Urinary sodium-to-potassium ratio: a simple and useful indicator of diet quality in population-based studies

Abstract Background Current evidence regarding the prognostic relevance of urinary sodium-to-potassium ratio (Na-to-K ratio), as an indicator of diet quality is limited. This study was conducted to investigate whether urinary Na-to-K ratio could be related to habitual dietary patterns, in a general population. Methods This study was conducted in the framework of the Tehran Lipid and Glucose Study (2014–2017) on 1864 adult men and women. Urinary Na and K concentrations were measured in the morning spot urine samples. Dietary intakes of the participants were assessed using a validated 147-item Food Frequency Questionnaire (FFQ) and major dietary patterns were obtained using principal component analysis. Mediterranean dietary pattern and Dietary Approaches to Stop Hypertension (DASH) score, were also calculated. Multivariable-adjusted linear regression was used to indicate association of dietary patterns and urinary Na-to-K ratio. Results Mean (± SD) age of participants was 43.7 ± 13.9 years and 47% were men. Mean (± SD) urinary Na, K and the ratio was 139 ± 41.0 and 57.9 ± 18.6 mmol/L, 2.40 ± 0.07, respectively. Higher urinary Na-to-K ratio (> 2.37 vs. < 1.49) was related to lower intakes of vegetables (282 vs. 321 g/day), low-fat dairy (228 vs. 260 g/day) and fruits (440 vs. 370 g/day). Western dietary pattern was related to higher urinary Na-to-K ratio (β = 0.06; 95% CI 0.01, 0.16). Traditional dietary pattern, Mediterranean and DASH diet scores were inversely associated with urinary Na-to-K ratio (β = − 0.14; 95% CI − 0.24, − 0.11, β = − 0.07; 95% CI − 0.09, − 0.01, β = − 0.12; 95% CI − 0.05, − 0.02, respectively). Conclusions Spot urinary Na-to-K ratio may be used as a simple and inexpensive method to monitor diet quality in population-based epidemiological studies.

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Urinary sodium to potassium ratio: A simple and useful indicator of diet quality in population-based studies

10.21203/rs.2.12332/v1 ◽

2019 ◽

Author(s):

Parvin Mirmiran ◽

Zahra Gaeini ◽

Zahra Bahadoran ◽

Asghar Ghasemi ◽

Norouzirad Reza ◽

...

Keyword(s):

Diet Quality ◽

Dietary Patterns ◽

Dietary Pattern ◽

Population Based ◽

Urinary Sodium ◽

Dash Score ◽

Dietary Intakes ◽

Linear Regression Models ◽

Significant Positive Association ◽

Spot Urine

Abstract Background Urinary sodium (Na) and potassium (K) are related to dietary intakes of Na and K, and well-known risk factors of hypertension and cardiovascular events. This study aimed to evaluate the associations between urinary Na/K ratio and different dietary patterns. Methods we recruited 1864 adult men and women (aged 18-93 years), participated in the sixth examination of Tehran Lipid and Glucose Study. Fasting spot urine samples were collected and concentrations of Na and K were determined. The principle component analysis (PCA) was conducted to drive major dietary patterns among population. Mediterranean dietary pattern score, as well as DASH score, were calculated. Linear regression models adjusted for potential confounding variables were used to assess associations between dietary patterns scores and urinary Na/K ratio. Results Mean age of participants was 43.7±13.9 years, and 47% were men. Mean urinary Na and K concentrations were 139±41.0 and 57.9±18.6 mmol/L, respectively. Mean urinary Na/K was 2.40±0.07. A significant positive association was found between Western dietary pattern and urinary Na/K ratio (β=0.06; 95% CI= 0.01, 0.16). Traditional dietary pattern derived from usual dietary intakes of Iranian adults, as well as Mediterranean and DASH dietary pattern scores were inversely associated to urinary Na/K ratio (β= –0.14; 95% CI= –0.24, –0.11, β=–0.07; 95% CI= –0.09, –0.01, β=–0.12; 95% CI= –0.05, –0.02, respectively). Conclusions Urinary Na/K ratio may suggest as a simple, inexpensive and helpful method to monitor and improve diet quality in population-based studies.

