Excessive dietary salt (sodium chloride) intake is associated with an increased risk for hypertension, which in turn is especially a major risk factor for stroke and other cardiovascular pathologies, ...but also kidney diseases. Besides, high salt intake or preference for salty food is discussed to be positive associated with stomach cancer, and according to recent studies probably also obesity risk. On the other hand a reduction of dietary salt intake leads to a considerable reduction in blood pressure, especially in hypertensive patients but to a lesser extent also in normotensives as several meta-analyses of interventional studies have shown. Various mechanisms for salt-dependent hypertension have been put forward including volume expansion, modified renal functions and disorders in sodium balance, impaired reaction of the renin-angiotensin-aldosterone-system and the associated receptors, central stimulation of the activity of the sympathetic nervous system, and possibly also inflammatory processes.Not every person reacts to changes in dietary salt intake with alterations in blood pressure, dividing people in salt sensitive and insensitive groups. It is estimated that about 50-60 % of hypertensives are salt sensitive. In addition to genetic polymorphisms, salt sensitivity is increased in aging, in black people, and in persons with metabolic syndrome or obesity. However, although mechanisms of salt-dependent hypertensive effects are increasingly known, more research on measurement, storage and kinetics of sodium, on physiological properties, and genetic determinants of salt sensitivity are necessary to harden the basis for salt reduction recommendations.Currently estimated dietary intake of salt is about 9-12 g per day in most countries of the world. These amounts are significantly above the WHO recommended level of less than 5 g salt per day. According to recent research results a moderate reduction of daily salt intake from current intakes to 5-6 g can reduce morbidity rates. Potential risks of salt reduction, like suboptimal iodine supply, are limited and manageable. Concomitant to salt reduction, potassium intake by higher intake of fruits and vegetables should be optimised, since several studies have provided evidence that potassium rich diets or interventions with potassium can lower blood pressure, especially in hypertensives.In addition to dietary assessment the gold standard for measuring salt intake is the analysis of sodium excretion in the 24 h urine. Spot urine samples are appropriate alternatives for monitoring sodium intake. A weakness of dietary evaluations is that the salt content of many foods is not precisely known and information in nutrient databases are limited. A certain limitation of the urine assessment is that dietary sources contributing to salt intake cannot be identified.Salt reduction strategies include nutritional education, improving environmental conditions (by product reformulation and optimization of communal catering) up to mandatory nutrition labeling and regulated nutrition/health claims, as well as legislated changes in the form of taxation.Regarding dietary interventions for the reduction of blood pressure the Dietary Approaches to Stop Hypertension (DASH) diet can be recommended. In addition, body weight should be normalized in overweight and obese people (BMI less than 25 kg/m
), salt intake should not exceed 5 g/day according to WHO recommendations (<2 g sodium/day), no more than 1.5 g sodium/d in blacks, middle- and older-aged persons, and individuals with hypertension, diabetes, or chronic kidney disease, intake of potassium (~4.7 g/day) should be increased and alcohol consumption limited. In addition, regular physical activity (endurance, dynamic resistance, and isometric resistance training) is very important.
Salt need needs investigation Leshem, Micah
British journal of nutrition,
06/2020, Letnik:
123, Številka:
11
Journal Article
Recenzirano
Odprti dostop
Expensive and extensive studies on the epidemiology of excessive Na intake and its pathology have been conducted over four decades. The resultant consensus that dietary Na is toxic, as well as the ...contention that it is less so, ignores the root cause of the attractiveness of salted food. The extant hypotheses are that most Na is infiltrated into our bodies via heavily salted industrialised food without our knowledge and that mere exposure early in life determines lifelong intake. However, these hypotheses are poorly evidenced and are meagre explanations for the comparable salt intake of people worldwide despite their markedly different diets. The love of salt begins at birth for some, vacillates in infancy, climaxes during adolescent growth, settles into separate patterns for men and women in adulthood and, with age, fades for some and persists for others. Salt adds flavour to food. It sustains and protects humans in exertion, may modulate their mood and contributes to their ailments. It may have as yet unknown benefits that may promote its delectability, and it generates controversy. An understanding of the predilection for salt should allow a more evidence-based and effective reduction of the health risks associated with Na surfeit and deficiency. The purpose of this brief review is to show the need for research into the determinants of salt intake by summarising the little we know.
