scholarly journals Dietary Potassium Intake Remains Low and Sodium Intake Remains High, and Most Sodium is Derived from Home Food Preparation for Chinese Adults, 1991–2015 Trends

2020 ◽  
Vol 150 (5) ◽  
pp. 1230-1239 ◽  
Author(s):  
Shufa Du ◽  
Huijun Wang ◽  
Bing Zhang ◽  
Barry M Popkin
Keyword(s):  
Central Region ◽  
Rural Areas ◽  
Sodium Intake ◽  
Food Preparation ◽  
Western World ◽  
Processed Food ◽  
Nutrition Survey ◽  
Random Effects Models ◽  
Potassium Intake ◽  
Most At Risk Populations

ABSTRACT Background Intervention strategies to reduce sodium intake and increase potassium intake may decrease blood pressure; however, most are focused on reducing sodium in processed food globally. Objectives We attempt to fill important gaps in understanding the dynamics of these dietary determinants of hypertension in China. Methods We used data on 29,926 adults aged ≥20 y between 1991 and 2015 from an ongoing cohort, the China Health and Nutrition Survey. We collected detailed diet data with use of weighing methods with 3 consecutive 24-h recalls. With panel data random-effects models, we analyzed factors associated with sodium and potassium intakes and sodium to potassium (Na/K) ratios. Results Sodium intake decreased from 6.3 g/d in 1991 to 4.1 g/d in 2015, still twice the tolerable upper intake recommended by the WHO. Potassium intake was 1.7 g/d in 1991 and 1.5 g/d in 2015, below half that recommended by the WHO. The Na/K ratio decreased from 4.1 (ratios in g) in 1991 to 3.1 in 2015, 5 times the recommendation of the WHO. More than two-thirds (67%) of sodium intake was from salt added during food preparation, with 8.8% from processed foods in 2015, up from 5.0% in 1991. The most at-risk populations lived in China's central region and rural areas, were middle aged, had lower educations, or were farmers. Conclusions Sodium intake is very high across all regions in China. As part of sodium reduction efforts, China should target people living in the central region and adults aged above 60 whose sodium intakes are much higher. Strategies to decrease sodium intake and increase potassium intake should be different from those applied in the Western world where the major source is processed food. Reduced sodium higher potassium salts should become a major policy initiative in China.

scholarly journals Is a Hypertension Diagnosis Associated with Improved Dietary Outcomes Within 2 to 4 Years? A Fixed-effects Analysis from the China Health and Nutrition Survey (P10-063-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Tania Aburto ◽  
Penny Gordon-Larsen ◽  
Jennifer Poti ◽  
Annie Howard ◽  
Linda Adair ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Kidney Diseases ◽  
Sodium Intake ◽  
Nutrition Survey ◽  
Sodium Potassium ◽  
Household Level ◽  
Potassium Intake ◽  
Health And Nutrition ◽  
Hypertension Diagnosis ◽  
Diagnosis Of Hypertension

Abstract Objectives To estimate the longitudinal association between self-reported doctor diagnosis of hypertension and subsequent short-term changes (within 2–4 years) in sodium intake, potassium intake and sodium-potassium (Na/K) ratio. Methods We used data from nine waves of the China Health and Nutrition Survey (1991 to 2015) including 16,268 adults (18–75 years of age) without hypertension at their first entry wave. Diet data were collected using three consecutive 24-hour dietary recalls and a weighed household food inventory. Diagnosed hypertension was defined as self-reported doctor diagnosis of hypertension. We used fixed-effects models to estimate the association between the first occurrence of a hypertension diagnosis and subsequent within-individual changes in sodium intake, potassium intake and Na/K ratio. To further understand the observed heterogeneity by sex, we examined changes in diet outcomes in pairs of spouses, and changes at the household level. Results Model-based results suggest that on average, men who were diagnosed with hypertension decreased their sodium intake by 260 mg/d and their Na/K ratio by 0.21 within two to four years after diagnosis (P < 0.01). Among spouse pairs, sodium intake and Na/K ratio of women decreased when their husbands were diagnosed with hypertension (P < 0.05). At the household level, sodium density and Na/K ratio decreased (-8.5 mg/100 kcal and -0.19) after a man was diagnosed (P < 0.05). In contrast, when women were diagnosed, sodium, potassium and Na/K ratio changes associated with hypertension diagnosis were not statistically significant. Conclusions Our study suggests that when men were diagnosed with hypertension, dietary sodium intake and Na/K ratio improved for them, as well as their wife and other household members. However, when women were diagnosed, none of the changes were statistically significant. There is a need to address the gender bias, along with efforts to increase hypertension diagnosis in China. Funding Sources The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, National Heart, Lung, Blood Institute, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and CONACyT.

