scholarly journals An Assessment of Usual Salt Intake among Older Normotensive Adults in Atonsu, a Suburb of Kumasi in the Ashanti Region of Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Rufai Safianu ◽  
Jacob Plange-Rhule

Background. Globally, sodium intake has been found to be far above the normal level required by the body. Within countries, variations in salt intake exist between rural communities and urban communities. Experimental and epidemiological studies as well as studies involving clinical trials show the existence of adverse effect of salt consumption on the blood pressure of adults. The study evaluated salt intake among older normotensive adults in Atonsu, a suburb of Kumasi in the Ashanti region of Ghana. Methods. Participants were randomly selected from five churches which constituted cluster samples. A questionnaire was administered to participants for demographic information and dietary and lifestyle assessments. The study targeted 100 participants, twenty from each of the five churches. Eighty-two individuals gave their informed consent. Out of the 82 who gave their informed consent, 15 withdrew and 67 completed the course. The 67 participants comprised 36 (53.7%) men and 31 (46.3%) women. Systolic and diastolic blood pressure, BMI, urinary sodium, urinary potassium, serum creatinine, serum sodium, and serum potassium concentrations were also measured. Results. Participants’ mean age was 52.3 ± 8.7 years. Participants had 24 hr urinary sodium excretion of 153.0 ± 26.9 mmol/day. All participants indicated that they consume foods high in salt even though none of them added salt to their diet at table. Mean 24 hr urinary potassium was 52.5 ± 12.9 mmol/day. Mean systolic blood pressure was 119.9 ± 10.8 mmHg and mean diastolic blood pressure was 72.5 ± 7.3 mmHg. Their mean BMI was 23.7 ± 3.5 kg/m2. Conclusion. The participants who can be described as quite old and normotensive were high salt consumers, indicated by their dietary assessment and urinary sodium excretion, even though they had normal blood pressure.

2015 ◽  
Vol 9 (4) ◽  
pp. e72
Author(s):  
Katarzyna Stolarz-Skrzypek ◽  
Adam Bednarski ◽  
Grzegorz Kiełbasa ◽  
Malgorzata Kloch-Badelek ◽  
Danuta Czarnecka

2019 ◽  
Vol 105 (3) ◽  
pp. e484-e493
Author(s):  
Christian Adolf ◽  
Daniel A Heinrich ◽  
Finn Holler ◽  
Benjamin Lechner ◽  
Nina Nirschl ◽  
...  

Abstract Context High dietary salt intake is known to aggravate arterial hypertension. This effect could be of particular relevance in the setting of primary aldosteronism (PA), which is associated with cardiovascular damage independent of blood pressure levels. The aim of this study was to determine the impact of therapy on salt intake in PA patients. Patients and Methods A total of 148 consecutive PA patients (66 with unilateral and 82 with bilateral PA) from the database of the German Conn’s Registry were included. Salt intake was quantified by 24-hour urinary sodium excretion before and after initiation of PA treatment. Study design Observational longitudinal cohort study. Setting Tertiary care hospital. Results At baseline, unilateral PA patients had a significantly higher urinary sodium excretion than patients with bilateral disease (205 vs 178 mmol/d, P = 0.047). Higher urinary sodium excretion correlated with an increased cardiovascular risk profile including proteinuria, impaired lipid, and glucose metabolism and was associated with higher daily doses of antihypertensive drugs to achieve blood pressure control. In unilateral disease, urinary sodium excretion dropped spontaneously to 176 mmol/d (P = 0.012) 1 year after unilateral adrenalectomy and remained low at 3 years of follow-up (174 mmol/d). In contrast, treatment with mineralocorticoid receptor antagonists (MRA) in bilateral PA patients was not associated with a significant change in urinary sodium excretion at follow-up (179 mmol/d vs 183 mmol/d). Conclusion PA patients consuming a high-salt diet, estimated based on urinary sodium excretion, respond to adrenalectomy with a significant reduction of salt intake, in contrast to MRA treatment.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1062-1062
Author(s):  
Paula Moliterno ◽  
Carmen Marino Donangelo ◽  
Luciana Borgarello ◽  
Alicia Olascoaga ◽  
José Boggia

Abstract Objectives To examine the association between knowledge, attitudes and behavior towards salt use and its consumption estimated by urinary sodium excretion in a population adult cohort from Uruguay (Genotype Phenotype and Environment of Hypertension Study - GEFA-HT-UY). Methods Participants [n = 243; age 18–89y (min-max); 61.9% women], provided a single 24-hour urine sample validated according to volume and creatinine excretion. A questionnaire describing knowledge, attitudes and behaviors (KAB) was adapted from the WHO/PAHO protocol for population level sodium determination where participants answered on a range of scales. Anthropometric and blood pressure measurements were also taken. Associations between KAB categories and estimated salt intake were examined by general linear models, adjusted for sex, age tertiles and body mass index (BMI) categories. Results Considering all participants, 35.8% were hypertensive (77% on antihypertensive treatment). Systolic/diastolic blood pressure was 125.6 ± 23.4/79.7 ± 9.9 mmHg, with no difference between sexes. Estimated salt intake was 7.8 ± 3.6 g (3116 ± 1433 mg sodium), higher in men (8.9 ± 3.9 g) compared to women (7.3 ± 3.3 g) (P = 0.0013). Salt intake decreased with age tertiles (P = 0.0001), and increased with BMI categories (P = 0.0067). The majority (88.5%) of participants acknowledge that a high salt diet may cause serious health problems, 92.2% were unaware of WHO salt intake recommendation (<5 g/d) and 78.6% had intake over that limit. Only 12.4% considered they consumed “too much salt”. Although 74.7% reported that limiting salt intake was important for their health, only 56% reported taking regular actions to control its intake. No difference in salt intake was found between participants who considered they use salt “too much” (8.5 ± 0.62 g), “the right amount” (7.9 ± 0.28 g), or “too little” (7.6 ± 0.52 g) (P = 0.56). However, those who reported following a healthy diet had 1.4g lower salt intake than those who reported not doing so (P = 0.016). There was no difference in salt intake between those who reported using/not using salt when cooking (P = 0.65), and adding/not adding salt to food at table (P = 0.087). Conclusions No associations were found between knowledge, attitudes and behaviors towards salt use and intake. Perceived salt consumption underestimated salt intake. Funding Sources CSIC, ANII, Uruguay.


