Tanaka Equation Research Articles

P176 SPOT URINE FORMULAS OVERESTIMATE DIETARY SODIUM INTAKE DURING LOW SODIUM CONSUMPTION

Background and objective: Long-term sodium balance studies have revealed a phenomenon of temporary storage of sodium in tissues. Consequently, relying on an individual's single 24-hour urine collections may lead to an unreliable estimation of sodium intake. Our recent research has shown that the accuracy of repeated spot urine collections is equal to that of a single 24-hour urine collection at a sodium intake level of 5 gram/day. Since no data is available about the performance at recommended sodium intake (i.e., <2 grams/day), we determined their accuracy during low sodium consumption. Methods: We performed a post-hoc analysis on data from a metabolic ward study in which 16 healthy male adults consumed a diet with a fixed sodium content of 50 or 200 mmol/day for 7 days. Each day, urine was collected in 4 intervals (7:00-13:00 h, 13:00-19:00 h, 19:00-23:00 h, 23:00-07:00 h). We estimated sodium intake by the European Toft formula using urines of the same interval on 3 consecutive days during steady state (day 5-7). In sensitivity analyses we applied the Tanaka and Kawasaki formulas. Results: During a 200-mmol sodium intake, the Toft formula estimates appeared the most accurate, deviating 10 [IQR 3-14], 8 [6-19], 36 [16-49] and 20 [10-43] mmol from the intake for intervals 7:00-13:00 h, 13:00-19:00 h, 19:00-23:00 h, 23:00-07:00 h, respectively (Figure 1A). This accuracy did not significantly differ from a single 24-hour urine (20 [12-55] mmol). However, at a 50-mmol sodium intake, the Toft formula estimates deviated 62 [IQR 45-69], 75 [67-97], 99 [90-109] and 51 [45-61] mmol from the intake for similar intervals (Figure 1B). These estimates were significantly less accurate than a single 24-hour urine (9 [6-23] mmol). Although the Tanaka equation outperformed the Toft equation, this formula was also significantly inferior to a 24-hour urine collection. Conclusions: Repeated spot urine collection substantially overestimates sodium intake when sodium intake is low, whereas it performs similarly to a 24-hour urine collection at an average sodium intake.

Dark tea consumption is associated with a reduced risk of dysglycaemia and increased urinary glucose and sodium excretion in Chinese adults.

To examine the associations of tea consumption (both frequency and type) with (1) prediabetes and diabetes and (2) urinary glucose and sodium excretion in Chinese community-dwelling adults. In 1923 participants (457 with diabetes, 720 with prediabetes, and 746 with normoglycaemia), the frequency (occasional, frequent, daily, or nil) and type (green, black, dark, or other) of tea consumption were assessed using a standardized questionnaire. Morning spot urinary glucose and urine glucose-to-creatinine ratios (UGCRs) were assessed as markers of urinary glucose excretion. Tanaka's equation was used to estimate 24-h urinary sodium excretion. Logistic and multivariate linear regression analyses were performed. Compared with non-tea drinkers, the corresponding multivariable-adjusted odds ratios (ORs) for prediabetes and diabetes were 0.63 (95% confidence interval [CI] 0.48, 0.83) and 0.58 (95% CI 0.41, 0.82) in participants drinking tea daily. However, only drinking dark tea was associated with reduced ORs for prediabetes (0.49, 95% CI 0.36, 0.66) and diabetes (0.41, 95% CI 0.28, 0.62). Dark tea consumption was associated with increased morning spot urinary glucose (0.22 mmol/L, 95% CI 0.11, 0.34 mmol/L), UGCR (0.15 mmol/mmol, 95% CI 0.05, 0.25 mmol/L) and estimated 24-h urinary sodium (7.78 mEq/day, 95% CI 2.27, 13.28 mEq/day). Regular tea consumption, especially dark tea, is associated with a reduced risk of dysglycaemia and increased urinary glucose and sodium excretion in Chinese community-dwelling adults.

Salt intake across the hypertension care cascade in the Bangladeshi adult population: a nationally representative cross-sectional study

ObjectivesThis study aimed to examine the distribution of daily salt intake across the hypertension care cascade and assess the proportional distribution of these care cascade categories across various salt consumption...

Reducing the Sodium Intake of Patients With Chronic Kidney Disease Through Education and Estimating Salt Excretion: A Propensity Score Matching Analysis.

