Sodium-to-potassium ratio and blood pressure, hypertension, and related factors

Metabolic risk factors, blood pressure and atherogenic indices of cardiovascular disease across different quartiles of dietary sodium to potassium ratio among young semi-professional athletes with overweight or obesity

BACKGROUND

Previous studies have revealed the role of the dietary sodium-to-potassium ratio in predicting cardiovascular and total mortality. However, a limited number of studies have investigated the association between the dietary sodium-to-potassium ratio and individual biomarkers of metabolic disease in athletes. In this study, we aimed to compare metabolic, atherogenic, and anthropometric risk factors for cardiovascular disease across different quartiles of the dietary sodium-to-potassium ratio among young semi-professional athletes with overweight or obesity.

METHODS

In this cross-sectional study, 637 young semi-professional athletes, aged 20-40 years, were selected from active athletic and fitness clubs. Anthropometric measurements were performed, and fasting blood sugar, serum lipids, and lipoprotein (a) [Lp(a)] were measured. Atherogenic indices, including the atherogenic index of plasma (AIP), Castelli risk index (CRI)-I, CRI-II, and lipid tetrad index (LTI), were calculated.

RESULTS

Participants in the highest quartile of the dietary sodium-to-potassium ratio were younger and had a higher waist-to-hip ratio (WHR) compared to those in the lowest quartile. Additionally, those in the highest quartile showed significantly higher serum total cholesterol and Lp(a) concentrations after adjusting for confounding factors (P < 0.05).

CONCLUSION

Our findings suggest that individuals in the higher quartiles of the dietary sodium-to-potassium ratio exhibit less favorable serum lipid profiles. Further longitudinal and interventional studies are needed to clarify the potential therapeutic role of reducing the dietary sodium-to-potassium ratio in managing cardiovascular disease risk factors.

Impact of altitudinal variations on plant growth dynamics, nutritional composition, and free living rhizospheric N2 fixing bacterial community of Eruca sativa

High-altitude environments present unique abiotic stresses, yet their impact on the growth, nutritional quality, and rhizospheric interactions of E. sativa remains underexplored. Here, we investigate the altitudinal variations in growth dynamics, nutritional composition, and rhizospheric free-living N2-fixing bacteria (NFBs) of E. sativa (Arugula) grown at higher (3,524 m, Leh-Ladakh) and lower (321 m, Chandigarh) altitudes. Results revealed significant physiological adaptations to high-altitude conditions, with increased concentrations of magnesium (748.84 ± 4.06 mg/100 g), iron (189.83 ± 2.16 mg/100 g), and manganese (8.48 ± 0.27 mg/100 g), while potassium (3,400.83 ± 3.82 mg/100 g), sodium (175.83 ± 1.44 mg/100 g), and copper (1.69 ± 0.01 mg/100 g) were higher at lower-altitude. Zinc content remained unchanged. Notably, dietary nitrate was higher (155.67 ± 22.12 mg/100 g) at high-altitudes. Rhizospheric NFBs were isolated and functionally characterized for N2-fixation efficacy along with various plant growth-promoting (PGP) attributes; viz., production of ammonia, siderophores, HCN, IAA and phosphate solubilization. Field inoculation with selected strains significantly enhanced nitrogen content and plant growth. Soil chemical analysis further revealed significant differences between the altitudes. A total of twenty-seven NFBs belonging to Actinobacteria (77%), Proteobacteria (11%), Firmicutes(8%), and Bacteroidetes(4%) were isolated, with Streptomyces being the predominant genus, exhibiting distinct species at different altitudes. Remarkably, high-altitude strains showed significantly higher N2-fixing efficiencies (88.15 ± 17.41 µgN mL-1) than lower-altitude (65.7 ± 14.36 µgN mL-1) along with superior PGP traits. Overall, these findings suggest that E. sativa, enriched in key nutrients at high-altitudes, could be a valuable functional food crop, addressing the dietary needs of high-altitude populations. Furthermore, the rhizospheric NFBs identified in this study may be potentially beneficial for the development of novel bio-fertilizers, promoting eco-friendly agricultural practices through improved N2-fixation. Further field trials are recommended to validate their potential for sustainable crop production.

