Salt intake and blood pressure in Iranian children and adolescents: a population-based study

Abstract Background Previous studies have reported a high prevalence of hypertension in Iranian students, especially in rural areas. The aim of this study was to investigate the daily intake of salt in students and its association with high blood pressure. Methods A random sub-sample was selected from the participants of the second phase of Shahroud schoolchildren eye cohort study and then a random urine sample was tested for sodium, potassium and creatinine. Urine electrolyte esexcretion and daily salt intake were calculated by Tanaka et al.’s formula. Results Among 1455 participants (including 230 participants from rural area and 472 girls), the mean age was 12.9 ± 1.7 year and the mean daily salt intake was 9.7 ± 2.6 g (95% CI 9.5–9.8). The mean salt consumption in rural areas [10.8 (95% CI 10.4–11.2)] was higher than urban areas [9.4 (95% CI 9.3–9.6)], in people with hypertension [10.8 (95% CI 10.3–11.3)] was more than people with normal blood pressure [9.4 (95% CI 9.3–9.6)], and in boys [9.8 (95% CI 9.7–10.0)] was more than girls [9.3 (95% CI 9.1–9.6)]. Higher age, BMI z-score, male sex and rural life, were associated with increased daily salt intake. Increased salt intake was associated with increased systolic and diastolic blood pressure. Conclusion Daily salt intake in Iranian adolescents was about 2 times the recommended amount of the World Health Organization, was higher in rural areas and was associated with blood pressure. Reducing salt intake should be considered as an important intervention, especially in rural areas.

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Sodium and potassium intake, blood pressure, and cardiovascular prevention

ESC CardioMed ◽

10.1093/med/9780198784906.003.0568 ◽

2018 ◽

pp. 2431-2444

Author(s):

Francesco P. Cappuccio

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

World Health Organization ◽

Salt Intake ◽

World Health ◽

Salt Reduction ◽

Potassium Intake ◽

Salt Consumption ◽

The World ◽

Health Organization

Salt consumption is now much greater than needed for survival. High salt intake increases blood pressure in both animals and humans. Conversely, a reduction in salt intake causes a dose-dependent reduction in blood pressure in men and women of all ages and ethnic groups, and in patients already on medication. The risk of strokes and heart attacks rises with increasing blood pressure, but can be decreased by antihypertensive drugs. However, most cardiovascular disease events occur in individuals with ‘normal’ blood pressure levels. Non-pharmacological prevention is therefore the only option to reduce such events. Reduction in population salt intake reduces the number of vascular events. It is one of the most important public health measures to reduce the global cardiovascular burden. Salt reduction policies are powerful, rapid, equitable, and cost saving. The World Health Organization recommends reducing salt consumption below 5 g per day aiming at a global 30% reduction by 2025. A high potassium intake lowers blood pressure in people with and without hypertension. Its beneficial effects extend beyond blood pressure, and may include a reduction in the risk of stroke (independent of blood pressure changes). Potassium intake in the Western world is relatively low, and a lower potassium intake is associated with increased risks of cardiovascular disease, especially stroke. A moderate increase in potassium intake, either as supplement or with diet, reduces blood pressure, and the World Health Organization has issued global recommendations for a target dietary potassium intake of at least 90 mmol/day (≥3510 mg/day) for adults.

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Salt and potassium intake among adult Ghanaians: WHO-SAGE Ghana Wave 3

BMC Nutrition ◽

10.1186/s40795-020-00379-y ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Elias K. Menyanu ◽

Barbara Corso ◽

Nadia Minicuci ◽

Ilaria Rocco ◽

Joanna Russell ◽

...

