Salt and Health: Survey on Knowledge and Salt Intake Related Behaviour in Italy

Background and aim: Excess sodium intake is a recognised causal factor of hypertension and its cardiovascular complications; there is however a lack of practical instruments to assess and monitor the level of knowledge and behaviour about dietary salt intake and to relate these factors to the population general dietary habits. Methods and Results: A self-administered questionnaire was developed to assess the salt and health related knowledge and behaviour of the Italian population through an online survey. A sample of 11,618 Italian participants completed the questionnaire. The degree of knowledge and the reported behaviour about salt intake were both found to be related to age, gender, home region, level of education and occupation. There was a significant interrelation between salt knowledge and behaviour and both were significantly and directly related to the degree of adherence to a Mediterranean-like dietary pattern. A hierarchical evaluation was also made of the relevance of any single question to the overall assessment of knowledge and behaviour about salt intake. Conclusions: The study population overall appeared to have a decent level of knowledge about salt, but a less satisfactory behaviour. Our findings point to social inequalities and young age as the main factors having a negative impact on knowledge and behaviour about salt intake as part of generally inadequate dietary habits. The degrees of knowledge and behaviour were significantly and directly interrelated, confirming that improving knowledge is a key step for behavioural changes, and suggesting that educational campaigns are crucial for the implementation of good practices in nutrition.

Download Full-text

Genetically, dietary sodium intake is causally associated with salt-sensitive hypertension risk in a community-based cohort study: a Mendelian randomization approach

European Heart Journal ◽

10.1093/ehjci/ehaa946.2791 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J.R Choi

Keyword(s):

Mendelian Randomization ◽

Salt Intake ◽

Sodium Intake ◽

Dietary Sodium ◽

Funding Source ◽

Dietary Salt ◽

Community Based ◽

Dietary Salt Intake ◽

Hypertension Risk ◽

Salt Sensitive Hypertension

Abstract Excessive dietary salt intake is associated with an increased risk of hypertension. Salt sensitivity, i.e., an elevation in blood pressure in response to high dietary salt intake, has been associated with a high risk of cardiovascular disease and mortality. We investigated whether a causal association exists between dietary sodium intake and hypertension risk using Mendelian randomization (MR). We performed an MR study using data from a large genome-wide association study comprising 15,034 Korean adults in a community-based cohort study. A total of 1,282 candidate single nucleotide polymorphisms associated with dietary sodium intake, such as rs2960306, rs4343, and rs1937671, were selected as instrumental variables. The inverse variance weighted method was used to assess the evidence for causality. Higher dietary sodium intake was associated with salt-sensitive hypertension risk. The variants of SLC8E1 rs2241543 and ADD1 rs16843589 were strongly associated with increased blood pressure. In the logistic regression model, after adjusting for age, gender, smoking, drinking, exercise, and body mass index, the GRK4 rs2960306TT genotype was inversely associated with hypertension risk (OR = 0.356, 95% CI = 0.236–0.476). However, the 2350GG genotype (ACE rs4343) exhibited a 2.11-fold increased hypertension risk (OR = 2.114, 95% CI = 2.004–2.224) relative to carriers of the 2350AA genotype, after adjusting for confounders. MR analysis revealed that the odds ratio for hypertension per 1 mg/day increment of dietary sodium intake was 2.24 in participants with the PRKG1 rs12414562 AA genotype. Our findings suggest that dietary sodium intake may be causally associated with hypertension risk. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (2017R1D1A3B03034119, 2014M3C9A3064552), and the KRIBB Initiative program. This research was also supported by the Medical Research Center Program (2017R1A5A2015369). This work was supported (in part) by the Yonsei University Research Fund 2017. Bioresources for this study were provided by the National Biobank of Korea and the Centers for Disease Control and Prevention, Republic of Korea (2017-009).

Download Full-text

P1857SALT CONSUMPTION, LIFESTYLE AND PROTEINURIA IN A HETEROGENEOUS YOUNG POPULATION

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1857 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Claudia Zullo ◽

Lorenzo Dallari ◽

Alfredo Bagalà ◽

Chiara Somma ◽

Giuseppe Ferro ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Dietary Habits ◽