A cross-sectional study of the relationship between health literacy and health-promoting lifestyles in patients with hypertension in northwest Iran

BACKGROUND

Health literacy is a key factor in determining the use of health-related information, promoting health, and improving the quality of life. Therefore, the present study was conducted to investigate the relationship between health literacy and health-promoting lifestyle in patients with hypertension.

METHODS

The present study was conducted using a descriptive-correlation method on 406 patients with hypertension who visited the emergency room of a northwestern Iranian hospital in 2022. The sampling method was convenient in type. The data collection instrument consisted of three parts, including the demographic information section, followed by the health literacy and health-promoting lifestyle sections. The inferential data analysis was done using Pearson's correlation coefficient, and multiple linear regression in SPSS 24 (Inc., Chicago, Ill., USA). The significance level was set at 5%.

RESULTS

The mean and standard deviation of participants' age was 53.77 ± 13.79 years, within a range of 47 to 65 years. The results showed that a health-promoting lifestyle has a positive and significant relationship with health literacy (r = 0.927, p < 0.001). The health-promoting lifestyle had the highest correlation with the decision-making dimension (r = 0.913, p = < 0.001) and the lowest correlation with the reading dimension (r = 0.772, p = < 0.001). The results of linear regression showed that the dimensions of reading, understanding, appraisal, and decision-making were statistically significant in the regression model. The decision-making dimension with a coefficient of 0.592 had the greatest impact on the health-promoting lifestyle.

CONCLUSION

The moderate health literacy level among patients with hypertension is associated with lower adherence to healthy lifestyle practices. Therefore, it is essential for community health policymakers to organize the design of educational program interventions in the areas of health literacy and healthy lifestyle practices to help improve the overall health of patients.

NMR-based metabolomics and pathway analysis of leaves and fruits of Cucumis melo L. cultivated under saline stress conditions

The consumption of healthy food has become increasingly present and eating fresh, quality fruit is part of this trend. Nevertheless, the scarcity of fresh water and the increasing demand for food have been driving the search for more sustainable agricultural practices worldwide. In this context, cultivation with lower-quality water, characterized by a high concentration of salts, emerges as alternative to enhance water use efficiency and ensure food security in regions prone to water scarcity. In this regard, the aim of this work was to use an NMR-based metabolomics approach to investigate the growth and metabolomic profile of yellow melon fruits and leaf cultivated under water salinity conditions (1.5, 2.5, and 4.5 dS m-1). The research was conducted in a protected environment at Embrapa Agroindústria Tropical (3°44'S, 38°33'W, altitude 19.5 m, Fortaleza, Ceará, Brazil). Melon plants (yellow type, inodorous group, non-climacteric) were grown in 12 L pots filled with coconut fiber substrate and irrigated using a drip irrigation system. Salinity reduced fruit weight and metabolic activity, but did not significantly alter soluble solids content. Metabolic profile determinate by NMR showed that essential pathways in the leaves produced metabolites for defense, energy maintenance, and cellular integrity, minimizing the impact on fruit composition. Under salinity, hexoses (glucose and fructose) were more efficiently converted into sucrose, indicating that melon plants maintain its essential metabolism in leaves under saline stress, enhancing tolerance. The increased sucrose content in the fruit, important for consumers, is preserved, making melon a viable option for implementation of efficient water use strategies.

Potassium-Based Sodium Substitutes Impact the Sodium and Potassium Content of Foods

OBJECTIVE

Potassium-based sodium substitutes (PBSS) can be used to replace sodium during food processing. How potassium and sodium content is associated with PBSS is not known. The objectives of the study were to describe the prevalence of PBSS by sodium content claim category and describe how PBSS are associated with sodium and potassium concentrations by sodium level.

DESIGN AND METHODS

This cross-sectional analysis used the July 2018 version of the United States Department of Agriculture's Branded Food Products Database. Products were divided into sodium content claim category and were analyzed for the presence of PBSS. Products with nonmissing values for sodium and potassium were grouped by sodium level and analyzed for the prevalence of PBSS to explore potassium and sodium concentration. Column proportion z-test with the Bonferroni correction was used to explore the occurrence of PBSS by sodium content claim category. Mann-Whitney U-test was used to assess differences in potassium and sodium concentrations across sodium levels and within levels by the presence/absence of PBSS.