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The association of priori and posteriori dietary patterns with the risk of incident hypertension: Tehran Lipid and Glucose Study

Journal of Translational Medicine ◽

10.1186/s12967-021-02704-w ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Azra Ramezankhani ◽

Firoozeh Hosseini-Esfahani ◽

Parvin Mirmiran ◽

Fereidoun Azizi ◽

Farzad Hadaegh

Keyword(s):

Dietary Patterns ◽

Principal Component ◽

Healthy Eating Index ◽

Dash Score ◽

Dietary Intakes ◽

Dietary Recommendations ◽

Incident Hypertension ◽

Increased Risk ◽

Incident Cases

Abstract Background The aim of this study was to investigate the association of dietary patterns with incident hypertension. Materials/methods This prospective study was conducted on 4793 individuals of Tehran lipid and glucose study participants, aged ≥ 18 years who were followed for a median of 6.3 years from 2008–2011 to 2016–2018. A valid and reliable semi-quantitative food frequency questionnaire was used to assess usual dietary intakes. Anthropometrics and blood pressure were assessed at baseline and during follow up examinations. Dietary patterns were derived using principal component analysis (PCA). Healthy eating index (HEI) and dietary approach to stop hypertension (DASH) score were measured based on dietary recommendations. Time-dependent Cox models adjusting for confounders were used to examine the association between dietary patterns and the risk of hypertension. Results During follow-up, a total of 727 incident cases of hypertension were identified. The mean ± SD age at baseline was 40.3 ± 13.5 and 37.9 ± 12.1 years in men and women, respectively. Two dietary patterns (the healthy and unhealthy) were extracted by PCA. Compared with participants in the first quartile, a 23% (HR: 1.23; 95%CI 1.00–1.53; P trend: 0.056) increased risk of hypertension was found in the fourth quartile of HEI score. This association was disappeared after further adjustment for confounders. Increasing DASH score, the healthy and unhealthy dietary pattern were not associated with risk of hypertension. Conclusion Our findings showed that higher adherences to the posteriori- and priori-dietary patterns were not associated with risk of hypertension in this population.

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Current evidence on the association of the metabolic syndrome and dietary patterns in a global perspective

Nutrition Research Reviews ◽

10.1017/s095442241600007x ◽

2016 ◽

Vol 29 (2) ◽

pp. 152-162 ◽

Cited By ~ 24

Author(s):

Zeinab Hosseini ◽

Susan J. Whiting ◽

Hassan Vatanparast

Keyword(s):

Metabolic Syndrome ◽

Dietary Patterns ◽

Dietary Pattern ◽

A Priori ◽

Population Based ◽

Global Perspective ◽

Current Evidence ◽

A Posteriori ◽

The Metabolic Syndrome ◽

The Mediterranean

AbstractThe metabolic syndrome (MetS) is a key indicator of two main causes of death worldwide: CVD and diabetes. The present paper aimed to perform a review of the population-based research on the association of dietary patterns and the MetS in terms of methodology and findings. For the purpose of the present study, a scoping literature review was conducted using MEDLINE and EMBASE databases and hand searching in Google Scholar. Thirty-nine population-based studies were selected. Most of these studies used the factor analysis method and the a priori dietary approach, which had been initially extracted via a posteriori methods such as using the Mediterranean dietary pattern. The main finding was that following the Mediterranean or similar ‘healthy’ pattern reduced risk of the MetS, while following a ‘Western’ pattern increased risk of the MetS. The methodological approach in determining the dietary pattern of a population, whether a priori or a posteriori, should be chosen based on the purpose of the research. Overall, evidence suggests a diet based on the components of the Mediterranean diet and the avoidance of the ‘Western’ diet can aid in preventing the MetS.

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Food intake patterns are associated with the risk of impaired glucose and insulin homeostasis: a prospective approach in the Tehran Lipid and Glucose Study

Public Health Nutrition ◽

10.1017/s1368980016000616 ◽

2016 ◽

Vol 19 (13) ◽

pp. 2467-2474 ◽

Cited By ~ 13

Author(s):

Tayebeh Doostvandi ◽

Zahra Bahadoran ◽

Hassan Mozaffari-Khosravi ◽

Parvin Mirmiran ◽

Fereidoun Azizi

Keyword(s):

