Development and validation of a short questionnaire to assess sodium
                    intake

AbstractObjectivesTo develop and validate a short food-frequency questionnaire to assess habitual dietary salt intake in South Africans and to allow classification of individuals according to intakes above or below the maximum recommended intake of 6 g salt day−1.DesignCross-sectional validation study in 324 conveniently sampled men and women.MethodsRepeated 24-hour urinary Na values and 24-hour dietary recalls were obtained on three occasions. Food items consumed by >5% of the sample and which contributed ≥50 mg Na serving−1 were included in the questionnaire in 42 categories. A scoring system was devised, based on Na content of one index food per category and frequency of consumption.ResultsPositive correlations were found between Na content of 35 of the 42 food categories in the questionnaire and total Na intake, calculated from 24-hour recall data. Total Na content of the questionnaire was associated with Na estimations from 24-hour recall data (r = 0.750; P < 0.0001; n = 328) and urinary Na (r = 0.152; P = 0.0105; n = 284). Urinary Na was higher for subjects in tertile 3 than tertile 1 of questionnaire Na content (P < 0.05). Questionnaire Na content of <2400 and ≥2400 mg day−1 equated to a reference cut-off score of 48 and corresponded to mean (standard deviation) urinary Na values of 145 (68) and 176 (99) mmol day−1, respectively (P < 0.05). Sensitivity and specificity against urinary Na ≥100 and <100 mmol day−1 was 12.4% and 93.9%, respectively.ConclusionA 42-item food-frequency questionnaire has been shown to have content-, construct- and criterion-related validity, as well as internal consistency, with regard to categorising individuals according to their habitual salt intake; however, the devised scoring system needs to show improved sensitivity.

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Mean Dietary Salt Intake in Vanuatu: A Population Survey of 755 Participants on Efate Island

Nutrients ◽

10.3390/nu11040916 ◽

2019 ◽

Vol 11 (4) ◽

pp. 916

Author(s):

Katherine Paterson ◽

Nerida Hinge ◽

Emalie Sparks ◽

Kathy Trieu ◽

Joseph Alvin Santos ◽

...

Keyword(s):

Salt Intake ◽

Urine Samples ◽

World Health ◽

Dietary Salt ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

Dietary Salt Intake ◽

Spot Urine ◽

Salt Consumption

Non-communicable diseases are responsible for 63% of global deaths, with a higher burden in low- and middle-income countries. Hypertension is the leading cause of cardiovascular-disease-related deaths worldwide, and approximately 1.7 million deaths are directly attributable to excess salt intake annually. There has been little research conducted on the level of salt consumption amongst the population of Vanuatu. Based on data from other Pacific Island countries and knowledge of changing regional diets, it was predicted that salt intake would exceed the World Health Organization’s (WHO) recommended maximum of 5 g per day. The current study aimed to provide Vanuatu with a preliminary baseline assessment of population salt intake on Efate Island. A cross-sectional survey collected demographic, clinical, and urine data from participants aged 18 to 69 years in rural and urban communities on Efate Island in October 2016 and February 2017. Mean salt intake was determined to be 7.2 (SD 2.3) g/day from spot urine samples, and 5.9 (SD 3.6) g/day from 24-h urine samples, both of which exceed the WHO recommended maximum. Based on the spot urine samples, males had significantly higher salt intake than females (7.8 g compared to 6.5 g; p < 0.001) and almost 85% of the population consumed more than the WHO recommended maximum daily amount. A coordinated government strategy is recommended to reduce salt consumption, including fiscal policies, engagement with the food industry, and education and awareness-raising to promote behavior change.