RESULTS

The prevalence of PBSS in the categories "without a sodium content claim" (2.4%), "lightly salted" (0.5%), and "unsalted" claims (0.6%) were statistically significantly lower than prevalence of PBSS in the "sodium free" (9.5%), "low sodium" (10.3%), and "reduced sodium" claim categories (23.3%; all P < .01). Among the group of products with serving sizes more than 30 g containing PBSS, there was a 357 mg per serving higher median sodium concentration and a 160 mg per serving higher median potassium concentration compared to the group without PBSS (both P < .01).

CONCLUSION

In the "reduced sodium" claim category, a higher prevalence of PBSS was found compared to other sodium claim categories. The presence of PBSS was associated with higher potassium and sodium concentrations in foods.

Role of dietary potassium and salt substitution in the prevention and management of hypertension

Cardiovascular diseases (CVD) continue to be the leading cause of deaths and disability worldwide and the major contributor is hypertension. Despite all the improvements in detecting hypertension together with technological advances and affordable, efficacious and relatively free of adverse effects anti-hypertensive agents, we continue to struggle to prevent the onset of hypertension and to control blood pressure (BP) to acceptable targets. The poor control of hypertension is commonly due to non-adherence to medications. Another reason is the failure to adopt diet and lifestyle changes. Reduction of dietary salt intake is important for lowering BP but the role of potassium intake is also important. Globally the intake of sodium is double that of the recommended 2 gm per day (equivalent to 5 gm of sodium chloride/salt) and half that of the daily recommended intake of potassium of 3500 mg/day, giving a sodium-to-potassium ratio of >1, when ideally it should be <1. Many studies have shown that a higher potassium intake is associated with lower BPs, particularly when coupled concurrently with a lower sodium intake giving a lower sodium to potassium ratio. Most hypertension guidelines, while recommending reduction of salt intake to a set target, do not specifically recommend a target for potassium intake nor potassium supplementation. Here we review the role of potassium and salt substitution with potassium in the management of hypertension. Hence, the focus of dietary changes to lower BP and improve BP control should not be on reduction of salt intake alone but more importantly should include an increase in potassium intake.

The association of schooling, sibling life situation, and dietary habits with the estimated 24-h urinary salt excretion and sodium-to-potassium ratio in 3-year-old children

OBJECTIVES

We examined the association of schooling, sibling life situation, and dietary habits with the estimated 24-h urinary salt excretion and the urinary sodium-to-potassium (Na/K) ratio in 3-year-old children.

METHODS

The subjects were 639 children who underwent a health checkup in four cities and towns in Kyoto Prefecture from January to November 2019. The children's parents answered questionnaires about weekday childcare places, the birth order, and the awareness of reducing the salt intake. The questions on food intake frequency included 10 items. The estimated 24-h salt excretion and Na/K ratio were calculated from the participants' first voiding urine in the morning.

RESULTS

Data were available for 294 children. The median (interquartile range (IQR)) of salt excretion (g/day) was 2.6 (1.7-3.4), and urinary Na/K ratio (mmol ratio) was 2.6 (1.6-4.1). Multinomial logistic regression analysis showed that the group with older siblings was significantly associated with high salt (odds ratio 1.89 (95% confidence interval 1.04 to 3.46)). In the urinary Na/K ratio, the nursery group had a significantly lower Na/K (odds ratio 0.32 (0.17 to 0.60)). High processed meat products intake was associated with a higher Na/K (odds ratio 1.96 (1.05-3.66)), whereas high vegetable intake was associated with a lower Na/K (odds ratio 0.45 (0.23-0.87)). Other factors showed no significant associations.

CONCLUSIONS

In Japanese 3-year-old children, the estimated 24-h urinary salt excretion was associated with older siblings, and the urinary Na/K ratios were associated with schooling situation and the intake of processed meat products and vegetables.

