scholarly journals Confusion Regarding the DASH Diet and Sodium Restriction in Inner-city Clinic Patients: Association with Poor DASH Scores and Sodium Adherence (P04-111-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Katerina Lembrikova ◽  
Jonathan Leong ◽  
Georgiana Yang ◽  
Jessamine Fazli ◽  
Matthew Moy ◽  
...  
Keyword(s):  
Inner City ◽  
Nutrient Intake ◽  
Dietary Habits ◽  
Sodium Intake ◽  
Dash Score ◽  
Sodium Restriction ◽  
Eating Pattern ◽  
Dash Diet ◽  
Low Sodium Diet ◽  
Low Sodium

Abstract Objectives Adherence to the DASH (Dietary Approaches to Stop Hypertension) diet is associated with slower progression of kidney disease and decreased cardiovascular risk. We evaluated the association between knowledge of the DASH diet, DASH scores and nutrient intake in an inner-City population. Methods A random sample of patients from CKD (37), medicine/diabetes (18) and transplant clinic (31) was studied using 24-hour food recall, with nutrient intake analyzed by ASA24 software used to calculate DASH score. Patients were asked to respond to the question “Do you know what the DASH diet is?” Results Mean age was 63.8 ± 14.1yrs; 50% (43) had diabetes; 85% (73) had hypertension. 45% (39) reported income < $20 K/yr. 78% (67) stated that they were familiar with the DASH diet and defined it as decreased or “low” intake of sodium or salt (LoNa); 33% (28) were not familiar (NoAns). No patient was able to provide a correct explanation of the DASH diet as per the U.S. Department of Health and Human Services. Most common answers were “no salt” (26), “low salt” (38), 3 pts described the limit of sodium as 2gm (2) or <80 mg (1). Several patients commented “nasty” or “tasteless”. Mean DASH scores were poor and did not differ between the two groups (LoNa 3.75 ± 0.88 vs NoAns 3.8 ± 0.8, P = NS), nor did intake of sodium (LoNa 2.51 ±0.96 g vs NoAns 2.59 ± 1.3 g, P = NS). There was no difference in creatinine (LoNa 2.0 ± 1.6 vs 1.79 ± 1.3 mg/dl, P = NS), BMI, blood pressure systolic or diastolic, income, education or marital status between the two groups. 92% (57/62) pts in the LoNa group answered yes to the question “Are you familiar with a low sodium diet” vs 1% (1/16) in the NoAns group, P < 0.0001. Conclusions In our population of inner-City pts: 1. Understanding of the DASH diet was poor and equated with low or absent sodium intake with unclear understanding of actual amount. 2. DASH adherence was poor in all groups. 3. There was no difference in sodium intake between pts who stated that they knew about the DASH diet and those who did not. Neither group met the recommendations for < 2gm/d intake. 4. Pts who answered they knew what a DASH diet was were more likely to report familiarity with low sodium diets. 5. Confusion regarding the DASH diet and sodium restriction is common. As the DASH eating pattern is a more comprehensive change in dietary habits, targeted education may be needed in this population to improve overall adherence. Funding Sources none.

Adrenergic control of renin during dietary sodium deprivation in conscious dogs

1989 ◽  
Vol 256 (6) ◽  
pp. E863-E871 ◽  
Author(s):  
H. Hisa ◽  
Y. H. Chen ◽  
K. J. Radke ◽  
J. L. Izzo ◽  
C. D. Sladek ◽  
...  
Keyword(s):  
Sodium Intake ◽  
Conscious Dogs ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Adrenergic Stimulation ◽  
Sodium Diet ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
Dietary Sodium Restriction

These experiments evaluated the contribution of alpha- and beta-adrenergic stimulation to plasma renin activity (PRA) during early and long-term dietary sodium restriction, compared with normal sodium intake. Uninephrectomized conscious dogs with catheters in the aorta, vena cava, and remaining renal artery were studied during normal sodium diet (approximately 70 meq/day), after 2-3 days of low-sodium diet (5-7 meq/day), and after greater than or equal to 2 wk of low-sodium diet. Direct renal arterial (ira) infusion of phenoxybenzamine plus propranolol decreased PRA by similar proportions (39-48%) during all three states of dietary sodium intake. The PRA achieved after adrenergic blockade remained higher (P less than 0.05) during early and long-term sodium restriction than during normal sodium intake. The effect on PRA of ira infusion of propranolol alone was not different from that of phenoxybenzamine plus propranolol during normal or low-sodium diet, and the magnitude of decrease in PRA during low-sodium diet was the same whether propranolol (1 microgram.kg-1.min-1) was infused ira or intravenously. In summary, beta-adrenergic stimulation accounts for similar proportions of PRA during early and long-term dietary sodium restriction and during normal sodium intake. Renal alpha-adrenoceptors appear to play little or no role in control of PRA under these conditions.