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Genetically, dietary sodium intake is causally associated with salt-sensitive hypertension risk in a community-based cohort study: a Mendelian randomization approach

European Heart Journal ◽

10.1093/ehjci/ehaa946.2791 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J.R Choi

Keyword(s):

Mendelian Randomization ◽

Salt Intake ◽

Sodium Intake ◽

Dietary Sodium ◽

Funding Source ◽

Dietary Salt ◽

Community Based ◽

Dietary Salt Intake ◽

Hypertension Risk ◽

Salt Sensitive Hypertension

Abstract Excessive dietary salt intake is associated with an increased risk of hypertension. Salt sensitivity, i.e., an elevation in blood pressure in response to high dietary salt intake, has been associated with a high risk of cardiovascular disease and mortality. We investigated whether a causal association exists between dietary sodium intake and hypertension risk using Mendelian randomization (MR). We performed an MR study using data from a large genome-wide association study comprising 15,034 Korean adults in a community-based cohort study. A total of 1,282 candidate single nucleotide polymorphisms associated with dietary sodium intake, such as rs2960306, rs4343, and rs1937671, were selected as instrumental variables. The inverse variance weighted method was used to assess the evidence for causality. Higher dietary sodium intake was associated with salt-sensitive hypertension risk. The variants of SLC8E1 rs2241543 and ADD1 rs16843589 were strongly associated with increased blood pressure. In the logistic regression model, after adjusting for age, gender, smoking, drinking, exercise, and body mass index, the GRK4 rs2960306TT genotype was inversely associated with hypertension risk (OR = 0.356, 95% CI = 0.236–0.476). However, the 2350GG genotype (ACE rs4343) exhibited a 2.11-fold increased hypertension risk (OR = 2.114, 95% CI = 2.004–2.224) relative to carriers of the 2350AA genotype, after adjusting for confounders. MR analysis revealed that the odds ratio for hypertension per 1 mg/day increment of dietary sodium intake was 2.24 in participants with the PRKG1 rs12414562 AA genotype. Our findings suggest that dietary sodium intake may be causally associated with hypertension risk. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (2017R1D1A3B03034119, 2014M3C9A3064552), and the KRIBB Initiative program. This research was also supported by the Medical Research Center Program (2017R1A5A2015369). This work was supported (in part) by the Yonsei University Research Fund 2017. Bioresources for this study were provided by the National Biobank of Korea and the Centers for Disease Control and Prevention, Republic of Korea (2017-009).

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Barriers of dietary salt reduction among hypertensive patients: a cross sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20203907 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3459

Author(s):

Mariyam Khwaja

Keyword(s):

Blood Pressure ◽

Salt Intake ◽

Lifestyle Modification ◽

Cross Sectional Study ◽

Sectional Study ◽

Dietary Salt ◽

Cross Sectional ◽

Salt Reduction ◽

Hypertensive Patients ◽

Dietary Salt Intake

Background: Healthy dietary practice is an important lifestyle modification and one of the key adjuncts to pharmacotherapy in management of hypertension. A modest reduction in salt intake of 5 gm/day lowered blood pressure by 7/4 mmHg diastolic in hypertensive patients. Despite knowledge about the ill consequences, many people continue to consume high levels of salt in their diet. To motivate people to reduce salt in their diet, a solid understanding of barriers encountered by those under salt reduction recommendation is necessary. Hence, this study was conducted with the aim of identifying the barriers to dietary salt reduction among hypertensive patients.Methods: A community based cross sectional study was conducted on a sample of 356 hypertensive patients in field practice areas (urban and rural) in Department of Community Medicine, JNMC, AMU, Aligarh. A pretested semi-structured questionnaire was used for the study. Compliance to dietary salt intake was assessed by calculating average salt intake per person per day. The tenets of health belief model were used to examine the key determinants of human behavior. Analysis was done by using correlation, proportions, chi-square and multiple linear regression.Results: 31.4% of the participants took salt <5 gm per day. A significant association was noticed with area, religion, social class, family size, perceived benefits and perceived susceptibility. A significant positive correlation was seen with total adherence score and family size.Conclusions: A lot of barriers hinder the compliance to dietary salt reduction. Health Education stressing the role of salt reduction in control of blood pressure is recommended.

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Salt and Health: Survey on Knowledge and Salt Intake Related Behaviour in Italy

Nutrients ◽

10.3390/nu12020279 ◽

2020 ◽

Vol 12 (2) ◽

pp. 279 ◽

Cited By ~ 2

Author(s):

Paola Iaccarino Idelson ◽

Lanfranco D’Elia ◽

Giulia Cairella ◽

Paola Sabino ◽

Luca Scalfi ◽

...