scholarly journals Association between Parent and Child Dietary Sodium and Potassium Intakes: Aomori Prefectural Health and Nutrition Survey, 2016

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1414
Author(s):  
Tatsuya Koyama ◽  
Nobuo Yoshiike
Keyword(s):  
Sodium Intake ◽  
Dietary Sodium ◽  
Nutrition Survey ◽  
Potassium Intake ◽  
Health And Nutrition ◽  
Aomori Prefectural ◽  
Dietary Record ◽  
Mother And Child ◽  
Using Data ◽  
Sodium And Potassium

This study investigated the association between parent and child sodium and potassium intakes using data from the 2016 Aomori Prefectural Health and Nutrition Survey. We analyzed one day dietary record data of 103 mothers, 94 fathers, 51 children aged 1–3 years, 39 children aged 4–6 years, 91 children aged 7–14 years, and 56 children aged 15–19 years. We also examined the association of sodium and potassium intake between co-habiting grandparents and their grandchildren. After adjusting for covariates, the total daily sodium intake in mothers was positively associated with that in children for every age group. Potassium intakes by the mothers during breakfast and dinner were positively associated with those in children aged 1–3, 4–6, and 7–14 years. The associations in sodium and potassium intakes between fathers and children were weaker. In addition, these associations were similar to those between the sodium intakes of grandchildren and their grandparents. The association between mother and child sodium and potassium intakes at breakfast and dinner was related to the consumption of similar foods, which suggests the importance of home environment in influencing total dietary sodium and potassium intake in Japanese people.

scholarly journals Diet or Additional Supplement to Increase Potassium Intake: Protocol For An Adaptive Clinical Trial

2021 ◽  
Author(s):  
Swapnil Hiremath ◽  
Dean Fergusson ◽  
Greg Knoll ◽  
Tim Ramsay ◽  
Jennifer Kong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
High Blood Pressure ◽  
Sodium Intake ◽  
Western World ◽  
Dietary Advice ◽  
Ageing Population ◽  
Potassium Supplement ◽  
Participant Satisfaction ◽  
Potassium Intake

Abstract Background High blood pressure is the leading cause of cardiovascular disease worldwide. The prevalence of high blood pressure is steadily rising, with the growing and ageing population. Many medicines are available to decrease blood pressures successfully, as well as many non-medical options, such as dietary changes and exercise. There is a marked preference amongst patients, reiterated in a Hypertension Canada report, for more research into methods for controlling blood pressure without medicines or to reduce the burden of taking many pills to control high blood pressure. Indeed, effective options do exist, especially with diet, specifically decreasing sodium and increasing potassium in diet. Current public health outreach mostly focusses on sodium intake, even as the potassium intake in diet remains low especially in the Western world. Excellent data exist in the published research reporting that increasing potassium intake, either as diet or even as supplements, reduces blood pressure and reduces risk of cardiovascular outcomes such as stroke. However, the advice most often provided is to ‘eat more fruits and vegetables’ which does not get translated into concrete change. Methods We propose to do a clinical trial in two stages, with an adaptive trial design. In the first stage, participants with high blood pressure and proven low potassium intake (measured on the basis of a 24 hour urine collection) will get individually tailored dietary advice, reinforced by weekly supportive phone/email support. If at 4 weeks, there has not been a desired increase in potassium intake, they will be prescribed an additional potassium supplement. Testing will be conducted again at 4 weeks post initiating the potassium supplement, to confirm the efficacy of the potassium supplement. Final measurements will be planned at 52 weeks to observe and measure the persistence of the effect of diet or additional supplement. Concurrent measurements of sodium intake, blood pressure, participant satisfaction, and safety measures will also be done. Discussion The results of the study would help determine the most effective method of increasing potassium intake, thus reducing blood pressure, need for blood pressure lowering medicines, at the same time potentially increasing participant satisfaction. The current guidelines recommend changes in diet, not supplement, to increase potassium intake, hence the two stage design will only add supplements if the most rigorous dietary advice does not work. Trial registration: This study has been registered on ClinicalTrials.gov identifier NCT03809884, registered on January 18, 2019. URL: https://clinicaltrials.gov/ct2/show/NCT03809884

scholarly journals Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaofu Du ◽  
Le Fang ◽  
Jianwei Xu ◽  
Xiangyu Chen ◽  
Yamin Bai ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sodium Excretion ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium ◽  
Inverse Association ◽  
Potassium Excretion ◽  
Chinese Adults ◽  
Potassium Intake ◽  
Sodium And Potassium

