Main Sources, Socio-Demographic and Anthropometric Correlates of Salt Intake in Austria

The status of sodium intake and excretion and the primary dietary sources of sodium in Iranian adults, a comprehensive pilot study

Background

Coronary artery disease and hypertension are the leading causes of death and disability worldwide, primarily due to high sodium intake. Therefore, accurate assessment of the status of sodium intake and excretion is crucial. The present study aimed to assess the dietary sodium intake and excretion in Iranian population.

Methods

This cross-sectional study was carried out on 150 adults aged 20-65 years in Tehran, Iran. A 24-h dietary recall was used to measure the intake of sodium. A food frequency questionnaire was also used to identify the food items that contributed the highest amount of sodium in the diet. A 24-h urine collection was applied to assess the amount of sodium excretion.

Results

The mean of dietary sodium intake and sodium excreted in 24-h urine collections were 3888 ± 2931 mg/day and 125.2 ± 49 mmol/dl, respectively. Sodium intake and sodium excretion were significantly higher in men compared to women (P = 0.012 and P = 0.004, respectively). Traditional flatbreads were identified as the two main food sources contributing to dietary sodium intake, accounting for 31.2% of the total sodium intake from food sources. The average daily salt intake exceeded the recommended amount (5 g/day) in over 80% of the participants.

Conclusion

Sodium intake in a wide range of Iranian adults may be higher than the recommended values. Iranian flatbreads are the primary source of sodium intake In Iranian diets. If be confirmed in future studies, these results could help policymakers make decisions on reducing salt intake to prevent diseases associated with high salt consumption.

Mineral content in commercially branded and local salt in selected villages from Bahi, Iramba, Manyoni, and Singida urban districts, Tanzania

The study examines the mineral content of table salts used by households in villages adjacent to the production areas. A total of 210 samples from commercial and local salts were collected, and analyzed using iodometry titration, spectrophotometry, colorimetry, and atomic absorption spectroscopy (AAS) techniques, followed by a household interview for salt type preference. The lowest detectable concentration LOD, lowest quantifiable concentration LOQ and, recovery of methods ranged (0.32-2.155 μg/kg), (0.117-6.387 μg/kg) and, (94.2-103.6 %), respectively. Significant differences in mineral contents were observed within and between local and commercially branded salts (p < 0.001). The mean iodine in the local salt samples from Kitangiri (SA), Singidani (SB), Kindai (SC), Chibumagwa (SD), and Sulunga (SE) ranged from 10.5 ± 0,02 to 16.9 ± 0.01 mg/Kg, with only SA and SC in the World Health Organization (WHO) limits, while commercially branded salt samples SF (Malindi), and SG (Dar es salaam) ranged from 23.4 ± 0.01 to 35.9 ± 0,02 mg/kg that were in the Tanzania Bureau of Standards (TBS) and WHO agreed range. Other ions recorded were nitrate (3.3-4.4 mg/kg, 5.45-7.40 mg/kg), phosphate (0.02-0.48 mg/kg, 0.03 mg/kg), sulphate (0.31-0.42 mg/kg, 0.03-0.07 mg/kg), ammonia (0.5 mg/kg, 0.5 mg/kg to 0.6 mg/kg), copper (1.0-2.0 mg/kg, 0.9-2.0 mg/kg), iron (0.5-1.8 mg/kg, 0.9 mg/kg), and manganese (0.5-1.8 mg/kg, 0.9 mg/kg) for local and commercially branded salt, respectively. Households preferred local to commercial-branded salts: Nkonkilangi 163 (69.9, 32.1 %), Mangwanjuki 96 (17.2, 82.8 %), Unyanga 54 (26.7, 73.3 %), Chibumagwa 106 (63.0, 37.0 %), and Chali Igongo 51 (74.6, 25.4 %), respectively. Public health interventions are recommended to promote the consumption of adequately iodized salt for informed dietary choices.

Salt content of prepacked cereal-based products and their potential contribution to salt intake of the Italian adult population: Results from a simulation study

BACKGROUND AND AIMS

High sodium intake is one of the main risk factors for noncommunicable diseases, and its consumption should be reduced. This study aimed to simulate changes in the daily salt intake of the Italian adult population based on consumption scenarios of prepacked cereal-based foods sold in Italy.