Keyword(s):

Online Survey ◽

Social Inequalities ◽

Dietary Habits ◽

Salt Intake ◽

Negative Impact ◽

Sodium Intake ◽

Italian Population ◽

Dietary Salt ◽

Dietary Salt Intake ◽

Level Of Knowledge

Background and aim: Excess sodium intake is a recognised causal factor of hypertension and its cardiovascular complications; there is however a lack of practical instruments to assess and monitor the level of knowledge and behaviour about dietary salt intake and to relate these factors to the population general dietary habits. Methods and Results: A self-administered questionnaire was developed to assess the salt and health related knowledge and behaviour of the Italian population through an online survey. A sample of 11,618 Italian participants completed the questionnaire. The degree of knowledge and the reported behaviour about salt intake were both found to be related to age, gender, home region, level of education and occupation. There was a significant interrelation between salt knowledge and behaviour and both were significantly and directly related to the degree of adherence to a Mediterranean-like dietary pattern. A hierarchical evaluation was also made of the relevance of any single question to the overall assessment of knowledge and behaviour about salt intake. Conclusions: The study population overall appeared to have a decent level of knowledge about salt, but a less satisfactory behaviour. Our findings point to social inequalities and young age as the main factors having a negative impact on knowledge and behaviour about salt intake as part of generally inadequate dietary habits. The degrees of knowledge and behaviour were significantly and directly interrelated, confirming that improving knowledge is a key step for behavioural changes, and suggesting that educational campaigns are crucial for the implementation of good practices in nutrition.

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Renal denervation chronically lowers arterial pressure independent of dietary sodium intake in normal rats

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01029.2002 ◽

2003 ◽

Vol 284 (6) ◽

pp. H2302-H2310 ◽

Cited By ~ 52

Author(s):

Frédéric Jacob ◽

Pilar Ariza ◽

John W. Osborn

Keyword(s):

Arterial Pressure ◽

Salt Intake ◽

Sodium Intake ◽

Recovery Period ◽

Control Period ◽

Dietary Sodium ◽

Renal Nerves ◽

Dietary Salt ◽

Dietary Salt Intake ◽

High Salt Intake

The present study was designed to test the hypothesis that renal nerves chronically modulate arterial pressure (AP) under basal conditions and during changes in dietary salt intake. To test this hypothesis, continuous telemetric recording of AP in intact (sham) and renal denervated (RDNX) Sprague-Dawley rats was performed and the effect of increasing and decreasing dietary salt intake on AP was determined. In protocol 1, 24-h AP, sodium, and water balances were measured in RDNX ( n = 11) and sham ( n = 9) rats during 5 days of normal (0.4% NaCl) and 10 days of high (4.0% NaCl) salt intake, followed by a 3-day recovery period (0.4% NaCl). Protocol 2 was similar with the exception that salt intake was decreased to 0.04% NaCl for 10 days after the 5-day period of normal salt (0.04% NaCl) intake (RDNX; n = 6, sham; n = 5). In protocol 1, AP was lower in RDNX (91 ± 1 mmHg) compared with sham (101 ± 2 mmHg) rats during the 5-day 0.4% NaCl control period. During the 10 days of high salt intake, AP increased <5 mmHg in both groups so that the difference between sham and RDNX rats remained constant. In protocol 2, AP was also lower in RDNX (93 ± 2 mmHg) compared with sham (105 ± 4 mmHg) rats during the 5-day 0.4% NaCl control period, and AP did not change in response to 10 days of a low-salt diet in either group. Overall, there were no between-group differences in sodium or water balance in either protocol. We conclude that renal nerves support basal levels of AP, irrespective of dietary sodium intake in normal rats.

