas the daily consumption of boiled vegetables (OR = 0.1, P = 0.011) was inversely associated with the risk of hepatocellular carcinoma. The findings obtained in the current study support the hypotheses that non-viral factors, such as lifestyle factors, reproductive factors, and a history of diabetes, might be involved in the etiology of hepatocellular carcinoma.

Prompts, Feedback, Positive Reinforcement, and Potty Training

Two parents were concerned because their two young girls were delayed in learning to use the potty. In this study we obtained data on the frequency of wet diapers and use of the potty at home. Following baseline, an intervention was implemented that involved increased intake of liquids and salty foods, prompting, and positive reinforcement. Once a substantial decrease in wet diapers was achieved, together with an increase in use of the potty, the girls were offered the opportunity to wear “Princess Underwear!” as an even more powerful prompt and reinforcer. An ABC design was used with each girl. The results showed significant increases in their use of the potty and decreased incidents of wet diapers when the intervention was in effect. Although this design does not rule out possible effects of coincidences, the data are consistent with the hypothesis that the intervention produced improvements in potty training.

Synergistic upregulation of inducible nitric oxide synthase and cyclooxygenase-2 in gastric mucosa of Mongolian gerbils by a high-salt diet and Helicobacter pylori infection.

The intake of salt and salty food is known as a risk factor for gastric cancer. We have previously demonstrated that a high-salt diet dose-dependently enhances Helicobacter pylori (H. pylori)-associated gastritis and stomach carcinogenesis in Mongolian gerbils. In this study, we focused on the influence of excessive salt intake on the expression of inflammatory mediators involved in progression of H. pylori-induced chronic gastritis. A total of 45 stomach samples from Mongolian gerbils were evaluated by immunohistochemistry. The animals were infected with H. pylori and fed basal (0.32%) or a high-salt (10%) diet, and sacrificed after 40 weeks. Proliferative activity and expression of cyclooxygenase-2 (COX-2) in gastric mucosa were significantly increased in H. pylori-infected gerbils. The additional high-salt diet significantly up-regulated the expression of inducible nitric oxide synthase (iNOS) and COX-2 in H. pylori-infected groups (P<0.01 and P<0.05, respectively), while no significant effects were noted in non-infected animals. There was significant synergistic interaction between H. pylori infection and 10% NaCl diet on the expression of iNOS (P<0.05) and also a tendency for enhanced COX-2 expression (P=0.0599). The present results suggest that a high-salt diet works synergistically with H. pylori infection to enhance iNOS and COX-2 expression in the gastric mucosa of Mongolian gerbils, and support the hypothesis that excessive salt intake may be associated with progression of H. pylori-induced gastritis.

Fast food for family meals: relationships with parent and adolescent food intake, home food availability and weight status

The purpose of the present study was to examine the prevalence of fast-food purchases for family meals and the associations with sociodemographic variables, dietary intake, home food environment, and weight status in adolescents and their parents. This study is a cross-sectional evaluation of parent interviews and adolescent surveys from Project EAT (Eating Among Teens). Subjects included 902 middle-school and high-school adolescents (53% female, 47% male) and their parents (89% female, 11% male). The adolescent population was ethnically diverse: 29% white, 24% black, 21% Asian American, 14% Hispanic and 12% other. Results showed that parents who reported purchasing fast food for family meals at least 3 times per week were significantly more likely than parents who reported purchasing fewer fast-food family meals to report the availability of soda pop and chips in the home. Adolescents in homes with fewer than 3 fast-food family meals per week were significantly more likely than adolescents in homes with more fast-food family meals to report having vegetables and milk served with meals at home. Fast-food purchases for family meals were positively associated with the intake of fast foods and salty snack foods for both parents and adolescents; and weight status among parents. Fast-food purchases for family meals were negatively associated with parental vegetable intake. Fast-food purchases may be helpful for busy families, but families need to be educated on the effects of fast food for family meals and how to choose healthier, convenient family meals.

