Salt consumption and the risk of chronic diseases among Chinese adults in Ningbo city

Factors associated with total cholesterol and blood glucose levels among Afghan people aged 18-69 years old: Evidence from a national survey

The objective of this study was to determine the associated factors of total cholesterol (TC) and blood glucose (BG) levels in people aged 18-69 years old in Afghanistan. This was an analytical cross-sectional study using data from the National Survey of Non-Communicable Disease STEPs 2018 (NCD STEPS) in Afghanistan. The total sample size in the original study was 3,972 and a multi-stage cluster sampling method was used. Total cholesterol and blood glucose were the outcome variables for this study; simple and multiple linear regression was performed to find the associated factors for the outcome variables using a designed-based modeling incorporating sampling techniques and weights. The result of univariate linear regression analysis indicates that age, marital status, hypertension, and BMI are positively associated with TC and BG levels while education, salt intake, and any type of physical activity are negatively associated with TC and BG levels (p-values<0.05). Each year of age increases TC by 0.42 mg/dl and BG by 0.48 mg/dl; ever-married individuals have higher TC (21.8 mg/dl) and BG (8.8 mg/dl) levels; hypertension increases TC by 16.8 mg/dl and BG by 14.5 mg/dl; and higher BMI is associated with increased TC (1.3 mg/dl) and BG (0.9 mg/dl). Moreover, multivariate analysis using multiple linear regression indicates the same result; however, the results of marital status and gender are not significant with BG level and results of education levels, salt intake and any type of physical activity are not significant with TC levels. The finding of this study shows that total cholesterol and blood glucose increase in people of older age categories, married people, people with hypertension, overweight, and obesity; while decreases in people with higher education categories, people who always take salt, and people who do physical exercise.

High-Salt Diet and Intestinal Microbiota: Influence on Cardiovascular Disease and Inflammatory Bowel Disease

Salt, or sodium chloride, is an essential component of the human diet. Recent studies have demonstrated that dietary patterns characterized by a high intake of salt can influence the abundance and diversity of the gut microbiota, and may play a pivotal role in the etiology and exacerbation of certain diseases, including inflammatory bowel disease and cardiovascular disease. The objective of this review is to synthesize the effects of elevated salt consumption on the gut microbiota, including its influence on gut microbial metabolites and the gut immune system. Additionally, this review will investigate the potential implications of these effects for the development of cardiovascular disease and inflammatory bowel disease. The findings of this study offer novel insights and avenues for the management of two common conditions with significant clinical implications.

A Novel Compound with Kokumi Properties: Enzymatic Preparation and Taste Presentation Evaluation of N-Lauroyl Phenylalanine

To satisfy the demands of the food industry, innovative flavor enhancers need to be developed urgently to increase the food flavor. In our work, N-lauroyl phenylalanine (LP) was prepared from phenylalanine (l-Phe) and lauric acid (Lau) in water through the use of commercial enzymes (Promatex, Sumizyme FP-G, and Trypsin), and its flavor-presenting properties and mechanism were investigated. The highest LP yields obtained under one-factor optimized conditions were 61.28, 63.43, and 77.58%, respectively. Sensory assessment and an e-tongue test revealed that 1 mg/L LP enhanced the kokumi, saltiness, and umami of the simulated chicken broth solution and attenuated the bitterness of the l-isoleucine solution. The molecular simulation results suggested that the mechanisms of LP enhancement of kokumi and umami were related to hCaSR and hT1R1-hT1R3, and that hydrophobic forces and hydrogen bonds were involved in the binding of LP to taste receptors. The results implied that LP is a potential flavor enhancer for food applications.

Identification and quantification of microplastics in salts by complementary approaches using pyrolysis-gas chromatography/quadrupole-time of flight mass spectrometry (Py-GC/QTOFMS) and laser direct infrared (LDIR) chemical imaging analysis

Microplastics (MPs) and nanoplastics (NPs) have been suspected as contaminants in various foodstuffs, including salts, all over the world. Regarding the different sizes and polymer types, the mass concentrations of actual plastic particles in salt are not very clear. The purpose of this study is to develop a scalable method for qualitative and quantitative analysis of MPs and NPs by using Pyrolysis Gas Chromatography Quadrupole-Time of Flight mass spectrometry (Py-GC/QTOFMS) to detect their mass concentrations in salt samples. The targeted and suspected lists of polymers in salts were compiled based on the combined results of the high-resolution mass spectrometry (HRMS) full scanning with auxiliary MS dataset and the laser direct infrared (LDIR) chemical imaging analysis. The seven targeted MPs with polymer standards, i.e., polyvinyl chloride (PVC), polymethyl methacrylate (PMMA), polypropylene (PP), polystyrene (PS), polyethylene (PE), polyethylene terephthalate (PET), and polycarbonate (PC), were first subjected to a full MS scanning mode of the Py-GC/QTOFMS analysis. Subsequently, the parental masses of their pyrolysis compounds were used as the seeds to generate the related daughter masses. This process established both retention time and mass-pairs matching for the target MS/MS mode for enabling the identification and quantification of the particles. The suspected MPs with a matching degree >0.65 in the LDIR list were explored either by the full scan MS. Only PVC was identified, and PET was suspected. The Py-GC/QTOFMS result is complementary and comparable to the LDIR detection with the matching degree >0.85. We identified that PVC and PET (suspected) can be measured in both commercial and bulk sea salts, and their concentrations in sea salts are much higher than in rock salts, implying heavy contamination of the seawater.