Japanese people traditionally consume high quantities of salt. This study aimed to investigate the effects of educating patients with chronic kidney disease (CKD) on simple methods for reducing their daily dietary salt intake. This single-center, retrospective observational study included 115 outpatients with CKD at Kawashima Hospital (Tokushima, Japan). One physicianroutinely recommended that patients should reduce their salt intake and provided tips for salt restriction. The physician estimated the patients' daily salt intake using spot urine samples at each medical examination (education group; n = 61). The other physicians' outpatients only received dietary guidance on recommended salt intake (control group; n = 54). The estimated 24-hour urinary sodium excretion (24hUNaV) and 24-hour potassium excretion (24hUKV) were calculated using Tanaka's equation. Estimated 24hUNaV was positively correlated with body mass index (BMI), estimated 24hUKV, and urinary Na/K ratio. The patients in the education group were younger and had a lower BMI, higher estimated glomerular filtration rate, and lower systolic blood pressure (SBP). Using 38 pairs of patients obtained by propensity score matching with these variables, estimated 24hUNaV, estimated 24hUKV, and diastolic blood pressure (DBP) after one year were significantly reduced in the education group. A simple salt reduction education may reduce salt intake in outpatients with CKD.

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

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

Association between salt intake and gastric atrophy by Helicobacter pylori infection: first results from the Epidemiological Investigation of Gastric Malignancy (ENIGMA).

Gastric atrophy (GA), usually linked to chronic infection with Helicobacter pylori (H. pylori), may over time evolve into gastric malignancy. Besides H. pylori, high salt intake may play a role in GA development. This study evaluates cross sectionally the association between salt intake and GA in Chilean adults. Population-based samples were recruited from two sites, Antofagasta and Valdivia, partaking in the Epidemiological Investigation of Gastric Malignancies. At recruitment, participants answered questionnaires and provided biospecimens. Salt intake (g/day) was estimated from casual spot urine samples using the Tanaka equation. GA was determined by serum pepsinogen levels. Only participants ≥ 40 to 70years of age were considered in this analysis, n = 565. For the association between salt intake (as sex-specific quartiles) and GA, odds ratios (ORs) and the corresponding 95% confidence intervals (CI) were estimated through multivariable logistic regression. In women, the multivariable-adjusted OR for GA comparing quartile 4 of the estimated salt intake (12.8g/day) to quartile 1 (6.6g/day) was 1.18 (95% CI 0.52-2.68, P-trend = 0.87). The corresponding OR in men was 0.49 (95% CI 0.19-1.27, P-trend = 0.17) with salt intakes of 12.8g/day and 7.1g/day for quartiles 4 and 1, respectively. There was little evidence for an association between salt intake estimated from spot urine and GA risk in our cross-sectional analysis of middle aged and older adults in Chile. Reverse causation bias cannot be ruled out and the sample size was limited to provide more precise estimates.

Validation of spot urine in estimating 24-h urinary sodium, potassium and sodium-to-potassium ratio during three different sodium diets in healthy adults

Purpose To evaluate the validity of spot urine assay methods in estimating the 24-h urinary sodium, potassium and sodium-to-potassium ratio during three different sodium diets. Materials and methods Twelve healthy volunteers were asked to adhere to 3 dietary sodium targets (3.3–5.0g/day,<3.3 g/day and >5.0 g/day) for three consecutive weeks and to measure salt excretion daily in spot urine samples using a self-monitoring device. On day 7 of each week, 24-h urine was collected to compare measured with estimated 24-h salt excretion (by the Kawasaki, Tanaka and INTERSALT equations). Results Correlation coefficients relating measured and estimated 24-h sodium excretion were low and not significant for Kawasaki and INTERSALT and moderate for the Tanaka equation (τ 0.56–0.64,p<.05). Bland–Altman plots showed considerable differences between estimated and measured sodium excretion across all salt diets. Over 40% of the participants showed an absolute difference between measured and estimated 24-h sodium of more than 1000 mg/day. The correlation coefficients between 24-h and spot Na/K ratio were 0.67, 0.94 and 0.85(p<.05), and mean differences were 0.59, 0.06 and 0.48 for the intermediate, low and high sodium diets, respectively. Conclusion These findings do not support estimation of individual 24-h salt excretion from spot urine by the Kawasaki, Tanaka, or INTERSALT formula.

Normative data in resting and maximum heart rates and a prediction equation for young Tunisian soccer players: a cross-sectional study.