High salt diets dose‐dependently promote gastric chemical carcinogenesis in Helicobacter pylori‐infected Mongolian gerbils associated with a shift in mucin production from glandular to surface mucous cells

Intake of salt and salty food is known as a risk factor for gastric carcinogenesis. To examine the dose-dependence and the mechanisms underlying enhancing effects, Mongolian gerbils were treated with N-methyl-N-nitrosourea (MNU), Helicobacter pylori and food containing various concentrations of salt, and were sacrificed after 50 weeks. Among gerbils treated with MNU and H. pylori, the incidences of glandular stomach cancers were 15% in the normal diet group and 33%, 36% and 63% in the 2.5%, 5% and 10% NaCl diet groups, showing dose-dependent increase (p < 0.01). Intermittent intragastric injection of saturated NaCl solution, in contrast, did not promote gastric carcinogenesis. In gerbils infected with H. pylori, a high salt diet was associated with elevation of anti-H. pylori antibody titers, serum gastrin levels and inflammatory cell infiltration in a dose-dependent fashion. Ten percent NaCl diet upregulated the amount of surface mucous cell mucin (p < 0.05), suitable for H. pylori colonization, despite no increment of MUC5AC mRNA, while H. pylori infection itself had an opposing effect, stimulating transcription of MUC6 and increasing the amount of gland mucous cell mucin (GMCM). High salt diet, in turn, decreased the amount of GMCM, which acts against H. pylori infection. In conclusion, the present study demonstrated dose-dependent enhancing effects of salt in gastric chemical carcinogenesis in H. pylori-infected Mongolian gerbils associated with alteration of the mucous microenvironment. Reduction of salt intake could thus be one of the most important chemopreventive methods for human gastric carcinogenesis.

Contributions of Sodium and Chloride to NaCl-Induced Hypertension

The recommendation to avoid high dietary “salt” intake for the prevention and treatment of hypertension is often expressed in terms of dietary sodium. However, a consistent body of evidence suggests that the chloride component of salt is an important contributor to NaCl-induced elevations of blood pressure.1 In several rat models of salt-sensitive hypertension (Dahl salt-sensitive [S] rat, DOCA-salt hypertension, stroke-prone SHR [SHRSP], angiotensin II-induced salt-sensitive hypertension), selective dietary sodium loading, in the absence of chloride, fails to produce hypertension. In various feeding protocols, anions provided with sodium included various combinations of bicarbonate, phosphate, aspartate, glutamate, and glycinate. Overall, the failure of selective dietary sodium loading to produce hypertension in these studies was not related to group differences of body weight, net sodium balance, blood pH, or serum concentrations of sodium, potassium, or chloride. Similarly, a limited number of clinical observations also indicate that blood pressure is not increased in humans by high dietary sodium intakes in the absence of chloride. In 1929, Berghoff et al reported that blood pressure increased in 7 hypertensive individuals on a high NaCl intake, but not on a high sodium bicarbonate intake.2 This observation was subsequently confirmed.3 Similarly, other investigators have also observed that in contrast to the increase of blood pressure induced by a high NaCl intake in hypertensive patients, blood pressure is not increased by a high sodium intake provided as sodium phosphate or sodium citrate.1 Further suggesting a modulating effect of dietary chloride on blood pressure, in hypertensive and normotensive subjects, substitution of dietary NaCl with equimolar sodium bicarbonate leads to a reduction of blood pressure.4,5 Additionally, in hypertensive humans, the reduction of blood pressure by dietary potassium is attenuated by potassium chloride compared with that of potassium citrate.6 Because the blood pressure increment in response …

Exhaustive exploring using Artificial Neural Network for identification of SNPs combination related to Helicobacter pylori infection susceptibility