scholarly journals Achieving Salt Restriction in Chronic Kidney Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Emma J. McMahon ◽  
Katrina L. Campbell ◽  
David W. Mudge ◽  
Judith D. Bauer
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sodium Intake ◽  
Epidemiological Studies ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Restricted Diet ◽  
Salt Restriction ◽  
Low Sodium Diet ◽  
Low Sodium

There is consistent evidence linking excessive dietary sodium intake to risk factors for cardiovascular disease and chronic kidney disease (CKD) progression in CKD patients; however, additional research is needed. In research trials and clinical practice, implementing and monitoring sodium intake present significant challenges. Epidemiological studies have shown that sodium intake remains high, and intervention studies have reported varied success with participant adherence to a sodium-restricted diet. Examining barriers to sodium restriction, as well as factors that predict adherence to a low sodium diet, can aid researchers and clinicians in implementing a sodium-restricted diet. In this paper, we critically review methods for measuring sodium intake with a specific focus on CKD patients, appraise dietary adherence, and factors that have optimized sodium restriction in key research trials and discuss barriers to sodium restriction and factors that must be considered when recommending a sodium-restricted diet.

scholarly journals Evidence related to sodium restriction in patients with heart failure

2020 ◽  
Vol 73 (4) ◽  
Author(s):  
Mailson Marques de Sousa ◽  
Bernadete de Lourdes André Gouveia ◽  
Taciana da Costa Farias Almeida ◽  
Maria Eliane Moreira Freire ◽  
Francisco de Assis Brito Pereira de Melo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sodium Intake ◽  
Main Tool ◽  
Dietary Sodium ◽  
Protective Measure ◽  
Sodium Restriction ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
Asymptomatic Patients ◽  
Patients With Heart Failure

ABSTRACT Objectives: to analyze the scientific production about sodium restriction in patients with heart failure. Methods: integrative literature review from articles published from 2007 to 2017, located in the CINAHL and Scopus databases. Results: thirteen studies were analyzed. Sodium intake restriction was associated with lower unfavorable clinical outcomes in patients with marked symptomatology. The 24-hour urine sodium dosage was the main tool to assess adherence to the low sodium diet. Conclusions: based on the studies included in this review, in symptomatic patients, dietary sodium restriction should be encouraged in clinical practice as a protective measure for health. However, in asymptomatic patients, it should be well studied.

scholarly journals PENERAPAN ANJURAN DIET DASH DIBANDINGKAN DIET RENDAH GARAM BERDASARKAN KONSELING GIZI TERHADAP PENURUNAN TEKANAN DARAH PADA PASIEN HIPERTENSI DI PUSKESMAS LARANGAN UTARA

2021 ◽  
Vol 44 (1) ◽  
pp. 109-120
Author(s):  
Agustina Pungki Astuti ◽  
Didit Damayanti ◽  
Iskari Ngadiarti
Keyword(s):  
Blood Pressure ◽  
Nutritional Status ◽  
Diastolic Blood Pressure ◽  
Sodium Intake ◽  
Hypertensive Patients ◽  
Dash Diet ◽  
Sodium Diet ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
Significant Difference