Keyword(s):

Salt Intake ◽

Population Based ◽

Dietary Sodium ◽

World Health ◽

Adult Health ◽

Salt Reduction ◽

Hypertension Prevalence ◽

Salt Consumption ◽

Consumption Data

Abstract Though Ghana has high hypertension prevalence, the country lacks current national salt consumption data required to build and enhance advocacy for salt reduction. We explored the characteristics of a randomly selected sub sample that had valid urine collection, along with matched survey, anthropometric and BP data (n = 839, mean age = 60y), from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE), Ghana Wave 3, n = 3053). We also investigated the relationship between salt intake and blood pressure (BP) among the cohort. BP was measured in triplicate and 24 h urine was collected for the determination of urinary sodium (Na), potassium (K), creatinine (Cr) and iodine levels. Hypertension prevalence was 44.3%. Median salt intake was 8.3 g/day, higher in women compared to men (8.6, interquartile range (IQR) 7.5 g/day vs 7.5, IQR 7.4 g/day, p < 0.01), younger participants (18–49 y) compared to older ones (50+ y) (9.7, IQR 7.9 g/day vs 8.1, IQR 7.1 g/day, p < 0.01) and those with higher Body Mass Index (BMI) (> 30 kg/m2) compared to a healthy BMI (18.5–24.9 kg/m2) (10.04, IQR 5.1 g/day vs 6.2, IQR 5.6 g/day, p < 0.01). More than three quarters (77%, n = 647) of participants had salt intakes above the WHO maximum recommendation of 5 g/d, and nearly two thirds (65%, n = 548) had daily K intakes below the recommended level of 90 mmol. Dietary sodium to potassium (Na: K) ratios above 2 mmol/mmol were positively associated with increasing BP with age. Population-based interventions to reduce salt intake and increase K consumption are needed.

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Prevalence of Dyslipidemia in Urban and Rural Areas of the Northwest of Iran: The Sociodemographic, Dietary and Psychological Determi-nants

Iranian Journal of Public Health ◽

10.18502/ijph.v48i5.1810 ◽

2019 ◽

Author(s):

Jafar Sadegh TABRIZI ◽

Leila NIKNIAZ ◽

Homayoun SADEGHI-BAZARGANI ◽

Mostafa FARAHBAKHSH ◽

Zeinab NIKNIAZ ◽

...

Keyword(s):

Physical Activity ◽

Rural Areas ◽

Salt Intake ◽

Population Based ◽

Major Health Problem ◽

Psychological Determinants ◽

Preventable Risk Factor ◽

Low Hdl ◽

Northwest Of Iran ◽

The Mean

Background: As dyslipidemia is a preventable risk factor for Coronary heart disease (CHD), precise estimation of its prevalence and determinants is crucial for proper development of health actions. This population-based study aimed at investigating the socioeconomic, dietary and psychological determinants of dyslipidemia in Iran. Methods: The data (n=700) for this study were collected in 2015 as a part of the major Lifestyle Promotion Project (LPP) conducted in East Azerbaijan (urban and regional parts). The data for socio-demographic status, dietary information, and physical activity and anxiety levels were collected through validated questionnaires. Then, physical examinations including blood pressure, body mass index (BMI) and conicity index were performed. The levels of serum lipids were measured by enzymatic colorimetric methods. Results: The prevalence of hypercholesterolemia, high LDL-C, hypertriglyceridemia, low HDL-C and dyslipidemia was 29.4%, 10.3%, 62.3%, 41.4%, 83.3% respectively. The mean TC (184.3±41.2 vs. 174.5±38.1 mg/dl), LDL-C (94.6±30.3 vs. 88.1±28.7 mg/dl) and HDL-C (46.7±10.4 vs. 39.5±8.0 mg/dl) in women were significantly higher than men (P<0.05). However, the mean of TG (182.3±119.3 vs. 145.1±87.8 mg/dl) was significantly higher in men compared to women (P<0.05). Obesity, family history of dyslipidemia, sedentary lifestyle, smoking habits, salt intake, and anxiety were risk factors for different components of dyslipidemia in men and women. Conclusion: Dyslipidemia is a major health problem in northwest of Iran. Focusing on screening, regular drug intake, proper nutrition, physical activity, and changing lifestyles of patients with dyslipidemia are essential.