Is the Theory of Planned Behavior a good model for predicting salt consumption behavior in pregnant women? A structural equation modeling approach

BACKGROUND

Non-communicable illnesses are the leading reason for wide-reaching death. Reducing the burden of these illnesses is one of the significant objectives of the World Health Organization's action plan. In this respect, reducing salt consumption is one of the most cost-effective public health interventions. The present study aimed to adjust the Theory of Planned Behavior (TPB) in expecting salt consumption behavior in pregnant women visiting the health centers in Birjand.

MATERIALS AND METHODS

In this cross-sectional study, 273 pregnant women who visited the health centers in Birjand were selected through Quota sampling method. The data were collected using a self-administered questionnaire based on the TPB constructs. The data analysis was done in SPSS 19 and AMOS 24.

RESULTS

The mean age of participants was 27.33 ± 5.77 years, and their mean gestational age was 12.67 ± 4.11 weeks. The mean score of attitude construct was 86.54 ± 8.50, subjective norm construct 36.59 ± 4.47, perceived behavioral control construct 41.63 ± 7.01, intention construct 16.01 ± 2.65 and behavior construct 19.86 ± 2.57. There was a statistically significant relationship between attitude construct (p < 0.001), perceived behavioral control (p < 0.001), and intention (p < 0.001) with salt consumption behavior (p < 0.05). The goodness of fit indices showed a proper fit of data (χ2/df = 1.94, PNFI = 0.6, TLI = 0.9, CFI = 0.9 and RMSE = 0.06).

CONCLUSION

The results of this study showed that the TPB is an appropriate model for reviewing the behavior of salt consumption. Hence, this model offers a suitable basis for designing an educational intervention to regulate the quantity of salt consumed by pregnant women and; thus, its usage in health promotion programs is suggested.

The World Hypertension League Science of Salt: a regularly updated systematic review of salt and health outcomes studies (Sept 2019 to Dec 2020)

The World Hypertension League Science of Salt health outcomes review series highlights high-quality publications relating to salt intake and health outcomes. This review uses a standardised method, outlined in previous reviews and based on methods developed by WHO, to identify and critically appraise published articles on dietary salt intake and health outcomes. We identified 41 articles published between September 2019 to December 2020. Amongst these, two studies met the pre-specified methodological quality criteria for critical appraisal. They were prospective cohort studies and examined physical performance and composite renal outcomes as health outcomes. Both found an association between increased/higher sodium intake and poorer health outcomes. Few studies meet criteria for high-quality methods. This review adds further evidence that dietary salt reduction has health benefits and strengthens evidence relating to health outcomes other than blood pressure and cardiovascular disease. We observe that most studies on dietary sodium do not have adequate methodology to reliably assess sodium intake and its association with health outcomes.

Mediating effect of telomere length in a hypertension population exposed to cadmium: a case-control study

Cadmium (Cd) is associated with telomere length and hypertension, respectively, but the mechanism behind its relationship is unclear. Our study aimed to clarify the role of telomere length in the relationship between Cd and hypertension. A 1:1 matched case-control study was conducted with 213 hypertensive patients and 213 normotensive controls in Taiyuan, Shanxi Province, China, from February and June 2016. General demographic characteristics information and lifestyle were collected using a structured questionnaire. Urine samples were collected to test urinary Cd (UCd) levels and corrected by urinary creatinine (UCr) levels. Peripheral leukocyte absolute telomere length (ATL) was measured using quantitative polymerase chain reaction. Logistic regression was used to screen the influencing factors of hypertension. A mediation effect analysis was used to explore the role of telomere length between Cd exposure and the risk of hypertension. We found that the hypertension group had a significantly higher UCd level compared to the control group (0.91 vs 0.80 μg/g Cr, P < 0.01), while ATL showed the opposite relationship (2.36 vs 2.65 kb, P < 0.01). The Regression analysis of hypertension identified these significant predictors: family history of hypertension (OR = 3.129, 95% confidence interval (95% CI): 1.767-5.540), Body mass index (BMI, OR = 1.088, 95% CI: 1.023-1.157), total cholesterol (TC, OR = 1.277, 95% CI: 1.024-1.592), UCd (OR = 2.092, 95% CI: 1.179-3.710), ATL (OR = 0.105, 95% CI: 0.025-0.453) and 8-hydroxy-2-deoxyguanosine (8-OHdG, OR = 7.864, 95% CI: 3.516-17.589). Mediating effect analysis revealed that ATL was a potential partial mediating factor between Cd and hypertension. Cd may induce hypertension by affecting telomere length, but this requires further exploration.