METHODS AND RESULTS

Information on food packages was retrieved from 2893 cereal-based products. Potential changes in salt intake were simulated based on food consumption scenarios that consider the daily consumption of cereal-based products suggested in the Italian Dietary Guidelines and their current daily consumption by Italian adults. The highest salt content was retrieved in bread (median, 25th-75th percentile: 1.3, 1.1-1.4 g/100 g) and bread substitutes (1.8, 1.0-2.2 g/100 g). If the suggested daily amounts were consumed, bread would contribute to 44% of the 5 g salt/day target, whereas bread substitutes, breakfast cereals, biscuits and sweet snacks would marginally contribute (1-2%). Compared to bread with median salt content, a -44% and +10% salt intake would be observed if products within the first and the last quartile of salt content were chosen, respectively. However, considering the actual intake of Italian consumers, bread would cover 25% and bread substitutes 7% of the daily salt target.

CONCLUSION

Food labels have a pivotal role and efforts are required to encourage consumers to use them to make healthy choices. Moreover, these results may contribute to setting sodium benchmarks in cereal-based products and encourage the food industry to reduce the salt content in the products.

Determinants of Diet Quality in Adolescents: Results from the Prospective Population-Based EVA-Tyrol and EVA4YOU Cohorts

(1) Background: Unhealthy dietary behaviors are estimated to be one of the leading causes of death globally and are often shaped at a young age. Here, we investigated adolescent diet quality and its predictors, including nutrition knowledge, in two large Central European cohorts. (2) Methods: In 3056 participants of the EVA-Tyrol and EVA4YOU prospective population-based cohort studies aged 14 to 19 years, diet quality was assessed using the AHEI-2010 and DASH scores, and nutrition knowledge was assessed using the questionnaire from Turconi et al. Associations were examined utilizing multivariable linear regression. (3) Results: The mean overall AHEI-2010 score was 42%, and the DASH score was 45%. Female participants (60.6%) had a significantly higher diet quality according to the AHEI-2010 and DASH score. AHEI-2010 and DASH scores were significantly associated (p < 0.001) with sex, school type, smoking, and total daily energy intake. The DASH score was additionally significantly associated (p < 0.001) with age, socioeconomic status, and physical activity. Participants with better nutrition knowledge were more likely to be older, to attend a general high school, to live in a high-income household, to be non-smokers, and to have a higher diet quality according to the AHEI-2010 and DASH score. (4) Conclusions: Predictors of better diet quality included female sex, physical activity, educational level, and nutrition knowledge. These results may aid focused interventions to improve diet quality in adolescents.

Excessive sodium chloride ingestion promotes inflammation and kidney fibrosis in aging mice

In aging kidneys, a decline of function resulting from extracellular matrix (ECM) deposition and organ fibrosis is regarded as "physiological." Whether a direct link between high salt intake and fibrosis in aging kidney exists autonomously from arterial hypertension is unclear. This study explores kidney intrinsic changes (inflammation, ECM derangement) induced by a high-salt diet (HSD) in a murine model lacking arterial hypertension. The contribution of cold shock Y-box binding protein (YB-1) as a key orchestrator of organ fibrosis to the observed differences is determined by comparison with a knockout strain (Ybx1ΔRosaERT+TX). Comparisons of tissue from mice fed with normal-salt diet (NSD, standard chow) or high-salt diet (HSD, 4% NaCl in chow; 1% NaCl in water) for up to 16 mo revealed that with HSD tubular cell numbers decrease and tubulointerstitial scarring [periodic acid-Schiff (PAS), Masson's trichrome, Sirius red staining] prevails. In Ybx1ΔRosaERT+TX animals tubular cell damage, a loss of cell contacts with profound tubulointerstitial alterations, and tubular cell senescence was seen. A distinct tubulointerstitial distribution of fibrinogen, collagen type VI, and tenascin-C was detected under HSD, transcriptome analyses determined patterns of matrisome regulation. Temporal increase of immune cell infiltration was seen under HSD of wild type, but not Ybx1ΔRosaERT+TX animals. In vitro Ybx1ΔRosaERT+TX bone marrow-derived macrophages exhibited a defect in polarization (IL-4/IL-13) and abrogated response to sodium chloride. Taken together, HSD promotes progressive kidney fibrosis with premature cell aging, ECM deposition, and immune cell recruitment that is exacerbated in Ybx1ΔRosaERT+TX animals.NEW & NOTEWORTHY Short-term experimental studies link excessive sodium ingestion with extracellular matrix accumulation and inflammatory cell recruitment, yet long-term data are scarce. Our findings with a high-salt diet over 16 mo in aging mice pinpoints to a decisive tipping point after 12 mo with tubular stress response, skewed matrisome transcriptome, and immune cell infiltration. Cell senescence was aggravated in knockout animals for cold shock Y-box binding protein (YB-1), suggesting a novel protective protein function.

