scholarly journals Comparing Three Approaches to Salt Intake Assessment Among Lactating Women in Rural Cambodia

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 633-633
Author(s):  
Kathleen Chan ◽  
Jelisa Gallant ◽  
Shalem Leemaqz ◽  
Mam Borath ◽  
Frank Wieringa ◽  
...  
Keyword(s):  
New York ◽  
Salt Intake ◽  
Sodium Intake ◽  
Urinary Sodium ◽  
York Academy ◽  
Lactating Women ◽  
Intake Assessment ◽  
Breastfed Infants ◽  
Funding Sources ◽  
Gates Foundation

Abstract Objectives Monitoring population salt intake is a critical component of implementing salt fortification programs. In Cambodia, salt is being considered as a vehicle for thiamine fortification to prevent infantile beriberi among breastfed infants. However, salt intake among lactating mothers is not known. The gold standard for assessing sodium intake is repeat 24-hr urinary sodium concentrations. This method has logistical barriers, especially in low-resource settings, and other methods have not been trialed in this population. Here we compare three methods of assessing salt intake in lactating Cambodian women: repeat 24-hr urinary sodium concentrations (USC), repeat 12-hr observed weighed intake records (OWIR), and household salt disappearance (HSD). Methods Data from trial: NCT03616288. Salt intake was assessed using the three methods in a subsample of lactating women (n = 104) between 8 and 22 weeks postpartum. Women were asked to collect two 24-hour urine samples within 7 days. Repeat 12-hr OWIR were collected from women. Household salt disappearance was recorded fortnightly, and was divided by the number of household members to estimate individual intakes. Descriptive household salt use was also recorded. Differences in estimated salt intake from each method were compared using a Kruskal-Wallis test. Results Mean (95%CI) estimated salt intakes from repeat 24-hr USC, repeat 12-hr OWIR, and HSD were: 9.0 (8.3, 9.8) g/day, 9.1 (7.9, 10.3) g/day, and 10.9 (9.8, 11.9) g/day, respectively. Estimated intakes from HSD were significantly higher than both 24-hr USC (p = 0.009) and 12-hr OWIR (p = 0.002). Estimated intakes from 24-hr USC and 12-hr OWIR were not statistically different (p = 0.6). Salt was being used for purposes other than consumption, such as cleaning fish and vegetables, in 26% of fortnightly visits. Conclusions Repeat 24-hr USC and 12-hr OWIR are both acceptable and logistically feasible methods of salt intake assessment among lactating women in rural Cambodia. While HSD is a less resource-intensive approach, this method over-estimated salt intake. Salt being used for purposes other than consumption may contribute to over-estimation using this method. Funding Sources Bill & Melinda Gates Foundation, New York Academy of Sciences, Canadian Institutes of Health Research, Research Nova Scotia.

scholarly journals Benefits of Maternal Thiamine Supplementation for Enhancing Cambodian Infants’ Social Responsiveness at 24 Weeks

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 891-891
Author(s):  
Dare A Baldwin ◽  
Jeffrey Measelle ◽  
Jenna Rudolph ◽  
Hou Kroeun ◽  
Prak Sophonneary ◽  
...  
Keyword(s):  
New York ◽  
Cognitive Development ◽  
Social Engagement ◽  
Eye Contact ◽  
York Academy ◽  
Social Responsiveness ◽  
Negative Consequences ◽  
Funding Sources ◽  
Gates Foundation ◽  
Linear Contrast