The low sodium and Diet Approaches to Stop Hypertension (DASH) are diets for reducing high blood pressure. This study aimed to analyze the effect of nutrition counseling on the DASH diet compared to low sodium diet on blood pressure in hypertensive patients. The study design was an experimental study that randomly allocated 34 respondents to DASH diet and 35 respondents to low sodium diet. The ages of respondents were 43 to 76 years and women were 74.3 percent. Nutrition counseling was conducted by researchers to respondents who visited health center or Posbindu Larangan Utara. Nutritional counseling was conducted for an average of 20 minutes using existing brochures. Low sodium diet emphasizes reducing sodium intake while DASH diet emphasis more on consuming lots of vegetables, fruit, nuts and low-fat products. Variables collected were the characteristics of respondent, disease, drugs taken and nutritional status, while blood pressure using a sphygmomanometer, food intake including sodium were measured before and 2 weeks after nutritional counseling. Results showed that there was a significant difference in diastolic blood pressure after patients were given DASH diet compared to low sodium diet (p 0.05) and there was a significant difference in delta of systolic and diastolic reduction in DASH diet compared to low sodium diet. Test also showed a significant reduction in systolic, diastolic blood pressure and sodium intake (p 0.001) in both diet groups after receiving counseling. It concluded that DASH diet can be recommended to decrease blood pressure in hypertensive patients with consider nutritional status. ABSTRAK  Diet Rendah Garam (RG) dan Diet Approaches to Stop Hypertension (DASH) adalah diet untuk menurunkan tekanan darah tinggi. Penelitian ini bertujuan untuk menganalisa pengaruh konseling gizi diet DASH dibandingkan diet RG terhadap tekanan darah pasien hipertensi. Rancangan penelitian adalah eksperimen yang secara acak mengalokasi diet DASH kepada 34 orang dan diet RG kepada 35 orang responden. Usia responden antara 43 hingga 76 tahun dan sebagian besar perempuan (74,3%). Konseling gizi dilakukan oleh tim peneliti kepada pasien hipertensi yang memeriksakan diri ke puskesmas atau posbindu Larangan Utara. Konseling gizi dilakukan rata-rata 20 menit menggunakan brosur yang sudah ada. Diet RG menekankan pengurangan asupan natrium sedangkan diet DASH lebih menekankan ke banyak konsumsi sayur, buah, kacang-kacangan dan produk rendah lemak. Variabel yang dikumpulkan adalah karakteristik responden, penyakit dan obat yang diminum serta status gizi sedangkan tekanan darah menggunakan sfigmomanometer, asupan makanan, zat gizi termasuk natrium diukur sebelum dan 2 minggu setelah konseling gizi dilakukan. Hasil menunjukkan adanya perbedaan yang bermakna pada tekanan darah diastolik setelah pasien diberi diet DASH dibandingkan dengan pasien yang diberi diet RG (p0,05) dan terdapat perbedaan delta penurunan sistolik dan diastolik bermakna pada diet DASH dibanding diet RG. Analisa juga menunjukkan adanya penurunan tekanan darah sistolik, diastolik dan asupan natrium  yang bermakna (p0.001) pada kedua kelompok diet setelah mendapat konseling diet DASH dan diet RG. Disimpulkan diet DASH dapat direkomendasikan untuk membantu menurunkan tekanan darah pada pasien hipertensi dengan memperhatikan status gizi. Kata kunci: hipertensi, tekanan darah, diet rendah garam, diet DASH

scholarly journals Sodium reduction in New Zealand requires major behaviour change

2020 ◽  
Author(s):  
C Lofthouse ◽  
Lisa Te Morenga ◽  
R McLean
Keyword(s):  
New Zealand ◽  
Dietary Habits ◽  
Sodium Intake ◽  
Structured Interview ◽  
World Health ◽  
Sodium Reduction ◽  
Eating Behaviours ◽  
Sodium Diet ◽  
Low Sodium Diet ◽  
Low Sodium

© 2016 Elsevier Ltd This pilot study examined the feasibility of adherence to a low sodium diet in a sample of healthy New Zealand adults. It also addressed whether following a low sodium diet was accompanied by changes in intakes of other nutrients that influence cardiovascular risk. Eleven healthy adults provided dietary intake data and a 24-hour urine collection at baseline and follow-up. They then received nutritional counselling based on the World Health Organization recommendation for sodium intake (<2000 mg/day) and received ongoing nutritional support while undertaking a low sodium diet for four weeks. At the end of the four-week period, participants completed a semi-structured interview that elicited participants’ opinions on barriers and facilitators to following a low sodium diet and explored changes in participants’ dietary habits and behaviours. Thematic analysis revealed that adherence to a low sodium diet required substantial changes to participants’ usual food purchasing and preparation habits. Participants reported that lack of control over the sodium content of meals eaten away from the home, the complex and time-consuming nature of interpreting nutrition information labels, and difficulty identifying suitable snacks were barriers to adherence. Detailed meal planning and cooking from scratch, using flavour replacements, reading food labels to identify low sodium foods, receiving support from other people and receiving tailored nutrition advice were facilitators. Mean sodium intake reduced over the period, accompanied by a decrease in mean intake of total fat. These factors suggest that sodium reduction in New Zealand adults was feasible. However, considerable changes to eating behaviours were required.