Characterization, ultrafiltration, depolymerization and gel formulation of ulvans extracted via a novel ultrasound-enzyme assisted method

Sea lettuce, or Ulva spp., dominates global algal biomass and significantly contributes to "green tides.", representing a sustainable source for biomaterials. This study explores an innovative ultrasound-enzyme assisted extraction method with the novel Cellic® CTEC3 enzyme cocktail, applied for the first time in Ulva spp. succesfully enhancing ulvan release and extraction efficiency. Various processing methods, including ultrafiltration and dialysis, were employed to achieve higher ulvan purity. Dialyzation of ulvan resulted in a more purified product with a carbohydrate content up to 55.34 %, a sulfate content up to 21 %, and no glucose contamination. Liquid extracts were fractionated through ultrafiltration, with a 3 kDa MWCO yielding 93.51 % ulvan precipitate, representing 50.28 % of the total extractable ulvan. Sequential ultrafiltration concentrated ulvans but only partially modified their molecular weight distribution. Depolymerization using microwave and H2O2 shifted ulvans towards lower molecular weights, reducing high molecular weight residue. HPSEC confirmed pH-dependent aggregation behavior, with all isolated ulvans having molecular weights above 786 kDa. Hydrolysis methods were compared, with 2-hour 1 M TFA hydrolysis at 121 °C providing the best monosaccharide profile of ulvan. FTIR and NMR analyses showed preservation of sulfation. Rheology indicated biopolymeric behavior and stable gel formation. Ulvans demonstrated nutraceutical potential, being suitable for a low Na+ and high K+ diet, with a Na+:K+ ratio as low as 0.14, and were rich in Mg2+.

Global Associations of the Traditional Japanese Diet Score with Hypertension Prevalence and Systolic Blood Pressure from 2009 to 2019: A Cross-Sectional and Longitudinal Ecological Study

OBJECTIVE

Prevention and improvement of hypertension is one of the most important health issues worldwide. The traditional Japanese diet contributes to the prevention of some non-communicable diseases associated with hypertension. However, whether traditional Japanese dietary patterns are associated with hypertension prevalence and systolic blood pressure (SBP) worldwide remains unknown. In this study, we aimed to investigate whether the traditional Japanese diet score (TJDS) is associated with hypertension prevalence and SBP.

METHODS

This cross-sectional and longitudinal ecological study from 2009 to 2019 included 141 countries with a population of at least 1 million. All data used for analysis were obtained from internationally available databases. The TJDS was calculated using country-specific supplies of five foods commonly eaten in the traditional Japanese diet (rice, fish, soybean, vegetables, and egg) and three less commonly eaten foods (wheat, milk, and red meat). Hypertension was defined by SBP ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or use of antihypertensive medications. The mean SBP was >25 age-standardized data. A general linear model was used for the cross-sectional model in 2009, and a linear mixed model was used for the longitudinal analysis from 2009 to 2019. The covariates included gross domestic product, percentage of population aged >65 years, years of education, smoking rate, average body mass index, physical activity, and energy supply.

RESULTS

The TJDS was negatively associated with hypertension prevalence (β ± standard error: -0.861 ± 0.202, p < 0.001) and SBP (β ± standard error: -0.364 ± 0.154, p < 0.05) in the cross-sectional analysis. The TJDS was significantly negatively associated with hypertension prevalence (β ± standard error: -0.845 ± 0.200, p < 0.001) and SBP (β ± standard error: -0.312 ± 0.149, p < 0.05) in the 10-year longitudinal analysis controlled for full covariables.

CONCLUSIONS

Traditional Japanese dietary patterns are associated with lower hypertension prevalence and SBP worldwide.

Consumption of processed meat but not red meat is associated with the incidence of hypertension: ELSA-Brasil cohort

OBJECTIVES

To verify the association between the consumption of red and processed meats and the incidence of hypertension in participants of the Longitudinal Study of Adult Health.