Abstract Objectives Infants in Cambodia are at risk for thiamine deficiency, with long-term negative consequences for neuro-cognitive development. We investigated the extent to which maternal thiamine supplementation enhances infants’ responsiveness to social engagement. Such responsiveness is both indicative of neuro-cognitive development and beneficial for subsequent neuro-cognitive progress. Methods 335 lactating Cambodian mothers were randomly assigned to receive a capsule containing 0, 1.2, 2.4, or 10 mg of thiamine daily from 2- until 24-weeks postnatal. We assessed infants’ social responsiveness via a new method – the Primary Engagement Task (PET) – when infants were 2-, 12-, and 24-weeks. In the PET, mothers were asked to elicit and sustain a smile from infants as they added and then removed modalities of engagement (eye-contact/facial expression, voice and touch) across six 30-second “epochs.” Subsequent behavioral coding from video-recordings determined changes in infants’ state across the epochs of the PET. Results Preliminary analyses based on 103 of the 335 infants in the PET at 24 weeks revealed that infants displayed significantly increased alertness as mothers introduced new modalities of engagement in the PET, and a partial decline in alertness as modalities were removed (linear contrast F(1,102) = 24.37, P = 0.000; quadratic contrast F(1,102) = 7.27, P = 0.008). Although maternal thiamine dosage did not influence these patterns overall (F's < 1.56, P's > 0.20), higher maternal thiamine dosage was associated with infants displaying enhanced alertness when mothers first offered eye-contact in the PET (beta-weight = 0.026; t = 2.01, P = 0.047). This pattern of alerting to maternal eye-contact was statistically significant only in the 10 mg group (paired t(25) = 3.14, P = 0.004). Conclusions Infants whose mothers received 10 mg daily thiamine supplementation displayed increased alertness to opportunities to interact socially. These preliminary findings (a) showcase the value of the PET for assessing infants’ responsiveness to caregiver's efforts to engage them socially, and (b) hint that maternal thiamine supplementation promotes infants’ social responsiveness, thereby underscoring the importance of infants’ early access to adequate thiamine for neuro-cognitive thriving. Funding Sources Bill & Melinda Gates Foundation & New York Academy of Sciences.

Abstract P403: Seasonal Variation in the Daily Urinary Sodium Excretion in Outpatients From the Northern Japan

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Tomoko Hashimoto
Keyword(s):  
Seasonal Variation ◽  
Sodium Excretion ◽  
Salt Intake ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium ◽  
Reliable Estimate ◽  
Significant Difference ◽  
The Mean ◽  
Northern Japan

Although the daily urinary sodium excretion (UNaV) is considered to provide the most reliable estimate of the daily sodium intake, it may be affected by salt loss due to sweating in summer. However, theseasonal variation in the daily UNaV associated with a normal lifestyle is unknown. This study was performed in 348 outpatients from the Morioka region during three seasons: summer(summer 1), winter, and the following summer (summer 2). The daily UNaV (g salt/day) was estimated by the second morning urine method three times during each season. Seasonal variation was defined as a significant trend across the three seasons together with a significant difference between winter and both summers. In women, the daily UNaV was higher in winter (11.8±3.0 g salt/day) than in summer 1 (11.2±2.9g salt/day) or summer 2 (11.0±2.9 g salt/day). In contrast, there was no marked seasonal variation in men. An analysis stratified by age (4 quartiles) identified seasonal variation in the older 2 quartiles of women (aged ≧68 years). In these women, the mean seasonal difference in the daily UNaV was 0.9 g of salt/day for both winter vs. summer 1 and winter vs. summer 2, while it was 0.1-0.8 g of salt/day in the other groups. Seasonal variation in the daily UNaV only occurred in older female patients and was relatively small. This is evidence for restricting salt intake throughout the year and should reassure patients who are anxious about salt loss due to sweating in summer.

scholarly journals Urine Spot Samples Can Be Used to Estimate 24-Hour Urinary Sodium Excretion in Children

2018 ◽  
Vol 148 (12) ◽  
pp. 1946-1953 ◽  
Author(s):  
Magali Rios-Leyvraz ◽  
Pascal Bovet ◽  
René Tabin ◽  
Bernard Genin ◽  
Michel Russo ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Salt Intake ◽  
Sodium Intake ◽  
Population Level ◽  
Urinary Sodium Excretion ◽  
Cross Sectional Study ◽  
Urinary Sodium ◽  
Cross Sectional ◽  
High Sodium ◽  
Individual Level