AbstractThe direction and magnitude of the association between sodium and potassium excretion and blood pressure (BP) may differ depending on the characteristics of the study participant or the intake assessment method. Our objective was to assess the relationship between BP, hypertension and 24-h urinary sodium and potassium excretion among Chinese adults. A total of 1424 provincially representative Chinese residents aged 18 to 69 years participated in a cross-sectional survey in 2017 that included demographic data, physical measurements and 24-h urine collection. In this study, the average 24-h urinary sodium and potassium excretion and sodium-to-potassium ratio were 3811.4 mg/day, 1449.3 mg/day, and 4.9, respectively. After multivariable adjustment, each 1000 mg difference in 24-h urinary sodium excretion was significantly associated with systolic BP (0.64 mm Hg; 95% confidence interval [CI] 0.05–1.24) and diastolic BP (0.45 mm Hg; 95% CI 0.08–0.81), and each 1000 mg difference in 24-h urinary potassium excretion was inversely associated with systolic BP (− 3.07 mm Hg; 95% CI − 4.57 to − 1.57) and diastolic BP (− 0.94 mm Hg; 95% CI − 1.87 to − 0.02). The sodium-to-potassium ratio was significantly associated with systolic BP (0.78 mm Hg; 95% CI 0.42–1.13) and diastolic BP (0.31 mm Hg; 95% CI 0.10–0.53) per 1-unit increase. These associations were mainly driven by the hypertensive group. Those with a sodium intake above about 4900 mg/24 h or with a potassium intake below about 1000 mg/24 h had a higher risk of hypertension. At higher but not lower levels of 24-h urinary sodium excretion, potassium can better blunt the sodium-BP relationship. The adjusted odds ratios (ORs) of hypertension in the highest quartile compared with the lowest quartile of excretion were 0.54 (95% CI 0.35–0.84) for potassium and 1.71 (95% CI 1.16–2.51) for the sodium-to-potassium ratio, while the corresponding OR for sodium was not significant (OR, 1.28; 95% CI 0.83–1.98). Our results showed that the sodium intake was significantly associated with BP among hypertensive patients and the inverse association between potassium intake and BP was stronger and involved a larger fraction of the population, especially those with a potassium intake below 1000 mg/24 h should probably increase their potassium intake.

scholarly journals Low potassium intake and its association with blood pressure among adults in Malaysia: findings from the MyCoSS (Malaysian Community Salt Survey)

2021 ◽  
Vol 40 (S1) ◽  
Author(s):  
Lalitha Palaniveloo ◽  
Rashidah Ambak ◽  
Fatimah Othman ◽  
Nor Azian Mohd Zaki ◽  
Azli Baharudin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Adult Population ◽  
Further Education ◽  
Cluster Sampling ◽  
Potassium Excretion ◽  
Daily Consumption ◽  
Blood Pressure Monitor ◽  
Potassium Intake ◽  
Urinary Potassium

Abstract Background High blood pressure or hypertension is well recognized as an important modifiable risk factor for cardiovascular diseases. Several studies had indicated potassium intake has a blood pressure lowering effect. This study aimed to estimate potassium intake via 24-h urinary potassium excretion and to determine the association between potassium intake and blood pressure among adults in Malaysia. Methods Data for 424 respondents in this study were drawn from MyCoSS, a nationwide cross- sectional study conducted among Malaysians who were 18 years and above. Respondents were recruited using stratified cluster sampling, covering urban and rural areas in each state in Malaysia. Data collection was undertaken from October 2017 until March 2018. A single urine sample was collected over 24 h for quantification of potassium excreted. Information on socio-demography and medical history of the respondents were collected by interviewer-administered questionnaires. Anthropometric measurements were measured using validated equipment. BMI was estimated using measured body weight and height. Digital blood pressure monitor (Omron HBP-1300) was used to measure blood pressure. Descriptive statistics, analysis of variance (ANOVA), and multivariable linear regression were used to analyze the data in SPSS Version 21. Results Mean 24-h urinary potassium excretion for the 424 respondents was 37 mmol (95% CI 36, 38). Gender and ethnicity showed statistically significant associations with 24-h urinary potassium excretion. However, potassium excretion was not significantly associated with blood pressure in this study. Conclusion Potassium intake is very low among the adults in Malaysia. Therefore, further education and promotional campaigns regarding daily consumption of potassium-rich diet and its benefits to health need to be tailored for the Malaysian adult population.

