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Dietary Sodium, Potassium Intake and Blood Pressure

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (25 April 2024) | Viewed by 5346

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Dr. Rachael McLean

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Department of Preventive and Social Medicine, University of Otago, Dunedin 9054, New Zealand
Interests: diet; cardiovascular disease; dietary sodium and potassium; epidemiology; population health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Reducing the population's sodium intake and reducing blood pressure are two urgent strategies to lower the prevalence of noncommunicable diseases worldwide. Progress towards limiting the sodium intake of the global population has been slow, due to food industry inaction, political inertia and scientific disagreement. Recent research on the use of reduced sodium salt substitutes shows that this is a promising intervention, although questions remain about its effectiveness and safety in some population groups. As the World Health Organization launches its global report on sodium reduction, we launch this Special Issue, which aims to provide further evidence to inform this important topic area. In particular, we encourage the submission of papers that inform the development and implementation of population strategies to reduce blood pressure by decreasing sodium and/or increasing potassium intakes.

This Special Issue aims to provide insight into:

Population-level interventions to reduce blood pressure by altering the intake of sodium and/or potassium.
The use of reduced sodium salt substitutes.
Methodological issues that inform interpretation of the evidence.
Epidemiological evidence regarding intakes of sodium and/or potassium and health outcomes, including blood pressure.

Dr. Rachael McLean
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

sodium
potassium
salt
blood pressure
cardiovascular disease
population
epidemiology

Published Papers (5 papers)

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Research

12 pages, 269 KiB

Open AccessArticle

Urinary Biomarkers in Screening for the Usual Intake of Fruit and Vegetables, and Sodium, Potassium, and the Sodium-to-Potassium Ratio: Required Number and Accuracy of Measurements

by Aoi Suzuki, Ribeka Takachi, Junko Ishihara, Sachiko Maruya, Yuri Ishii, Kumiko Kito, Kazutoshi Nakamura, Junta Tanaka, Taiki Yamaji, Hiroyasu Iso, Motoki Iwasaki, Shoichiro Tsugane and Norie Sawada

Nutrients 2024, 16(3), 442; https://doi.org/10.3390/nu16030442 - 01 Feb 2024

Cited by 1 | Viewed by 1011

Abstract

Because of within-individual variation, surveys to estimate an individual’s usual food intake must be conducted over many days, in general. Here, using non-invasive biomarkers, we examined the number of measurements required to screen for the usual intake of fruit and vegetables, in addition to sodium, potassium, and the sodium-to-potassium (Na/K) ratio. Participants were 202 subjects aged 40–74 years from five areas of Japan who completed weighed food records (WFR) and five 24-hour urinary collections (24-h UCs) between 2012 and 2013. The number of 24-h UCs required to screen for intake that deviated from guidelines estimated by the WFR and their accuracies were assessed by the area under the curve (AUC) in a receiver-operating characteristics (ROC) analysis. The single urinary excretion of sodium, potassium, and the Na/K ratio showed moderate performance (AUC value: >0.7) in discriminating deviations from their criteria by respective intake based on the WFR. Urinary potassium excretion also showed moderate performance (AUC value: >0.7) in estimating the intake of vegetables but could not be used to estimate fruit intake even after five collections. The non-invasive measurement of biomarkers in a single 24-h UC showed moderate performance in screening the usual intake of vegetables, as measured based on the 12-day WFR, as well as of sodium, potassium, and the Na/K ratio. Full article

(This article belongs to the Special Issue Dietary Sodium, Potassium Intake and Blood Pressure)

11 pages, 753 KiB

Open AccessArticle

Awareness and Availability of Low Sodium Iodized Salt: Results from Formative Research of Promoting Uptake of Low SodiUm Iodized Salt by Rural and Urban HousehoLds in India—The PLURAL Study

by Reena Sehgal, Nikhil Srinivasapura Venkateshmurthy, Rajesh Khatkar, Shiva Prasad Konkati, Prashant Jarhyan, Manika Sharma, Nicole Ide, Dorairaj Prabhakaran and Sailesh Mohan

Nutrients 2024, 16(1), 130; https://doi.org/10.3390/nu16010130 - 30 Dec 2023

Viewed by 921

Abstract

Dietary sodium intake is high among adults in India. Use of low sodium iodized salt (LSIS) can help reduce sodium intake. However, contextually relevant and culturally appropriate interventions to promote LSIS uptake in India have not been developed and implemented. We carried out formative research to inform an intervention to promote uptake of LSIS among rural and urban households in north (Sonipat district) and south (Visakhapatnam and Anakapalli districts) India. Sixty-two in-depth interviews of six focus groups were held with a range of stakeholders—consumers, retailers and influencers. Participant views on availability, affordability, taste and safety of LSIS, along with views on hypertension, its risk factors and potential intervention design and delivery strategies were elicited. Thematic analysis of the data was carried out. While the awareness of hypertension and its risk factors was high among the participants, awareness of LSIS was low. There was also low demand for, and availability of, LSIS. Since cost of LSIS was higher than regular salt, participants preferred that a subsidy be provided to offset the cost. Based on these findings, an intervention to promote the uptake of LSIS was implemented by project staff using various educational materials such as posters, pamphlets and short videos. Full article

(This article belongs to the Special Issue Dietary Sodium, Potassium Intake and Blood Pressure)

