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

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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Abstract P170: Associations of Calibrated Dietary Sodium and Potassium Intakes With the Risk of Heart Failure and its Subtypes in Postmenopausal Women: The Women's Health Initiative

Circulation ◽

10.1161/circ.137.suppl_1.p170 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Xiao Gu ◽

Lesley F Tinker ◽

Alison E Field ◽

Mary B Roberts ◽

Matthew Allison ◽

...

Keyword(s):

Heart Failure ◽

Dose Response ◽

Sodium Intake ◽

Dietary Sodium ◽

Response Relationship ◽

Dose Response Relationship ◽

Potassium Intake ◽

Health Initiative ◽

Dietary Potassium ◽

Sodium And Potassium

Background: Previous studies have suggested that sodium reduction could be a viable strategy for reducing heart failure-related disease burden. Relatively few studies had been conducted on dietary sodium and the incidence of heart failure (HF) and its major subtypes; HF with preserved ejection function (HFpEF) and HF with reduced ejection function (HFrEF). Hypothesis: We hypothesized that dietary sodium was positively associated with the risk of HF and its major subtypes with a linear dose-response relationship, whereas dietary potassium was inversely associated with the risks of these outcomes. Methods: Our observational cohort study included 118,057 racial/ethnically diverse postmenopausal women recruited during 1993-1998 and followed up until 2015 in the Women’s Health Initiative. Women who reported a history of HF, were underweight, or had implausible/missing food frequency questionnaire (FFQ) data were excluded at baseline. The exposures of our study were FFQ-measured dietary sodium and potassium calibrated by recovery biomarkers estimated from 24-hour urine excretion collections. The main outcomes were hospitalized heart failure, including HFpEF and HFrEF subtyping, as adjudicated by trained physicians. Results: During up to 22 years of follow-up, 2,533, 1,048 and 673 participants developed HF, HFpEF and HFrEF, respectively. The mean age of the study population was 63.4 years, in which 84.3% (99,297 of 118,057) were white, 7.8% (9,150 of 118,057) were African American, 3.8% (4,469 of 118,057) were Hispanic and 4.1% (4,832 of 118,057) were other race/ethnicity groups. The median of calibrated dietary sodium intake was 2,712.4 mg/day (interquartile range: 2,503.3 mg/day-2,948.4 mg/day) and the median of dietary potassium intake was 2,494.5 mg/day (interquartile range: 2,249.8 mg/day-2,718.2 mg/day). After adjusting for potential confounding variables and risk factors of HF, calibrated sodium intake was positively associated with the incidence of HF (HR Q5 vs. Q1 =2.59, 95% CI: 2.26-2.98, P-trend <0.001). Comparing extreme quintiles of sodium intake, the HR was 2.87 for HFpEF (95% CI: 2.29-3.60) and 1.71 for HFrEF (95% CI: 1.28-2.30, both P-trend<0.001). The dose-response relationships between calibrated sodium intake and the risk of HF and HFrEF were non-linear with accelerated increasing risks at higher intake level, while the dose-response relationship for HFpEF was linear. Similar positive associations were observed for the analyses on calibrated sodium/potassium ratio, whereas calibrated potassium intake was not associated with the risk of HF and its major subtypes. Conclusions: Higher sodium intake is associated with increased risk of HF and its major subtypes. The observed positive association appears to be stronger for HFpEF than for HFrEF. These findings help to inform dietary recommendations for primary heart failure prevention.

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P1690Lab-on-a-chip based self-monitoring device for dietary intake of potassium and sodium: the LAB-CHIPS study

European Heart Journal ◽

10.1093/eurheartj/ehz748.0445 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A C Vendeville ◽

H A H Kaasjager ◽

R E A Musson ◽

W Spiering

Keyword(s):