Heart rate (HR) is an important indicator of work intensity during physical activity. Maximum heart rate (MHR) is a physiological measure that is frequently used as a benchmark for maximal exercise intensity. The aim of this study was to establish reference curves for maximum heart rate (MHR) and resting heart rate (RHR) and to develop an estimated equation for Tunisian adolescent footballers. The study involved 801 adolescent players, aged 11 to 18, who belonged to five Tunisian first-division soccer teams. The LMS method was used for smoothing the curves and the multivariate linear regression to develop a prediction equation of MHR. Our results showed that MHR and RHR reference curves decrease with age. The values of the median curves of MHR and RHR ranged from 208.64 bpm (11 years) to 196.93 (18 years) and 73.86 (11 years) to 63.64 (18 years), respectively. The prediction equation obtained from the model was MHR= 225.08 - 1.55 X Age (years) (R2 = 0.317; P < 0.001; standard error of the estimate (SEE) = 5.22). The comparisons between the estimated values and the measured values have found that our model (- 0.004 ±5.22 bpm) was to be more accurate than two other widely known models. BOX's equation underestimates the measured MHR values by -3.17 ± 5.37 bpm and TANAKA's equation overestimates by + 4.33 ±5.5 bpm. The reference curves can be used by coaches and physical trainers to classify the resting heart rate (RHR) and maximum heart rate (MHR) of each adolescent player, track their evolution over time, and design tailored training programs with specific intensities for Tunisian soccer players.

Performance of equations for estimation of 24-hour urinary sodium from morning fasting urine samples in a multisite study in India.

Background Dietary salt intake is an important modifiable risk factor for cardiovascular diseases. Estimation of 24-hour salt intake using morning urine samples needs to be validated in the Indian context. We examined the performance of INTERSALT, Tanaka and Kawasaki equations for the estimation of 24-hour urinary sodium from morning fasting urine (MFU) samples. Methods We enrolled 486 adults aged 18-69 years from four regions of India with equal rural/urban and sex representation to provide 24-hour urine samples. The next day, a MFU sample was obtained. Based on the volume and sodium content of the 24-hour urine sample, 24-hour sodium excretion (reference method) was calculated. Sodium levels in the MFU samples were measured along with other parameters required, and the above equations were used to estimate 24-hour urinary sodium levels. Intraclass correlation coefficient (ICC) was used to assess the degree of agreement between the estimates from the reference method and the three equations. Bland-Altman (BA) plots were used to identify systematic bias and limits of agreement. A difference of 1 g of salt (0.39 g of sodium) between the mean salt intake by 24-hour urine and as estimated by equations was considered acceptable. Results A total of 346 participants provided both the samples. The mean (SD) daily salt intake estimated by the 24-hour urine sample method was 9.9 (5.8) g. ICC was low for all the three equations: highest for Kawasaki (0.16; 95% CI 0.05-0.26) and least for Tanaka (0.12; 0.02-0.22). Only Tanaka equation provided estimates within 1 g of measured 24-hour salt intake (-0.36 g). BA plots showed that as the mean values increased, all the three equations provided lower estimates of salt intake. Conclusion Tanaka equation provided acceptable values of 24-hour salt intake at the population level. However, poor performance of all the equations highlights the need to understand the reasons and develop better methods for the measurement of sodium intake at the population level.

MO561: Salt and Chronic Kidney Disease: How Much Does the Patient Know? A Pilot Study