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Sodium and Salt Consumption in Latin America and the Caribbean: A Systematic-Review and Meta-Analysis of Population-Based Studies and Surveys

Nutrients ◽

10.3390/nu12020556 ◽

2020 ◽

Vol 12 (2) ◽

pp. 556 ◽

Cited By ~ 2

Author(s):

Rodrigo M Carrillo-Larco ◽

Antonio Bernabe-Ortiz

Keyword(s):

Systematic Review ◽

Latin America ◽

Salt Intake ◽

Meta Analysis ◽

Population Based ◽

Urine Samples ◽

World Health ◽

Salt Consumption ◽

The Caribbean ◽

Sodium Consumption

Sodium/salt consumption is a risk factor for cardiovascular diseases. Although global targets to reduce salt intake have been established, current levels and trends of sodium consumption in Latin America and the Caribbean (LAC) are unknown. We conducted a systematic review and meta-analysis of population-based studies in which sodium consumption was analyzed based on urine samples (24 hour samples or otherwise). The search was conducted in Medline, Embase, Global Health, Scopus and LILACS. From 2350 results, 53 were studied in detail, of which 15 reports were included, providing evidence for 18 studies. Most studies were from Brazil (7/18) and six collected 24 hour urine samples. In the random effects meta-analysis, 12 studies (29,875 people) were analyzed since 2010. The pooled mean 24 hour estimated sodium consumption was 4.13 g/day (10.49 g/day of salt). When only national surveys were analyzed, the pooled mean was 3.43 g/day (8.71 g/day of salt); when only community studies were analyzed the pooled mean was 4.39 g/day (11.15 g/day of salt). Studies had low risk of bias. The estimated 24 hour sodium consumption is more than twice the World Health Organization recommendations since 2010. Regional organizations and governments should strengthen policies and interventions to measure and reduce sodium consumption in LAC.

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Sodium and Potassium Intake in Residents of Retirement Homes

Nutrients ◽

10.3390/nu12092725 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2725

Author(s):

Boštjan Rejec ◽

Petra Golja ◽

Cirila Hlastan Ribič ◽

Matjaž Klemenc

Keyword(s):

Elderly People ◽

Salt Intake ◽

Daily Intake ◽

Public Health Problem ◽

Free Living ◽

Potassium Intake ◽

Salt Consumption ◽

Balanced Diet ◽

The Mean ◽

Sodium And Potassium

Excessive salt intake and its impact on health is a public health problem in many regions of the world. The currently estimated dietary intake of salt among free-living adults is well above the WHO recommendations. Over the years, the number of residents in retirement homes has increased. Besides this, the nutrition of elderly people may be affected by physiological changes that occur with aging. The question is whether residents of retirement homes receive a more balanced diet, or whether the trend of excessive salt consumption continues even among institutionalised elderly people. Salt and potassium intake were assessed by measuring sodium and potassium excretion over 24 h in urine collected from a sample of residents of three retirement homes in the Goriška region, Slovenia. The average salt intake was 8.3 (2.9) g/day, which was significantly higher (p < 0.001) in men than in women (10.1 (3.1) vs. 7.3 (2.2) g/day, respectively). The estimated total daily potassium intake was 2.6 (0.6) g/day in men and 2.0 (0.8) g/day in women (mean 2.2 (0.8) g/day). The ratio of sodium to potassium was 1.53 (0.48). The salt intake among residents of retirement homes in the Goriška region, especially in men, exceeds the WHO recommended daily intake of <5 g. The mean daily potassium intake was below the WHO recommendations of 3.5 g/day.

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Should bread be targeted as a vector to reduce sodium intake in Morocco?

10.7287/peerj.preprints.188v1 ◽

2014 ◽

Author(s):

Abdelfettah Derouiche ◽

Ali Jafri ◽

Younes ElKardi ◽

Mohammed Jabari ◽

Rachida Habbal ◽

...