METHODS

This was a cohort with data from the baseline (2008-2010) and second wave (2012-2014) with 8,089 public workers of both sexes and different racial groups, with mean age of 49 ± 8 years (35-74 years old). Meat consumption (g/d) was estimated using a food frequency questionnaire and was divided into consumption tertiles. Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic ≥90 mm Hg and/or antihypertensive medication. Cox proportional hazards models were used to estimate adjusted Hazard Ration (HRs) and 95% confidence interval (CI) for incident hypertension.

RESULTS

A total of 1186 incident cases of hypertension were identified. Even adjusting for confounders, such as urinary Na/K (sodium/potassium) ratio and BMI (body mass index), participants in the second (HR:1.19; 95% CI 1.03-1.30) and third (HR:1.30; 95% CI:1.11-1.53) tertile of processed meat consumption had a higher risk of developing hypertension than those in the first tertile. We did not find a significant association between red meat consumption and hypertension.

CONCLUSIONS

The increased risk of developing hypertension is associated with moderate and high consumption of processed meats but not with consumption of red meat.

Diet to Stop Hypertension: Should Fats be Included?

PURPOSE OF REVIEW

International guidelines emphasize advice to incorporate dietary measures for the prevention and in the management of hypertension. Current data show that modest reductions in weight can have an impact on blood pressure. Reducing salt and marine oils have also shown consistent benefit in reducing blood pressure. Whether other dietary constituents, in particular the amount and type of fat that play important roles in cardiovascular prevention, influence blood pressure sufficiently to be included in the management of hypertension is less certain. In this review, we provide a summary of the most recent findings, with a focus on dietary patterns, fats and other nutrients and their impact on blood pressure and hypertension.

RECENT FINDINGS

Since reducing salt consumption is an established recommendation only corollary dietary advice is subject to the current review. Population studies that have included reliable evaluation of fat intake have indicated almost consistently blood pressure lowering with consumption of marine oils and fats. Results with vegetable oils are inconclusive. However dietary patterns that included total fat reduction and changes in the nature of vegetable fats/oils have suggested beneficial effects on blood pressure. Plant-based foods, dairy foods and yoghurt particularly, may also lower blood pressure irrespective of fat content. Total fat consumption is not directly associated with blood pressure except when it is part of a weight loss diet. Consumption of marine oils has mostly shown moderate blood pressure lowering and possibly greatest effect with docosahexaenoic acid-rich oil.

Sustainability and cost of typical and heart-healthy dietary patterns in Australia

Study objective

The aim was to quantify and compare the environmental and financial impact of two diets: a heart-healthy Australian diet (HAD) and the typical Australian diet (TAD).

Design

The study involved a secondary analysis of two modelled dietary patterns used in a cross-over feeding trial.

Setting

The evaluation focused on two-week (7-day cyclic) meal plans designed to meet the nutritional requirements for a reference 71-year-old male (9000 kJ) for each dietary pattern.

Main outcome measures

The environmental footprint of each dietary pattern was calculated using the Global Warming Potential (GWP*) metric, taking into account single foods, multi-ingredient foods, and mixed dishes. Prices were obtained from a large Australian supermarket.

Results

The HAD produced 23.8 % less CO2 equivalents (CO2e) per day (2.16 kg CO2e) compared to the TAD (2.83 kg CO2e per day). Meat and discretionary foods were the primary contributors to the environmental footprint of the TAD, whereas dairy and vegetables constituted the largest contributors to the HAD footprint. However, the HAD was 51 % more expensive than the TAD.

Conclusion

Transitioning from a TAD to a HAD could significantly reduce CO2 emissions and with benefits for human health and the environment. Affordability will be a major barrier. Strategies to reduce costs of convenient healthy food are needed. Future studies should expand the GWP* database and consider additional environmental dimensions to comprehensively assess the impact of dietary patterns. Current findings have implications for menu planning within feeding trials and for individuals seeking to reduce their carbon footprint while adhering to heart-healthy eating guidelines.