ABSTRACT Background The gold standard to assess salt intake is 24-h urine collections. Use of a urine spot sample can be a simpler alternative, especially when the goal is to assess sodium intake at the population level. Several equations to estimate 24-h urinary sodium excretion from urine spot samples have been tested in adults, but not in children. Objective The objective of this study was to assess the ability of several equations and urine spot samples to estimate 24-h urinary sodium excretion in children. Methods A cross-sectional study of children between 6 and 16 y of age was conducted. Each child collected one 24-h urine sample and 3 timed urine spot samples, i.e., evening (last void before going to bed), overnight (first void in the morning), and morning (second void in the morning). Eight equations (i.e., Kawasaki, Tanaka, Remer, Mage, Brown with and without potassium, Toft, and Meng) were used to estimate 24-h urinary sodium excretion. The estimates from the different spot samples and equations were compared with the measured excretion through the use of several statistics. Results Among the 101 children recruited, 86 had a complete 24-h urine collection and were included in the analysis (mean age: 10.5 y). The mean measured 24-h urinary sodium excretion was 2.5 g (range: 0.8–6.4 g). The different spot samples and equations provided highly heterogeneous estimates of the 24-h urinary sodium excretion. The overnight spot samples with the Tanaka and Brown equations provided the most accurate estimates (mean bias: −0.20 to −0.12 g; correlation: 0.48–0.53; precision: 69.7–76.5%; sensitivity: 76.9–81.6%; specificity: 66.7%; and misclassification: 23.0–27.7%). The other equations, irrespective of the timing of the spot, provided less accurate estimates. Conclusions Urine spot samples, with selected equations, might provide accurate estimates of the 24-h sodium excretion in children at a population level. At an individual level, they could be used to identify children with high sodium excretion. This study was registered at clinicaltrials.gov as NCT02900261.

scholarly journals Revised Reference Values for the Intake of Sodium and Chloride

2017 ◽  
Vol 72 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Daniela Strohm ◽  
Angela Bechthold ◽  
Sabine Ellinger ◽  
Eva Leschik-Bonnet ◽  
Peter Stehle ◽  
...  
Keyword(s):  
Breast Milk ◽  
Reference Values ◽  
Salt Intake ◽  
Sodium Intake ◽  
Chloride Salt ◽  
Dietary Recommendations ◽  
Balance Study ◽  
Lactating Women ◽  
Adverse Health Effects ◽  
Sodium Loss

Background: In January 2017, the nutrition societies of ­Germany, Austria and Switzerland revised the reference values for sodium and chloride intake. Methods: For adults, the estimated value for sodium intake was derived on the basis of a balance study. The estimated values for children and adolescents were extrapolated from this estimated value considering differences in body mass. For infants aged 0 to under 4 months, an estimated value was set based on the sodium intake via breast milk. From this value the estimated value for infants aged 4 to under 12 months was also derived by extrapolation. The estimated value for lactating women takes into account the fact that the sodium loss via breast milk is compensated through homoeostatic mechanisms. Except for infants, the reference values for chloride intake were derived based on the estimated values for sodium intake. Results: For adults, pregnant and lactating women, the estimated values for sodium and chloride intake are set at 1,500 and 2,300 mg/day. Discussion and Conclusion: Reference values for sodium and chloride can be derived in terms of estimated values. Considering dietary recommendations for sodium and chloride, it must be taken into account that high intake of sodium chloride (salt) is associated with adverse health effects, for example, hypertension and cardiovascular diseases. Therefore, it is necessary to lower salt intake in the general population.

scholarly journals Differences in the Fecal Metabolome and Microbiome Between Exclusive and Partial Breastfed Infants are More Pronounced at 2 Months Compared to 5 Months