Salt Intake ◽

World Health ◽

Dietary Salt ◽

Dietary Salt Intake ◽

Italian Regions

Abstract Background and Aims Obesity, hypertension, smoke, high dietary salt intake and physical inactivity are the main modifiable risk factors for chronic kidney disease, that affects about 9-10% of Italian people. About daily salt intake, the World Health Organization recommends a maximum consumption of 5 grams of salt per day. In Italy, most people consume too much salt – on average 8-10 grams per day or around twice the recommended maximum level of intake. Aim of this study was to investigate dietary habits and lifestyle of the heterogeneous students population of “Scuola Carabinieri di Firenze” (attended by people coming from all Italian regions) and their relations with urinary abnormalities. Method from November 2018 to March 2019 we collected anamnestic and anthropometric data, blood pressure measurements and body cellular mass (BCM) of 257 young subjects (152 males, 105 females; mean age 32 + 11 yy). We determinated sodium, chlorine and protein excretion on a spot urine sample in addition to plasma creatinine levels. Statistical analyses were performed using SPSS. Results We analyzed preliminary data of urinary sodium excretion (UNa), proteinuria (Up) and hematuria (Urbc) of all the subjects. Fifty-five percent of them had a UNa higher than 100 mmol/L (approximately equivalent to a dietary salt intake of 6 grams/day). In these subjects with higher salt consumption, Up and Urbc, measured by urine dipstick, were detectable in 32% and 21% respectively. In subjects with lower salt intake (less than 6 grams/day), Up and Urbc were 0% and 5% respectively. To determine if there was an association between our variables, we used Pearson correlation coefficient. We found that UNa was directly related to Up (r 0.26, p 0.002), age (r 0.22 p 0.011) and diastolic blood pressure (DBP, r 0.22, p 0.012). We also found that poor exercise (r -0.15, p 0.7) and low lean body mass percentage (r -0.15, p 0.7) were inversely related to UNa. Conclusion high dietary salt intake is associated with elevated blood pressure and proteinuria in a young and “healthy” population. Hypertension and proteinuria are both known risk factors for the development of chronic kidney disease. Wrong dietary habits and lifestyles must be detected and corrected in order to prevent nephropathy onset.

Download Full-text

Renal denervation chronically lowers arterial pressure independent of dietary sodium intake in normal rats

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01029.2002 ◽

2003 ◽

Vol 284 (6) ◽

pp. H2302-H2310 ◽

Cited By ~ 52

Author(s):

Frédéric Jacob ◽

Pilar Ariza ◽

John W. Osborn

Keyword(s):

Arterial Pressure ◽

Salt Intake ◽

Sodium Intake ◽

Recovery Period ◽

Control Period ◽

Dietary Sodium ◽

Renal Nerves ◽

Dietary Salt ◽

Dietary Salt Intake ◽

High Salt Intake

The present study was designed to test the hypothesis that renal nerves chronically modulate arterial pressure (AP) under basal conditions and during changes in dietary salt intake. To test this hypothesis, continuous telemetric recording of AP in intact (sham) and renal denervated (RDNX) Sprague-Dawley rats was performed and the effect of increasing and decreasing dietary salt intake on AP was determined. In protocol 1, 24-h AP, sodium, and water balances were measured in RDNX ( n = 11) and sham ( n = 9) rats during 5 days of normal (0.4% NaCl) and 10 days of high (4.0% NaCl) salt intake, followed by a 3-day recovery period (0.4% NaCl). Protocol 2 was similar with the exception that salt intake was decreased to 0.04% NaCl for 10 days after the 5-day period of normal salt (0.04% NaCl) intake (RDNX; n = 6, sham; n = 5). In protocol 1, AP was lower in RDNX (91 ± 1 mmHg) compared with sham (101 ± 2 mmHg) rats during the 5-day 0.4% NaCl control period. During the 10 days of high salt intake, AP increased <5 mmHg in both groups so that the difference between sham and RDNX rats remained constant. In protocol 2, AP was also lower in RDNX (93 ± 2 mmHg) compared with sham (105 ± 4 mmHg) rats during the 5-day 0.4% NaCl control period, and AP did not change in response to 10 days of a low-salt diet in either group. Overall, there were no between-group differences in sodium or water balance in either protocol. We conclude that renal nerves support basal levels of AP, irrespective of dietary sodium intake in normal rats.