scholarly journals Assessment of Foods Associated with Sodium and Potassium Intake in Japanese Youths Using the Brief-Type Self-Administered Diet History Questionnaire

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2345
Author(s):  
Masayuki Okuda ◽  
Satoshi Sasaki
Keyword(s):  
Sodium Excretion ◽  
Sodium Intake ◽  
Molar Ratio ◽  
Potassium Excretion ◽  
Potassium Intake ◽  
Soybean Paste ◽  
Diet History Questionnaire ◽  
Diet History ◽  
8Th Graders ◽  
Sodium And Potassium

The identification of sodium and potassium intake in youths is an important step to preventing the increase of blood pressure in childhood. We examined food intake and estimated mineral intake using a brief-type self-administered diet history questionnaire (BDHQ) to test its validity as a comparison with urinary excretion in Japanese youths. The subjects were 5th and 8th graders (n = 2377), who completed the BDHQ and permitted the use of their overnight urine specimens. Sodium intake was poorly associated with sodium excretion (Rho = 0.048), and the coefficients of dietary potassium and a sodium-to-potassium molar ratio were 0.091–0.130. Higher soybean paste (miso) intake and pickles were significantly associated with higher sodium excretion (p ≤ 0.005). However, these foods were positively associated with potassium excretion (p = 0.002–0.012), and not associated with an excreted sodium-to-potassium ratio. Fruits and dairy products were positively associated (p ≤ 0.048), whereas beverages were negatively associated with potassium excretion (p ≤ 0.004). The association of the sodium-to-potassium ratio was opposite to that of potassium (p ≤ 0.001). The choice of foods, potassium, and the sodium-to-potassium ratio assessed using the BDHQ are available as part of health education for youths, but the assessment of sodium intake in population levels should be carefully conducted.

Effects of sodium intake on steady-state potassium excretion

1984 ◽  
Vol 246 (6) ◽  
pp. F772-F778 ◽  
Author(s):  
D. B. Young ◽  
T. E. Jackson ◽  
U. Tipayamontri ◽  
R. C. Scott
Keyword(s):  
Steady State ◽  
Potassium Concentration ◽  
Sodium Intake ◽  
Plasma Potassium ◽  
Potassium Excretion ◽  
Distal Nephron ◽  
Concentration Data ◽  
Potassium Intake ◽  
Independent Variable ◽  
The Relationship

The effects of changes in sodium intake on the steady-state relationship between plasma potassium concentration and potassium excretion were studied in 15 chronically adrenalectomized dogs. Throughout the experiments the dogs received aldosterone at a rate of 50 micrograms/day and methylprednisolone at 1 mg/day. The relationship between plasma potassium and steady-state potassium excretion was obtained by changing potassium intake from 10 to 30 to 100 meq/day, each level being maintained for 7-10 days. At the conclusion of each period at a given level of potassium intake, plasma potassium and excretion were measured and plotted, plasma potassium being the independent variable. Such a relationship was obtained while the dogs were on three different levels of sodium intake: 10, 100, and 200 meq/day. The curves from the data obtained at 100 and 200 meq/day sodium intake both were shifted to the left of the curve obtained at 10 meq/day (P less than 0.05), although the 100 and 200 meq/day curves were not different from each other. On the basis of these data one could predict that, at a plasma potassium concentration of 4.0 meq/liter, the animals would excrete potassium at a rate of 17 meq/day on a 10 meq/day sodium intake, 37 meq/day on a 100 meq/day sodium intake, and 47 meq/day on a 200 meq/day sodium intake. Urine flow and electrolyte concentration data are consistent with the hypothesis that the sodium intake effect on potassium excretion was mediated through increases in distal nephron flow rate and decreases in distal nephron potassium concentration.