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1097-1097 ◽  
Author(s):  
Aidong Wang ◽  
Aly Diana ◽  
Sofa Rahmannia ◽  
Rosalind Gibson ◽  
Lisa Houghton ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Feeding Practices ◽  
Illumina Miseq ◽  
Short Chain Fatty Acids ◽  
P Value ◽  
Fecal Samples ◽  
Breastfed Infants ◽  
Funding Sources ◽  
Gates Foundation ◽  
The Impact

Abstract Objectives This study aimed to characterize the impact of feeding practices on the infant fecal metabolome and microbiome at 2 months and 5 months of age in exclusive breastfeeding (EBF) and partial breastfeeding (PBF) infants. Methods Fecal samples were collected from infants at 2 months and 5 months of age from Bandung, Indonesia. Exclusive breastfeeding was determined using the stable isotope deuterium dose-to-mother (DTM) technique. Fecal metabolites were extracted using Dulbecco's phosphate-buffered saline, and analyzed using NMR spectroscopy. Fecal microbial DNA was extracted at the same time using the MoBio PowerLyzer PowerSoil DNA isolation kit (MoBio, Carlsbad, CA). The V4 region of 16SrRNA was targeted. The DNA library sample was analyzed via 300-bp paired-end sequencing on the Illumina MiSeq platform. Results Fecal samples from EBF infants at 2 months of age revealed significantly higher human milk oligosaccharides (HMOs), short-chain fatty acids and related metabolites compared to PBF infants. However, fecal samples from infants at 5 months of age revealed no differences in metabolome between EBF and PBF after p-value adjustment for multiple comparisons. Gut microbes, especially Bifidobacterium were higher in EBF infants at age 2 months even though not statistically significant. However, this difference was eliminated at age 5 months. Conclusions In the present study, infant feeding practices had a stronger influence on the infant fecal metabolome and microbiome at the age of 2 months as compared to 5 months. Funding Sources 2014 Bill & Melinda Gates Foundation. CS would also like to acknowledge funding from the Kinsella endowed chair in Food, Nutrition, and health as well as USDA-NIFA Hatch project 1,021,411.

scholarly journals High Dietary Salt Intake in Pediatric Patients with Type 1 Diabetes Mellitus Not Related to Overweight and Obesity

2020 ◽  
pp. 1-5
Author(s):  
Angela Zanfardino ◽  
Angela Zanfardino ◽  
Pierluigi Marzuillo ◽  
Linda Sessa ◽  
Assunta S Rollato ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Sodium Excretion ◽  
Salt Intake ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium

Aim: People around the world are consuming much more sodium than is physiologically necessary. A number of studies suggest that dietary sodium intake is related to weight gain. The aim of our study was to evaluate in a population of children and adolescents with type 1 diabetes mellitus, possible correlations between the urinary sodium excretion (UNa24h), indirect marker of sodium intake, and both duration of diabetes and BMI z-score. Moreover, we also evaluated the correlation between UNa24h and duration of diabetes according with the presence/absence of overweight/obesity. Research Design and Methods: Children and adolescents aged between 4 and 18 years with type 1 diabetes were consecutively enrolled from Regional Center for Pediatric Diabetes in Naples. Urinary sodium concentrations were tested in three 24 h urine samples of 68 individuals (204 tests). Results: Mean UNa24h was 141.3±68.2 mmol/24h corresponding to 8.1±3.9 gr of NaCl intake. Seventyfive percent of subjects aged between 4 and 6 years, 95% of subjects aged between 7 and 10 years and 79.5% of subjects aged between 11 and 18 years consume more salt of the LARN’s advice. Urinary sodium excretion increased in relation to the increase of duration, in years, of diabetes (p=0.0027). No statistically significant relationship is between UNa24h (mmol/24h) and zBMI (p=0.705). Conclusions: This study shows that young patients with type 1 diabetes have high levels of UNa24h. Given the close correlation between the UNa24h and salt intake we can conclude that they take more salt with their diet. High salt intake is not related to overweight but to diabetes duration.

scholarly journals Correlation Between Spot Urine Sodium, 24 Hour Urinary Sodium and Food Frequency Questionnairein Estimation of Salt Intake in Healthy Individuals

