The Dietary Guideline with Great Therapeutic Potential

2008 ◽  
Vol 14 (3) ◽  
pp. 120 ◽  
Author(s):  
Trevor C. Beard
Keyword(s):  
Salt Intake ◽  
Therapeutic Potential ◽  
Sodium Content ◽  
Traffic Light ◽  
Salt Restriction ◽  
Food Standards ◽  
Dietary Guideline ◽  
Low Salt ◽  
Portion Sizes ◽  
Definition Of

Prescribing 'salt restriction' for patients with salt-related health problems - using diets measuring sodium content and portion sizes - has been notoriously unpopular and unreliable, and the only therapeutic alternative has been to prescribe diuretics. This article reports a new observation that total salt intake is low enough (sodium < 5 0 mmol/day) to be more effective and less troublesome than diuretics in people who follow the Australian dietary guideline to choose foods low in salt while using the definition of low salt foods in the Australia New Zealand Food Standards Code (Na =120 mg/100g). Low salt foods - eaten exclusively during human evolution - can usually abolish the severe vertigo of Meniere?s disorder as the sole treatment, and reverse the universal rise of blood pressure with age, preventing hypertension. This simple prescription for better food (a healthier salt intake) enables health professionals to obtain measurable and permanent clinical improvement in motivated patients. The full public health potential of better food will require a long period of gradual reform in food processing and the evolution of a new cuisine. Shoppers must know what they are buying, and Australia needs Britain?s traffic light labels that identify low salt foods at a glance with green lights for salt.

NO generation and action during changes in salt intake: roles of nNOS and macula densa

1998 ◽  
Vol 274 (6) ◽  
pp. R1588-R1593 ◽  
Author(s):  
Christopher S. Wilcox ◽  
Xiaolin Deng ◽  
William J. Welch
Keyword(s):  
Salt Intake ◽  
Selective Inhibitor ◽  
No Synthase ◽  
Macula Densa ◽  
Volume Replacement ◽  
Salt Loading ◽  
Salt Restriction ◽  
Low Salt ◽  
Renal Action ◽  
Renal Vascular

Micropuncture studies of single nephrons have shown that macula densa solute reabsorption via a furosemide-sensitive pathway activates nitric oxide (NO) generation via neuronal NO synthase (nNOS). This pathway is enhanced during salt loading. We investigated the hypothesis that changes in NO generation via nNOS in the macula densa contribute to changes in whole kidney NO generation and action during alterations in salt intake. Groups of rats ( n = 6–10) were equilibrated to high-salt (HS) or low-salt (LS) diets and were administered a vehicle (Veh), 7-nitroindazole (7-NI; a relatively selective inhibitor of nNOS), or furosemide (F; an inhibitor of macula densa solute reabsorption) with volume replacement. Compared with LS, excretion of the NO metabolites, NO2 plus NO3(NOX) was increased during HS (LS: 9.0 ± 0.5 vs. HS: 15.7 ± 0.8 μmol/24 h; P < 0.001), but this difference was prevented by 7-NI (LS: 7.4 ± 1.3 vs. HS: 9.4 ± 1.6 μmol/24 h; NS). During nonselective blockade of NOS with N G-nitro-l-arginine methyl ester (l-NAME), renal vascular resistance (RVR) increased more in HS than LS (HS: +160 ± 17 vs. LS: +83 ± 10%; P < 0.001). This difference in response to nonselective NOS inhibition was prevented by pretreatment with 7-NI (HS: +28 ± 6 vs. LS: +34 ± 8%; NS) or F with volume replacement (HS: +79 ± 11 vs. LS: +62 ± 4%; NS). In conclusion, compared with salt restriction, HS intake increases NO generation and renal action that depend on nNOS and macula densa solute reabsorption.