Recent studies have suggested that not only genetic factors such as single nucleotides polymorphisms (SNPs) but also environmental factors such as smoking, alcohol consumption, and intake of salty food affect the development of heterogeneous diseases. Revealing the polymorphisms that may contribute to Helicobacter pylori infection as a consequence of specific environmental factors will help in developing personalized medicine. Eighty-four H. pylori infection-positive and 84 H. pylori infection-negative subjects were analyzed using the data for 37 different polymorphisms with a machine learning method—artificial neural network (ANN) with the exhaustive combination search method. The constructed ANN model for H. pylori infection exhibited greater performance than the logistic regression (LR) model. ANN modeling was also separately applied to non-smokers and smokers data sets. The result implies that the different polymorphisms can be risk factors under the influence of specific environmental factors. In addition, the result also indicated that the susceptibility to H. pylori infection can be lowered by giving up smoking even though subjects with risk factor for smokers. The reported polymorphisms that are related to H. pylori infection were automatically identified using our method, without any prior knowledge. The identified polymorphisms affected the infection when present as combinations. This method will be a useful tool for the analysis of risk factors against multifactorial diseases.

Differential misclassification of exposure in case-crossover studies.

The aim of this study is to examine 2 types of differential misclassification of exposure in case-crossover studies. The first is the outcome-dependent misclassification of exposure, meaning that if an event has occurred, it could affect the reporting of exposure. The second is differential misclassification of exposure as a result of fading memory over time, which arises if the length of the recall period for case and control windows differs. We use empirical data from a case-crossover study of triggers of attacks in Ménière's disease. The study applied the matched-pair interval control window sampling approach. We examined misclassification in relation to 2 different types of exposures: emotional stress and salty food intake. The study covered repeated events reported by the same patients and involved the sampling of many control windows. Because some of these windows were related to case events and some unrelated, we were able to conduct both case-crossover and control-crossover analyses. Although this group of Ménière patients are well aware of their disease, and many of them have definite ideas regarding what triggers attacks, neither outcome-dependent misclassification nor differential misclassification of exposure resulting from fading memory over time seemed to be a major problem.

The epidemiology of gastric cancer

The epidemiology of gastric cancer is remarkable for both its dramatic decline in incidence over the past century and its continuing presence as the second leading cause of cancer deaths worldwide despite this decline. Factors including increased consumption of fruits and vegetables, and decreased intake of salty foods have largely been credited for the decline. Epidemiologic studies continue to provide data on other gastric cancer risk factors, including associations with Helicobacter pylori infection, as well as dietary factors, tobacco, and alcohol intake. In response to the opposing trends of decreasing distal gastric cancer and increasing gastric cardia adenocarcinoma, studies are beginning to identify gastric cancer risk factors separately by tumor subsite. Future epidemiologic studies that include information on site of origin as well as molecular markers promise to yield more homogeneous classification of case groups, which will enhance identification of underlying disease processes.

Family history and subsite of gastric cancer: data from a case-referent study in Japan.

A comparative case-referent study was conducted using data from the Hospital-Based Epidemiologic Research Program at Aichi Cancer Center (HERPACC) (Nagoya, Japan), with the aim of clarifying the effect of family history on gastric cancer by subsite. Our study comprised 995 histologically confirmed gastric cancer cases (180 cardia, 430 middle, 365 antrum and 20 unclassified) and a total of 43,846 non-cancer outpatients at Aichi Cancer Center Hospital between 1988 and 1995. Logistic regression was used to calculate odds ratios (ORs) for family history of gastric cancer and other cancers, adjusted for age, year and season at first hospital visit, habitual smoking, habitual alcohol drinking, regular physical exercise, preference for salty food and raw vegetable intake. In both genders, a positive family history of gastric cancer was associated with a moderate, but statistically significant increase in risk of gastric cancer [OR = 1.51, 95% confidence interval (95% CI) = 1.29-1.76], while no association was observed between the risk of gastric cancer and a family history of other cancers [OR = 0.97, 95% CI = 0.84-1.13]. OR increased for the middle and antrum parts of gastric cancer, but an increment for the cardiac part was observed only in those with a maternal history of gastric cancer. Our results suggest that the risk of gastric cancer in relation to family history varies by subsite and, furthermore, that the subsite-specific risk of gastric cancer is linked to a maternal history of gastric cancer.

Diet/nutrition and stomach cancer in Japan.