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Perspectives of the public on reducing population salt intake in Ireland

Public Health Nutrition ◽

10.1017/s1368980015002530 ◽

2015 ◽

Vol 19 (7) ◽

pp. 1327-1335 ◽

Cited By ~ 8

Author(s):

Áine Regan ◽

Christine Liran Shan ◽

Patrick Wall ◽

Áine McConnon

Keyword(s):

Online Survey ◽

Salt Intake ◽

High Salt ◽

Attitudes And Beliefs ◽

Dietary Salt ◽

Cross Sectional ◽

Salt Reduction ◽

Dietary Salt Intake ◽

The Public ◽

The Government

AbstractObjectiveAs countries struggle to meet the set targets for population salt intake, there have been calls for more regulated approaches to reducing dietary salt intake. However, little is known about how the public perceives various salt reduction policies; an important line of investigation given that the implementation and success of these policies often depend on public sentiment. We investigated the attitudes and beliefs of consumers towards salt reduction and their support for thirteen different government-led salt reduction policies.DesignA cross-sectional online survey measured participants’ knowledge, beliefs and attitudes in relation to salt reduction.SettingThe survey was carried out with participants from the Republic of Ireland.SubjectsFive hundred and one participants recruited via a market research agency completed the survey.ResultsWe found that the vast majority of participants supported eleven of the government-led salt reduction policies, which included measures such as education, labelling and salt restriction in foods (both voluntary and regulated, across a range of settings). The two proposed fiscal policies (subsidising low-salt foods and taxing high-salt foods) received less support in comparison, with the majority of participants opposed to a tax on high-salt foods. A series of multiple regressions revealed that individual attitudes and beliefs related to health and salt were stronger predictors of support than sociodemographic factors, lifestyle or knowledge.ConclusionsThe study provides an important evidence base from which policy makers may draw when making decisions on future policy steps to help achieve national salt targets.

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Association of Single Nucleotide Polymorphisms in Salt Taste Receptor Genes With Dietary Salt Intake and Blood Pressure Among Iranian Adults Population

Current Developments in Nutrition ◽

10.1093/cdn/nzab050_012 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 945-945

Author(s):

Noushin Mohammadifard ◽

Mojgan Gharipour ◽

Faezeh Moazeni

Keyword(s):

Blood Pressure ◽

Salt Intake ◽

Sodium Intake ◽

Taste Receptors ◽

Urine Collection ◽

Nucleotide Polymorphisms ◽

Dietary Salt ◽

Single Nucleotide ◽

Dietary Salt Intake ◽

Salt Taste

Abstract Objectives So far, few researches has examined how genetic variation in salt taste receptors affects food intake in Iranian population. Thus, in this study, we aimed to investigate associations of single nucleotide polymorphisms (SNPs) in salt taste receptors genes with dietary salt intake and blood pressure. Methods This cross-sectional study was carried out among 116 randomly selected adults aged 18 years and over in Isfahan city, Iran. Subjects with diabetes insipidus, renal insufficiency, a special dietary regimen, fasting or menstruating on the day of sampling, using diuretics and oral contraceptives or pregnant and lactating women as well as participants who had incomplete 24-h urine collection were excluded. A 24-h urine collection and blood pressure measurement were done. Whole blood was collected to extract DNA and measure SNP rs239345 in the ENaC and rs224534, rs4790151 and rs8065080 in the TRPV1 gene. Results Homozygous carriers of the T allele for rs239345 were found to consume significantly more sodium (4414.7 ± 1943.8 mg/day) compared to the AA genotype (3887.4 ± 1709.1 mg/day). Further, they also had higher diastolic blood pressure compared to subjects with the AA genotype (81.3 ± 9.7 vs. 75.3 ± 8.3 mmHg). Compared to subjects with the CC genotype, those with homozygous carriers of the T allele for rs8065080 in the TRPV1 had higher sodium intake (3592.6 ± 1645.2 mg/day vs. 4604.2 ± 2013.5 mg/day) and systolic blood pressure (118.1 ± 11.3 mmHg vs. 123.4 ± 11.5 mmHg). No differences were found in dietary sodium intake and blood pressure with the rs224534 and rs4790151 SNPs. Conclusions These findings suggest that genetic variation in the ENaC and TRPV1 genes may contribute to inter-individual differences in salt intake and blood pressure. Funding Sources The National Institute for Medical Research Development (NIMAD) was funded this study via grant number of 977,549.