Lifestyle Modification ◽

Sodium Intake ◽

Lab On A Chip ◽

Dietary Sodium ◽

Monitoring Device ◽

Self Monitoring ◽

Potassium Intake ◽

Self Test ◽

Sodium And Potassium ◽

Kawasaki Formula

Abstract Background Dietary sodium restriction and upholding adequate potassium intake is an important lifestyle modification strategy advocated in guidelines for the management of hypertension and for lowering cardiovascular risk in the general population. The gold standard for estimating sodium and potassium intake, 24-hour urine collection (24hUc), is time consuming and cumbersome, but most importantly not a good indicator of dietary habit due to day-to-day variation. New lab-on-a-chip technology has been developed to measure urinary sodium, potassium and creatinine excretion in a single drop of urine using microcapillary electrophoreses combined with conductivity analyses. Self-monitoring can be done at home over a longer period of time. Results are readily available. Purpose To assess agreement between 24hUc and the lab-on-a-chip self-monitoring device for estimating past 24h dietary sodium and potassium intake for single and multiple self-tests by using the Kawasaki, INTERSALT and Tanaka formulae. Methods Healthy participants (n=12) were asked to adhere to three different weekly dietary sodium restriction goals. Participants received verbal and written information to aim between 3.3 and 5.0 grams of sodium intake a day during week 1 (“normal”), >3.3<5.0 grams in week 2 (low) and >5.0 grams during week 3 (high). Weekly measurement instructions consisted of one self-test on day 1 through 6 and multiple self-tests (n=3) combined with a 24hUc on day 7. To estimate 24h sodium and potassium intake, Kawasaki, INTERSALT and Tanaka formulas were used. The Bland-Altman method was used to calculate the agreement. Results The agreement (mg/day) for sodium between 24hUc and a self-test on first morning urine (fmu) (Kawasaki), was −102±804 (normal), −860±592 (low) and 340±1406 (high). For multiple self-tests (n=3) performed on 24hUc days, using the INTERSALT formula, the agreement was: 577±832 (normal), −701±721 (low) and 1788±911 (high). Any combination of same day single or multiple INTERSALT or Tanaka self-tests and fmu Kawasaki did not result in better agreement. For potassium the agreement between 24hUc and fmu (Kawaksaki) was 1071±966 (normal), 1376±678 (low) and 1654±880 (high). Using the Tanaka formula resulted in further underestimation and thus worse agreement for same day self-tests and fmu. Conclusion In this study, agreement between 24hUc and the lab-on-a-chip self-monitoring device for estimating past 24h dietary sodium intake was best for a fmu self-test calculated with the Kawasaki formula. For estimating potassium intake, a fmu self-test with help of the Kawasaki formula overestimated potassium intake considerably. This lab-on-a-chip self-monitoring device has the potential to improve current lifestyle modification strategies.

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Salt Consumption in Latvian Population: A Pilot Study

Medicina ◽

10.3390/medicina54010010 ◽

2018 ◽

Vol 54 (1) ◽

pp. 10

Author(s):

Ilva Lazda ◽

Māris Goldmanis ◽

Inese Siksna

Keyword(s):

Pilot Study ◽

Sodium Intake ◽

Large Population ◽

Population Based ◽

Dietary Sodium ◽

World Health ◽

Food Diary ◽

Potassium Intake ◽

Sodium And Potassium ◽

Dietary Data

Background and objective: High dietary sodium intake is associated with multiple health risks, and the average sodium intake in Latvia is higher than the World Health Organization has recommended. In Latvia, no study so far has combined self-reported dietary data on sodium and potassium intake with objective measurements in 24-h urine samples. This pilot study aimed to cross-validate both methods and to assess any possible factors interfering with the collection of samples and data in large, population-based future studies of sodium and potassium intake in Latvian adults. Materials and methods: A stratified random sample of healthy Latvian adults aged 19–64 (n = 30) was drawn. Dietary data of sodium and potassium was collected using one 24-h dietary recall and a two-day food diary. Sodium and potassium excretion was measured by one 24-h urinary collection. Results: Median intake of sodium and potassium based on dietary data was 2276.4 mg/day (interquartile range (IQR), 1683.3–3979.4) and 2172.0 mg/day (IQR, 1740.6–3506.5), respectively. Median intake of sodium and potassium based on urinary data was 3500.3 mg/day (IQR, 2191.0–5535.0) and 2965.4 mg/day (IQR, 2530.2–3749.9), respectively. Urinary data showed significantly higher results than dietary records (Wilcoxon signed rank test, p = 0.023). Only 13% of the subjects did not exceed the WHO-recommended limit of 2000 mg of sodium per day, and only 33% consumed at least the recommended allowance of 3510 mg of potassium per day. Median intake of salt was 8.8 g/day (IQR, 5.5–13.8) (according to urinary data). Conclusions: The findings from the present study showed considerable underestimation of dietary sodium and potassium intake based on self-reported dietary data. Urinary data revealed more accurate results, and showed that Latvian adults exceed the amount of salt recommended and consume less potassium than recommended. The pilot study also showed that the chosen methods are adequate for implementation in large, population-based studies to evaluate dietary intake of salt, sodium, and potassium in populations of Latvian adults.

