Dietary Intake Ratios of Calcium-to-Phosphorus and Sodium-to-Potassium Are Associated with Serum Lipid Levels in Healthy Korean Adults

Dietary Calcium-to-Phosphorous Ratio, Metabolic Risk Factors and Lipid Accumulation Product, Skeletal Muscle Mass, and Visceral Fat Area Among Healthy Young Individuals

BACKGROUND

Numerous studies have revealed the role of low dietary calcium-to-phosphorous ratio and low bone health. However, its possible role in visceral adiposity, skeletal muscle mass (SMM), and metabolic parameters has not been investigated before. Therefore, the aim of the current cross-sectional study was to evaluate the relation between dietary calcium-to-phosphorous ratio, metabolic risk factors, SMM, and visceral fat area (VFA) among physically active young individuals.

METHODS

In the current study, the sample was composed of 391 healthy young individuals (e.g., 205 men and 186 women), aged between 20 and 35 years old, who were engaged in moderate physical activity for at least 4 hr per week and were recruited thorough cluster sampling from seven sport clubs. Anthropometric measurements were performed, and VFA and SMM index (SMI) were calculated. Biochemical assays were also performed by standard kits. Data were analyzed by one-way analysis of variance, analysis of co-variance, and multinomial logistic regression analysis using SPSS software.

RESULTS

Those in the fourth quartile of dietary calcium-to-phosphorous ratio were more likely to have lower VFA (odds ratio [OR] = 0.98; 95% confidence interval [CI] [0.97, 0.99]; p = .023) and a nonsignificantly higher SMI (OR = 1.15; 95% CI [0.99, 1.34]; p = .058) after adjustment for the effects of confounders (e.g., age, gender, body mass index, physical activity level, dietary energy intake). Also, being in the third quartile of dietary calcium-to-phosphorous ratio made the subjects more susceptible to have lower insulin concentration (OR = 0.99; 95% CI [0.88, 0.93]; p = .026) in the adjusted model.

CONCLUSION

The findings of the current study revealed that a higher dietary calcium-to-phosphorous ratio in the habitual diet was negatively associated with visceral adiposity and insulin concentrations and higher SMM among physically active young individuals. Further interventional studies are required to confer causality that was not inferable in the current study because of cross-sectional design.

Food consumption and dyslipidemia in middle-aged adults in Indonesia: A cross-sectional national study

Background: Most people with abnormal lipid profiles are found in middle-aged adults in Indonesia. Unhealthy food consumption was positively associated with dyslipidemia. In contrast, healthy food consumption, including fruits and vegetables, was inversely associated with dyslipidemia. Aim: The aim of the study was to explore the association between food consumption with dyslipidemia among middle-aged adults in Indonesia. Methods: This is a cross-sectional study using secondary data from the national representative survey of Indonesian Basic Health Research (IBHR) conducted by the National Institute of Health Research Development (NIHRD), Ministry of Health, Indonesia, in 2018. The study recruited 10,608 participants aged from 45 to 59 years old. An unadjusted or adjusted odds ratio (OR) and 95% confidence intervals (CIs), and a multivariate logistic regression model were performed to evaluate the associations of food consumption with dyslipidemia. Results: Frequent consumption of barbecue and soft drink was significantly correlated with dyslipidemia (OR = 1.149, CI: 1.055-1.251 and OR = 1.202, CI: 1.041-1.388). Frequent consumption of soft drink, and inadequate intakes of fruits and vegetables were significantly correlated with dyslipidemia (OR = 1.254, CI: 1.012-1.553, OR = 1.178, CI: 1.013-1.388, OR = 1.219, CI: 1.011-1.471, respectively) in men. While, frequent consumption of barbecue was significantly correlated with dyslipidemia (OR = 1.203, CI: 1.068-1.355) in women. Conclusion: Frequent consumption of barbecue and soft drink increased the risk of developing dyslipidemia among middle-aged adults in Indonesia.

Association between dietary calcium to Phosphorus Ratio and the odds of ulcerative colitis: A case-control study

Background & aims

Ulcerative colitis (UC) is a recurrent, inflammatory, autoimmune intestinal disease. The dietary calcium to phosphorus (Ca:P) ratio is suggested to affect the inividuals' normal metabolic and inflammatory pathways. The present study aimed to investigate the association between dietary Ca:P ratio and the odds of developing UC in a case-control format.