Download Full-text

Perspectives of the public on reducing population salt intake in Ireland

Public Health Nutrition ◽

10.1017/s1368980015002530 ◽

2015 ◽

Vol 19 (7) ◽

pp. 1327-1335 ◽

Cited By ~ 8

Author(s):

Áine Regan ◽

Christine Liran Shan ◽

Patrick Wall ◽

Áine McConnon

Keyword(s):

Online Survey ◽

Salt Intake ◽

High Salt ◽

Attitudes And Beliefs ◽

Dietary Salt ◽

Cross Sectional ◽

Salt Reduction ◽

Dietary Salt Intake ◽

The Public ◽

The Government

AbstractObjectiveAs countries struggle to meet the set targets for population salt intake, there have been calls for more regulated approaches to reducing dietary salt intake. However, little is known about how the public perceives various salt reduction policies; an important line of investigation given that the implementation and success of these policies often depend on public sentiment. We investigated the attitudes and beliefs of consumers towards salt reduction and their support for thirteen different government-led salt reduction policies.DesignA cross-sectional online survey measured participants’ knowledge, beliefs and attitudes in relation to salt reduction.SettingThe survey was carried out with participants from the Republic of Ireland.SubjectsFive hundred and one participants recruited via a market research agency completed the survey.ResultsWe found that the vast majority of participants supported eleven of the government-led salt reduction policies, which included measures such as education, labelling and salt restriction in foods (both voluntary and regulated, across a range of settings). The two proposed fiscal policies (subsidising low-salt foods and taxing high-salt foods) received less support in comparison, with the majority of participants opposed to a tax on high-salt foods. A series of multiple regressions revealed that individual attitudes and beliefs related to health and salt were stronger predictors of support than sociodemographic factors, lifestyle or knowledge.ConclusionsThe study provides an important evidence base from which policy makers may draw when making decisions on future policy steps to help achieve national salt targets.

Download Full-text

Association of Single Nucleotide Polymorphisms in Salt Taste Receptor Genes With Dietary Salt Intake and Blood Pressure Among Iranian Adults Population

Current Developments in Nutrition ◽

10.1093/cdn/nzab050_012 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 945-945

Author(s):

Noushin Mohammadifard ◽

Mojgan Gharipour ◽

Faezeh Moazeni

Keyword(s):

Blood Pressure ◽

Salt Intake ◽

Sodium Intake ◽

Taste Receptors ◽

Urine Collection ◽

Nucleotide Polymorphisms ◽

Dietary Salt ◽

Single Nucleotide ◽

Dietary Salt Intake ◽

Salt Taste

Abstract Objectives So far, few researches has examined how genetic variation in salt taste receptors affects food intake in Iranian population. Thus, in this study, we aimed to investigate associations of single nucleotide polymorphisms (SNPs) in salt taste receptors genes with dietary salt intake and blood pressure. Methods This cross-sectional study was carried out among 116 randomly selected adults aged 18 years and over in Isfahan city, Iran. Subjects with diabetes insipidus, renal insufficiency, a special dietary regimen, fasting or menstruating on the day of sampling, using diuretics and oral contraceptives or pregnant and lactating women as well as participants who had incomplete 24-h urine collection were excluded. A 24-h urine collection and blood pressure measurement were done. Whole blood was collected to extract DNA and measure SNP rs239345 in the ENaC and rs224534, rs4790151 and rs8065080 in the TRPV1 gene. Results Homozygous carriers of the T allele for rs239345 were found to consume significantly more sodium (4414.7 ± 1943.8 mg/day) compared to the AA genotype (3887.4 ± 1709.1 mg/day). Further, they also had higher diastolic blood pressure compared to subjects with the AA genotype (81.3 ± 9.7 vs. 75.3 ± 8.3 mmHg). Compared to subjects with the CC genotype, those with homozygous carriers of the T allele for rs8065080 in the TRPV1 had higher sodium intake (3592.6 ± 1645.2 mg/day vs. 4604.2 ± 2013.5 mg/day) and systolic blood pressure (118.1 ± 11.3 mmHg vs. 123.4 ± 11.5 mmHg). No differences were found in dietary sodium intake and blood pressure with the rs224534 and rs4790151 SNPs. Conclusions These findings suggest that genetic variation in the ENaC and TRPV1 genes may contribute to inter-individual differences in salt intake and blood pressure. Funding Sources The National Institute for Medical Research Development (NIMAD) was funded this study via grant number of 977,549.

Download Full-text

Implications of dietary salt intake for multiple sclerosis pathogenesis

Multiple Sclerosis Journal ◽

10.1177/1352458515609431 ◽

2015 ◽

Vol 22 (2) ◽

pp. 133-139 ◽

Cited By ~ 13

Author(s):

Stephanie Hucke ◽

Heinz Wiendl ◽

Luisa Klotz

Keyword(s):

Multiple Sclerosis ◽

Dietary Habits ◽

Salt Intake ◽

Cell Types ◽

Epidemiological Studies ◽

Special Focus ◽

Potential Contribution ◽

Dietary Salt ◽

Dietary Salt Intake ◽

Cns Autoimmunity

In recent years it has become increasingly clear that, alongside genetic risk factors, environmental factors strongly influence the incidence and severity of multiple sclerosis (MS). Based on observations from epidemiological studies, the potential contribution of dietary habits has lately been a matter of debate. Recently it was shown that high salt conditions promote pathogenic T-cell responses and aggravate autoimmunity in an animal model of MS, suggesting that high dietary salt intake might promote central nervous system (CNS) autoimmunity. However, so far, not much is known about the influence of dietary salt intake on MS disease pathology. Here, we discuss the association of dietary salt levels and MS with a special focus on the mechanisms of salt-mediated modulation of the different cell types critically involved in the pathophysiology of MS.