36-Month Evaluation of a Weight Management Programme in Chinese Overweight and Obese Adults

Background: Few comprehensive lifestyle intervention programmes have been investigated on overweight and obese adults in China. This study was to evaluate the effect of a 36-month weight management programme on weight loss and its maintenance among overweight and obese patients in Ningbo, China.

Methods: Adults with BMI ≥24kg/m² enrolled in this programme, including nutritional, physical activity, psychological and endocrinological counselling sessions, from July 2015 to January 2020. Adults participated in face-to-face counselling sessions and group-based education. Then, participants joined 21-day intensive programme using Bohe health APP and WeChat group to get personal advice of nutrition and lifestyle. In the end, participants were requested to join 33-month follow-ups including face-to-face counselling and personal advice on WeChat group. The main outcome was to evaluate the changes in weight at each followup from baseline weight.

Results: In total, 692 adults participated in this entire weight management programme. During follow-ups, 579, 475, 299, 219, and 135 adults participated at 3, 6, 12, 24, and 36 months, respectively. All participants had a significant initial weight loss at 3 months, then maintained the weight loss during 33-month follow-ups. At 36 months, 11.0%, 6.4%, and 3.5% of all participants achieved 5%, 10%, and 15% weight loss from the baseline weight, respectively. Adjusted weight at 36 months was significantly reduced from the baseline weight in both sex (−7.2 kg).

Conclusion: This weight management programme is suggested to benefit to reduce initial body weight and maintain long-term weight loss among overweight and obese adults.

Feeding behavior among health-care workers in a tertiary health institution Southeast Nigeria

Background

Feeding behavior is an important factor in the prevention and management of noncommunicable diseases, which are the leading cause of death globally.

Objective

This study is aimed to investigate the feeding behaviors among health-care workers in a tertiary hospital in southeast Nigeria.

Materials and Methods

The study was a cross-sectional survey. A total of 418 participants (186 males and 232 females) were involved in the study. The instrument is a sociodemographic questionnaire and a modified form of the British Heart Foundation's questions to assess the nutritional value of individuals. The participants were consecutively recruited from their workstations. Data were collected using self-administered questionnaires, which were hand distributed and collected back on the same day after completion.

Results

The study showed that health workers in the teaching hospital had an overall "fair" feeding behavior (86.13 ± 8.52 out of 140). It also showed that females had a significant (P < 0.05) overall better feeding behavior (88.15 ± 9.00) compared to males (83.62 ± 7.18). The studied participants had poor feeding behavior in carbohydrates and fats and oil consumption and just fair behavior in fruits and vegetables, salt intake, and water consumption. The feeding behavior was inadequate, and there was no significant gender or profession-related differences in the overall behavior of the participants.

Conclusion

The health-care workers in the tertiary health institution in southeast Nigeria have inadequate feeding behavior. They should join in the global call and awareness on healthy feeding behavior to prevent and reduce the burden of noncommunicable diseases.

Association Between Dietary Salt and Plasma Glucose, Insulin and Hemoglobin A1c Levels Among Type 2 Diabetes Patients in Eastern China

PURPOSE

Type 2 diabetes (T2D) is one of the major public health concerns in China. Studies on the association between dietary salt intake and the glycemic response of T2D are lacking in China. The aim was to investigate the association between the levels of dietary salt intake and the plasma glucose, insulin and hemoglobin A_1c (HbA_{1 c}) levels in T2D patients.

METHODS

Patients with T2D, who accepted management and treatment by the National Standardized Metabolic Disease Management Center at Ningbo First Hospital from March 2018 to January 2020, were included in this study. Dietary salt intake was assessed through a standardized food frequency questionnaire. Anthropometry, blood pressure and biomarkers were measured by well-trained endocrinology nurses. Generalized linear models (GLMs) were used to examine the associations.

RESULTS

A total of 1145 eligible T2D patients with a mean age of 51.4 years were included in the study. Fasting plasma glucose (FPG), 2-hour postprandial plasma glucose and 2-hour postprandial insulin were significantly increased across dietary salt categories. The GLMs further showed that dietary salt intake >8 g/day was positively associated with FPG and HbA_1c.

CONCLUSION

Higher daily salt intake was found to be associated with FPG and HbA_1c in T2D patients. Lifestyle education and promotion of salt reduction should be provided to T2D patients.