Sodium-to-Potassium Ratio as an Indicator of Diet Quality in Healthy Pregnant Women

This study aimed to investigate diet quality in healthy pregnant women based on the Na-to-K ratio from 24 h urine sample and food frequency questionnaire (FFQ), to compare dietary micro- and macronutrient intake with current nutritional recommendations (RDA), and to investigate whether gestational weight gain (GWG) is associated with Na-to-K ratio and diet quality during pregnancy in general. Sixty-four healthy pregnant women between 37 and 40 weeks of gestation participated in the study. Participants' GWG, body composition, molar 24 h urine Na-to-K ratio, and FFQ data on average daily total energy, food groups, and micro-/macronutrient intake were obtained. A Na-to-K ratio of 2.68 (1.11-5.24) does not meet nutrition quality and is higher than the WHO recommendations due to excessive sodium and insufficient potassium intake. FFQ Na-to-K ratio was associated with a higher daily intake of soups, sauces, cereals, fats, and oils and a low intake of fruit and non-alcoholic beverages. A total of 49% of pregnant women exhibited excessive GWG, which was attributed to the increase in adipose tissue mass. GWG was not associated with total energy but may be the result of insufficient physical activity during pregnancy. Daily intake of vitamin D, vitamin E, folate, niacin, riboflavin, calcium, iron, and zinc was suboptimal compared to RDA.

Development of a short-form Chinese health literacy scale for low salt consumption (CHLSalt-22) and its validation among hypertensive patients

Background

With the accelerated pace of people’s life and the changing dietary patterns, the number of chronic diseases is increasing and occurring at a younger age in today’s society. The speedily rising hypertensive patients have become one of the main risk factors for chronic diseases. People should focus on health literacy related to salt consumption and reach a better quality of life. Currently, there is a lack of local assessment tools for low salt consumption in mainland China.

Objective

To develop a short-form version of the Chinese Health Literacy Scale For Low Salt Consumption instrument for use in mainland China.

Methods

A cross-sectional design was conducted on a sample of 1472 people in Liaoxi, China. Participants completed a sociodemographic questionnaire, the Chinese version of the CHLSalt-22, the measuring change in restriction of salt (sodium) in the diet in hypertensives (MCRSDH-SUST), the Brief Illness Perception Questionnaire (BIPQ), and the Benefit-Finding Scales (BFS) to test the hypothesis. Exploratory factor analysis and confirmatory factor analyses were performed to examine the underlying factor structure of the CHLSalt-22. One month later, 37 patients who participated in the first test were recruited to evaluate the test-retest reliability.

Results

The CHLSalt-22 demonstrated adequate internal consistency, good test-retest reliability, satisfactory construct validity, convergent validity and discriminant validity. The CHLSalt-22 count scores were correlated with age, sex, body mass index (BMI), education level, income, occupation, the Measuring Change in Restriction of Salt (sodium) in Diet in Hypertensives (MCRSDH-SUST), the Brief Illness Perception Questionnaire (BIPQ), and the Benefit-Finding Scales (BFS).

Conclusion

The results indicate that the Chinese Health Literacy Scale For Low Salt Consumption (CHLSalt-22) version has good reliability and validity and can be considered a tool to assess health literacy related to salt consumption in health screenings.