scholarly journals Salt Intake and All-Cause Mortality in Hemodialysis Patients

2018 ◽  
Vol 48 (2) ◽  
pp. 87-95
Author(s):  
Tatsuyoshi Ikenoue ◽  
Kiyomi Koike ◽  
Shingo Fukuma ◽  
Satoshi Ogata ◽  
Kunitoshi Iseki ◽  
...  
Keyword(s):  
Salt Intake ◽  
Cardiovascular Death ◽  
Hemodialysis Patients ◽  
High Salt ◽  
Salt Restriction ◽  
Data Registry ◽  
High Salt Intake ◽  
Low Salt ◽  
All Cause Mortality ◽  
Registry Database

Background: Although some clinical practice guidelines regarding hemodialysis recommend salt restriction, few studies have examined the association between salt intake and clinical outcomes in hemodialysis patients. This study aimed to clarify the association between salt intake and mortality in hemodialysis patients. Methods: This retrospective cohort study was based on the Japanese Society for Dialysis Therapy renal data registry database (2008) and included 88,115 adult patients who had received hemodialysis for at least 2 years. Estimated salt intake was the main predictor and was calculated from intra-dialytic weight loss and pre- and post-dialysis serum sodium levels. Nonlinear logistic regression was used to determine the association between salt intake and mortality, adjusting for potential confounders. The outcomes considered were all-cause mortality and cardiovascular death at 1 year. Results: The median (25–75th percentile) salt intake at baseline was 6.4 (4.6–8.3) g/day. At 1 year, all-cause mortality occurred in 1,845 (2.1%) patients, including 807 cardiovascular deaths. The low salt intake group (< 6 g/day) demonstrated the highest all-cause mortality and cardiovascular deaths. No association was observed between high salt intake, all-cause mortality and cardiovascular deaths. The lowest risk for all-cause mortality and cardiovascular death occurred among patients with an estimated salt intake of 9 g/day. Conclusion: Low salt intake, but not high salt intake, was associated with all-cause and cardiovascular mortality in Japanese hemodialysis patients. Further studies to justify including a lower limit of salt intake for hemodialysis patients are suggested.

scholarly journals Low-Salt Diet Attenuates B-Cell- and Myeloid-Cell-Driven Experimental Arthritides by Affecting Innate as Well as Adaptive Immune Mechanisms

2021 ◽  
Vol 12 ◽  
Author(s):  
Bettina Sehnert ◽  
Sandy Pohle ◽  
Cornelia Heuberger ◽  
Rita Rzepka ◽  
Maximilian Seidl ◽  
...  
Keyword(s):  
T Cells ◽  
Salt Intake ◽  
Mitogen Activated Protein Kinase ◽  
Chloride Salt ◽  
Dietary Salt ◽  
Salt Restriction ◽  
Effector Phase ◽  
Low Salt ◽  
The Impact ◽  
And Cartilage

A link between high sodium chloride (salt) intake and the development of autoimmune diseases was previously reported. These earlier studies demonstrated exacerbation of experimental autoimmune encephalomyelitis and colitis by excess salt intake associated with Th17- and macrophage-mediated mechanisms. Little is known about the impact of dietary salt intake on experimental arthritides. Here, we investigated if salt restriction can exert beneficial effects on collagen-induced arthritis (CIA) and K/BxN serum transfer-induced arthritis (STIA). CIA depends on both adaptive and innate immunity, while STIA predominantly mimics the innate immune cell-driven effector phase of arthritis. In both models, low salt (LS) diet significantly decreased arthritis severity compared to regular salt (RS) and high salt (HS) diet. We did not observe an aggravation of arthritis with HS diet compared to RS diet. Remarkably, in STIA, LS diet was as effective as IL-1 receptor blocking treatment. Complement-fixing anti-CII IgG2a antibodies are associated with inflammatory cell infiltration and cartilage destruction. LS diet reduced anti-CII IgG2a levels in CIA and decreased the anti-CII IgG2a/IgG1 ratios pointing toward a more Th2-like response. Significantly less inflammatory joint infiltrates and cartilage breakdown associated with reduced protein concentrations of IL-1 beta (CIA and STIA), IL-17 (CIA), and the monocyte chemoattractant protein-1 (MCP-1) (CIA) were detected in mice receiving LS diet compared to HS diet. However, we did not find a reduced IL-17A expression in CD4+ T cells upon salt restriction in CIA. Analysis of mRNA transcripts and immunoblots revealed a link between LS diet and inhibition of the p38 MAPK (mitogen-activated protein kinase)/NFAT5 (nuclear factor of activated T-cells 5) signaling axis in STIA. Further experiments indicated a decreased leukodiapedesis under LS conditions. In conclusion, dietary salt restriction ameliorates CIA and STIA, indicating a beneficial role of LS diet during both the immunization and effector phase of immune-mediated arthritides by predominantly modulating the humoral immunity and the activation status of myeloid lineage cells. Hence, salt restriction might represent a supportive dietary intervention not only to reduce cardiovascular risk, but also to improve human inflammatory joint diseases like rheumatoid arthritis.