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

Nutrients ◽

10.3390/nu11061414 ◽

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.

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ALDOSTERONE SECRETION RATES IN CHILDREN WITH NORMAL ADRENAL FUNCTION

PEDIATRICS ◽

10.1542/peds.47.3.587 ◽

1971 ◽

Vol 47 (3) ◽

pp. 587-593

Author(s):

George T. Bryan

Keyword(s):

Sodium Intake ◽

Dietary Sodium ◽

Careful Attention ◽

Aldosterone Secretion ◽

High Sodium ◽

Precise Control ◽

Potassium Intake ◽

Independent Variable ◽

Sodium And Potassium ◽

Secretion Rates

Aldosterone secretion rate (ASR) was measured in 17 children during low, normal, and high dietary sodium intakes. Their ages varied from 3 months to 16 years; there were eight girls and nine boys. The average ASR with low, normal, and high sodium intakes were 236, 77, and 18 µg/ day respectively. The independent contribution of patient age, sex, sodium and potassium intake, and duration of fixed sodium intake was tested by least squares multiple regression analysis. The most important independent variable was sodium intake, although the sex and age of the patient were statistically significant variables. From this study it seems unlikely that precise control of all nutrients is necessary for evaluation of ASR if careful attention is paid to sodium intake.

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Dietary sodium, potassium, and blood pressure in normotensive pregnant women: the National Health and Nutrition Examination Survey

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2019-0186 ◽

2020 ◽

Vol 45 (2) ◽

pp. 155-160

Author(s):

Abbi D. Lane-Cordova ◽

Lara R. Schneider ◽

William C. Tucker ◽

James W. Cook ◽

Sara Wilcox ◽

...

Keyword(s):

Blood Pressure ◽

Sodium Intake ◽

Ethnically Diverse ◽

Dietary Sodium ◽

Nutrition Examination Survey ◽

Sodium Potassium ◽

Health And Nutrition ◽

Race Ethnicity ◽

Sodium And Potassium ◽

Normotensive Pregnancy

Dietary sodium, potassium, and sodium-to-potassium ratio are linearly associated with blood pressure in nonpregnant adults. Earlier investigations suggested null or inverse associations of blood pressure and sodium during normotensive pregnancy; findings have not been confirmed in race/ethnically diverse women or while accounting for potassium. Our purpose was to evaluate associations of blood pressure with sodium and potassium and sodium-to-potassium ratio in race/ethnically diverse normotensive pregnant women. We used cross-sectional blood pressure and dietary data from 984 women in multiple cycles of the National Health and Nutrition Examination Survey (mean age = 27.6 ± 0.2 years). We tested for differences in blood pressure across quartiles of sodium intake using Kruskal–Wallis tests and linear regression to evaluate associations of sodium, potassium, and the sodium-to-potassium ratio with systolic (SBP) and diastolic (DBP) blood pressures. We adjusted for potential confounding variables: age, race/ethnicity, education, marital status, body mass index, smoking, and month of pregnancy. SBP and DBP were similar across quartiles of sodium intake: quartile 1 (lowest sodium intake): 107/59; quartile 2: 106/59; quartile 3: 108/60; quartile 4 (highest sodium intake): 108/58 mm Hg, p > 0.60 for all. Sodium (β = 0.16, 95% confidence interval (CI): –0.20 to 0.52) and potassium (β = 0.18, 95% CI: –0.24 to 0.60) and the sodium-to-potassium ratio (β = –0.54, 95% CI: –1.55 to 0.47) were not associated with SBP or DBP. Results were similar in stratified analyses. Novelty Blood pressure was similar among quartiles of sodium or potassium intake, even in analyses stratified by race/ethnicity and trimester of pregnancy. There was no association of sodium or potassium with blood pressure. Blood pressure may be insensitive to dietary sodium and potassium during normotensive pregnancy.

