Sodium intake is increased by social stress and the Y chromosome and reduced by clonidine

Sodium Intake and Disease: Another Relationship to Consider

Sodium (Na+) is crucial for numerous homeostatic processes in the body and, consequentially, its levels are tightly regulated by multiple organ systems. Sodium is acquired from the diet, commonly in the form of NaCl (table salt), and substances that contain sodium taste salty and are innately palatable at concentrations that are advantageous to physiological homeostasis. The importance of sodium homeostasis is reflected by sodium appetite, an "all-hands-on-deck" response involving the brain, multiple peripheral organ systems, and endocrine factors, to increase sodium intake and replenish sodium levels in times of depletion. Visceral sensory information and endocrine signals are integrated by the brain to regulate sodium intake. Dysregulation of the systems involved can lead to sodium overconsumption, which numerous studies have considered causal for the development of diseases, such as hypertension. The purpose here is to consider the inverse-how disease impacts sodium intake, with a focus on stress-related and cardiometabolic diseases. Our proposition is that such diseases contribute to an increase in sodium intake, potentially eliciting a vicious cycle toward disease exacerbation. First, we describe the mechanism(s) that regulate each of these processes independently. Then, we highlight the points of overlap and integration of these processes. We propose that the analogous neural circuitry involved in regulating sodium intake and blood pressure, at least in part, underlies the reciprocal relationship between neural control of these functions. Finally, we conclude with a discussion on how stress-related and cardiometabolic diseases influence these circuitries to alter the consumption of sodium.

Testing a Model of Sodium Reduction in Hypertensive Older Thai Adults

Hypertensive older adults will benefit if there is a clear understanding of the factors related to sodium reduction. That would raise awareness of the causes, consequently reducing many health risks, lowering health care costs, and diminishing economic and social burden from high blood pressure. This study explored predictors of urinary sodium excretion. A cross-sectional, correlational study was conducted in 312 hypertensive older Thai adults. Questionnaires related to knowledge, self-care agency, self-care behavior of sodium reduction, and 24-hour urinary sodium analyses were used, followed by the application of structural equation modeling and the Analysis of Moment Structures program. Self-care agency, knowledge, self-care behavior, rural/urban location, and education accounted for 61% of urinary sodium excretion. Self-care agency, knowledge, and self-care behavior were the main predictors in the urinary sodium excretion model. This study suggests establishing supportive educative sodium reduction-related programs that improve knowledge and enhance self-care agency, as well as a comparison of the changes of sodium reduction self-care behavior and urinary sodium excretion over time after the intervention.

Does stress induce salt intake?

Psychological stress is a common feature of modern day societies, and contributes to the global burden of disease. It was proposed by Henry over 20 years ago that the salt intake of a society reflects the level of stress, and that stress, through its effect on increasing salt intake, is an important factor in the development of hypertension. This review evaluates the evidence from animal and human studies to determine if stress does induce a salt appetite and increase salt consumption in human subjects. Findings from animal studies suggest that stress may drive salt intake, with evidence for a potential mechanism via the sympatho-adrenal medullary system and/or the hypothalamo-pituitary-adrenal axis. In contrast, in the few laboratory studies conducted in human subjects, none has found that acute stress affects salt intake. However, one study demonstrated that life stress (chronic stress) was associated with increased consumption of snack foods, which included, but not specifically, highly salty snacks. Studies investigating the influence of chronic stress on eating behaviours are required, including consumption of salty foods. From the available evidence, we can conclude that in free-living, Na-replete individuals, consuming Na in excess of physiological requirements, stress is unlikely to be a major contributor to salt intake.

The Salted Food Addiction Hypothesis may explain overeating and the obesity epidemic

One plausible explanation for the controversy that surrounds the causes and clinical management of obesity is the notion that overeating and obesity may only be a couple of "symptoms" associated with a yet to be discovered medical disorder.

OBJECTIVES

To introduce the Salted Food Addition Hypothesis. This theory proposes that salted food acts in the brain like an opiate agonist, producing a hedonic reward which has been perceived as being only peripherally "flavorful", "tasty" or "delicious". The Salted Food Addition Hypothesis also proposes that opiate receptor withdrawal has been perceived as "preference," "urges," "craving" or "hunger" for salted food.