2016 ◽  
Vol 46 (6) ◽  
pp. 766-777 ◽  
Author(s):  
Sonal Dhemla ◽  
Kanika Varma

Purpose There has been a dramatic increase in hypertension in developing countries along with changes in food consumption patterns contributing to higher levels of sodium. Evidence shows that a high level of sodium intake is a major cause of high blood pressure and other heart diseases along with other associated diseases. Therefore, it is important to determine current consumption levels of sodium in a population to facilitate the development and implementation of any specific salt reduction program. Design/methodology/approach The study was conducted among 60 subjects (25-45 years) residing in Jaipur City. Subjects’ sodium consumption levels were assessed via assessment of 24-h urinary sodium excretion levels, the “gold standard” method advocated by WHO/PAHO (2010) and 24-h dietary recall for three days including one holiday. Findings The findings of the study indicated that the subjects were found to be consuming higher levels of sodium (males, 5,792 mg/d; females, 5,911 mg/d) than recommended by WHO, i.e. less than 2,300 mg/d. Completeness of urine was confirmed by fat-free mass determined by electrical bio-impedance (47.6 ± 7.6 kg) and determined by using 24-h urinary excretion of creatinine (33.7 ± 10.1 kg). Two variables were found to be significantly correlated (r = 0.52, p = 0.00). Assuming that the sodium eliminated in the urine comes from the salt only, this excretion would correspond with a dietary salt intake of 14.71 and 15.01 g/d in males and females, respectively. Dietary sodium intake was reported to be 4,133 ± 1,111 mg/day and 3,953 ± 945 mg/d in males and females, respectively. A non-significant difference was found between the two variables. Urinary sodium excretion correlated non-significantly with systolic and diastolic blood pressure figures (r = 0.09 and r = −0.02, respectively). Research limitations/implications The limitations of this study included the small sample size. Purposive sampling was adopted due to difficulty in obtaining urine sample and required willingness of the respondent. This may give fair robust estimate. Originality/value The present results will help provide new data about the baseline salt intake in young and middle-aged population of Jaipur City and will further help the concerned agencies to plan meaningful strategies to reduce salt intake, and it must involve public education and awareness to change the consumption pattern.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaofu Du ◽  
Le Fang ◽  
Jianwei Xu ◽  
Xiangyu Chen ◽  
Yamin Bai ◽  
...  

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.


2021 ◽  
pp. 1-42
Author(s):  
Yi-Jie Wang ◽  
Kuo-Lioug Chien ◽  
Hsiu-Ching Hsu ◽  
Hung-Ju Lin ◽  
Ta-Chen Su ◽  
...  

Abstract Urinary sodium excretion is a potential risk factor for cardiovascular diseases (CVD). However, the underlying biological mechanisms and effects of salt sensitivity are unclear. The purpose of this study was to characterize the relative contribution of biological factors to the sodium-CVD association. A total of 2112 participants were enrolled in this study. Structured questionnaires and blood and urine samples were obtained. Twenty-four-hour sodium excretion was estimated using a single overnight urine sample. Hypertension, metabolic syndrome, and overweight status were considered to indicate salt sensitivity. Cox proportional hazard models were used to investigate the effects of salt sensitivity on urinary sodium excretion and CVD risk. The traditional mediation approach was used to calculate the proportion of mediation. The mean age (standard deviation) of the 2112 participants was 54.5 (12.2) years, and they were followed up for a mean of 14.1 [8.1] years. Compared with those in the lowest quartile, the highest baseline urinary sodium excretion (>4.2g/24 hours) was associated with a 43% higher CVD risk (hazard ratio, 1.43; 95% confidence interval, 1.02-1.99). Participants with high urinary sodium excretion, hypertension, or metabolic syndrome had a significantly high risk of CVD. The carotid intima-media thickness had the largest mediating effect (accounting for 35% of the sodium-CVD association), followed by systolic blood pressure (33%), left ventricular mass (28%), and diastolic blood pressure (14%). Higher urinary sodium excretion increased the risk of CVD, which was explained largely by carotid media-thickness and systolic blood pressure.


Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Tomoko Hashimoto

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.


2018 ◽  
Vol 148 (12) ◽  
pp. 1946-1953 ◽  
Author(s):  
Magali Rios-Leyvraz ◽  
Pascal Bovet ◽  
René Tabin ◽  
Bernard Genin ◽  
Michel Russo ◽  
...  

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.


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