Methods

The study included sixty-two currently diagnosed UC patients and one hundred twenty-four matched controls, designed as a case-control study. The dietary intakes of the participants were assessed by a food frequency questionnaire (FFQ), and the dietary Ca:P ratio was calculated. The association between tertiles of Ca:P ratio and UC was examined using the logistic regression. P-values <0.05 were considered as significant.

Results

The study sample consisted of participants with an average age of 36.63 ± 12.42 years and a mean body mass index (BMI) of 25.39 ± 3.82 kg/m2. The overall energy-adjusted ratio of Ca:P was 0.74 ± 0.11. In the multivariate model, after adjustment for potential confounders, participants in the third tertile of dietary Ca:P ratio had a lower odds of developing UC compared to the lowest tertlie (OR: 0.34, 95% CI: 0.13-0.87; p = 0.026).

Conclusion

Our results indicate that a higher ratio of dietary Ca:P ratio might be protective against developing UC. However, further studies are warranted to examine this association in various populations.

Nutritional profiling of some selected commercially important freshwater and marine water fishes of Bangladesh

The purpose of the study was to investigate the proximate composition and mineral content of Bangladesh's economically important freshwater and marine water fish. Proximate composition and mineral content was determined according to the Association of Official Agricultural Chemists (AOAC) standard method. All of the factors had a substantial variation (p < 0.05), according to the findings. The maximum protein content was observed in Lates calcarifer (18.673%) and minimum in Pangasius pangasius (15.616%). The content of lipid among the species varied from 0.316% to 13.396%, with Mugil cephalus having the highest lipid content and Channa striata having the lowest. The moisture content ranges from 68.343% to 81.160%. All the fishes have an average ash content of 0.850%–4.350%. The energy content is also significantly higher in marine water fishes. The mineral content was highly variable. Calcium content was lowest in Pangasius pangasius (0.555%) and highest in Setipinna phasa (3.495%). The magnesium content ranged between 0.281% and 1.885%. Phosphorus was lowest in Lepturacanthus savala (0.826%) and highest in Setipinna phasa (2.114%). The amount of sodium, potassium, and sulfur was relatively less for all fish species but there were substantial differences across the twelve samples. The PCA biplot's for proximate composition analyses has demonstrated positive affinity only between Lates calcarifer and Mugil cephalus in case of ash, lipid, and carbohydrate whereas Setipina phasa, Mugil cephalus, Lutjanus lutjanus, and Oreochromis mossambicus were grouped together with magnesium, phosphorus, calcium, and sulfur in the case of mineral content. Overall, the marine water fishes can be a good food item in terms of nutrition which could provide better health benefits for human.

Temporal Relationship Between Changes in Serum Calcium and Hypercholesteremia and Its Impact on Future Brachial-Ankle Pulse Wave Velocity Levels

Background: The high levels of serum calcium and cholesterol are the important risk factors of cardiovascular disease (CVD), which frequently influence each other during the development of CVD. However, few studies have examined their temporal relationship to confirm the precursor, and it is still largely unknown whether and how their temporal relationship would influence the development of CVD. This study aimed to establish the temporal relationship between the changes in serum calcium and cholesterol using the longitudinal cohort data, and examine whether this temporal relationship influenced the arterial elasticity indicated by brachial-ankle pulse wave velocity (baPWV). Methods: This is a cohort study with a sample of 3,292 Chinese participants (aged 20-74 years) with 5.7 years follow-up. Serum calcium and cholesterol were measured at baseline and follow-up survey. The cross-lagged path analysis was used to examine their temporal relationship, and mediation analysis was performed to evaluate the potential mediating effect. Results: The cross-lagged path coefficients (β₂ values) from baseline serum calcium to follow-up cholesterol was significantly greater than the path coefficients (β₁ values) from baseline cholesterol to follow-up serum calcium (β₂ = 0.110 vs. β₁ = 0.047; P = 0.010) after adjusting for the multiple covariates. The path coefficients from baseline serum calcium to follow-up cholesterol in the participants with high baPWV was significantly greater than the participants with low baPWV (β₂ = 0.155 for high baPWV and β₂ = 0.077 for low baPWV, P = 0.028 for the difference between the β₂ values). Moreover, cholesterol partially mediated the association between the higher serum calcium and greater subsequent baPWV values, the percentage of the total effect mediated by cholesterol was estimated at 21.7%. Conclusion: Our findings indicate that increased serum calcium precedes increased in serum cholesterol, and this temporal relationship may contribute to the development of higher baPWV levels.