This study aimed to objectively evaluate the diet consumed in a workplace cafeteria to group Japanese workers according to vegetables and salt intake and estimate the association of these groups with ...changes in cardiometabolic measurements.
This longitudinal observational study estimated the food and nutrient intake of Japanese workers from data recorded in the cafeteria system of their workplace. The primary outcomes included cardiometabolic measures obtained via regular health check-ups conducted at the workplace. The participants were divided into four groups according to high or low vegetables and salt intake based on their respective medians and the association of each group with cardiometabolic measurement changes was estimated using robust regression with MM-estimation.
A Japanese automobile manufacturing factory.
The study included 1,140 men and women workers with available cafeteria and health check-up data.
An inverse marginal association was observed between changes in triglyceride levels and high vegetables and low salt intake (β: -9.93, 95% confidence interval CI: -20.45, 0.59, p: 0.065) with reference to low vegetables and high salt intake. This association was stronger in participants who used the cafeteria more frequently (>71 days; β: -13.55, 95% CI: -25.51, -1.60, p: 0.027).
The participants in the higher vegetables and lower salt intake group were more likely to exhibit decreased triglyceride levels. These findings encourage using workplace cafeteria meals to promote the health of workers.
In 2013, the WHO recommended that all member states aim to reduce population salt intake by 30% by 2025. The year 2019 represents the midpoint, making it a critical time to assess countries' progress ...towards this target. This review aims to identify all national salt reduction initiatives around the world in 2019, and to quantify countries' progress in achieving the salt reduction target. Relevant data were identified through searches of peer-reviewed and gray literature, supplemented with responses from prefilled country questionnaires sent to known country leads of salt reduction or salt champions, WHO regional representatives, and international experts to request further information. Core characteristics of each country's strategy, including evaluations of program impact, were extracted and summarized. A total of 96 national salt reduction initiatives were identified, representing a 28% increase in the number reported in 2014. About 90% of the initiatives were multifaceted in approach, and 60% had a regulatory component. Approaches include interventions in settings (n= 74), food reformulation (n = 68), consumer education (n = 50), front-of-pack labeling (n = 48), and salt taxation (n = 5). Since 2014, there has been an increase in the number of countries implementing each of the approaches, except consumer education. Data on program impact were limited. There were 3 countries that reported a substantial decrease (>2 g/day), 9 that reported a moderate decrease (1–2 g/day), and 5 that reported a slight decrease (<1 g/day) in the mean salt intake over time, but none have yet met the targeted 30% relative reduction in salt intake from baseline. In summary, there has been an increase in the number of salt reduction initiatives around the world since 2014. More countries are now opting for structural or regulatory approaches. However, efforts must be urgently accelerated and replicated in other countries and more rigorous monitoring and evaluation of strategies is needed to achieve the salt reduction target.
Salt intake is one of the important predictors of hypertension, a widespread chronic disease among adults. Much remains to be known about its causes, especially in the Romanian context, where there ...is a scarcity of analyses on this particular topic. Its predictors are relevant for public policy in order to evaluate what strategy should be adopted given actual levels of salt intake and the way people think about their levels of salt intake. Our analyses focus on actual and perceived salt intake. Data for this analysis come from the SEPHAR project, gathered in 2016 (wave 3), a nationally representative sample of Romanians. After noting a major discrepancy between perceived and actual levels of salt intake, we used two regressions with actual and perceived salt intake as dependent variables and three types of factors as independent variables: socio-demographic (age, gender, region, type of locality, education), lifestyle (fat diet, alcohol consumption, active lifestyle, and smoking) and related diseases (obesity and diabetes). Results show Romanians have similar levels of salt intake perceptions independently of the characteristics considered, except fat diet and diabetes, and similar levels of actual salt intake except age and gender, even though previous research shows that there are differences between individuals across these characteristics when it comes to considering hypertension as a dependent variable. We conclude by noting policy interventions regarding salt intake based on the results of this research, especially the need to update the current Romanian TV campaign to reduce salt intake or similar campaigns from other countries.