Incidence rates of stomach cancer in Japan are much higher than in other countries, but have shown a large decline in the past 20 years. Incidence rates among the Japanese in Hawaii are only one third or less of the indigenous Japanese in Japan. Epidemiologic studies indicate that consumption of salt or salty foods is associated with increased risk of stomach cancer, in concert with the results of experimental studies in rodents. In contrast, consumption of vegetables and fruit is associated with decreased risk. Accumulated evidence is strong that a reduction in salty food intake and an increase in vegetable and fruit intake is important to primary prevention of stomach cancer. Possible protective roles of tea and allium vegetables and supplemental use of micronutrients, interaction between salty food intake and H. pylori infection and other factors need further investigation. Occurrence of stomach cancer in Japan may be reduced by two thirds or more via dietary changes, as seen in the population of Japanese ancestry in Hawaii.

Health promotion activities in Japan.

In Japan, the spread of immunization and the development of antibiotics and antituberculosis drugs have dramatically decreased the mortality rate from infectious diseases since World War II. Alterations in health practices, such as decreasing the intake of salty foods and strict management of hypertension, have resulted in prominent decreases in the mortality rate from cerebrovascular diseases, especially from cerebral hemorrhage. However, we still have high death rates from malignant neoplasms and circulatory diseases, which may be partly prevented through improvement of health status. We discuss here about various health promotion activities recently reported in Japan, including prevention of smoking, promotion of exercise, improvement of nutrition, improvement of mental health status, and health risk appraisal. Finally we would like to stress the importance of comprehensive assessment of health status in order to encourage health promotion activities further.

Salty Food Intake and Risk of Helicobacter pylori Infection

To clarify the risk factors for Helicobacter pylori infection, which is considered to play an etiologic role in atrophic gastritis, duodenal ulcer and gastric cancer, various parameters including diet and socioeconomic characteristics were compared between H. pylori‐infected and non‐infected men. In a cross‐sectional study of 634 men aged 40 to 49 years selected randomly from five areas with different rates of gastric cancer mortality, 474 of 628 men evaluated were positive for IgG antibody against H. pylori. After logistic regression analysis adjusted for area, the results showed a significant association between frequent intake of pickled vegetables and prevalence of H. pylori antibody (odds ratios against men who consume < 1 day/week were 1.19 for 1–2 days/week, 1.92 for 3–4 days/week, 1.90 for 5–7 days/week; P for trend = 0.02). Daily consumption of miso soup was also associated with an increased risk (odds ratio against non‐daily consumer = 1.60, 95% confidence interval = 1.03–2.49). Occupation, number of siblings, education, smoking and alcohol drinking, and other dietary habits were not significantly associated with the prevalence of infection in this population. Although there are limitations in a cross‐sectional study such as this, consumption of salty foods appears to increase the risk of H. pylori infection, which could be a marker of salty food intake or an intermediate risk factor in the etiologic sequence between salty food intake and gastric cancer.

Geophysical, Cultural and Behavioral Differences between High and Low Risk Areas of Gastric Cancer in Liaonin Province in China

Geophysical and socio-medical backgrounds including dietary habits between high risk and low risk areas of gastric cancer in Liaonin Province, China, were compared and analysed. Case-control study on psychobehavioral factors was carried out. The characteristics of high risk area was acid brown soil, drinking water with high nitrates, high rate of illiterates, unfavorable eating behavior and frequent intake of salty foods and foods with mutagens. Psychobehavioral factors may associate with higher incidence of gastric cancer.

Effect of restricted access to water on the intake of salty foods by Merino and Border Leicester sheep

Sheep were fed on diets containing 7.5, 11.25, and 15% added sodium chloride to simulate diets containing up to 100% saltbush (Atriplex spp.). When access to water was restricted to once daily, there was a reduction in food intake, the reduction being more severe with the more salty diets. When fed on the diet containing 15% added sodium chloride and when their access to water was restricted to once daily, Merino sheep drank 5.01 l/day and Border Leicester sheep 7.6 l/day. Food intakes differed in approximately the same proportion, and on a body weight basis (kg0.73) the Border Leicesters ate 22% more food than the Merinos. It is concluded that Merino sheep will need to drink more often than once daily when their water intake exceeds 5 l/sheep/day, and that this would occur when the saltbush intake reached 500–600 g/day.