Nutritional profile of wild, pond-, gher- and cage-cultured tilapia in Bangladesh

The proximate, minerals, amino acid and fatty acid composition of wild, pond-, gher- and cage-cultured tilapia in Bangladesh were evaluated and varied significantly (p < 0.05). The major component of the tilapia was moisture (79.12%-81.36%), followed by protein (14.93%-16.03%), lipid (0.59%-2.35%), carbohydrate (1.23%-1.51%), fibre (0.47%-0.88%), ash (0.31%-0.53%); the energy value was between 97.62 and 126.73 kcal/100 g. Macro-nutrients and micro-nutrients were detected in following order: K > Na > Mg > Ca and Fe > Mn, respectively in all the tilapia and the ratio of Na/K was <1. Essential amino acids, leucine (1.47-1.56 g/100 g) and lysine (1.66-1.74 g/100 g), were the predominant amino acids in tilapia, followed by non-essential amino acids, aspartic acid (1.72-1.84 g/100 g) and glutamic acid (2.88-3.07 g/100 g). Saturated palmitic acid (25.4%-35.54%), monounsaturated elaidic acid (31.51%-35.63%) and polyunsaturated linolenic acid (17.69%-22.57%) were the main fatty acids found in tilapia. The desirable protein percentage, Na/K ratio, the presence of essential amino acids, leucine and lysine, n-3 and n-6 fatty acid contents proved that the consumption of wild, pond-, gher- and cage-cultured tilapia are beneficial to human health and could be recommended to prevent different diseases particularly of cardiovascular type.

Influence of Habitual Dairy Food Intake on LDL Cholesterol in a Population-Based Cohort

BACKGROUND

Cholesterol has a pivotal role in human physiology, exerting both structural and functional activity. However, higher blood cholesterol levels, especially low-density lipoprotein cholesterol (LDL-C), are a major cardiovascular risk factor. Therefore, special attention has been given to the effect of dietary factors in influencing LDL-C blood levels. In particular, much research has focused on dairy products, since they are a main component of different dietary patterns worldwide. A large body of evidence did not support the hypothesis that dairy products significantly increase circulating LDL-C, but no definitive data are available. Hence, we aimed to assess the relationships among LDL-C, habitual dairy food intake and anthropometric variables in a cohort representative of the general population in a Mediterranean area.

METHODS

We evaluated 802 healthy adults included in the ABCD_2 (Alimentazione, Benessere Cardiovascolare e Diabete) study (ISRCTN15840340), a longitudinal observational single-center study of a cohort representative of the general population of Palermo, Sicily. The habitual intake of dairy products was assessed with a validated food frequency questionnaire, and LDL-C serum levels and several anthropometric parameters were measured.

RESULTS

The group with high LDL-C serum concentrations (≥130 vs. <130 mg/dL) exhibited higher age, body mass index (BMI), waist-to-hip ratio (WHR), body fat percentage, systolic and diastolic blood pressure, carotid intima-media thickness and glycated hemoglobin. The habitual diet was not different between the groups in terms of macronutrient, cholesterol, egg and dairy food intake, with the exception of the weekly number of portions of milk (higher in the low LDL-C group vs. the high LDL-C group) and ricotta cheese (higher in the high LDL-C group vs. the LDL-C group). No significant correlation was found between LDL-C blood levels and the habitual intake of dairy products or the dietary intake of cholesterol and fats. The multivariate regression analyses (R2 = 0.94) showed that LDL-C blood levels were significantly associated with the habitual intake of milk (p < 0.005) and ricotta cheese (p < 0.001) and with BMI (p < 0.001).

CONCLUSION

Our study reported that total dairy food consumption was not correlated with LDL-C blood levels. However, multivariate analyses showed an inverse association between serum LDL-C and milk intake as well as a positive association between ricotta cheese intake and LDL-C concentrations. More studies are needed to better characterize the relationship between dairy products and circulating LDL-C.