2020 ◽  
Vol 5 (1) ◽  
pp. 74
Author(s):  
Jaafar Maryam Kamiliah ◽  
Nordin Nani ◽  
Abdul Rahman Abdul Rashid
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Cost Effective ◽  
Urinary Sodium ◽  
Urine Samples ◽  
Urine Sodium ◽  
Gold Standard Method ◽  
Food Frequency ◽  
Spot Urine ◽  
Daily Sodium Intake

Background:Salt intake is a known contributor to increased blood pressure. However, it is rarely monitored in clinical practice. 24-hr urinary sodium (24-HrNa) is the gold standard method to estimate salt intake but this method is rather burdensome.Objective: The objective of this study is to correlate between spot urine sodium (SUNa), 24-HrNa and Na intake estimation by food frequency questionnaire (FFQ) (FFQNa).Methods : 430 healthy participants aged between 20-40 years old were recruited. Second morning voided urine samples were obtained from all participants to estimate SUNa. 24-HrNa samples were obtained from 77 out of 430 participants. All participants were required to answer a validated FFQ. Urine samples were analysed for Na using indirect ion-selective electrode (ISE) method. Daily sodium intake was calculated from the FFQ.Results:The mean daily sodium intake from 24-hrNa (n=77) was 155 mmol/day, SUNa (n=430) was 158 mmol/L and FFQNa (n=430) was 271 mmol/day. There was a moderate correlation between SUNa and 24-hrNa (ρ = 0.62, P < 0.000). No correlation was seen between both 24-hrNa and SUNa with FFQNa (ρ = 0.035, P = 0.768 and ρ = 0.026, P = 0.597 respectively).Conclusion: Spot urine Na is a simple cost-effective method to estimate daily Na intake and has the potential to replace 24-hour urinary Na.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 74-80

scholarly journals Dietary sodium intake in urban and rural Malawi, and directions for future interventions

2018 ◽  
Vol 108 (3) ◽  
pp. 587-593 ◽  
Author(s):  
Josephine E Prynn ◽  
Louis Banda ◽  
Alemayehu Amberbir ◽  
Alison J Price ◽  
Ndoliwe Kayuni ◽  
...  
Keyword(s):  
Rural Communities ◽  
Salt Intake ◽  
Sodium Intake ◽  
Urinary Sodium ◽  
Sub Saharan Africa ◽  
Dietary Sodium ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Spot Urine ◽  
Per Capita

ABSTRACT Background High dietary sodium intake is a major risk factor for hypertension. Data on population sodium intake are scanty in sub-Saharan Africa, despite a high hypertension prevalence in most countries. Objective We aimed to determine daily sodium intake in urban and rural communities in Malawi. Design In an observational cross-sectional survey, data were collected on estimated household-level per capita sodium intake, based on how long participants reported that a defined quantity of plain salt lasts in a household. In a subset of 2078 participants, 24-h urinary sodium was estimated from a morning spot urine sample. Results Of 29,074 participants, 52.8% of rural and 50.1% of urban individuals lived in households with an estimated per capita plain salt consumption >5 g/d. Of participants with urinary sodium data, 90.8% of rural and 95.9% of urban participants had estimated 24-h urinary sodium >2 g/d; there was no correlation between household per capita salt intake and estimated 24-h urinary sodium excretion. Younger adults were more likely to have high urinary sodium and to eat food prepared outside the home than were those over the age of 60 y. Households with a member with previously diagnosed hypertension had reduced odds (OR: 0.59; 95% CI: 0.51, 0.68) of per capita household plain salt intake >5 g/d, compared with those where hypertension was undiagnosed. Conclusions Sodium consumption exceeds the recommended amounts for most of the population in rural and urban Malawi. Population-level interventions for sodium intake reduction with a wide focus are needed, targeting both sources outside the home as well as home cooking. This trial was registered at clinicaltrials.gov as NCT03422185.