Keyword(s):

Blood Pressure ◽

High Blood Pressure ◽

Sodium Intake ◽

Daily Intake ◽

Public Health Problem ◽

World Health ◽

Average Amount ◽

Salt Consumption ◽

Daily Food ◽

Health Organization

Background: High blood pressure is a serious public health problem in Morocco; the national survey of cardiovascular risk factors in Morocco found a prevalence of 33.6% of people with high blood pressure (HBP) with a higher prevalence among women, also, the World Health Organization estimated the prevalence of HBP in 2008 at 41.2%. Our study aimed to evaluate the amount of salt provided by the consumption of bread, since it is a staple food, in daily food intake and compare it to the recommendations. This study aims to raise awareness about salt consumption and its impact in causing high blood pressure. Methods: We used the MOHR method to quantify sodium in bread samples from 80 professional bakeries in Casablanca. Results: Results showed that the average amount of salt used in the preparation of bread is 17.42 ± 1.28 g / kg, which is the equivalent of a daily intake of 8 to 9 g of salt through bread alone, and exceeds all recommendations. Conclusion: We can only recommend using it as a vector for the programme of awareness about salt over-consumption and its impact on raising the prevalence of hypertension.

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Parents’ Perceptions about Salt Consumption in Urban Areas of Peru: Formative Research for a Social Marketing Strategy

Nutrients ◽

10.3390/nu12010176 ◽

2020 ◽

Vol 12 (1) ◽

pp. 176 ◽

Cited By ~ 1

Author(s):

Vilarmina Ponce-Lucero ◽

Lorena Saavedra-Garcia ◽

Erik Cateriano-Arévalo ◽

Silvana Perez-Leon ◽

David Villarreal-Zegarra ◽

...

Keyword(s):

Marketing Strategy ◽

Social Marketing ◽

Urban Areas ◽

Quantitative Data ◽

Qualitative Data ◽

Salt Intake ◽

World Health ◽

Low Socioeconomic ◽

Salt Consumption ◽

High Salt Intake

Background: Salt intakes in Latin America currently double the World Health Organization’s recommendation of 5 g/day. Various strategies to reduce the population’s salt consumption, such as raising awareness using social marketing, have been recommended. This study identified parents’ perceptions of salt consumption to inform a social marketing strategy focused on urban areas in Peru. Methods: Using a sequential exploratory methods design, parents of pre-school children, of high and low socioeconomic status, provided qualitative data in the form of interviews and focus groups. Following this, quantitative data was obtained via questionnaires, which were sent to all parents. The information was analyzed jointly. Results: 296 people (mean age 35.4, 82% women) participated, 64 in the qualitative and 232 in the quantitative phase of the study. Qualitative data from the first phase revealed that the majority of mothers were in charge of cooking, and female participants expressed that cooking was “their duty” as housewives. The qualitative phase also revealed that despite the majority of the participants considered their salt intake as adequate, half of them mentioned that they have tried to reduce salt consumption, and the change in the flavor of the food was stated as the most difficult challenge to continue with such practice. Quantitative data showed that 67% of participants would be willing to reduce their salt intake, and 79.7% recognized that high salt intake causes hypertension. In total, 84% of participants reaffirmed that mothers were in charge of cooking. There were no salient differences in terms of responses provided by participants from high versus low socioeconomic groups. Conclusions: The results point towards the identification of women as a potential target-audience of a social marketing strategy to promote reductions in salt intake in their families and, therefore, a gender-responsive social marketing intervention is recommended.

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Determinants of change in blood pressure in Ghana: Longitudinal data from WHO-SAGE Waves 1–3

PLoS ONE ◽

10.1371/journal.pone.0244807 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0244807

Author(s):

Elias K. Menyanu ◽

Barbara Corso ◽

Nadia Minicuci ◽

Ilaria Rocco ◽

Joanna C. Russell ◽

...