Abstract BACKGROUND AND AIMS Despite World Health Organisation recommends a salt intake of &amp;lt;5 g per day, many studies reported a much higher consumption in the general population. High salt intake is a known risk factor for hypertension and worsening of chronic kidney disease; however, studies assessing the effective sodium intake and patient's perspective towards salt in this population are lacking. METHOD We conducted a single centre, cross-sectional, observational study enrolling patients older than 18, with a diagnosis of chronic kidney disease stage 3 to 5, who underwent a regular visit at the outpatient clinic of our Unit, from 12 March 2021 to 10 October 2021. Clinical data, including medical history, treatments and sociodemographic information were collected from patients’ records. Anthropometric measurements were performed during the visit. Every patient was asked to provide a random urine sample, to perform a 24-h urine collection and filled a questionnaire on Knowledge, Attitude and Practice toward salt that we adapted from other studies[1,2]; a section was focused on Mediterranean Diet adherence. Salt intake was assessed by means of 24-h sodium excretion and using three equations (namely Tanaka, Nerbass and Kawasaki) to estimate it from spot urine. Adequacy of 24-h urine collection was defined upon values of creatininuria. We evaluated whether there was a correlation between sodium intake with demographic and clinical data and with the scores from various sections of the questionnaire. RESULTS We enrolled 90 patients, 55 males and 35 females, aged 73.7 ± 8.7 years; mean BMI was 29.1 ± 5.5. Of 90 patients, 78 provided the 24-h urine collection; however, 30 out of 78 were not included due to inadequacy. Twenty-four hours sodium excretion of remaining 48 was compared with the estimates obtained from spot urine. Bland Altman test revealed best performance for Tanaka equation (bias 0.99 ± 62.5 mEq/d, 95% LoA from -121.6 to 123.6); thus, this was used for subsequent analysis. Mean sodium intake in our population was 156.2 ± 50.5 mEq/d. We found no difference in sodium intake according to gender, age, stage of CKD, blood pressure, education, smoking habits or residency; however, we found higher intake in overweight (148.5 ± 38.9 mEq/d) and obese (179.5 ± 62.4 mEq/d) people when compared with normal weight subjects (142.2 ± 43.1 mEq/d; P = 0.0301). Patients on diuretic treatment were found to have higher sodium intake (173.6 ± 58.6 versus 137.9 ± 30.7 mEq/d, P = 0.0018), but there was no association of sodium intake with number of antihypertensive medications. Although 63.3% of patients thought of consuming a diet with the right amount of salt, less than 10% of them knew exactly the recommended daily salt intake. We found no correlation between the questionnaire scores and clinical and sociodemographic data, even if female patients showed a trend toward better performance in Knowledge (P = 0.0756) and Mediterranean Diet adherence (P = 0.0632). A positive correlation between Knowledge and Practice scores was found (r = 0.3506, P = 0.0007). CONCLUSION Our study shows that the mean salt intake in chronic kidney disease patient is much higher than recommended, despite the importance of a low salt diet. Obese patients showed the highest sodium intake, possibly due to the elevate intake of processed food. The questionnaire showed a lack of knowledge that encompasses every sociodemographic category. Also, the high number of inadequate 24-h urine collections points out the critical role of the assessment method, which may need to be reconsidered.

Monitoring population salt intake using casual urinary sodium: Tehran Lipid and Glucose Study

BackgroundWe aimed to estimate salt intake among an Iranian population using spot urine-based equations and a dietary-based method.MethodsAdult men and women (n = 2069) were recruited from the Tehran Lipid and Glucose Study (2014–2017). Urinary sodium (Na), potassium (K), and creatinine (Cr) concentrations were measured in the morning spot urine samples. The 24-h urinary Na excretion and predicted salt intake was estimated using five equations, i.e., Kawasaki, Tanaka, Intersalt, Toft, and Whitton. A validated food frequency questionnaire (FFQ) was used to obtain dietary intake of salt. The agreement of each urinary- and FFQ-based salt estimation with the overall mean of the methods, considered as the gold standard, was assessed using the Bland–Altman method.ResultsMean age of the participants was 45.6 ± 14.8 y, and 45.4% were men. Mean (SD) estimated salt intake, derived from the overall mean of the methods, was 9.0 ± 2.2 g/d (10.2 ± 2.1 and 7.9 ± 1.7 g/d in men and women, respectively). Mean bias of the estimations from the overall mean ranged from − 0.2.42 to 2.75 g/d, with the Tanaka equation having the least bias (mean bias = 0.13 ± 1.10, 95% CI − 2.37, 2.30 g/d). Tanaka estimated a mean salt intake of 8.9 g/d (range 2.1 to 18.7 g/d); accordingly, only 5.1% of participants adhered to the recommendation (< 5 g/d salt intake), whereas 26.8% and 2.4% exceeded the recommendation by 2- and threefold.ConclusionThe Tanaka equation could provide a more accurate mean-population estimated salt intake from casual urinary Na concentration in our population. About 95% of the Iranian population exceeded the current recommendations of salt intake.