Download Full-text

Immunoreactive Substance P in Human Plasma: Response to Changes in Posture and Sodium Balance

Clinical Science ◽

10.1042/cs0590075 ◽

1980 ◽

Vol 59 (1) ◽

pp. 75-77 ◽

Cited By ~ 6

Author(s):

H. J. Kramer ◽

R. Düsing ◽

H. Stelkens ◽

R. Heinrich ◽

J. Kipnowski ◽

...

Keyword(s):

Substance P ◽

Salt Intake ◽

Sodium Intake ◽

Plasma Concentrations ◽

Mean Value ◽

Dietary Sodium ◽

Sodium Balance ◽

Dietary Salt ◽

Dietary Salt Intake ◽

High Sodium

1. In healthy volunteers plasma concentrations of immunoreactive substance P were measured in response to changes in posture and dietary salt intake. 2. In 14 subjects plasma immunoreactive substance P was 168 ± 31 pmol/l when subjects were supine and 401 ± 51 pmol/l (P < 0.001) when they were ambulant. 3. Measurement of supine plasma immunoreactive substance P at 6 h intervals gave a mean value of 240 ± 39 pmol/l at 14.00 hours and a lowest value of 76 ± 9 pmol/l at 02.00 hours. 4. In eight healthy subjects plasma immunoreactive substance P rose only slightly from 169 ± 41 pmol/l, on a sodium intake ad lib., to 244 ± 45 pmol/l by day 4 of dietary sodium restriction (35 mmol/day) and significantly fell to 51 ± 20 pmol/l (P < 0.001) by day 4 of high sodium intake (350 mmol/day). 5. Although exogenous substance P was shown to be natriuretic in dog and rat, the present results do not favour a role of endogenous substance P as a circulating natriuretic factor in man.

Download Full-text

Estimation of Salt Intake Assessed by 24-Hour Urinary Sodium Excretion among Somali Adults in Oslo, Norway

Nutrients ◽

10.3390/nu10070900 ◽

2018 ◽

Vol 10 (7) ◽

pp. 900 ◽

Cited By ~ 6

Author(s):

Sairah Chen ◽

Cecilie Dahl ◽

Haakon Meyer ◽

Ahmed Madar

Keyword(s):

Sodium Excretion ◽

Western Europe ◽

Dietary Habits ◽

Salt Intake ◽

Urinary Sodium Excretion ◽

Cross Sectional Study ◽

Dietary Salt ◽

Cvd Risk ◽

Cross Sectional ◽

Dietary Salt Intake

High dietary salt intake is associated with increased blood pressure (BP) and cardiovascular disease (CVD) risk. The migration of Somalis from East Africa to Norway may have altered their dietary habits, making them vulnerable to adverse health outcomes. Since little is known about the lifestyle and health status of this population, the purpose of our study was to estimate salt intake in Somali adults in Oslo, Norway. In this cross-sectional study, we included 161 Somali adults (76 men, 86 women) from the Sagene borough in Oslo, Norway. Sodium and potassium excretion was assessed through the collection of 24-hour urine. Creatinine-based exclusions were made to ensure completeness of urine collections. Sodium excretion corresponding to an estimated dietary salt intake of 8.66 ± 3.33 g/24 h was found in men and 7.39 ± 3.64 g/24 h in women (p = 0.013). An estimated 72% of participants consumed >5 g salt/day. The Na:K ratio was 2.5 ± 1.2 in men and 2.4 ± 1.1 in women (p = 0.665). In conclusion, estimated salt intake was, while above the WHO recommendation, within the lower range of estimated salt intakes globally and in Western Europe. Further research is required to assess the health benefits of sodium reduction in this Somali immigrant population.

Download Full-text

Clearance of endogenous lithium in humans: altered dietary salt intake and comparison with exogenous lithium clearance

AJP Renal Physiology ◽

10.1152/ajprenal.1995.268.4.f718 ◽

1995 ◽

Vol 268 (4) ◽

pp. F718-F722 ◽

Cited By ~ 3

Author(s):

E. Folkerd ◽

D. R. Singer ◽

F. P. Cappuccio ◽

N. D. Markandu ◽

B. Sampson ◽

...