The Sweet and Salty Dietary Face of Hypertension and Cardiovascular Disease in Lebanon

According to the World Health Organization (WHO), an estimated 1.28 billion adults aged 30–79 years worldwide have hypertension; and every year, hypertension takes 7.6 million lives. High intakes of salt and sugar (mainly fructose from added sugars) have been linked to the etiology of hypertension, and this may be particularly true for countries undergoing the nutrition transition, such as Lebanon. Salt-induced hypertension and fructose-induced hypertension are manifested in different mechanisms, including Inflammation, aldosterone-mineralocorticoid receptor pathway, aldosterone independent mineralocorticoid receptor pathway, renin-angiotensin system (RAS), sympathetic nervous system (SNS) activity, and genetic mechanisms. This review describes the evolution of hypertension and cardiovascular diseases (CVDs) in Lebanon and aims to elucidate potential mechanisms where salt and fructose work together to induce hypertension. These mechanisms increase salt absorption, decrease salt excretion, induce endogenous fructose production, activate fructose-insulin-salt interaction, and trigger oxidative stress, thus leading to hypertension. The review also provides an up-to-date appraisal of current intake levels of salt and fructose in Lebanon and their main food contributors. It identifies ongoing salt and sugar intake reduction strategies in Lebanon while acknowledging the country’s limited scope of regulation and legislation. Finally, the review concludes with proposed public health strategies and suggestions for future research, which can reduce the intake levels of salt and fructose levels and contribute to curbing the CVD epidemic in the country.

Assessing the (anti)-inflammatory potential of diets

PURPOSE OF REVIEW

It is accepted that several chronic diseases are associated with inflammation. Dietary habits and the consumption of certain nutrients have been shown to influence inflammation, reflected by inflammatory cytokines. In this narrative review, we discuss currently developed tools to assess the inflammatory potential of diets and compare them with established tools.

RECENT FINDINGS

Four new indices were recently developed. The Inflammatory Score of the Diet is a modified version of the established Dietary Inflammatory Index. The novel Empirical Dietary Inflammatory Index works without previous dietary intake assessment and the Anti-Inflammatory Diet Index was specifically developed in a northern European population. The Dietary and Lifestyle Inflammation Scores addresses additional confounders. The informative value of dietary indices relies on the accuracy and completeness of dietary intake assessment.

SUMMARY

Dietary inflammatory indices are important tools to assess, compare and validate the inflammatory potential of diets across populations without the need for biomarker assessments. They allow to investigate associations between an (anti)-inflammatory diet with disease risk and course. Although the Dietary Inflammatory Index remains the most used index worldwide, currently developed indices allow more flexibility, have a different focus or simplify assessment. Additional foods, that were recently shown to modulate inflammation, but are not (fully) considered yet, may deserve more attention in the future.

Risk factors related with high sodium intake among Malaysian adults: findings from the Malaysian Community Salt Survey (MyCoSS) 2017-2018

BACKGROUND

High sodium intake was an established risk factor for stroke and cardiovascular diseases. The objective of this study was to investigate factors associated with high sodium intake based on 24-h urinary sodium excretion from the MyCoSS study.

METHODS

The cross-sectional survey was conducted among adults aged 18 years and above in Malaysia. A multi-stage stratified sampling was used to represent nationally. Twenty-four-hour urine was collected from a total of 900 respondents. Indirect ion-selective electrode (ISE) method was used to measure sodium intake. Descriptive and logistic regression analysis was applied to determine factors associated with high sodium intake based on 24-h urinary sodium excretion.

RESULTS

A total of 798 respondents (76% response rate) completed the 24-h urine collection process. Logistic regression revealed that high sodium intake associated with obese [aOR 2.611 (95% CI 1.519, 4.488)], male [aOR 2.436 (95% CI 1.473, 4.030)], having a waist circumference of > 90cm for adult males [aOR 2.260 ( 95% CI 1.020, 5.009) and >80cm for adult females [aOR 1.210 (95% CI 0.556, 2.631)], being a young adult [aOR 1.977 (95% CI 1.094, 3.574)], and living in urban areas [aOR 1.701 (95% CI 1.094, 2.645)].

CONCLUSION

Adults who are obese, have a large waist circumference, of male gender, living in urban areas, and belonging to the young adult age group were found to have higher sodium intake than other demographic groups. Hence, reduction of salt consumption among these high-risk groups should be emphasised to reduce the risk of cardiovascular diseases.