347 From arterial hypertension to left ventricular hypertrophy and heart failure: role of cardiopulmonary exercise testing in heart failure with preserved ejection fraction

Abstract Aims Arterial hypertension (AHT) represents the leading cause of heart failure (HF). A complex cardiovascular (CV) continuum of events leads to the progression from AHT to left ventricular hypertrophy (LVH), the hallmark of hypertensive heart (HH), towards heart failure with preserved ejection fraction (HFpEF) or reduced ejection fraction (HFrEF). Cardiopulmonary exercise testing (CPET) represents an important tool to evaluate HF patients (both with HFpEF and HFrEF) allowing quantification of functional capacity and mechanisms of dyspnoea as well as providing prognostic markers. To investigate CPET responses in AHT patients at various stages of disease progression from AHT to LVH and HF with preserved and reduced ejection fraction. Methods and results From a CPET registry of 1.397 consecutive subjects, 92 patients were selected (matched according to age, gender, BMI, CV risk factors, beta-blockers) and divided into four groups: 23 AHT patients without LVH, 23 HH patients, 23 HFpEF patients and 23 HFrEF. HFrEF were defined according to LV-EF values while HFpEF were defined according to the presence of NYHA Class ≥2 and HFA-PEFF Score. Mean age was 65 ± 10 years, mean BMI was 28.5 ± 5, male gender was prevalent 83% and 33% had diabetes. Both HFpEF and HFrEF showed lower cardiorespiratory fitness (peak VO2; P &amp;lt; 0.001), cardiovascular efficiency (VO2/Watt slope: P &amp;lt; 0.001), oxygen pulse (VO2/HR: P &amp;lt; 0.001), cardiac output (P &amp;lt; 0.001) and stroke volume (P &amp;lt; 0.001) at peak as well as lower chronotropic response (P &amp;lt; 0.001), ventilatory efficiency (VE/VCO2 slope: P &amp;lt; 0.001), and heart rate recovery (HRR: P = 0.004) compared with both AHT and HH groups. Interestingly, no differences between HFpEF and HFrEF have been found in all CPET data except for chronotropic response (using Tanaka equation), lower in HFpEF (37.5 ± 16.5 vs. 53.5 ± 20.5; P &amp;lt; 0.001) and ventilatory efficiency, lower in HFrEF (VE/VCO2 slope: 32 ± 5 vs. 37 ± 10; P &amp;lt; 0.001). Finally, adding functional capacity (peak VO2) data to ESC Criteria an improvement in HFpEF diagnosis accuracy was found, with 82% sensitivity and 90% specificity (AUC: 859—95% CI: 754–963; P &amp;lt; 0.0001). Conclusions Despite the intrinsic differences in ejection fraction, both HFpEF and HFrEF shares similar cardiopulmonary mechanisms and cardiovascular responses to exercise. CPET may represent a useful tool in order to identify and stratify hypertensive heart patients with HFpEF with high diagnostic accuracy.

Association of rheumatoid arthritis and high sodium intake with major adverse cardiovascular events: a cross-sectional study from the seventh Korean National Health and Nutrition Examination Survey

ObjectivesHigh salt intake has a harmful effect on hypertension; however, the association between major adverse cardiovascular events (MACE) and salt intake is still controversial. Rheumatoid arthritis (RA) is also characterised...

Development of a Method for Estimating Dietary Salt Intake Using the Overnight Urinary Sodium/Potassium Ratio.

BackgroundThere are many patients who need to restrict and assess salt in their diet. However, it is difficult to estimate daily salt intake accurately and easily. Therefore, a method for estimating dietary salt intake using the overnight urinary sodium (Na)/potassium (K) ratio was developed.MethodsThe study involved 43 healthy adults (13 males, 30 females). From 2018 to 2020, subjects consumed a salt-adjusted diet for 11 - 30 days continuously, and overnight urine was collected daily. Using the previous day’s salt intake as the objective variable, an equation for estimating the salt intake was developed using a general linear model. To verify the accuracy of the estimating equation, the estimated salt intake of the previous day was calculated using our equation and Tanaka’s equation, which is an estimating equation from spot urine widely used in clinical practice and epidemiological studies to estimate dietary salt intake, and they were compared with the actual salt intake.ResultsThe results of the analysis showed that model 1 (previous day’s salt intake (g) = 3.62 + 0.64 × urinary Na/K ratio + 0.18 × conductivity (mS/cm) - 0.43 × sex (male 0, female 1)) was the optimal model. Then, salt intake was estimated using model 1 and Tanaka’s equation, and compared with actual salt intake. The Pearson’s product-moment correlation coefficient between the actual and estimated salt intake was r = 0.618 (P < 0.001) and r = 0.573 (P < 0.001) for model 1 estimates and Tanaka’s equation estimates, respectively. The percentages of errors within ±30% from the actual salt intake were 64.2% and 58.4% for model 1 and Tanaka’s equation, respectively.ConclusionAn equation for estimating salt intake was developed using the Na/K ratio and conductivity of overnight urine. Although the applicability of this method to hypertensive patients and the elderly has not been studied and needs to be clarified in the future, the estimating equation developed is simple and may be a useful method for daily monitoring of dietary salt intake.