Effect of Dietary Salt Restriction on Renal Sensitivity to Vasopressin in Man

1995 ◽  
Vol 89 (1) ◽  
pp. 37-43 ◽  
Author(s):  
M. Sutters ◽  
R. Duncan ◽  
W. S. Peart
Keyword(s):  
Arginine Vasopressin ◽  
Low Dose ◽  
Salt Intake ◽  
Renal Plasma Flow ◽  
High Salt ◽  
Dietary Salt ◽  
Salt Restriction ◽  
Vasopressin Infusion ◽  
Antidiuretic Effect ◽  
Low Salt

1. We have previously described a progressive antidiuresis in response to low-dose vasopressin infusion during salt restriction in man, despite stable or even declining plasma vasopressin concentration. In the present study we examine the hypothesis that renal sensitivity to the antidiuretic effect of arginine vasopressin may be enhanced by salt restriction. 2. Extremely low-dose infusions of arginine vasopressin were given to normal subjects after equilibration to high (260 mmol/day) and low (20 mmol/day) sodium intakes. 3. Salt restriction increased the antidiuretic effect of arginine vasopressin (2 fmol min−1 kg−1 arginine vasopressin increased urine osmolality from 67.8 ± 2.6 to 196.3 ± 35.7 mosmol/l in the high-salt study and from 268.3 ± 49 mosmol/l in the low-salt study; P < 0.05 between sodium intakes). Glomerular filtration rate, estimated from inulin clearance, was unchanged during arginine vasopressin infusion irrespective of salt intake (high salt 116.5 ± 9.4 to 118.9 ± 6.4 ml/min; low salt, 135.1 ± 9.2 to 111.2 ± 12.4 ml/min). Renal plasma flow, estimated from para-aminohippurate clearance, fell further during infusion of 2 fmol min−1 kg−1 arginine vasopressin in the low-salt study than in the high-salt study (low salt, from 555.7 ± 22.7 to 298.3 ± 27.6 ml/min; high salt, from 544.5 ± 30.2 to 452.9 ± 28.9 ml/min; P < 0.05 between sodium intakes). 4. Plasma atrial natriuretic peptide concentration increased during infusion of 2 fmol min−1 kg−1 arginine vasopressin in the low-salt study (to 136.5% ± 19.9% of baseline, P < 0.05), if anything falling in the high-salt study (to 90.5% ± 13.6% of baseline). Packed cell volume fell during arginine vasopressin infusion in the low-salt study (high salt, to 98.2% ± 0.4% of baseline; low salt, to 95.7% ± 0.4% of baseline, P < 0.05 for the low-salt study only). 5. Plasma arginine vasopressin concentration was constant throughout each study (high salt 0.48 ± 0.12 to 0.48 ± 0.1 pmol/l; low salt, 0.38 ± 0.05 to 0.4 ± 0.04 pmol/l). 6. Our findings suggest that renal sensitivity to the hydro-osmotic and vascular effects of arginine vasopressin is enhanced by salt restriction.