Using Social Marketing to Reduce Salt Intake in Iran

Objectives: WHO has recommended that the average salt intake must be <5 grams per day. However, people consume salt much more in many countries. In this study, we design and implement an intervention based on social marketing model to reduce salt consumption in Yasuj, Iran. Materials and Methods: This study employed a quasi-experimental pretest-posttest with control group design which consisted of a formative research (qualitative-quantitative) and an interventional phase. To collect the qualitative data, six focus group discussions by participating of 66 people were established. The qualitative data were analyzed manually using directed content analysis. In quantitative study, 166 people aged 25-50 years completed a KAP questionnaire, and their average salt intake was determined through measuring sodium in their urine sample. By analyzing the data, marketing mix components were determined for designing an intervention. An educational package (including posters for installing in the kitchen, pamphlets, phone counseling, four educational classes, and brief interventions done by physicians and other health personnel) focused on reducing salt intake and using alternatives was developed. For one month, program was implemented for intervention group. Two months later, KAP survey and measuring the urine sodium were repeated for intervention and control groups. The data was compared for two groups, before and after the intervention by using independent t-test, paired t-tests and repeated measures ANOVA. Results: The qualitative findings showed that most participants agreed that the salt intake was high in Iran. Most of them recommended home-based and family-driven strategies to reduce salt intake, offered using healthier alternatives for salt, and recognized physicians and health care providers in healthcare facilities as the most important to encourage people to reduce salt intake. After the intervention, the mean and standard deviation of KAP were improved significantly in intervention group. The mean salt intake decreased significantly by 3.01 ± 2.38 in the intervention group and repeated measures ANOVA showed significant change over time (P < 0.001) and a significant difference between two groups (P = 0.04)_. Also, the interaction between time and group was significant (P = 0.001). Conclusion: The mean salt intake among the study population was approximately three times more than the level recommended by the WHO. The social marketing-based intervention succeeded in reducing the salt intake of the study subjects by ~3 grams on average.

A Systematic Review of the Sources of Dietary Salt Around the World

Excess salt intake contributes to hypertension and increased cardiovascular disease risk. Efforts to implement effective salt-reduction strategies require accurate data on the sources of salt consumption. We therefore performed a systematic review to identify the sources of dietary salt around the world. We systematically searched peer-reviewed and gray literature databases for studies that quantified discretionary (salt added during cooking or at the table) and nondiscretionary sources of salt and those that provided information about the food groups contributing to dietary salt intake. Exploratory linear regression analysis was also conducted to assess whether the proportion of discretionary salt intake is related to the gross domestic product (GDP) per capita of a country. We identified 80 studies conducted in 34 countries between 1975 and 2018. The majority (n = 44, 55%) collected data on dietary salt sources within the past 10 y and were deemed to have a low or moderate risk of bias (n = 75, 94%). Thirty-two (40%) studies were judged to be nationally representative. Populations in Brazil, China, Costa Rica, Guatemala, India, Japan, Mozambique, and Romania received more than half of their daily salt intake from discretionary sources. A significant inverse correlation between discretionary salt intake and a country's per capita GDP was observed (P < 0.0001), such that for every $10,000 increase in per capita GDP, the amount of salt obtained from discretionary sources was lower by 8.7% (95% CI: 5.1%, 12%). Bread products, cereal and grains, meat products, and dairy products were the major contributors to dietary salt intake in most populations. There is marked variation in discretionary salt use around the world that is highly correlated with the level of economic development. Our findings have important implications for the type of salt-reduction strategy likely to be effective in a country.