Association between childhood obesity and familial salt intake: analysis of data from Korean National Health and Nutrition Examination Survey, 2014-2017.

High salt intake is known as a risk factor of childhood obesity. As family members share not only genes but also their diet habit, parents' salt intake may affect to their children's obesity. In this study, we investigated correlations between childhood obesity and parents' or children's sodium intakes based on a nationwide survey data. From the Korean National Health and Nutrition Examination Survey data from 2014 to 2017, 802 boys and 657 girls aged 10-18 years, and their parents were included. BMI z-score and 24-hour urinary sodium excretion, which is estimated through Tanaka's equation, were used to examine associations between obesity and sodium intakes. The BMI status and the prevalence of obesity between children and their parents showed strong positive correlations in both sexes (all p < 0.001). The urinary sodium excretion between children and their parents showed positive correlations in both sexes (all p < 0.05). Children with higher urinary sodium excretion showed higher BMI (in both sexes, p < 0.001) and higher parental obesity compared to those with lower urinary sodium excretion, however, statistical significances of the latter relationship were varied by sex. In conclusion, our study suggests close relationship between childhood obesity and their sodium intakes, which also correlate well with parental BMIs and diet behavior. Therefore, parental education and active participation could be crucial in regulating childhood obesity.

Estudio comparativo de la densidad del agua y su aplicación en el presupuesto de incertidumbre para calibraciones en volumen

In the quantity of volume, gravimetric method is considered the best accuracy method for the quantitative determination of an analyte based on its mass. The distilled water is selected as calibration liquid because it is well known how its density changes with temperature. For volume calculation at reference temperature, the water density value is obtained by known mathematic models, for example, Tanaka equation (Tanaka, et al., 2001). According to ISO 3696 (International Organization for Standardization, 1987), there are requirements for water (Grade 3), the lab needs to perform periodic studies of conductivity, but it is necessary to study the water density deviation and comparing this value with that obtained by Tanaka equation. If this deviation value (calculated by Tanaka Equation vs Oscillation – type density meter is significant, it must be considered in the uncertainty estimation for volume calibration using gravimetric method.

Urinary sodium and iodine concentrations among Belgian adults: results from the first national Health Examination Survey.

Iodine deficiency and excessive salt intakes have adverse health consequences. The objective was to measure sodium and iodine concentrations in urine spot samples among a representative sample of Belgian adults and compare those to World Health Organization (WHO) recommendations. Spot urine samples were collected in 2018 from participants of the Belgian Health Examination Survey. Iodine and sodium concentrations were measured by inductively coupled plasma mass spectrometry and ion selective electrodes respectively. Tanaka and INTERSALT equations were used to predict 24-h urinary sodium excretion using sodium and creatinine concentration in spot samples, sex, and measured height and weight. Median urinary iodine concentration (UIC) among adults (n = 1092) was 93.6 µg/L, indicating mild iodine deficiency according to WHO thresholds. Median UIC among participants who reported thyroid problems over the last year was significantly higher than among those who did not report thyroid problems (104.1 µg/L versus UIC = 92.2 µg/L, p < 0.001). There were no significant differences in median UIC between sexes, age groups, and regions. The average salt intake among Belgian adults (n = 1120) was 8.3 ± 0.1 g/day using the Tanaka equation and 9.4 ± 0.1 g/day using the INTERSALT equation. For both equations, <5% of the population met the recommended WHO upper salt intake level of 5 g/day. Iodine nutrition in the Belgian adult, nonpregnant population likely indicates mild iodine deficiency as the median UIC was below the WHO threshold for iodine sufficiency. Salt intake was substantially higher than the WHO recommendations. Further policy efforts are needed to optimize iodine and reduce salt intake in Belgium.

