The publication in the last few years of a number of prospective observational studies suggesting a J-shaped association between levels of salt (sodium) consumption and cardiovascular outcomes has ...opened a debate on the pertinence of population-wide salt reduction policies to reduce cardiovascular disease burden, and some have even questioned the global World Health Organization guidelines, that recommend a 30% reduction in salt consumption by 2025, aiming at an ideal target of no more than 5 g of salt consumption per day.
In September 2018 the European Salt Action Network (E.S.A.N.), after appraising the quality of publications questioning the appropriateness of population salt reduction, discussed the scientific evidence and identified the pitfalls of recent data. The new evidence was deemed inadequate and, in places, biased by flawed methodology. These were identified in the biased assessment of sodium intake from spot urine and the use of the Kawasaki formula, the biased assessment of the sodium–outcome relationships in prospective observational studies using spot urine samples, the impact of reverse causality in such studies, the inadequate analytical approaches to data analysis, the lack of biological plausibility and the lack of precision in assessing long-term salt consumption, as recently demonstrated in studies using more stringent quality features in their study designs.
On the basis of such appraisal, the E.S.A.N. agreed a statement confirming the support to the implementation of national and regional programmes of moderate reduction in salt intake, as recommended by the World Health Organization.
Objective To assess the relation between the level of habitual salt intake and stroke or total cardiovascular disease outcome.Design Systematic review and meta-analysis of prospective studies ...published 1966-2008.Data sources Medline (1966-2008), Embase (from 1988), AMED (from 1985), CINAHL (from 1982), Psychinfo (from 1985), and the Cochrane Library. Review methods For each study, relative risks and 95% confidence intervals were extracted and pooled with a random effect model, weighting for the inverse of the variance. Heterogeneity, publication bias, subgroup, and meta-regression analyses were performed. Criteria for inclusion were prospective adult population study, assessment of salt intake as baseline exposure, assessment of either stroke or total cardiovascular disease as outcome, follow-up of at least three years, indication of number of participants exposed and number of events across different salt intake categories.Results There were 19 independent cohort samples from 13 studies, with 177 025 participants (follow-up 3.5-19 years) and over 11 000 vascular events. Higher salt intake was associated with greater risk of stroke (pooled relative risk 1.23, 95% confidence interval 1.06 to 1.43; P=0.007) and cardiovascular disease (1.14, 0.99 to 1.32; P=0.07), with no significant evidence of publication bias. For cardiovascular disease, sensitivity analysis showed that the exclusion of a single study led to a pooled estimate of 1.17 (1.02 to 1.34; P=0.02). The associations observed were greater the larger the difference in sodium intake and the longer the follow-up.Conclusions High salt intake is associated with significantly increased risk of stroke and total cardiovascular disease. Because of imprecision in measurement of salt intake, these effect sizes are likely to be underestimated. These results support the role of a substantial population reduction in salt intake for the prevention of cardiovascular disease.
Abstract
Thermal piping insulation of implants is crucial for heat delivery, production, collection, or storage at high temperature values. It is currently obtained by enveloping low thermal ...conductivity materials such as rockwool, fiberglass, polyurethane, polystyrene, and aerogel. However, better performances can be reached by adopting vacuum technology. In this case, conductive losses are annihilated, and the radiative heat transfer mechanism represents the only loss mechanism. Here, we compare a high vacuum-based novel solution and the traditional insulation for heat delivery applications. We propose a high vacuum- based solution consisting of an evacuated gap that surrounds the hot pipe coated by a thin aluminium foil. Experimental results using this novel solution show a fivefold reduction of the thermal radiation losses compared to the traditional solutions when in the temperature range between 100 °C and 250 °C.
Leptin (LPT) is associated with unfavourable cardio-metabolic risk profile. Although a number of studies have found a positive association between LPT and insulin resistance (IR), no observational ...study has evaluated a prospective association to detect a predictive role of LPT in IR. Therefore, the aim of this study was to estimate the role of LPT on the incidence of IR in an 8-year follow-up of a sample of adult men (The Olivetti Heart Study).
The study included 527 not diabetic men without IR (homeostasis model assessment - HOMA index < 2.77 UI) at baseline. Baseline LPT was significantly and positively associated with HOMA index, body mass index (BMI), waist circumference and blood pressure. At the end of the 8-year follow-up period, a positive and significant association was detected between baseline LPT and changes in HOMA index (r = 0.25, p < 0.01) and incidence of IR (OR: 2.6, 95%CI: 1.9–3.4). This trend was also confirmed after adjustment for potential confounders. In addition, the predictive value of LPT was found in subjects who had not experienced any weight increase over the years, and for normal weight and excess body weight participants, separately.
The results of this prospective study suggest a predictive role of circulating LPT levels on a reduction of insulin sensitivity over time, independently of main potential confounders, in non-diabetic men without IR at baseline. In addition, in normal weight individuals, LPT levels were associated with development of IR.
•Leptin is associated with unfavourable cardio-metabolic profile risk.•No prospective studies evaluated a predictive role of leptin on insulin resistance.•Leptin is associated with insulin resistance development over time, in non-diabetic men at baseline.•The predictive value of leptin is confirmed in normal weight and excess body weight participants, separately.