High salt intake may play a critical role in the etiology of psoriasis. Yet, evidence on the association of high salt intake with risk of psoriasis is limited.
To estimate the association between ...frequency of adding salt to foods and risk of psoriasis.
We conducted a prospective cohort study of 433,788 participants from the UK Biobank. Hazard ratios (HRs) and their 95 % confidence intervals (CIs) for risk of psoriasis in relation to frequency of adding salt to foods were estimated using multivariable Cox proportional hazards models. We further evaluated the joint association of adding salt to foods and genetic susceptibility with risk of psoriasis. We conducted a mediation analysis to assess how much of the effect of adding salt to foods on risk of psoriasis was mediated through several selected mediators.
During a median of 14.0 years of follow-up, 4279 incident cases of psoriasis were identified. In the multivariable-adjusted model, a higher frequency of adding salt to foods was significantly associated with an increased risk of psoriasis (“always” versus “never/rarely” adding salt to foods, HR = 1.25, 95 % CI: 1.10, 1.41). The observed positive association was generally similar across subgroups. In the joint association analysis, we observed that participants with a high genetic risk (above the second tertile) and the highest frequency of adding salt to foods experienced 149 % higher risk of psoriasis, when compared with participants with a low genetic risk (below the first tertile) and the lowest frequency of adding salt to foods (HR = 2.49, 95 % CI: 2.05, 3.02). Mediation analysis revealed that 1.8 %–3.2 % of the positive association between frequency of adding salt and risk of psoriasis was statistically significantly mediated by obesity and inflammatory biomarkers such as C-reactive protein and systemic immune-inflammation index (all P values < 0.004).
Our study demonstrated a positive association between frequency of adding salt to foods and risk of psoriasis. The positive association was independent of multiple other risk factors, and may be partially mediated through obesity and inflammation.
•A higher frequency of adding salt to foods was related to an increased risk of psoriasis, regardless of other risk factors.•The frequency of adding salt to foods-psoriasis association may be partially mediated through obesity and inflammation.•Our findings provide evidence that greater salt intake may be a novel risk factor for psoriasis.
Objective: This study aimed to clarify salt intake among children in Gero City, Gifu, and compare and examine dietary content according to salt intake.Methods: From April 2016 to March 2019, 535 ...children aged 3 years who underwent health checkups in Gero City and 657 children aged 5 years enrolled in nursery schools were included. A urinalysis and lifestyle questionnaire, including dietary content, were administered. Daily salt intake was estimated using urine salt test paper or the conversion formula from urinary sodium concentration. We categorized the breakfast and dinner dietary contents for those whose salt intake was within the target range of the Japanese Dietary Reference Intake (2020) and above the 95th percentile, and compared them.Results: Mean salt intakes were 6.9 g and 7.8 g for 3- and 5-year-olds, respectively. There were 82 children (15.5%) aged 3 years and 22 (3.4%) aged 5 years whose salt intake was within the target range. Breakfast for both 3- and 5-year-olds was mostly classified as "breads" and "other Japanese foods." Among 5-year-olds whose salt intake was above the 95th percentile, 13 children (32.5%) ate soba noodles, udon noodles, rice bowls, and curry and rice for dinner.Conclusion: Children aged 3 and 5 years were found to have high salt intake. Among children with a particularly high salt intake, 52.3% of 3-year-olds and 62.5% of 5-year-olds ate other Japanese foods for breakfast. Promotional activities for salt reduction should continue to improve and support dietary habits at home and throughout the community.
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