Food Intake ◽

Dietary Patterns ◽

Dietary Pattern ◽

Serum Insulin ◽

Principal Component ◽

Model Assessment ◽

Dietary Intakes ◽

Western Dietary Pattern ◽

Insulin Homeostasis ◽

Healthy Dietary Pattern

AbstractObjectiveTo investigate the association of major dietary patterns with the risk of impaired glucose and insulin homeostasis during a 3-year follow-up.DesignFasting serum insulin (FSI), fasting (FSG) and 2 h serum glucose (2h-SG) were measured at baseline and again after 3 years. Dietary intakes were evaluated using a validated 168-item semi-quantitative FFQ and major dietary patterns were obtained using principal component analysis. Logistic regression models were used to estimate the occurrence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), pre-diabetes (IGT/IFG), β-cell dysfunction and hyperinsulinaemia across tertiles of dietary patterns, with adjustment for potential confounding variables.SettingTehran Lipid and Glucose Study.SubjectsIranian men and women (n 904).ResultsMean age of participants was 38·7 (sd 11·3) years and 44·6 % were men. Major dietary patterns were Western, traditional and healthy, which explained 25·2 % of total variance in food intake. There was a positive association between Western and traditional scores with 3-year change in 2h-SG, while the healthy pattern was negatively related to 3-year changes in FSG, 2h-SG, FSI and homeostasis model assessment of insulin resistance. Highest compared with the lowest tertile of the Western dietary pattern was accompanied by a higher risk for development of IGT (OR=3·09; 95 % CI 1·28, 7·50); a higher score on the healthy dietary pattern was associated with a significantly reduced risk of hyperinsulinaemia (OR=0·53; 95 % CI 0·28, 0·94).ConclusionsOur findings showed that adherence to a Western dietary pattern may be a risk factor for the development of IGT, while a healthy dietary pattern may prevent hyperinsulinaemia.

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The Association of Priori and Posteriori Dietary Patterns With the Risk of Incident Hypertension: Tehran Lipid and Glucose Study

10.21203/rs.3.rs-42285/v1 ◽

2020 ◽

Author(s):

Azra Ramezankhani ◽

Firoozeh Hosseini-Esfahani ◽

Parvin Mirmiran ◽

Fereidoun Azizi ◽

Farzad Hadaegh

Keyword(s):

Dietary Patterns ◽

Principal Component ◽

Healthy Eating Index ◽

Dash Score ◽

Dietary Intakes ◽

Dietary Recommendations ◽

Incident Hypertension ◽

Increased Risk ◽

Incident Cases

Abstract Background The aim of this study was to investigate the association of dietary patterns with incident hypertension. Materials/methods: This prospective study was conducted on 4793 individuals of Tehran lipid and glucose study participants, aged ≥ 18 years who were followed for a median of 6.3 years from 2008-11 to 2016-18 surveys. A valid and reliable semi-quantitative food frequency questionnaire was used to assess usual dietary intakes. Anthropometrics and blood pressure were assessed at baseline and during follow up examinations. Dietary patterns were derived using principal component analysis (PCA); healthy eating index (HEI) and dietary approach to stop hypertension (DASH) score were measured based on dietary recommendations. Time-dependent Cox models, adjusting for confounders were used to examine the association between dietary patterns and the risk of hypertension. Results During follow-up, a total of 727 incident cases of hypertension were identified. The mean ± SD age at baseline was 40.3 ± 13.5 and 37.9 ± 12.1 years in men and women, respectively. Two dietary patterns (the healthy and unhealthy) were extracted by PCA. Compared with participants in the first quartile, a 23% (HR: 1.23; 95%CI: 1.00-1.53; P trend: 0.056) increased risk of hypertension was found in the fourth quartile of HEI score. This association was disappeared after further adjustment for confounders. Increasing DASH score, the healthy and unhealthy dietary pattern were not associated with risk of hypertension. Conclusion According to our findings, after adjustment for confounders, higher adherence to posteriori- and priori-dietary patterns was not associated with risk of hypertension.

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Diet Quality and Risk of Parkinson’s Disease: The Rotterdam Study

Nutrients ◽

10.3390/nu13113970 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3970

Author(s):

Anne J. Strikwerda ◽

Lisanne J. Dommershuijsen ◽

M. Kamran Ikram ◽

Trudy Voortman

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Mediterranean Diet ◽

Diet Quality ◽

Dietary Patterns ◽

Principal Component ◽

Population Based ◽

Quality Score ◽

Rotterdam Study ◽

The Mediterranean

The Mediterranean diet has been associated with the risk of Parkinson’s disease (PD), but limited research has been performed on other dietary patterns. We studied the relationship between overall diet quality and PD risk in the general population. We included 9414 participants from the Rotterdam Study, a prospective population-based study in the Netherlands. Diet was defined using a Dutch diet quality score, a Mediterranean diet score and data-driven dietary patterns constructed with principal component analysis (PCA). During an average follow-up of 14.1 years, PD was diagnosed in 129 participants. We identified a ‘Prudent’, ‘Unhealthy’ and ‘Traditional Dutch’ pattern from the PCA. We found a possible association between the Mediterranean diet (Hazard ratio (HR) per standard deviation (SD) 0.89 (95% confidence interval (CI) 0.74–1.07)), the ‘Prudent’ pattern (HR per SD 0.81 (95% CI 0.61–1.08)) and the risk of PD. However, no associations with PD risk were found for the Dutch diet quality score (HR per SD 0.93 (95% CI 0.77–1.12)), the ‘Unhealthy’ pattern (HR per SD 1.05 (95% CI 0.85–1.29)) or the ‘Traditional Dutch’ pattern (HR per SD 0.90 (95% CI 0.69–1.17)). In conclusion, our results corroborate previous findings of a possible protective effect of the Mediterranean diet. Further research is warranted to study the effect of other dietary patterns on PD risk.