Association Between Self-reported Adherence to a Low-Sodium Diet and Dietary Habits Related to Sodium Intake in Heart Failure Patients

2015 ◽  
Vol 30 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Eloisa Colin-Ramirez ◽  
Finlay A. McAlister ◽  
Elizabeth Woo ◽  
Nellie Wong ◽  
Justin A. Ezekowitz
Keyword(s):  
Heart Failure ◽  
Dietary Habits ◽  
Sodium Intake ◽  
Heart Failure Patients ◽  
Sodium Diet ◽  
Low Sodium Diet ◽  
Low Sodium

scholarly journals Sodium reduction in New Zealand requires major behaviour change

2020 ◽  
Author(s):  
C Lofthouse ◽  
Lisa Te Morenga ◽  
R McLean
Keyword(s):  
New Zealand ◽  
Dietary Habits ◽  
Sodium Intake ◽  
Structured Interview ◽  
World Health ◽  
Sodium Reduction ◽  
Eating Behaviours ◽  
Sodium Diet ◽  
Low Sodium Diet ◽  
Low Sodium

© 2016 Elsevier Ltd This pilot study examined the feasibility of adherence to a low sodium diet in a sample of healthy New Zealand adults. It also addressed whether following a low sodium diet was accompanied by changes in intakes of other nutrients that influence cardiovascular risk. Eleven healthy adults provided dietary intake data and a 24-hour urine collection at baseline and follow-up. They then received nutritional counselling based on the World Health Organization recommendation for sodium intake (<2000 mg/day) and received ongoing nutritional support while undertaking a low sodium diet for four weeks. At the end of the four-week period, participants completed a semi-structured interview that elicited participants’ opinions on barriers and facilitators to following a low sodium diet and explored changes in participants’ dietary habits and behaviours. Thematic analysis revealed that adherence to a low sodium diet required substantial changes to participants’ usual food purchasing and preparation habits. Participants reported that lack of control over the sodium content of meals eaten away from the home, the complex and time-consuming nature of interpreting nutrition information labels, and difficulty identifying suitable snacks were barriers to adherence. Detailed meal planning and cooking from scratch, using flavour replacements, reading food labels to identify low sodium foods, receiving support from other people and receiving tailored nutrition advice were facilitators. Mean sodium intake reduced over the period, accompanied by a decrease in mean intake of total fat. These factors suggest that sodium reduction in New Zealand adults was feasible. However, considerable changes to eating behaviours were required.

Increased Renal Sensitivity to Aldosterone in the Potassium-Loaded Rat

1976 ◽  
Vol 51 (s3) ◽  
pp. 315s-317s
Author(s):  
W. R. Adam ◽  
J. W. Funder
Keyword(s):  
Sodium Intake ◽  
Control Diet ◽  
High Potassium ◽  
High Sodium ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
High K ◽  
And Control

1. The renal response to aldosterone (urinary sodium and potassium excretion) was determined in adrenalectomized rats previously fed either a high potassium diet or a control diet. High K+ rats showed an enhanced response to aldosterone at all doses tested. 2. This enhanced response to aldosterone required the presence of the adrenal glands during the induction period, could be suppressed by a high sodium intake, but could not be induced by a low sodium diet. 3. No difference between high K+ and control rats could be detected in renal mineralocorticoid receptors, assessed by both in vivo and in vitro binding of tritiated aldosterone. 4. The method of the induction, and the mechanism of the enhanced response, remain to be defined.