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Renal adaptation to dietary sodium restriction and loading in rats treated neonatally with enalapril

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1997.273.4.r1421 ◽

1997 ◽

Vol 273 (4) ◽

pp. R1421-R1429 ◽

Cited By ~ 3

Author(s):

Gregor Guron ◽

Annika Nilsson ◽

Gerald F. Dibona ◽

Birgitta Sundelin ◽

Nicoletta Nitescu ◽

...

Keyword(s):

Sodium Intake ◽

Renal Plasma Flow ◽

Dietary Sodium ◽

Sodium Restriction ◽

Adult Rats ◽

Dietary Potassium ◽

Dietary Sodium Restriction ◽

Potassium Restriction ◽

Urinary Concentrating Ability ◽

Sodium And Potassium

Neonatal treatment of rats with angiotensin-converting enzyme inhibitors or the angiotensin II type 1 receptor antagonist losartan induces irreversible renal histological abnormalities, mainly papillary atrophy, in association with an impairment in urinary concentrating ability. In the present study, sodium and potassium balance were assessed during high and low sodium intake and dietary potassium restriction in adult Wistar rats treated neonatally with enalapril (10 mg ⋅ kg−1 ⋅ day−1) from 3 to 24 days of age. During balance studies, neonatally enalapril-treated rats showed 1) normal adaptation to dietary sodium restriction, 2) sodium retention during dietary sodium loading, and 3) a transient, modest, renal potassium wastage during dietary potassium restriction. Renal clearance determinations under pentobarbital anesthesia showed elevated fractional excretions of sodium and potassium and osmolar clearance without changes in glomerular filtration rate or effective renal plasma flow in enalapril-treated compared with vehicle-treated rats. Thus, in addition to the impaired urinary concentrating ability, adult rats treated neonatally with enalapril demonstrated alterations in renal sodium and potassium handling, which may be related to the prevailing papillary atrophy.

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Dietary Sodium and Potassium Intake in Hungarian Elderly: Results from the Cross-Sectional Biomarker2019 Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168806 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8806

Author(s):

Eszter Sarkadi-Nagy ◽

Andrea Horváth ◽

Anita Varga ◽

Leonóra Zámbó ◽

Andrea Török ◽

...

Keyword(s):

Sodium Intake ◽

Urinary Sodium ◽

Dietary Sodium ◽

World Health ◽

Reliable Estimate ◽

Cross Sectional ◽

Potassium Intake ◽

Urinary Potassium ◽

The Mean ◽

Sodium And Potassium

High sodium intake and inadequate potassium intake are associated with high blood pressure. The elderly are more salt sensitive than other age groups, yet a reliable estimate of the dietary sodium and potassium intake of this age group in Hungary is unavailable. The study aimed to estimate the sodium and potassium intakes in the Hungarian elderly from 24 h urine sodium and potassium excretion. In this cross-sectional study, participants were selected from patients of general practitioners practicing in western Hungary. The participants comprised 99 men and 90 women (mean age 67.1 (SD 5.4] years) who participated in the Biomarker2019 survey and returned a complete 24 h urine collection. We assessed dietary sodium and potassium by determining 24 h urinary sodium and potassium excretions and 3-day dietary records. The mean urinary sodium was 188.8 (73.5) mmoL/day, which is equivalent to 11.0 g of salt/day; and the mean urinary potassium was 65.8 (24.3) mmoL/day, which is equivalent to 3.03 g of potassium/day, after adjusting for non-urinary potassium losses. Only 7% of the subjects met the World Health Organization’s recommended target of less than 5 g of salt/day, and 33% consumed at least the recommended potassium amount of 3.5 g/day, based on the estimates from 24 h urine excretion. For most elderly, sodium intake exceeds, and potassium does not reach, dietary recommendations. The results underline the need to intensify salt reduction efforts in Hungary.

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Associations of Dietary Sodium, Potassium, and Sodium to Potassium Ratio with Blood Pressure—Regional Disparities in China

Nutrients ◽

10.3390/nu12020366 ◽

2020 ◽

Vol 12 (2) ◽

pp. 366

Author(s):

Lina Huang ◽

Huijun Wang ◽

Zhihong Wang ◽

Yun Wang ◽

Bing Zhang ◽

...