scholarly journals Regulation of NKCC2B by TNF-α in response to salt restriction

2020 ◽  
Vol 318 (1) ◽  
pp. F273-F282 ◽  
Author(s):  
Shoujin Hao ◽  
Joseph Salzo ◽  
Mary Hao ◽  
Nicholas R. Ferreri
Keyword(s):  
Renal Cortex ◽  
Salt Intake ◽  
Urine Volume ◽  
Thick Ascending Limb ◽  
Mrna Levels ◽  
Mrna Accumulation ◽  
Salt Restriction ◽  
Tnf Α ◽  
Low Salt

We have previously shown that TNF-α produced by renal epithelial cells inhibits Na+-K+-2Cl− cotransporter (NKCC2) activity as part of a mechanism that attenuates increases in blood pressure in response to high NaCl intake. As the role of TNF-α in the kidney is still being defined, the effects of low salt intake on TNF-α and NKCC2B expression were determined. Mice given a low-salt (0.02% NaCl) diet (LSD) for 7 days exhibited a 62 ± 7.4% decrease in TNF-α mRNA accumulation in the renal cortex. Mice that ingested the LSD also exhibited an ~63% increase in phosphorylated NKCC2 expression in the cortical thick ascending limb of Henle’s loop and a concomitant threefold increase in NKCC2B mRNA abundance without a concurrent change in NKCC2A mRNA accumulation. NKCC2B mRNA levels increased fivefold in mice that ingested the LSD and also received an intrarenal injection of a lentivirus construct that specifically silenced TNF-α in the kidney (U6-TNF-ex4) compared with mice injected with control lentivirus. Administration of a single intrarenal injection of murine recombinant TNF-α (5 ng/g body wt) attenuated the increases of NKCC2B mRNA by ~50% and inhibited the increase in phosphorylated NKCC2 by ~54% in the renal cortex of mice given the LSD for 7 days. Renal silencing of TNF-α decreased urine volume and NaCl excretion in mice given the LSD, effects that were reversed when NKCC2B was silenced in the kidney. Collectively, these findings demonstrate that downregulation of renal TNF-α production in response to low-salt conditions contributes to the regulation of NaCl reabsorption via an NKCC2B-dependent mechanism.

scholarly journals Midterm Evaluation of Malaysia's National Salt Reduction Strategy – Lessons Learned on Adapting Salt Reduction ‘Best Buys’ to the Local Context

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 288-288
Author(s):  
Kathy Trieu ◽  
Viola Michael ◽  
Feisul Mustapha ◽  
Ying-Ru Lo ◽  
Jacqui Webster
Keyword(s):  
Salt Intake ◽  
Sodium Content ◽  
Nominal Group ◽  
World Health ◽  
Local Context ◽  
Contextual Influences ◽  
Salt Reduction ◽  
Low Salt ◽  
The World ◽  
Packaged Foods

Abstract Objectives To evaluate the implementation progress and contextual influences of Malaysia's five-year national salt reduction program at midpoint, with a view to generating lessons on adapting the World Health Organization's salt reduction ‘best buys’ to suit the local context. Methods The Malaysian Government's multi-faceted strategy includes three of four salt-related ‘best buys’; reduce salt intake through 1) behavior change communication, 2) reformulation of food products to contain less salt and 3) implementation of front-of-pack labeling, as well as a strategy to monitor population salt intake and sodium levels in foods. Based on the UK Medical Research Council's guidance on process evaluation, routinely-collected administrative data, 12 semi-structured interviews and public information were used and synthesized in NVivo to evaluate the reach, dose, adoption, fidelity and contextual influences of implementation. This was supplemented with data from three focus groups (43 participants) conducted using the nominal group technique to understand the priority barriers and facilitators of lowering salt intake in Malaysia. Results In the first 3 years, there was high progress in accurately monitoring population salt intake and developing culturally-specific education resources. However, a major barrier to implementing the other interventions was the absence of mandatory sodium content declaration on packaged foods. A lack of packaged foods with sodium content labeling hindered the program implementers' ability to identify and engage high-salt food producers in reformulation, identify low-salt foods eligible for the Healthy Choice Logo front-of-pack label, educate consumers to identify high or lower-salt foods and monitor the sodium content of packaged foods. This aligns with the perceived challenges of reducing salt consumption in Malaysia being poor consumer knowledge and attitudes around salt reduction, and the absence of low-salt alternatives. Conclusions Countries without mandatory sodium or salt labeling on packaged foods should prioritize this regulation to enable effective implementation of the salt reduction ‘best buys’. Interim process evaluations are useful for identifying necessary intervention adaptations. Funding Sources The World Health Organization.