Dietary sodium:potassium ratio and CVD risk factors among Japanese adults: a retrospective cross-sectional study of pooled data from the National Health and Nutrition Survey, 2003-2017

Few studies have reported associations between the Na:K ratio and risk factors related to CVD among the general population in Asian countries. This study aimed to investigate the dietary Na:K ratio association with CVD risk factors among Japanese adults. This retrospective cross-sectional study included 48 800 Japanese participants (19 386 men and 29 414 women) aged ≥20 years, registered in the 2003-2017 National Health and Nutrition Survey. Multivariate OR and 95 % CI for risk of hypertension, high glycated HbA1c levels, hypercholesterolaemia, low serum levels of HDL-cholesterol and high non-HDL-cholesterol levels according to the Na:K ratio were estimated using logistic regression models. Dietary Na:K ratio decreased for both men and women from 2003 to 2017. Higher Na:K ratio and higher hypertension prevalence were observed (multivariate OR (fifth v. first quintiles) 1·27, 95 % CI 1·15, 1·40; Pfor trend < 0·001 for men and 1·12, 95 % CI 1·01, 1·23; Pfor trend = 0·007 for women). Higher Na:K ratio was associated with higher prevalence of high HbA1c levels in men (multivariate OR 1·56, 95 % CI 1·24, 1·96). Prevalence of low HDL-cholesterol levels was increased with higher Na:K ratio (Pfor trend =0·002 for men and <0·001 for women). No significant associations were found between Na:K ratio and hypercholesterolaemia in men or high non-HDL-cholesterol levels in both men and women. Our findings suggest that dietary Na:K ratio is associated with several CVD risk factors among Japanese adults.

Association between Dietary Cholesterol and Their Food Sources and Risk for Hypercholesterolemia: The 2012⁻2016 Korea National Health and Nutrition Examination Survey

It remains unclear whether cholesterol intake can increase serum cholesterol. Therefore, the present study aimed to investigate the hypothesis that the risk for hypercholesterolemia was not associated with intake of dietary cholesterol after adjusting for saturated fatty acid (SFA). Based on the data from the 2012–2016 KNHANES, dietary cholesterol was positively associated with the risk for abnormalities in total cholesterol (TC) (odds ratio (OR): 1.153, 95% confidence interval (CI): 0.995–1.337; p = 0.028) and low-density lipoprotein cholesterol (LDL-C) (OR: 1.186, 95% CI: 1.019–1.382; p = 0.018) levels before adjusting for SFA; after adjusting for SFA, no significant associations were found between these variables. The mediation analysis showed that dietary cholesterol had no direct effects on the serum levels of TC and LDL-C; in contrast, SFA had significant indirect effects on the association between dietary cholesterol and serum levels of TC and LDL-C. Furthermore, processed meats, but not eggs and other meats, were positively associated with the risk for abnormalities in both TC (OR: 1.220, 95% CI: 1.083–1.374; p = 0.001) and LDL-C (OR: 1.193, 95% CI: 1.052–1.354; p = 0.004) levels. The present study suggested that higher intake of processed meats with high SFA, but not dietary cholesterol was associated with higher risk for abnormalities in TC and LDL-C levels.

Association of dietary sodium:potassium ratio with the metabolic syndrome in Chinese adults

Several epidemiological studies have investigated that Na or K intakes might be associated with the metabolic syndrome (MetS). However, little evidence has evaluated the association between Na:K ratio and the MetS. In this study, we assessed the association between the dietary Na:K ratio and the MetS. The cross-sectional study was conducted among adults aged 18 years and older in Nanjing, using a multi-stage random sampling method, which resulted in a sample size of 1993 participants. Dietary Na and K intakes were assessed by 3 consecutive days of dietary recollection combined with condiments weighing method. Health-related data were obtained by standardised questionnaires, as well as physical examinations and laboratory assessments. The prevalence rate of the MetS was 36·5 % (728/1993). After adjusting for various lifestyle and dietary factors of the MetS, participants in the highest quartile of dietary Na:K ratio were at a higher risk of developing MetS (OR=1·602; 95 % CI 1·090, 2·353) compared with those in the lowest quartile. Each 1-sd increase in dietary Na:K ratio was associated with a higher risk of prevalent MetS (OR=1·166; 95 % CI: 1·018, 1·336). Among the components of the MetS, dietary Na:K ratio was positively associated with high blood pressure (quartile 3 v. quartile 1: OR=1·656; 95 % CI 1·228, 2·256) and hypertriacylglycerolaemia (quartile 4 v. quartile1: OR=1·305; 95 % CI 1·029, 1·655) in multivariate analysis. These results revealed that higher dietary Na:K ratio significantly increased the risk of the MetS in Chinese adults. Further studies are needed to verify this association.