Keyword(s):

Blood Pressure ◽

Health Insurance ◽

Rural Areas ◽

Urban Areas ◽

World Health ◽

Adult Health ◽

Cross Sectional ◽

Middle Income ◽

Significant Difference ◽

Survey Instruments

The prevalence of hypertension is increasing in low- and middle-income countries, however statistics are generally derived from cross sectional surveys that utilize different methodologies and population samples. We investigated blood pressure (BP) changes over 11–12 years in a large cohort of adults aged 50 years and older (n = 820) included in the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE Ghana) Wave 1 (2007/8) with follow up in Wave 3 (2019). Participants’ BP were measured in triplicate and a survey completed at both time points. Survey instruments collected information on sociodemographic characteristics, lifestyle, health behaviors and chronic conditions. While no significant difference was found in systolic BP between Waves 1 and 3, diastolic BP decreased by 9.7mmHg (mean = 88.6, 15.4 to 78.9, 13.6 respectively) and pulse pressure increased by 9.5mmHg (44.8, 13.7 to 54.3, 14.1). Awareness of hypertension increased by 37%, from (20% to 57%), but no differences were found for the proportion of hypertensives receiving treatment nor those that had controlled BP. Mixed effects modelling showed a decrease in diastolic BP was associated with increasing age, living in rural areas and having health insurance. Factors associated with an increased awareness of hypertension were residing in urban areas, having health insurance and increasing body mass index. While diagnosis of hypertension has improved over time in Ghana, there is an ongoing need to improve its treatment in older adults.

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Should bread be targeted as a vector to reduce sodium intake in Morocco?

10.7287/peerj.preprints.188 ◽

2014 ◽

Author(s):

Abdelfettah Derouiche ◽

Ali Jafri ◽

Younes ElKardi ◽

Mohammed Jabari ◽

Rachida Habbal ◽

...

Keyword(s):

Blood Pressure ◽

High Blood Pressure ◽

Sodium Intake ◽

Daily Intake ◽

Public Health Problem ◽

World Health ◽

Average Amount ◽

Salt Consumption ◽

Daily Food ◽

Health Organization

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Impact of an Innovative Equipment to Monitor and Control Salt Usage during Cooking at Home on Salt Intake and Blood Pressure—Randomized Controlled Trial iMC SALT

Nutrients ◽

10.3390/nu14010008 ◽

2021 ◽

Vol 14 (1) ◽

pp. 8

Author(s):

Tânia Silva-Santos ◽

Pedro Moreira ◽

Olívia Pinho ◽

Patrícia Padrão ◽

Sandra Abreu ◽

...

Keyword(s):

Blood Pressure ◽

Salt Intake ◽

Intervention Group ◽

World Health ◽

Salt Consumption ◽

Urinary Potassium ◽

And Control ◽

The Impact ◽

Monitor And Control ◽

At Home

(1) Background: Excessive salt consumption is associated with an increased risk of hypertension and cardiovascular disease, and it is essential to reduce it to the level recommended by the World Health Organization (<5 g/day). The main objective of this study is to verify the impact of an intervention, which used the Salt Control H equipment to reducing salt consumption; (2) Methods: The study was an 8-week randomized control trial with 114 workers from a public university. The intervention group (n = 57) used the equipment to monitor and control the use of salt during cooking (Salt Control H) at home for 8 weeks. The primary outcome was 24 h urinary sodium excretion as a proxy of salt intake. Secondary outcomes included changes in 24 h urinary potassium excretion, sodium to potassium ratio (Na:K), and blood pressure. (3) Results: There was a decrease in sodium intake after the intervention but with no statistical significance. When analyzing the results by sex and hypertension status, there was a reduction in sodium (−1009 (−1876 to −142), p = 0.025) and in Na:K ratio (−0.9 (−1.5 to −0.3), p = 0.007) in hypertensive men in the intervention group. (4) Conclusions: Interventions with dosage equipment can be valid approaches in individual salt reduction strategies, especially in hypertensive men.

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