453 Association of processed meat and sodium intake with atopic dermatitis in adults: A pooled analysis of three cross-sectional studies in China and validation in NHANES 2005-2006

Intake of processed food that contains high content of salt and nitrite are associated with poorer health outcomes. A recent study indicated that salt could stimulate Th2 cell differentiation in vitro experiment, and might link atopic dermatitis (AD). The study aimed to investigate intakes of processed meat, pickles, and estimated salt and nitrite with adult AD in three population-based studies among rural residents, civil servants, and workers in China. Intakes of processed meat and pickles during the past year were inquired through a food frequency questionnaire. Daily intake of salt was estimated according to food nutrition content and validated by urine sodium concentration-based estimates through the Tanaka equation. AD was ascertained by dermatologists during the field survey. NHANES 2005-2006 data was used to validate the results. AD in NHANES was defined as self-reported eczema with elevated IgE levels (>333 IU/ml). A mixed model was used to deal with the intra-cluster correlation, and to estimate the effect size in terms of adjusted odds ratio (AOR). A total of 15062 Chinese participants was analyzed. Intake of pickles for at least 1 time per week was associated with AD (AOR=1.35; 95% CI: 1.06–1.70). Intake of processed meat for at least 1 time per week was associated with AD (AOR=1.44; 95% CI: 1.11–1.87). In NHANES 2005-2006, intakes of bacon (AOR=4.47; 95% CI: 1.21–16.6) and sausage (AOR=8.59; 95% CI: 2.03–36.4), but not pickles (AOR=0.55; 95% CI: 0.07–4.67) for at least 3 times per week, were significantly associated with AD. In both Chinese and US population, cubic spline showed that the estimated daily sodium intake was linearly associated with the risk of AD. Processed meat, possibly through a mechanism involving sodium, may increase the risk of AD in adults.

Food intake and dietary patterns that affect urinary sodium excretion in young women.

We aimed to clarify food intake and dietary patterns that affect urinary sodium excretion (urinary salt excretion) among young women. We used 2012 to 2018 data from the health and nutrition testing on admission, which is a part of ongoing epidemiological studies, for students enrolling in the Faculty of Nutrition Science, Nakamura Gakuen University. Fasting urine samples were collected from the participants, and their estimated daily salt excretion was calculated using the Tanaka equation. The dietary assessment used was the semi-quantitative food frequency questionnaire, and we confirmed its validity. The participants included 2218 women aged 18 to 20years who were classified into four groups according to urinary salt excretion (g/d) from their spot urine: Q1 , <5.56; Q2 , 5.56≤, <6.79; Q3 , 6.79≤, <8.12; and Q4 , 8.12<. The high urinary salt group had a significantly higher consumption of oil and fat, fish, meat, eggs, soybean, green and yellow vegetables, white vegetables, seaweeds, and pickled vegetables compared with the low urinary salt groups. When we compared the differences of the quartiles for urinary sodium excretion and the factor loadings for three dietary patterns by factor analysis with varimax rotation, the high urinary salt group showed a higher tendency for Japanese dietary patterns of factor 1 compared with the low urinary salt group. In conclusion, the various foods, including foods containing proteins and vegetables and Japanese dietary pattern centering on fish, vegetables, soybeans, and seaweed, affected the urinary sodium excretion in young women.

Is salt intake reduction a universal intervention for both normotensive and hypertensive people: a case from Iran STEPS survey 2016

There is a direct association between salt intake and blood pressure (BP), one of the main risk factors for CVDs. However, yet there has been a debate that how strong is this association in people with and without hypertension. This study was conducted to evaluate the magnitude of the association between salt intake and BP in hypertensive and normotensive population among a nationally representative population. The study was conducted on a nationally representative sample of 18,635 Iranian adults aged 25years and older who participated in the STEPS survey 2016 and provided urine sample. Salt intake was estimated through spot urine sample and Tanaka equation. Multiple linear regression model in survey data analysis was used to assess the independent effect of salt intake on BP. After adjusting for covariates, there was a significant association between salt intake and SBP in hypertensive (p < 0.001) and normotensive people (p < 0.001). In hypertensive people, with 1g of increase in salt intake, the SBP and DBP increased 0.37mmHg and 0.07mmHg, respectively. Whereas in normotensive people, with 1g of increase in salt intake, the SBP and DBP increased 0.26mmHg and 0.05mmHg, respectively. Moreover, there was a significant trend toward an increase of SBP across salt intake quartiles in both hypertensive (p < 0.001) and normotensive people (p = 0.002), though the slope was steeper in hypertensive than in normotensive people. The present study demonstrated that salt intake significantly increased SBP in both hypertensive and normotensive people, though the magnitude of this increase was greater in hypertensive people as compared with normotensive people.