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Kebiasaan Membaca Label Gizi Berhubungan Dengan Asupan Natrium Pada Wanita Dewasa

Amerta Nutrition ◽

10.20473/amnt.v3i3.2019.158-163 ◽

2019 ◽

Vol 3 (3) ◽

pp. 158

Author(s):

Dea Dellyana Wahyutia Ady ◽

Sri Sumarmi

Keyword(s):

Food Frequency Questionnaire ◽

Random Sampling ◽

Food Packaging ◽

Sodium Intake ◽

Simple Random Sampling ◽

Sample Collection ◽

Nutrition Label ◽

Cross Sectional ◽

Blood Pressure Elevation ◽

Food Frequency

Background: Sodium is one of the nutrients which is mandatory to be displayed in food packaging. High intake of sodium can increase the risk blood pressure elevation and hypertension. The habit of reading the nutrition label can affect in dietary intake, one of them is sodium.Objective: The purpose of this study was to analyze the association between the habit of reading the nutrition label and sodium intake in female adolescents.Methods: This study was a cross sectional study with citizens of Modong Village, Tulangan Sub-district, Sidoarjo District with 70 participants. Sample collection used a simple random sampling method. Sodium intake data was collected through interview using Semi Quantitative Food Frequency Questionnaire (SQ-FFQ). Data of habit of reading the nutrition label were obtained through interview in reading nutrition label frequency. Statistical test performed was chi square test.Result: The results showed that there was a significant relationship between reading habit of nutrition fact with sodium intake among adult woman (p=0.023). Most respondents rarely read nutrition label (40%) and inadequate sodium intake (30%).Conclusion: The habit of reading nutrition label is significantly associated with sodium intake in female adolescents in Modong Village, Tulangan Sub-district, Sidoarjo District.ABSTRAK Latar Belakang: Natrium adalah salah satu zat gizi yang wajib ditampilkan di label pangan kemasan. Asupan tinggi natrium meningkatkan resiko peningkatan tekanan darah dan hipertensi. Kebiasaan membaca label gizi dapat berpengaruh terhadap asupan zat gizi, salah satunya natrium.Tujuan: Tujuan dari penelitian ini adalah untuk menganalisis hubungan kebiasaan membaca label gizi dengan asupan natrium pada wanita dewasa.Metode: Penelitian cross sectional ini dilakukan pada populasi wanita dewasa di Desa Modong, Kecamatan Tulangan, Kabupaten Sidoarjo dengan 70 orang responden. Teknik pengumpulan sampel menggunakan simple random sampling. Data asupan natrium didapatkan melalui wawancara menggunakan Semi Quantitative Food Frequency Questionnaire (SQ-FFQ). Data kebiasaan membaca label gizi didapatkan melalui wawancara frekuensi membaca label gizi. Hubungan antara kebiasaan membaca label gizi dengan asupan natrium dianalisis menggunakan uji statistic uji chi square.Hasil: Hasil penelitian menunjukkan terdapat hubungan yang bermakna antara kebiasaan membaca label gizi dengan asupan natrium (p=0,023). Sebagian besar responden jarang membaca label gizi (40%) dan mengonsumsi natrium yang berlebih (30%).Kesimpulan: Kebiasaan membaca label gizi memiliki hubungan yang bermakna dengan asupan natrium wanita dewasa di Desa Modong, Kecamatan Tulangan, Kabupaten Sidoarjo.

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Abstract P421: Estimation Of Adult Dietary Sodium Intake And Source In Shandong China 2011: Finding From SMASH Project Baseline Survey

Circulation ◽

10.1161/circ.129.suppl_1.p421 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Liuxia YAN ◽

Zilong LU ◽

Jixiang MA ◽

Xiaolei GUO ◽

Jiyu ZHANG ◽

...