Sodium and Potassium Intakes and Their Ratio in Adults (18-90 y): Findings from the Irish National Adult Nutrition Survey

An individual's sodium to potassium intake ratio (Na:K) has been shown to be an important predictor of hypertension. The aim of this study was to estimate the mean 24 h urinary Na, K and Na:K of Irish adults and to identify the foods that determine Na:K in a nationally representative sample of Irish adults. This study was based on data from the Irish National Adult Nutrition Survey (2008-2010) (NANS), which collected spot urine samples and dietary data in a nationally representative sample of Irish adults aged 18+ years. The mean urinary molar Na:K of Irish men and women was 1.90 and 2.15, respectively, which exceed target molar ratios of ≤1.0 and ≤2.0. The mean estimated 24-h urinary excretion of Na was 4631 mg for men and 3525 mg for women, which exceed target maximum population intakes for all gender and age groups. The mean estimated 24-h urinary excretion of K was 3894 mg for men and 2686 mg for women, with intakes in women of all ages and older men (65+ years) below current recommendations. The key foods positively associated with a lower Na:K were fruits, vegetables, potatoes, breakfast cereals, milk, yogurt and fresh meat, while the foods negatively associated with a lower Na:K were breads, cured and processed meats and butters and fat spreads. Strategies to reduce sodium and increase potassium intakes are necessary to lower population Na:K, which may help to reduce the burden of hypertension-related diseases in the Irish population.

Presence of Hypertension Is Reduced by Mediterranean Diet Adherence in All Individuals with a More Pronounced Effect in the Obese: The Hellenic National Nutrition and Health Survey (HNNHS)

Hypertension is a major risk of cardiovascular diseases. This study’s aim was to examine associations between hypertension and a priori known lifestyle risk factors, including weight status and Mediterranean diet adherence. The study included a representative sample of the adult population (N = 3775 (40.8% males)), from the Hellenic National Nutrition and Health Survey (HNNHS), which took place from September 2013 to May 2015. Demographic and anthropometric data were collected using validated questionnaires, and blood pressure (BP) measurements were performed for the two main metropolitan areas (N = 1040; 41.1%). Hypertension diagnosis was according to the International Classification of Diseases (ICD-10) guidelines. Weighted proportions, extended Mantel–Haenszel (M–H) analyses, and multiple logistic regressions (for the survey data) were performed. Mean systolic BP (SBP) and diastolic BP (DBP) were 118.6 mmHg and 72.2 mmHg respectively, with both values being higher in males compared to females in all age groups (p < 0.001). Study participants with hyperlipidemia or diabetes, and those overweight, were almost twice as likely to be hypertensives, with the odds increasing to 4 for those obese (p for all, < 0.05). Stricter Mediterranean diet adherence significantly decreased the likelihood of hypertension by 36% (OR: 0.64; 95% CI: 0.439, 0.943), and a significant interaction was found between Mediterranean diet adherence and weight status on hypertension. The presence of hypertension is clustered with comorbidities, but is significantly associated with modifiable risk factors, including Mediterranean diet and weight status, underlining the need for personalized medical nutritional treatment.

Sodium Intake from Foods Exceeds Recommended Limits in the Spanish Population: The ANIBES Study

Excessive sodium consumption is associated with adverse health effects. An elevated dietary intake of salt (sodium chloride) has been related to high blood pressure or hypertension, a major but modifiable risk factor for cardiovascular disease, as well as to other ill health conditions. In the present work, our aim was to describe the contribution of foods to sodium consumption within the Spanish population in a representative sample from the "anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles in Spain" (ANIBES) study (9-75 years), to identify high consumer groups, as well as the major food groups that contribute to sodium intake in the Spanish diet. Intakes were assessed by 3-day food records collected on a tablet device. Sodium intakes across the ANIBES study population exceeded recommendations, as total intakes reached 2025 ± 805 mg of sodium per day, that is approximately 5.06 g/day of salt (excluding discretionary salt, added at the table or during cooking). Sodium intakes were higher in males than in females and within the youngest groups. Main dietary sources of sodium were meat and meat products (27%), cereals and grains (26%), milk and dairy products (14%) and ready-to-eat meals (13%). Given the established health benefits of dietary salt reduction, it would be advisable to continue and even improve the current national initiatives of awareness and educational campaigns and particularly food reformulation to decrease overall salt intakes across the Spanish population.

Evaluation of ADL and BMI in the management of diabetes mellitus at secondary and tertiary health facilities

AIMS

Physical activities of daily living (ADL) constitutes one of diabetes management options. This study aimed to assess the extent that ADL and BMI are evaluated among diabetes patients in hospital practice.