Proximate composition, fatty acid characteristics, amino acid profile and mineral content of fish Acanthurus sohal

The study's objective was to explore the chemical composition of Acanthurus sohal fish flesh and their nutritional quality. Fish samples were caught in the Red Sea, prepared, and analysed for proximate composition, fatty acid, amino acid and mineral content. The results revealed that fish flesh contained 71.1 % moisture, 20.7 % crude protein, 5 % crude lipids and 1.7 % ash. The fatty acids were dominant by 61.93 % saturated fatty acids. Palmitic was the most common (40.35 %) saturated fatty acids, while monounsaturated fatty acids and polyunsaturated fatty acids accounted for 22.59 % and 15.48 %, respectively. The fish fat consisted of appreciable amounts of odd-numbered fatty acids heptadecanoic and heptadecenoic acids standing for 1.62 % and 1.45 %, respectively. The fatty acids were predominated by C16, C18 and C20 fatty acids. The percentage of n-6/n-3 reached 2.26. Seventeen amino acids were identified in A. sohal flesh protein, eight of which were essential amino acids (EAAs); they amounted to 375.47 mg/g crude protein. Lysine was the most common EAA (64.49 mg/g crude protein). Aromatic amino acid and sulphur amino acid constituted 112.43 and 47.56 mg/g protein, respectively. The following macroelement concentration ranking was identified: Ca > P > K > Na > Mg, while the concentration of vital elements was Fe > Zn > Cu > Cr > I > Se > Co.

Crucial Interactions between Altered Plasma Trace Elements and Fatty Acids Unbalance Ratio to Management of Systemic Arterial Hypertension in Diabetic Patients: Focus on Endothelial Dysfunction

The coexistence of SAH with T2DM is a common comorbidity. In this study, we investigated the link between altered plasma antioxidant trace elements (ATE: manganese, selenium, zinc, and copper) and fatty acids ratio (FAR: polyunsaturated/saturated) imbalance as transition biomarkers between vascular pathology (SAH) to metabolic pathology (T2DM). Our data revealed strong correlation between plasma ATE and FAR profile, which is modified during SAH-T2DM association compared to the healthy group. This relationship is mediated by lipotoxicity (simultaneously prominent visceral adipose tissue lipolysis, significant flow of non-esterified free fatty acids release, TG-Chol-dyslipidemia, high association of total SFA, palmitic acid, arachidonic acid, and PUFA ω6/PUFA ω3; drop in tandem of PUFA/SFA and EPA + DHA); oxidative stress (lipid peroxidation confirmed by TAS depletion and MDA rise, concurrent drop of Zn/Cu-SOD, GPx, GSH, Se, Zn, Se/Mn, Zn/Cu; concomitant enhancement of Cu, Mn, and Fe); endothelial dysfunction (endotheline-1 increase); athero-thrombogenesis risk (concomitant rise of ApoB100/ApoA1, Ox-LDL, tHcy, and Lp(a)), and inflammation (higher of Hs-CRP, fibrinogen and ferritin). Our study opens to new therapeutic targets and to better dietary management, such as to establishing dietary ATE and PUFA ω6/PUFA ω3 or PUFA/SFA reference values for atherosclerotic risk prevention in hypertensive/diabetic patients.

Home blood pressure measurement days and changes in urinary sodium-to-potassium ratio, estimated salt and potassium intakes and blood pressure: 1-year prospective study

OBJECTIVE

Current international guidelines recommend home blood pressure (BP) measurement and low sodium and high potassium intakes for the management of hypertension. We hypothesized that increased home BP measurement may result in more effective management of sodium and potassium intakes and BP.

METHODS

We examined associations of home BP measurement days with changes in the urinary sodium-to-potassium (Na/K) ratio, estimated salt and potassium intakes and BP. We included 209 healthy participants (mean age, 55.9 years; 56.5% women) from a prospective cohort study. We examined 1-year data on self-measured home BP and spot urine samples.