Abstract 17541: An Education Intervention Focused on Self-monitoring for Symptom and Sodium Intake Improves Adherence to the Low Sodium Diet and Health Outcome in Patients with Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Eun Kyeung Song ◽  
Debra K Moser ◽  
Seok-Min Kang ◽  
Terry A Lennie
Keyword(s):  
Health Outcomes ◽  
Cox Regression ◽  
Sodium Intake ◽  
Control Group ◽  
Education Intervention ◽  
Self Monitoring ◽  
Sodium Diet ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
Patients With Heart Failure

Background: Despite the clinical emphasis on recommending a low sodium diet (LSD), adherence to a LSD remains poor in patients with heart failure (HF). Additional research is needed to determine successful interventions to improve adherence to a LSD and health outcomes. Purpose: To determine the effect of an education intervention on adherence to a LSD and health outcomes. Method: A total of 109 HF patients (age 64±9 years, 29% female) who were non-adherent to LSD, indicating > 3g of 24-hour urinary sodium excretion (24hr UNa) at baseline, were randomly assigned to one of 3 groups: 1) symptom monitoring and restricted 3 gram sodium diet (SMART) group, 2) the telephone monitoring (TM) group, or 3) usual care control group. The SMART group received individualized teaching and guidance of self-monitoring for worsening symptom and sodium intake using symptom and food diary for 4 sessions over 8 weeks. Patients assigned to either of the 2 intervention groups (SMART or TM) received phone calls every 2 weeks over 8 weeks. At 6 months follow-up, adherence to a LSD was assessed using 24hr UNa. Patients were followed for 1 year to determine time to first event of hospitalization or death due to cardiac problems. Repeated measures ANOVA and Cox regression were used to determine the effect of intervention. Results: The SMART group (n=37) showed a significant reduction in sodium intake across time compared to the TM group (n=35) and control group (n=37) (p= .022). In the Cox regression, patients in the SMART group had longer cardiac event-free survival compared to the control group after controlling for age, gender, ejection fraction, angiotensin-converting enzyme inhibitor use, and better blocker use (p=.008). Conclusion: An education intervention focused on self-monitoring for symptom and sodium intake improved adherence to LSD and health outcomes in patients with HF. Helping patients engage in self-monitoring for symptom and sodium intake by themselves can promote better health outcome.

Abstract MP01: Effect Of The DASH-Sodium Diet On Serum Biomarkers Of Inflammation And Mineral Metabolism

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Valerie K Sullivan ◽  
Lawrence J Appel ◽  
Jesse C Seegmiller ◽  
Casey M Rebholz
Keyword(s):  
Mineral Metabolism ◽  
Sodium Intake ◽  
Random Sequence ◽  
Control Diet ◽  
Fibroblast Growth Factor 23 ◽  
Serum Samples ◽  
Urokinase Plasminogen Activator Receptor ◽  
Dash Diet ◽  
High Sodium ◽  
Low Sodium

Background: The blood pressure-lowering effects of the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and reduced sodium intake are well-established. The effects on other biomarkers related to vascular health are of interest and may assist in explaining cardiovascular benefits of the DASH diet. Objective: We hypothesized that a low-sodium DASH diet improves biomarkers of inflammation [i.e. reduces C-reactive protein (CRP) and soluble urokinase plasminogen activator receptor (suPAR)] and mineral metabolism [phosphorus and fibroblast growth factor-23 (FGF23)]. Methods: We conducted a post hoc analysis of the DASH-Sodium trial using stored frozen serum samples. This controlled feeding study randomized 412 adults to consume either a DASH diet or control diet representative of a typical American diet. Within each arm, participants received three sodium levels (low, intermediate, high) in random sequence, each for 30 days. To maximize contrast, samples collected at the end of the low-sodium DASH (n=198) and high-sodium control (n=194) diets were compared. Between-diet differences in biomarker concentrations were assessed by t-test or Wilcoxon rank sum test for normally distributed and skewed variables, respectively. Results: CRP concentrations did not differ between groups ( P =0.19), but suPAR was higher after the low-sodium DASH diet than the high-sodium control (median, IQR: 2473, 2127-2887 pg/mL vs. 2281, 1929-2679 pg/mL; P =0.003). FGF23 was also higher after the DASH diet (35.9, 26.9-44.8 pg/mL vs. 30.2, 23.5-37.5 pg/mL; P< 0.001). Serum phosphorus was higher after the DASH diet (mean±SEM: 3.5±0.04 mg/dL) versus the control (3.4±0.04 mg/dL; P =0.02). Conclusions: Contrary to our hypothesis, biomarkers of inflammation and mineral metabolism were increased or unchanged by a low-sodium DASH diet compared to a high-sodium control diet. Potential reasons (e.g. short duration of the trial, sodium-specific effects, bioavailable phosphorus-rich dairy intake) require further investigation.

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