METHOD

This was a clinical observational baseline study in two hospitals. Audit of medical files was performed to assess if BMI and occupations were recorded (N = 112). Afterwards, 'N = 38' who consented to participate in prospective study were conveniently sampled to assess ADL in relation to accessible metabolic syndrome tests. A validated questionnaire was used to collect data, which were analysed using SPSS version 20.

RESULTS

Audit shows 55/112 of clients' occupation were taken, of which 31% has BMI record. Those with lipid profile results are without blood pressure and vice versa. In the cross-sectional assessment, 74% are in physically demanding ADL occupations, but affirmed inactivity is 98% on leisure exercise. Further, 47% have BMI >25 kg/m2 and were consistently less active on all leisure ADL relative to those with BMI <25 kg/m2 (p < 0.02).

CONCLUSION

This report highlights oversight in clinical practice, whereby accessible metabolic syndrome parameters and occupation of clients living with diabetes are being assessed inconsistently. This implies an unmet need in the integration BMI and occupational information to improve diabetes self-management.

What's new in the ESC 2018 guidelines for arterial hypertension : The ten most important messages

The new guidelines on hypertension of the European Society of Cardiology (ESC) 2018 have refined the treatment cut-offs and therapy decisions in adults. This review highlights important recommendations of the guidelines and also on the situation of hypertension in Austria. The general treatment targets of blood pressure have been lowered to at least 130/80 mmHg for most patients. The definition of hypertension is specified as a repeated systolic blood pressure in the office of ≥140 and or diastolic BP ≥90 mmHg. For home blood pressure monitoring, an average value of ≥135/85 mmHg is now defined as hypertension. Ambulatory 24h-blood pressure measurement is recommended for diagnosis of hypertension and to demask lack of nocturnal blood pressure dipping. Whether drug treatment should be initiated immediately or after a delay with lifestyle intervention is focused on the individual high or low cardiovascular risk of the patients and the degree of hypertension. For most patients a combination therapy with single pill is now recommended as initial therapy for hypertension from the start. The salt consumption should be reduced in the majority of patients. The new guidelines have clarified the treatment of hypertension in different comorbidities.

[Impact of occupational noise in the development of arterial hypertension: A survey carried out in a company of electricity production]

BACKGROUND

Noise pollution is one of the major environmental pollutants that can adversely affect public health. Cardiovascular diseases are the primary out-auditory adverse outcome caused by occupational noise exposure.

AIMS

To investigate the association between occupational exposure to high level of noise and blood pressure among a group of workers in a company of electricity production in the Centre of Tunisia.

MATERIAL AND METHODS

A total of 120 occupational noise-exposed workers and 120 non-exposed employees were recruited to conduct a cross-sectional survey exploring the association between occupational noise-exposed and arterial hypertension. Data collection was based on a questionnaire, a clinical exam and biomarkers. Blood pressure was measured using a mercury sphygmomanometer following a standard protocol. The occupational noise level was measured with a portable calibrated sound meter. Multiple logistic regression was used to calculate the odds ratio (OR) and 95 % confidence interval (CI) of noise exposure adjusted by potential confounders.

RESULTS

The noise level to which our population was exposed ranged from 75dB to 103dB with an average noise level of 89dB. Mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and the prevalence of hypertension were significantly higher in exposed individuals than in non-exposed. In multivariate analysis, elevated SBP in exposed workers was associated with high-salt diet (OR adjusted=1.71, 95% CI adjusted [1.14-1.98]) and occupational seniority more than 8 years (adjusted OR=5.31, 95% CI [2.22-12.72]). The factors associated with high BP in the exposed group were diabetes (OR adjusted to 15.31; 95% adjusted CI [2.61-89.58]), history of hypertension in the family (OR adjusted to 11.46; 95% adjusted CI [5.18-83][1.58-83.05]), mean of age (OR adjusted to 6.65; 95% adjusted CI [1.87-23.59]) and high-salt diet (OR adjusted to 0.29; 95% adjusted CI [0.09-0.95]).

CONCLUSION

Occupational chronic noise exposure was associated with higher levels of SBP, DBP, and the risk of hypertension. These findings indicate that effective and feasible measures should be implemented to reduce the risk of hypertension caused by occupational noise exposure in companies of electricity production.