Keyword(s):

Salt Intake ◽

Sodium Intake ◽

Lithium Concentration ◽

Fractional Excretion ◽

Dietary Sodium ◽

Lithium Clearance ◽

Dietary Salt ◽

Renal Handling ◽

Dietary Salt Intake ◽

High Sodium

We compared endogenous with exogenous lithium clearance (CLi) and studied the effects of dietary salt intake on endogenous CLi in healthy volunteers. Lithium was detectable within a narrow fourfold range in serum and in urine in all 25 subjects studied [serum (n = 25), mean 0.27 +/- 0.02 mumol/l, range 0.13-0.55 mumol/l; urine (n = 20), range 1.49–7.32, mean 4.09 +/- 0.36 mumol/24 h]. Mean clearance and fractional excretion of endogenous lithium were lower (15.2 +/- 2.0 ml/min and 16.4 +/- 2.1%, respectively) compared with results obtained using the exogenous CLi technique (25.5 +/- 1.7 ml/min and 27.9 +/- 2.1%; P < 0.01 and P < 0.05, respectively; n = 17). In a separate group of six normal subjects, absolute (8.7 +/- 2.9 vs. 20.7 +/- 3.8 ml/min) and fractional excretion of lithium (8.3 +/- 2.9 vs. 18.0 +/- 5.1%) were significantly lower on 5 days of low (31 +/- 10 mmol/day) vs. high sodium intake (357 +/- 78 mmol/day; P < 0.05). Use of endogenous CLi precludes the need for lithium tablets. This could be a particular advantage in population studies and permits serial measurement of CLi on different days. Our results show that it is important to take dietary sodium intake into account in studies of endogenous CLi. Lower values for endogenous compared with exogenous CLi could reflect differences in renal handling depending on the plasma lithium concentration. This clearly requires further study.

Download Full-text

Proteinuria changes in kidney disease patients with clinical remission during the COVID-19 pandemic

PLoS ONE ◽

10.1371/journal.pone.0250581 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250581

Author(s):

Nobuo Tsuboi ◽

Takaya Sasaki ◽

Naoki Kashihara ◽

Takashi Yokoo

Keyword(s):

Kidney Disease ◽

Dietary Habits ◽

Salt Intake ◽

Lifestyle Changes ◽

University Hospital ◽

Dietary Salt ◽

Dietary Salt Intake ◽

Clinical Variables ◽

Salt Excretion ◽

June July

Backgrounds Data on how lifestyle changes due to the coronavirus disease 2019 (COVID-19) pandemic have influenced the clinical features of kidney disease patients remain scarce. Methods This study retrospectively analyzed clinical variables in patients with stage G1–G4 chronic kidney disease (CKD) with complete or incomplete remission of proteinuria, who were managed in a nephrology outpatient clinic of a university hospital in Tokyo. The clinical variables during the COVID-19 pandemic (term 1, June–July 2020) were compared to those one year before the pandemic (term 0, June–July 2019). The urinary protein excretion (UPE) was used as the primary outcome measure. Results This study included 325 patients with stage G1–G4 CKD (mean age 58.5 years old, 37.5% female, 80.6% on renin-angiotensin aldosterone system inhibitors [RAASis], 12.0% on maintenance dose immunosuppression therapy) evaluated at term 0. The UPE at terms 0 and 1 was 247 (92–624) and 203 (84–508) mg/day [median (25th–75th percentile)], respectively; the value in term 1 was 18% lower than that in term 0 (p<0.001), with no marked difference in body weight, blood pressure, protein intake or urinary salt excretion. In multivariable analyses, incomplete remission of proteinuria in term 0 (odds ratio [OR] = 2.70, p = <0.001), RAASi use (OR = 2.09, p = 0.02) and decreased urinary salt excretion in term 1 vs. term 0 (OR = 1.94, p = 0.002) were identified as independent variables associated with reduced UPE in term 1 vs. term 0. No significant interactions between the variables were observed. Conclusion In kidney disease patients receiving standard medical care from nephrologists, the UPE after the emergency declaration in relation to the COVID-19 pandemic was lower than before the declaration. The UPE reduction may be associated with reduced dietary salt intake during the pandemic in patients treated with RAASi for insufficient control of proteinuria. Our results support the current proposal to continue therapeutic approaches to these patients, which involve RAASi therapy along with optimizing dietary habits, even while dealing with the COVID-19 pandemic.

Download Full-text