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13 pages, 562 KiB

Open AccessArticle

Longitudinal Associations of Dietary Fructose, Sodium, and Potassium and Psychological Stress with Vascular Aging Index and Incident Cardiovascular Disease in the CARDIA Cohort

by Meaghan Osborne, Alexa Bernard, Emily Falkowski, Deni Peterson, Anusha Vavilikolanu and Dragana Komnenov

Nutrients 2024, 16(1), 127; https://doi.org/10.3390/nu16010127 - 29 Dec 2023

Cited by 1 | Viewed by 1161

Abstract

We explored how dietary behaviors (sucrose, fructose, sodium, and potassium consumption) and endured psychological stress in young adult males and females impact the vascular aging index (VAI) and CVD risk by mid-life. Data were obtained from the Coronary Artery Risk Development in Young Adults Study, an ongoing longitudinal study. The included participants (n = 2656) had undergone carotid artery ultrasound at year 20 allowing VAIs to be calculated. Demographics, dietary data, and depression scores were obtained at baseline and year 20 of follow-up. Regression analyses were used to assess the predictors of VAI. Cox regression analyses were conducted to assess the risk of CVD, stroke, and all-cause mortality. Predictors of vascular aging were found to be sex-specific. In females, depression scores at baseline were positively associated with VAI (B-weight = 0.063, p = 0.015). In males, sodium intake at year 20 positively predicted VAI (B-weight = 0.145, p = 0.003) and potassium intake inversely predicted VAI (B-weight = −0.160, p < 0.001). BMI significantly predicted CVD, stroke, and death. Fructose consumption at year 20 was a significant predictor of CVD risk while having high blood pressure at baseline was significantly associated with stroke risk. Our findings support the promotion of nutrient-specific behavior changes to prevent vascular aging in early adulthood and CVD risk in mid-life. Full article

(This article belongs to the Special Issue Dietary Sodium, Potassium Intake and Blood Pressure)

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11 pages, 904 KiB

Open AccessArticle

Measuring Sodium from Discretionary Salt: Comparison of Methods

by Rachael Mira McLean, Nan Xin Wang, Claire Cameron and Sheila Skeaff

Nutrients 2023, 15(24), 5076; https://doi.org/10.3390/nu15245076 - 12 Dec 2023

Viewed by 915

Abstract

(1) Background: The best method to assess discretionary salt intake in population surveys has not been established. (2) Methods: This secondary analysis compared three different methods of measuring sodium intake from discretionary salt in a convenience sample of 109 adults in New Zealand. Participants replaced their household salt with lithium-tagged salt provided by researchers over eight days. Baseline 24 h urine was collected, and two further 24 h urine and 24 h dietary recalls were collected between days six and eight. Discretionary salt was estimated from the lithium-tagged salt, focused questions in the 24 h dietary recall, and the ‘subtraction method’ (a combination of 24 h urine and 24 h dietary recall measures). (3) Results: Around one-third of estimates from the ‘subtraction method’ were negative and therefore unrealistic. The mean difference between 24 h dietary recall and lithium-tagged salt estimates for sodium from discretionary salt mean were 457 mg sodium/day and 65 mg/day for mean and median, respectively. (4) Conclusions: It is possible to obtain a reasonable estimate of discretionary salt intake from careful questioning regarding salt used in cooking, in recipes, and at the table during a 24 h recall process to inform population salt reduction strategies. Full article

(This article belongs to the Special Issue Dietary Sodium, Potassium Intake and Blood Pressure)

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13 pages, 1932 KiB

Open AccessArticle

Dietary Potassium and Clinical Outcomes among Patients on Peritoneal Dialysis

by Jinru Pan, Xiao Xu, Zi Wang, Tiantian Ma and Jie Dong

Nutrients 2023, 15(19), 4271; https://doi.org/10.3390/nu15194271 - 06 Oct 2023

Viewed by 975

Abstract

Background: The association between dietary potassium and clinical prognosis is unclear in patients with chronic kidney disease (CKD). Here, we explored the association between dietary potassium intake and all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients. Methods: Here, we present a retrospective analysis of a prospective study. Patients that began incident PD in our center between 1 October 2002 and 31 August 2014 were screened. We recorded all demographic and clinical data at baseline. Repeated measurements were recorded at regular intervals to calculate time-averaged values. Spline regression analysis and Cox proportional regression models were used to evaluate the relationship between dietary potassium and mortality. Results: We followed 881 PD patients for 45.0 (21.5, 80.0) months; 467 patients died, of which 189 (40.5%) died of CV death and 93 were still on PD treatment. Compared with those who had baseline dietary potassium ≥1200 mg/d, the majority of patients with lower dietary potassium were female, older, or poorly educated. They were prone to have poorer nutritional status, CV disease, and diabetes mellitus (p < 0.05). In the unadjusted analysis, both baseline and time-averaged dietary potassium <1200 mg/d predicted higher all-cause and CV mortality (p < 0.001~0.01). After adjusting for demographic and laboratory data, the association between potassium intake and all-cause and CV mortality weakened, which even disappeared after additional adjustment for dietary fiber, protein, and energy intake. Conclusions: Dietary potassium in PD patients was not independently associated with all-cause and CV mortality. Full article

(This article belongs to the Special Issue Dietary Sodium, Potassium Intake and Blood Pressure)

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