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The association of priori and posteriori dietary patterns with the risk of incident hypertension: Tehran Lipid and Glucose Study

10.21203/rs.3.rs-42285/v3 ◽

2021 ◽

Author(s):

Azra Ramezankhani ◽

Firoozeh Hosseini-Esfahani ◽

Parvin Mirmiran ◽

Fereidoun Azizi ◽

Farzad Hadaegh

Keyword(s):

Dietary Patterns ◽

Principal Component ◽

Healthy Eating Index ◽

Dash Score ◽

Dietary Intakes ◽

Dietary Recommendations ◽

Incident Hypertension ◽

Increased Risk ◽

Incident Cases

Abstract Background: The aim of this study was to investigate the association of dietary patterns with incident hypertension.Materials/methods: This prospective study was conducted on 4793 individuals of Tehran lipid and glucose study participants, aged ≥18 years who were followed for a median of 6.3 years from 2008-11 to 2016-18. A valid and reliable semi-quantitative food frequency questionnaire was used to assess usual dietary intakes. Anthropometrics and blood pressure were assessed at baseline and during follow up examinations. Dietary patterns were derived using principal component analysis (PCA). Healthy eating index (HEI) and dietary approach to stop hypertension (DASH) score were measured based on dietary recommendations. Time-dependent Cox models adjusting for confounders were used to examine the association between dietary patterns and the risk of hypertension.Results: During follow-up, a total of 727 incident cases of hypertension were identified. The mean±SD age at baseline was 40.3±13.5 and 37.9±12.1 years in men and women, respectively. Two dietary patterns (the healthy and unhealthy) were extracted by PCA. Compared with participants in the first quartile, a 23% (HR: 1.23; 95%CI: 1.00-1.53; P trend: 0.056) increased risk of hypertension was found in the fourth quartile of HEI score. This association was disappeared after further adjustment for confounders. Increasing DASH score, the healthy and unhealthy dietary pattern were not associated with risk of hypertension.Conclusion: Our findings showed that higher adherences to the posteriori- and priori-dietary patterns were not associated with risk of hypertension in this population.

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The association of priori and posteriori dietary patterns with the risk of incident hypertension: Tehran Lipid and Glucose Study

10.21203/rs.3.rs-42285/v2 ◽

2020 ◽

Author(s):

Azra Ramezankhani ◽

Firoozeh Hosseini-Esfahani ◽

Parvin Mirmiran ◽

Fereidoun Azizi ◽

Farzad Hadaegh

Keyword(s):

Dietary Patterns ◽

Principal Component ◽

Healthy Eating Index ◽

Dash Score ◽

Dietary Intakes ◽

Dietary Recommendations ◽

Incident Hypertension ◽

Increased Risk ◽

Incident Cases

Abstract Background: The aim of this study was to investigate the association of dietary patterns with incident hypertension.Materials/methods: This prospective study was conducted on 4793 individuals of Tehran lipid and glucose study participants, aged ≥18 years who were followed for a median of 6.3 years from 2008-11 to 2016-18. A valid and reliable semi-quantitative food frequency questionnaire was used to assess usual dietary intakes. Anthropometrics and blood pressure were assessed at baseline and during follow up examinations. Dietary patterns were derived using principal component analysis (PCA). Healthy eating index (HEI) and dietary approach to stop hypertension (DASH) score were measured based on dietary recommendations. Time-dependent Cox models adjusting for confounders were used to examine the association between dietary patterns and the risk of hypertension.Results: During follow-up, a total of 727 incident cases of hypertension were identified. The mean±SD age at baseline was 40.3±13.5 and 37.9±12.1 years in men and women, respectively. Two dietary patterns (the healthy and unhealthy) were extracted by PCA. Compared with participants in the first quartile, a 23% (HR: 1.23; 95%CI: 1.00-1.53; P trend: 0.056) increased risk of hypertension was found in the fourth quartile of HEI score. This association was disappeared after further adjustment for confounders. Increasing DASH score, the healthy and unhealthy dietary pattern were not associated with risk of hypertension.Conclusion: Based on our findings, higher adherence to the posteriori- and priori-dietary patterns was not associated with risk of hypertension.