Comparison of sodium, potassium, calcium, magnesium, zinc, copper and iron concentrations of elements in 24-h urine and spot urine in hypertensive patients with healthy renal function

Sodium, potassium, calcium, magnesium, zinc, copper and iron are associated with the sequela of hypertension. The most reliable method for testing those elements is by collecting 24-h urine samples. However, this is cumbersome and collection of spot urine is more convenient in some circumstance. The aim of this study was to compare the concentrations of different elements in 24-h urine and spot urine.

METHODS

Data was collected from a sub-study of China Salt Substitute and Stroke Study. 240 participants were recruited randomly from 12 villages in two counties in Ningxia, China. Both spot and 24-h urine specimens were collected from each patient. Routine urine test was conducted, and concentration of elements was measured using microwave digestion and Inductively Coupled Plasma-Optical Emission Spectrometry. Partial correlation analysis and Spearman correlation analysis were used to investigate the concentration of different elements and the relationship between 24- h urine and spot urine.

RESULTS

A partial correlation in sodium, potassium, calcium, magnesium and iron was found between paired 24-h urine and spot urine samples except copper and zinc: 0.430, 0.426, 0.550, 0.221 and 0.191 respectively.

CONCLUSIONS

Spot urine can replace 24-h urine for estimating some of the elements in hypertensive patients with normal renal function.

Mechanisms of calcium intake in lowering serum cholesterol levels

Cardiovascular diseases (CVDs), a group of disorders of the heart and blood vessels, are the leading cause of death globally. An estimated 17.1 million people die of CVDs each year, more than 40% of whom die from coronary heart disease (CHD). Hypercholesterolemia is a major risk factor for increasing CHD morbidity and mortality, and serum cholesterol level is a key predictor of CHD development. A number of studies have demonstrated that calcium supplement can lower serum cholesterol levels, which means that calcium might play an important role in preventing the development of CVDs, especially CHD. In this paper, the mechanisms of calcium intake in lowering serum cholesterol levels are summarized, including increasing the excretion of bile acids, interfering with cholesterol absorption, inhibiting the absorption of saturated fatty acids, promoting energy metabolism, regulating plasma 1,25(OH)₂D levels, affecting blood insulin sensibility and controlling appetite.

A pilot study to validate a standardized one-week salt estimation method evaluating salt intake and its sources for family members in China

The objective of this study was to develop a new method named the “one-week salt estimation method” that could estimate an individual’s salt intake and the sources of salt in the diet, and to evaluate this new method with a 24-h urine collection. The new method estimates salt intake from: (1) household cooking by weighing the family salt container and other high-salt condiments or sauces at the beginning and end of a week; (2) processed food according to established China food composition figures; and (3) cafeteria or restaurant meals using the results of previous studies. Consumption of salt additives and major salt contained foods and salt intake related eating habits were collected using a structured simple seven-day questionnaire. In order to validate the method, we studied 37 individuals from 11 families using the new method and 26 of these participants collected seven concurrent 24-h urine samples. The average salt intake for the 26 participants was 15.6 ± 5.5 g/person/day (mean ± standard deviation) by the 24-h urine collection and 13.7 ± 6.5 g/person/day by the new method. The difference was 1.8 ± 4.2 g/day/person (p = 0.037). The Pearson correlation coefficient was 0.762 (p < 0.001) and the partial correlation coefficient was 0.771 (p < 0.001) when adjusted for family code. Bland-Altman Plot showed the average of the difference between the two methods was −1.83, with 95% limits of −10.1 to 6.5 g/person/day. The new method showed that 43.7% of salt intake came from household cooking (33.5% from cooking salt, 10.2% from other condiments and sauces), 12.9% from processed food, and 43.4% from eating out. In conclusion, despite its limitations of underestimating salt intake, the “one-week salt estimation method” is easier for people to implement and is likely to provide useful information that highlights the excessively high intake of salt and its sources, and in turn is helpful in guiding dietary salt reduction.