Evaluation of Salt Intake, Urinary Sodium Excretion and Their Relationship to Overhydration in Chronic Kidney Disease Patients

2015 ◽  
Vol 40 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Andrea E.C. Hallvass ◽  
Lígia Maria Claro ◽  
Simone Gonçalves ◽  
Márcia Olandoski ◽  
Fabiana Baggio Nerbass ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sodium Excretion ◽  
Salt Intake ◽  
Fluid Overload ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium ◽  
Hydration Status ◽  
Body Composition Monitor

The purpose of this study was to estimate sodium intake in a group of patients with chronic kidney disease (CKD) and to correlate the results with the urinary excretion values of sodium and signs of fluid overload. We included patients with CKD in different stages. Urinary sodium was measured in 24 h urine samples. Body composition monitor (BCM) was used to estimate the hydration status. Sixty patients (38 ± 15 ml/min of GFR) presented 4.14 ± 1.71 g/24 h of urinary sodium excretion. Overhydration was detected in 50% of the patients by the BCM. There was a positive correlation between the measured sodium excretion values and BCM, ICW, ECW and TBW. In conclusion, markers of overhydration evaluated by BCM were positively correlated with urinary sodium excretion.

scholarly journals Strategies to Increase Micronutrient Intakes Among Laotian Women Adhering to Traditional Postpartum Dietary Restrictions

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 819-819
Author(s):  
Taryn Smith ◽  
Xiuping Tan ◽  
Charles Arnold ◽  
Dalaphone Sitthideth ◽  
Sengchanh Kounnavong ◽  
...  
Keyword(s):  
Dietary Diversity ◽  
Lao Pdr ◽  
Normal Diet ◽  
Soy Sauce ◽  
Micronutrient Deficiencies ◽  
Breastfed Infants ◽  
Supplement Use ◽  
Funding Sources ◽  
Dietary Restrictions ◽  
Gates Foundation

Abstract Objectives Culturally determined restrictive postpartum diets are common in Lao PDR, placing lactating women and breastfed infants at high risk of micronutrient deficiencies. The objective of this analysis was to explore if fortified condiments and supplements would be suitable strategies to improve micronutrient intakes among women adhering to dietary restrictions. Methods Mother-child (aged 21 days - &lt;18 months) dyads (n = 680) were enrolled into a prospective cohort study in Lao PDR. Women were interviewed about foods and condiments that were consumed or restricted in weekly (for the first four weeks) and monthly intervals postpartum, and if they would be willing to take supplements during this time if provided to them. Data on minimum dietary diversity for women (MDD-W) and household food insecurity was collected. Results Mean ± SD child and maternal age was 4.3 ± 3.3 mo and 24.7 ± 6.3 yr respectively, 95% of mothers were breastfeeding and 34% of households were moderately to severely food insecure. Almost all women (97%) reported adhering to food restrictions after childbirth for a median (IQR) length of time of 1 (1, 3) month (range 1 week to 36 months). White rice was consumed universally postpartum, however other diverse foods were highly restricted and consumed by &lt; 32% of women in the first month. MDD-W was achieved by 10.4% of women currently restricting their diet and 16.4% who had resumed/were consuming their normal diet (p = 0.04). Of the women interviewed about condiments (n = 480), 99%, 43% and 53% habitually consumed salt, fish sauce and soy sauce respectively. During the period of dietary restrictions, 54% and 38% of habitual consumers restricted fish and soy sauces respectively, while all women continued to consume salt. Of the women asked about supplement use (n = 415), 87% reported that they would take supplements during the period of dietary restrictions. Conclusions Postpartum dietary restrictions are widespread among women in Lao PDR. These highly restrictive diets and low dietary diversity likely contribute to micronutrient deficiencies in mothers that may have important consequences for their breastfed infants through reduced micronutrient content of breastmilk, which requires further exploration. Salt fortification and supplements could be viable strategies to increase micronutrient intakes among women. Funding Sources Bill & Melinda Gates Foundation.

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