Keyword(s):

Blood Pressure ◽

Linear Regression ◽

South China ◽

North China ◽

Dietary Sodium ◽

Sodium Potassium ◽

Potassium Intake ◽

Logistic Regressions ◽

Sodium And Potassium ◽

Intake Ratio

High dietary sodium and low potassium intake increase blood pressure and risk of hypertension, but whether the relationship between dietary sodium and potassium and risk of hypertension is different in North China and South China remains unclear. We used data from the longitudinal China Health and Nutrition Survey (CHNS) and selected 6705 adults who participated in at least two waves in 2009, 2011, and 2015 and had no hypertension in baseline. We performed multiple linear regression analysis and multiple logistic regressions stratified by area for the present study design. Sodium and potassium intake were higher in North China (4343.4 and 1624.8 mg/day, respectively) than in South China (4107.8 and 1516.1 mg/d, respectively) (p < 0.05). Multiple linear regression revealed that a positive correlation of sodium intake (β = 0.026, p < 0.05) and ratio of sodium to potassium (Na-K) intake (β = 0.041, p < 0.01) with diastolic blood pressure (DBP) was found in North China, and the association of sodium, potassium, and Na-K intake ratio with blood pressure was different in South China. Multiple logistic regressions documented a similar significant inverse association between dietary potassium intake and risk of hypertension in both North China and South China (risk ratio (RR): 0.63, 95%CI: 0.50–0.79; RR: 0.80, 95%CI: 0.66–0.98, respectively). The risk of hypertension increased in the fourth quartile of dietary sodium and Na-K intake ratio (RR: 1.20, 95%CI: 1.00–1.44; RR: 1.35, 95%CI: 1.13–1.62, respectively) in North China but no association was observed in South China. The current study indicates a different association of dietary sodium and Na-K intake ratio with systolic blood pressure (SBP), DBP, and risk of hypertension in North China and South China.

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Potassium Intake in Austrian Adults

Proceedings of The Nutrition Society ◽

10.1017/s0029665120003304 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Verena Hasenegger ◽

Petra Rust ◽

Kristina Englert ◽

Jürgen König

Keyword(s):

Sodium Intake ◽

Age Groups ◽

Dietary Sodium ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Potassium Intake ◽

Final Sample ◽

Dietary Potassium ◽

Austrian Study ◽

German Speaking

AbstractIntroductionBeing the predominant osmotically active element inside cells, potassium is a central regulator of the osmotic balance and the electrochemical membrane potential. As such, it has an effect on blood pressure and therefore counteracts the effects of excess dietary sodium intake. Furthermore, potassium affects glucose homeostasis by influencing insulin secretion from the pancreatic β-cells. Due to the health-promoting effects of potassium, the German-speaking countries have recently updated the reference values for potassium. The revised estimates of adequate potassium intake are 4000 mg/d instead of previously recommended 2000 mg/d. However, a typical Western diet on average contains less potassium and more sodium.Materials and methodsThe presented data were collected within the Austrian Study on Nutrition 2014/2016, a regularly conducted representative cross-sectional survey to monitor food consumption in Austria. Altogether, data from 2129 adults aged between 18 and 64 years were included in the analysis. In the course of two years, and thus with the consideration of seasonal variations, the survey was conducted on the basis of two non-consecutive 24 hour recalls in accordance with the guidelines of the European Food Safety Authority (EFSA). The survey was approved by the Ethical Committee of the University of Vienna (reference number: 00284).ResultsAfter exclusion of misreporters the final sample consisted of 2018 individuals, of which 1282 (63.5%) were women. The mean age was 38.8 ± 11.9 years.Median dietary potassium intake was 2783 mg/d (IQR: 1245). Men had a higher median intake than women (3018 mg/d (IQR: 1303) vs. 2546 mg/d (IQR: 1112), p < 0.001). Significant differences between sexes existed in all age groups (p < 0.001). However, there was no significant correlation between age and dietary potassium intake.The estimates of adequate potassium intake of 4000 mg/d (DGE et al., 2017) were met by only 13.3% of the participants, 7.4% of women and 19.2% of men. Moreover, only 479 participants (23.8%, 16.7% of women and 30.9% of men) had intakes equal to or above 3500 mg/d, the adequate intake established by EFSA (2016).DiscussionOur data show that potassium intake has to be improved in all gender and age groups by increasing the consumption of potassium-rich foods. However, since the estimates of adequate potassium intake have doubled recently, it seems even more difficult to achieve these recommendations in daily food routine.

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