scholarly journals Spot urine and 24-h diet recall estimates of dietary sodium intake from the 2008/09 New Zealand Adult Nutrition Survey: a comparison

2020 ◽  
Author(s):  
RM McLean ◽  
SM Williams ◽  
Lisa Te Morenga ◽  
JI Mann
Keyword(s):  
New Zealand ◽  
Sodium Excretion ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Dietary Sodium ◽  
Urine Collection ◽  
Limits Of Agreement ◽  
Nutrition Survey ◽  
Spot Urine ◽  
Diet Recall

© 2018, Macmillan Publishers Limited, part of Springer Nature. Background: We aimed to test the difference between estimates of dietary sodium intake using 24-h diet recall and spot urine collection in a large sample of New Zealand adults. Methods: We analysed spot urine results, 24-h diet recall, dietary habits questionnaire and anthropometry from a representative sample of 3312 adults aged 15 years and older who participated in the 2008/09 New Zealand Adult Nutrition Survey. Estimates of adult population sodium intake were derived from 24-h diet recall and spot urine sodium using a formula derived from analysis of INTERSALT data. Correlations, limits of agreement and mean difference were calculated for the total sample, and for population subgroups. Results: Estimated total population 24-h urinary sodium excretion (mean (95% CI)) from spot urine samples was 3035 mg (2990, 3079); 3612 mg (3549, 3674) for men and 2507 mg (2466, 2548) for women. Estimated mean usual daily sodium intake from 24-h diet recall data (excluding salt added at the table) was 2564 mg (2519, 2608); 2849 mg (2779, 2920) for men and 2304 mg (2258, 2350) for women. Correlations between estimates were poor, especially for men, and limits of agreement using Bland–Altman mean difference analysis were wide. Conclusions: There is a poor agreement between estimates of individual sodium intake from spot urine collection and those from 24-hour diet recall. Although, both 24-hour dietary recall and estimated urinary excretion based on spot urine indicate mean population sodium intake is greater than 2 g, significant differences in mean intake by method deserve further investigation in relation to the gold standard, 24-hour urinary sodium excretion.

Dietary Sodium, Potassium, and Sodium to Potassium Ratio in Patients With Systemic Lupus Erythematosus

2022 ◽  
pp. 109980042110654
Author(s):  
María Correa-Rodríguez ◽  
Sara DelOlmo-Romero ◽  
Gabriela Pocovi-Gerardino ◽  
José-Luis Callejas-Rubio ◽  
Raquel Ríos-Fernández ◽  
...  
Keyword(s):  
Disease Activity ◽  
Sodium Intake ◽  
Dietary Sodium ◽  
Complement C3 ◽  
Systemic Lupus ◽  
Sodium Potassium ◽  
Complement C4 ◽  
Potassium Intake ◽  
Dietary Potassium ◽  
Sodium And Potassium

Purpose: The aim of this study was to investigate the association between dietary sodium, potassium, and sodium:potassium ratio and clinical disease activity parameters, damage accrual, and cardiovascular disease risk factors in a population of patients with systemic lupus erythematous (SLE). Research design and study sample: A cross-sectional study including a total of 280 patients was conducted (90.4% females; mean age 46.9 ± 12.85 years). Data collection: The SLE Disease Activity Index (SLEDAI-2K) and the SDI Damage Index were used to assess disease activity and disease-related damage, respectively. A 24-hour diet recall was used to estimate dietary intake of sodium and potassium. Results: Dietary sodium intake was significantly associated with anti-dsDNA ( β  =  −.005; 95% CI [.002 .008]; p = .001) and complement C4 level ( β  =  −.002; 95% CI [−.003, .000]; p = .039). Dietary potassium intake was also significantly associated with complement C3 level ( β  =  −.004; 95% CI [−.007, −.001]; p = .021). Multiple logistic regression models revealed a positive association between dietary sodium intake and the risk of having hsCRP > 3 ( p = .005) and an inverse association between dietary potassium intake and the risk of having hsCRP > 3 ( p = .004). Conclusions: SLE patients with higher dietary sodium and lower dietary potassium intakes had an increased risk of higher hsCRP. Dietary sodium intake was significantly associated with anti-dsDNA and complement C4 level, while dietary potassium intake was associated with complement C3 level, supporting that dietary sodium and potassium intakes might play a key role in markers related to disease activity in SLE patients.

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