scholarly journals Low-Salt Intake during Mating or Gestation in Rats Is Associated with Low Birth and Survival Rates of Babies

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ranna Chou ◽  
Anna Hara ◽  
DongDong Du ◽  
Namiko Shimizu ◽  
Hiroe Sakuyama ◽  
...  
Keyword(s):  
Survival Rate ◽  
Birth Rate ◽  
Salt Intake ◽  
Survival Rates ◽  
High Salt ◽  
High Salt Diet ◽  
Salt Restriction ◽  
Salt Diet ◽  
Low Salt ◽  
Pup Survival

We investigated the influence of maternal salt restriction during mating or gestation on birth rate and offspring growth in Dahl salt-sensitive rats (DS). DS were divided into 5 groups: DS fed a low-salt (0.3% NaCl, w/w) (DS-low) or high-salt (4% NaCl, w/w) diet (DS-high) during mating and DS-high or DS-low during gestation, and DS fed regular chow (0.75% NaCl, w/w) (DS-regular) throughout mating and gestation. During the unspecified periods, the rats were given regular chow. DS-low during mating delivered fewer infants than high-salt mothers (P<0.05). The birth rate on regular chow was 87%. Six out of 11 DS-low rats during pregnancy produced pups while the rats fed a high-salt diet all delivered pups (P<0.025). The pup survival rate was 67% for high-salt mothers during mating and 54% for mothers on a low-salt diet. The pup survival rate was 95% for mothers on a high-salt diet during pregnancy and 64% for mothers on a low-salt diet (P<0.0001). Seven out of 8 DS-regular rats during mating delivered 59 neonates. However, 66% of the neonates survived. A low-salt diet during mating or pregnancy lowers birth rate and the neonates from low-salt mothers during pregnancy were more likely to die than those from high-salt mothers.

Contribution of angiotensin II internalization to intrarenal angiotensin II levels in rats

2002 ◽  
Vol 283 (5) ◽  
pp. F1003-F1010 ◽  
Author(s):  
Catherine Ingert ◽  
Michèle Grima ◽  
Catherine Coquard ◽  
Mariette Barthelmebs ◽  
Jean-Louis Imbs
Keyword(s):  
Blood Pressure ◽  
Angiotensin Ii ◽  
Renal Cortex ◽  
Salt Intake ◽  
Ang Ii ◽  
Converting Enzyme ◽  
Salt Restriction ◽  
Arterial Blood ◽  
Low Salt ◽  
Wistar Kyoto

This study was designed to determine the involvement of AT1 receptors in the uptake of ANG II in the kidney of rats exposed to differing salt intake. Male Wistar-Kyoto rats were treated with a normal-salt (NS; 1% NaCl, n = 7) or a low-salt (LS; 0.025% NaCl, n = 7) diet combined with (LS+Los, n = 7; NS+Los, n = 7) or without losartan (30 mg · kg−1 · day−1), an AT1 receptor antagonist. Renin (RA) and angiotensin-converting enzyme (ACE) activities and angiotensinogen, ANG I, and ANG II levels were measured in plasma, renal cortex, and medulla. In LS rats, in both plasma and renal cortex, the increase in RA was associated with an increase in ANG I and ANG II levels compared with NS rats, but intrarenal ANG II levels increased more than ANG I levels. In NS+Los rats, the increase in RA in plasma was followed by a marked increase in plasma ANG I and ANG II levels compared with NS rats whereas in the kidney the increase of renal RA was followed by a decrease of the levels of these peptides. The same pattern was observed in LS+Los rats, but the decrease in renal ANG II levels was much more pronounced in LS+Los rats than in NS+Los rats. Our results suggest that the increase in renal ANG II levels after salt restriction results mainly from an uptake of ANG II, via AT1 receptors. Such elevated intrarenal ANG II levels could contribute to maintain sodium and fluid balance and arterial blood pressure during salt-deficiency states.