Purpose
Leptin is associated with cardiovascular risk factors (e.g. hypertension, insulin resistance, kidney disease and excess body weight). Experimental studies showed that leptin might affect ...serum uric acid, by modulation of the uric acid excretion. However, there are few observational data on the relationship between leptin and uric acid in the general population. Therefore, the aim of the present study was to evaluate the relationship between leptin and uric acid and its excretion in a large middle-aged male general population.
Methods
A sample of 930 adult male individuals (mean age: 52 years) without therapy for high uric acid was included in the analysis (the Olivetti Heart Study).
Results
Uric acid was significantly and positively associated with blood pressure, BMI, waist circumference, insulin resistance, C-reactive protein and leptin (
p
< 0.01), while inversely with renal function (
p
= 0.01). The multivariate analysis confirmed the association between leptin and uric acid after adjustment for potential confounders (
p
< 0.01). After division for adiposity, this trend was confirmed separately for normal weight and excess body weight participants. Moreover, leptin was inversely associated with excretion of uric acid (
p
< 0.01), also in multivariate analysis (
p
= 0.03).
Conclusion
The results of this study indicate a positive association between circulating leptin levels and uric acid, independently of potential confounders, both in normal and excess body weight men. Furthermore, an inverse association between leptin and uric acid excretion was detected.
The present study aimed to test the capability of real-time three-dimensional echocardiography (RT3DE) in characterizing early abnormalities of left ventricular (LV) structure and function in native, ...untreated hypertensive patients.
Thirty-eight newly diagnosed, never-treated hypertensives (H) and 38 healthy controls (C) underwent both standard echo-Doppler and RT3DE assessment. LV volumes and ejection fraction (EF), sphericity index, LV mass index (LVMi), global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) were calculated by RT3DE. The two groups were comparable for age and heart rate. Body mass index and blood pressure (BP) were significantly higher in H. LV volumes, EF, and sphericity index calculated by RT3DE did not differ significantly between the two groups, while LVMi was higher in H than in C (P< 0.0001). GAS (-29.1 ± 2.5% in H vs. -33.6 ± 3.4% in C), GLS, and GRS (all P< 0.0001) were lower in H, but GCS was not significantly different between the two groups. Among the different 3D strain components, GAS showed the best independent associations with mean BP (β = -0.502, P< 0.0001) and LVMi (β = -0.385, P< 0.001; cumulative R(2) = 0.55, P< 0.0001) in the pooled population.
RT3DE identifies early functional LV changes in native hypertensive patients. GAS is precociously reduced, and longitudinal and radial strain impaired, while circumferential strain is still preserved, supporting a normal LV chamber systolic function. Reduction of GAS is independently associated with both pressure overload and magnitude of the LV mass.
Abstract
We propose an innovative flat plate hybrid Photovoltaic-Thermal system under high vacuum (HV PV-T) optimized for solar-to-thermal energy conversion. It consists of a glass cover, metallic ...vessel, and the actual PV-T device, which englobes a low-emissive Transparent Conductive Oxide (TCO), a perovskite-based PV cell, a Solar Absorber, and a copper substrate. We investigate, through a 1-D model developed in MATLAB, the performances of the proposed PV-T system, still mined by radiative losses, varying the operating temperature (T
op
) and the emittance of the TCO (
ε
TCO
) in the ranges of (25÷175) °C and (0.05÷0.45) respectively. The annual thermal and electrical productions are evaluated considering the Typical Meteorological Year of Naples, Italy. Specific annual costs and emission savings are evaluated and compared with the ones assured by commercial High Vacuum Flat Plate Solar-Thermal (HVFP ST) and PV collectors. Results indicate that the proposed HV PV-T increases the annual cost savings by 34% and 11% when compared to HVFP ST and PV collectors, respectively. Moreover, the presented HV PV-T increases the annual CO
2
emissions savings by 7% and 48% when compared to HVFP ST and PV collectors, respectively.
High sodium (Na) and low potassium (K) intake are associated with hypertension and CVD risk. This study explored the associations of health literacy (HL), food literacy (FL), and salt awareness with ...salt intake, K intake, and Na/K ratio in a workplace intervention trial in Switzerland.
The study acquired baseline data from 141 individuals, mean age 44.6 years. Na and K intake were estimated from a single 24-h urine collection. We applied validated instruments to assess HL and FL, and salt awareness. Multiple linear regression was used to investigate the association of explanatory variables with salt intake, K intake, and Na/K. Mean daily salt intake was 8.9 g, K 3.1 g, and Na/K 1.18. Salt intake was associated with sex (p < 0.001), and K intake with sex (p < 0.001), age (p = 0.02), and waist-to-height ratio (p = 0.03), as was Na/K. HL index and FL score were not significantly associated with salt or K intake but the awareness variable “salt content impacts food/menu choice” was associated with salt intake (p = 0.005).
To achieve the established targets for population Na and K intake, health-related knowledge, abilities, and skills related to Na/salt and K intake need to be promoted through combined educational and structural interventions.
Clinical Trials Registry number: DRKS00006790 (23/09/2014).
•Sodium/salt and potassium intake did not meet recommended levels.•Salt intake tended to be lower in people of higher literacy and awareness.•No significant association of health/food literacy with salt and potassium intake.•Salt awareness better explained differences in salt and potassium intake.•Along with food reformulation, education measures must enhance food choice skills.
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