METHODS

The Salted Food Addiction Hypothesis is made manifest by individually presenting a basic review of its primary coexisting components; the Neurological Component and the Psychosocial Component. We also designed a prospective study in order to test our hypothesis that opiate dependent subjects increase their consumption of salted food during opiate withdrawal.

RESULTS

The neuropsychiatric evidence integrated here suggests that salted food acts like an, albeit mild, opiate agonist which drives overeating and weight gain. The opiate dependent group studied (N=27) developed a 6.6% increase in weight during opiate withdrawal.

CONCLUSIONS

Salted Food may be an addictive substance that stimulates opiate and dopamine receptors in the brain's reward and pleasure center more than it is "tasty", while salted food preference, urge, craving and hunger may be manifestations of opiate withdrawal. Salted food and opiate withdrawal stimulate appetite, increases calorie consumption, augments the incidence of overeating, overweight, obesity and related illnesses. Obesity and related illnesses may be symptoms of Salted Food Addiction.

ARTERIAL BAROREFLEX IS NOT INVOLVED IN SALT PREFERENCE IN RATS

1. One unusual and interesting feature of spontaneously hypertensive rats (SHR) is their salt preference. This behaviour is known to be independent of blood pressure. 2. Arterial baroreflex (ABR) function is impaired in SHR. Therefore, the present study was designed to explore the relationship between ABR function and salt preference in rats. 3. Twenty-seven SHR, aged 11 months, were used. Blood pressure and baroreflex sensitivity (BRS) were determined in conscious, freely moving SHR after the measurement of salt preference. It was found that BRS did not relate to the salt preference in these rats. 4. Another group of normotensive Sprague-Dawley rats, aged 10 weeks, underwent either sinoaortic denervation (SAD) or sham operation. Salt preference was determined before and 4 weeks after SAD. Sinoaortic denervation did not alter salt preference in normotensive rats. 5. It is concluded that ABR function does not influence the salt preference in rats.

Salt preference of congenic strains derived from the spontaneously hypertensive rat

Previous studies using reciprocal crosses between the spontaneously hypertensive rat (SHR) and the normotensive Wistar-Kyoto (WKY) strain suggested a role for the Y chromosome in the SHR's exaggerated preference for saline solutions. We have reexamined the role of the Y chromosome in the salt preference of the SHR using a consomic strain derived from SHR and Brown Norway (BN-Lx) progenitors. We also studied congenic lines in which regions of BN-Lx chromosomes 8 and 20 had been introgressed into the SHR genome. Animals were given a choice of water and 0.9% saline to drink over a period of 7 days and their total fluid intake (TFI; water plus saline) and saline preference (proportion of the TFI taken as saline) calculated. SHR bearing the BN-Lx Y chromosome had a significantly reduced saline preference when compared to progenitor SHR. Evidence was also found for the existence of a region on chromosome 8, which influences fluid intake in the SHR. The causative genes involved in these effects however remain to be determined.

Estradiol increases salt intake in female normotensive and hypertensive rats

The objective of this study was to examine whether or not estradiol (E2) alters sodium intake in hypertensive and normotensive female rats. It was hypothesized that higher doses of E2 would increase sodium consumption and that this response would be greater in spontaneously hypertensive rats (SHR) compared with Wistar Kyoto (WKY) rats. The study involved female SHR and WKY (n = 12/group). All animals were ovariectomized. Six of twelve rats from each strain received three progressively larger doses of beta-estradiol propionate (each dose lasting 2 wk), whereas the other six rats from each strain received sham implants. Blood E2 levels were measured by radioimmunoassay after each 2-wk period, allowing a 10-day washout period before the next E2 dose. Rats had access to 0.0, 0.5, 1.0, and 1.5% NaCl solutions to drink throughout the experiment. There was a significant positive correlation between sodium intake and plasma E2 (r = 0.8, P < 0.001). Both strains avoided the 1.5% NaCl, and the increased sodium intake was achieved by an increase in consumption of the 0.5% NaCl. SHR females consumed more sodium than WKY females, which is similar to what has been observed in males of these strains. In conclusion, E2 was positively correlated with sodium intake in both strains of rat, with the hypertensive rats consuming more sodium than the normotensive rats.