scholarly journals Efficacy of Monosodium Glutamate as a Flavour Potentiator in Salt Reduction: A Review

2019 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
Jamuna Prakash ◽  
Prabhavathi S.N
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Monosodium Glutamate ◽  
Asian Population ◽  
Sodium Content ◽  
Salt Reduction ◽  
Overall Acceptability ◽  
Salt Level ◽  
Low Salt ◽  
Flavor Profile

Sodium is an essential micro nutrient and an indispensable ingredient in most of the savoury foods. The salty taste is mainly contributed by sodium chloride through a proto-typical stimulus. The current sodium intake has been estimated to be exceeding normal recommendation at an alarming rate. This has given rise to health concerns since excessive sodium intake is associated with rise in blood pressure and eventually to cardiovascular diseases. The habitual salt intake among Asian population is around 10-12g/day against the WHO recommendation of 5-6g/day. Today food processing industries are facing challenges pertaining to sodium reduction, since it reduces the overall acceptability. In any food sodium can be reduced through a gradual lowering of salt level, however, this would require several months since it also decreases the overall palatability of foods. Another strategy that can be adopted to overcome this problem is to employ salt substitutes like monosodium glutamate (MSG). MSG has 30% less sodium in comparison to table salt and can help maintain palatability of foods. There are many studies supporting this observation. Our studies on the acceptability profile of salt reduced MSG incorporated fried preparations showed that approximately 25% of salt could be reduced in products without any significant effect on flavor profile. The results indicated that spice added product could be consumed with lower sodium levels and MSG had synergistic effect with spices. In salt reduced tomato soups, the control product with low salt was given lower scores as against MSG incorporated samples. It was also observed that increasing levels of MSG resulted in higher acceptance of products. Hence, it can be said that using MSG as a substitute would be a better option for maintaining adequate palatability in savoury foods with reduced sodium content.

VARIATIONS IN PLASMA RENIN ACTIVITY AND URINARY ALDOSTERONE EXCRETION IN NORMAL SUBJECTS AFTER SALT RESTRICTION AND ACUTE PITUITARY INHIBITION WITH 6-DEHYDRO-16-METHYLENE HYDROCORTISONE

1971 ◽  
Vol 67 (1) ◽  
pp. 159-173
Author(s):  
A. Peytremann ◽  
R. Veyrat ◽  
A. F. Muller
Keyword(s):  
Plasma Renin Activity ◽  
Salt Intake ◽  
Plasma Renin ◽  
Normal Subjects ◽  
Inhibitory Effect ◽  
Renin Activity ◽  
Sodium Balance ◽  
Experimental Conditions ◽  
Salt Restriction ◽  
Aldosterone Production

ABSTRACT Variations in plasma renin activity and urinary aldosterone excretion were studied in normal subjects submitted to salt restriction and simultaneous inhibition of ACTH production with a new synthetic steroid, 6-dehydro-16-methylene hydrocortisone (STC 407). At a dose of 10 mg t. i. d. this preparation exerts an inhibitory effect on the pituitary comparable to that of 2 mg of dexamethasone. In subjects maintained on a restricted salt intake, STC 407 does not delay the establishment of an equilibrium in sodium balance. The increases in endogenous aldosterone production and in plasma renin activity are also similar to those seen in the control subjects. A possible mineralocorticoid effect of STC 407 can be excluded. Under identical experimental conditions, the administration of dexamethasone yielded results comparable to those obtained with STC 407.

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