Keyword(s):

Salt Intake ◽

Sodium Intake ◽

Monosodium Glutamate ◽

Soy Sauce ◽

Dietary Sodium ◽

Baseline Survey ◽

Dietary Salt ◽

Ministry Of Health ◽

Cross Sectional ◽

Dietary Recall

Zilong LU, Liuxia YAN, Jixiang MA, Xiaolei GUO, Jiyu ZHANG, Junli TANG, Huicheng WANG, Xiaoning CAI Background: Moderate population salt reduction could reduce blood pressure and the cardiovascular and stroke mortality in the long-term. In 2002, China’s national average dietary salt intake is twice of the recommendation sodium intake limit by Chinese Nutrition Association. To tackle the health burden of excessive salt intake, the former Ministry of Health has chosen Shandong province as national pilot and launched the Shandong & Ministry of Health Action on Salt and Hypertension (SMASH, 2011[[Unable to Display Character: –]]2015) project. Objective: To develop and target intervention priority, a cross-sectional population survey was conducted to collect baseline data on sodium intake and sources in Shandong adults in 2011. Methods: We used multi-stage clustering sampling method to select the provincial representative sample for Shandong adults aged 18~69 years old. The selected adults were invited to participate the questionnaire survey and consecutive three-round 24-hour dietary recall. The Chinese 24-hour dietary recall includes two parts, cooking condiment weighting and the food (exclude the condiment) intake diary. The sodium contents in the condiments and food were calculated by using reference values from China Food Composition 2004. Results: Overall, 2140 community adult residents were included in the data analysis. The total average dietary sodium intake estimated by 24-hour dietary recall was 5745mg (95%CI: 5428-6063). Men (6147mg/d, 5824-6471) consumed higher sodium than women (5339 mg/d, 5006-5673) (P<0.05). The majority of dietary sodium (81%) was from cooking condiments including salt, soy sauce, sauce and monosodium glutamate (MSG), with a mean sodium intake of 4640mg (4360-4920). Out of the cooking condiments, salt added during food preparation was the leading source (63%) of sodium intake, up to 3638mg/d (3397-3879) sodium intake. Sodium intake from processed food was account for 10% of the total sodium intake, averaged at 582 mg (498-666) sodium intake for Shandong adults. Conclusion: The Shandong adults consume excessive sodium than the recommendation intake and most is from the condiments added at cooking.

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Salt intake and prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States: the INTERMAP Study

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz067 ◽

2019 ◽

Vol 110 (1) ◽

pp. 34-40 ◽

Cited By ~ 17

Author(s):

Long Zhou ◽

Jeremiah Stamler ◽

Queenie Chan ◽

Linda Van Horn ◽

Martha L Daviglus ◽

...

Keyword(s):

United States ◽

United Kingdom ◽

Salt Intake ◽

The United States ◽

Dietary Salt ◽

Cross Sectional ◽

P Values ◽

Dietary Salt Intake ◽

Spot Urine ◽

The United Kingdom

ABSTRACT Background Several studies have reported that dietary salt intake may be an independent risk factor for overweight/obesity, but results from previous studies are controversial, reflecting study limitations such as use of a single spot urine or dietary recall to estimate daily salt intake rather than 24-h urine collections, and population samples from only a single country or center. Objective The aim of this study was to use data from the International Study of Macro-/Micro-nutrients and Blood Pressure (INTERMAP Study) to explore the relation between dietary salt intake estimated from 2 timed 24-h urine collections and body mass index (BMI; in kg/m2) as well as prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States. Methods Data were from a cross-sectional study of 4680 men and women aged 40–59 y in Japan (n = 1145), China (n = 839), the United Kingdom (n = 501), and the United States (n = 2195). General linear models were used to obtain the regression coefficients (β) of salt intake associated with BMI. Multivariable logistic regression models were used to determine the ORs and 95% CIs of overweight/obesity associated with a 1-g/d higher dietary salt intake. Results After adjustment for potential confounding factors including energy intake, salt intake 1 g/d higher was associated with BMI higher by 0.28 in Japan, 0.10 in China, 0.42 in the United Kingdom, and 0.52 in the United States, all P values < 0.001. Salt intake 1 g/d higher was associated with odds of overweight/obesity 21% higher in Japan, 4% higher in China, 29% higher in the United Kingdom, and 24% higher in the United States, all P values < 0.05. Conclusions Salt intake is positively associated with BMI and the prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States. This association needs to be further confirmed in well-designed prospective studies with repeated dietary and BMI measurements.This trial was registered at clinicaltrials.gov as NCT00005271.

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