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Cardiorespiratory fitness is positively associated with both healthy and western dietary pattern in Iranian middle-aged

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000685 ◽

2020 ◽

pp. 1-10

Author(s):

Hossein Shahinfar ◽

Farhang Djafari ◽

Nadia Babaei ◽

Samira Davarzani ◽

Mojdeh Ebaditabar ◽

...

Keyword(s):

Cardiorespiratory Fitness ◽

Dietary Patterns ◽

Dietary Pattern ◽

Principal Component ◽

Total Sample ◽

Linear Regression Models ◽

Middle Aged ◽

Anthropometric Measures ◽

Western Dietary Pattern ◽

Healthy Dietary Pattern

Abstract. Background: The association between dietary patterns and cardiorespiratory fitness (CRF) is not well established. Objective: We sought to investigate association between a posteriori dietary pattern and CRF in middle-aged adults. Design: Adults (n = 276), aged 20–74 years, who were residents of Tehran, Iran were recruited. Diet was assessed by using a validated 168-item semi-quantitative food frequency questionnaire. Principal component analysis was used to derive dietary patterns. Socio-economic status, anthropometric measures, body composition, and blood pressure were recorded. CRF was assessed by using a graded exercise treadmill test. Analysis of variance and linear regression models were used to discern the association between dietary patterns and CRF. Results: Higher scores of the healthy dietary pattern had no association with VO2max (p = 0.13 ). After controlling for potential confounders, VO2max was positively associated across tertiles of healthy dietary patterns (p < 0.001). Higher adherence to the “mixed” dietary pattern was inversely related to VO2max (p < 0.01). After adjusting for confounders, the significant association disappeared (p = 0.14). Higher scores of the “Western” dietary pattern was not associated with VO2max (p = 0.06). However, after controlling for potential confounders, VO2max was positively associated with the “Western” dietary pattern (p = 0.01). A positive linear association between the “healthy” dietary pattern and CRF for the total sample (R2 = 0.02; p < 0.01) were presented. Conclusions: Overall, our findings suggest that higher adherence to a “healthy” and “Western” dietary pattern was positively associated with CRF. However, further studies are required to examine and clarify the causal relationship between dietary patterns and CRF.

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A dairy and fruit dietary pattern is associated with a reduced likelihood of osteoporosis in Korean postmenopausal women

British Journal Of Nutrition ◽

10.1017/s0007114513001219 ◽

2013 ◽

Vol 110 (10) ◽

pp. 1926-1933 ◽

Cited By ~ 40

Author(s):

Sangah Shin ◽

Hyojee Joung

Keyword(s):

Lumbar Spine ◽

Postmenopausal Women ◽

Dietary Patterns ◽

Dietary Pattern ◽

Health Examination ◽

Dietary Intakes ◽

Mineral Density ◽

Nutrition Survey ◽

Cross Sectional ◽

White Rice

The aim of the present study was to identify the association of dietary patterns with osteoporosis in Korean postmenopausal women from the Korean Health and Nutrition Examination Survey 2008–10. The present cross-sectional analysis included 3735 postmenopausal women who completed a health interview, nutrition survey and a health examination including bone mineral density (BMD) measurements. The general characteristics and dietary intakes of the participants were obtained using a standardised questionnaire and a 24 h recall method, respectively. The BMD of the femoral neck and lumbar spine was measured using dual-energy X-ray absorptiometry; osteoporosis was defined based on the WHO T-score criteria. Overall, we identified four dietary patterns using factor analysis as follows: ‘meat, alcohol and sugar’, ‘vegetables and soya sauce’, ‘white rice, kimchi and seaweed’ and ‘dairy and fruit’, which accounted for 30·9 % of the total variance in food intake (11·3, 7·7, 6·0 and 5·9 %, respectively). The subjects in the highest quintile of the ‘dairy and fruit’ pattern showed a decreased risk of osteoporosis of the lumbar spine (53 %) compared with those in the lowest quintile, after adjusting for covariates (OR 0·47, 95 % CI 0·35, 0·65, P for trend < 0·0001). In contrast, the ‘white rice, kimchi and seaweed’ dietary pattern was negatively associated with bone health (OR 1·40, 95 % CI 1·03, 1·90, P for trend = 0·0479). The present results suggest that an increased intake of dairy foods and fruits in the traditional Korean diet, based on white rice and vegetables, may decrease the risk of osteoporosis in Korean postmenopausal women.

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