RESULTS

Median (interquartile range) days of home BP measurement was 324 (225-358) over 1-year. Baseline mean (SD) Na/K ratio, salt and potassium intakes, morning and evening SBP, and morning and evening DBP were 3.8 (2.3), 8.5 (1.9) g/day, 1833.5 (416.5) mg/day, 120.4 (14.0) mmHg, 118.2 (14.2) mmHg, 79.2 (10.1) mmHg, and 76.2 (10.1) mmHg, respectively. In multivariable-adjusted linear regression , β (standard error) per 10 days increase in number of home BP measurement were -0.031 (0.017) for Na/K ratio, -0.036 (0.015) for salt intake, -1.357 (2.797) for potassium intake, -0.178 (0.064) for morning SBP, -0.079 (0.041) for morning DBP, -0.109 (0.067) for evening SBP and -0.099 (0.045) for evening DBP. Additionally, relationships persisted for men and women, but changes in salt intake were more pronounced among participants taking antihypertensive medication (interaction P = 0.002).

CONCLUSION

Continuous measurement of home BP may lead not only to self-monitoring of BP, but also to declines in salt intakes and some BP indices.

Self-Performed Dietary Sodium Reduction and Blood Pressure in Patients With Essential Hypertension: A Randomized Clinical Trial

BACKGROUND

Hypertension is the leading risk factor for cardiovascular disease worldwide. Patients with blood pressure (BP) response to dietary sodium reduction are referred to as "salt sensitive." Salt sensitivity (SS) might be due to differences in sodium storage capacity and the erythrocyte SS examines this capacity of the red blood cells. This study aimed to test the effect of a self-performed sodium reduced diet on BP in patients with essential hypertension and examine whether erythrocyte SS predicts SS.

METHODS AND RESULTS

Seventy-two patients with hypertension were included and randomized 2:1 to either sodium reduction or a control group for 4 weeks. Blood samples, 24-hour BP measurement, and 24-hour urine collection were performed before and after. The intervention group received advice on how to lower sodium intake. Urinary sodium excretion decreased 66 mmol (95% CI, -96 to -37 mmol) in the intervention group compared with the control group. Systolic 24-hour BP decreased 9 mm Hg after low-sodium diet compared with the control group (95% CI, -13 to -4 mm Hg). Similarly, the difference in reduction in diastolic BP between the groups was 5 mm Hg (95% CI, -8 to -1 mm Hg). We found no correlation between erythrocyte SS at baseline and decrease in 24-hour BP, neither systolic nor diastolic (P=0.66 and P = 0.84).

CONCLUSIONS

Self-performed sodium reduction was feasible and led to decrease in 24-hour BP of 9/5 mm Hg compared with a control group. The erythrocyte SS did not correlate to the change in BP after lowering sodium intake.

REGISTRATION

URL: https://clinicaltrials.gov; Unique Identifier: NCT05165823.

Plant-Based Meat Analogs and Their Effects on Cardiometabolic Health: An 8-Week Randomized Controlled Trial Comparing Plant-Based Meat Analogs With Their Corresponding Animal-Based Foods

BACKGROUND

With the growing popularity of plant-based meat analogs (PBMAs), an investigation of their effects on health is warranted in an Asian population.

OBJECTIVES

This research investigated the impact of consuming an omnivorous animal-based meat diet (ABMD) compared with a PBMAs diet (PBMD) on cardiometabolic health among adults with elevated risk of diabetes in Singapore.

METHODS

In an 8-wk parallel design randomized controlled trial, participants (n = 89) were instructed to substitute habitual protein-rich foods with fixed quantities of either PBMAs (n = 44) or their corresponding animal-based meats (n = 45; 2.5 servings/d), maintaining intake of other dietary components. Low-density lipoprotein (LDL) cholesterol served as primary outcome, whereas secondary outcomes included other cardiometabolic disease-related risk factors (e.g. glucose and fructosamine), dietary data, and within a subpopulation, ambulatory blood pressure measurements (n = 40) at baseline and postintervention, as well as a 14-d continuous glucose monitor (glucose homeostasis-related outcomes; n = 37).

RESULTS

Data from 82 participants (ABMD: 42 and PBMD: 40) were examined. Using linear mixed-effects model, there were significant interaction (time × treatment) effects for dietary trans-fat (increased in ABMD), dietary fiber, sodium, and potassium (all increased in PBMD; P-interaction <0.001). There were no significant effects on the lipid-lipoprotein profile, including LDL cholesterol. Diastolic blood pressure (DBP) was lower in the PBMD group (P-interaction=0.041), although the nocturnal DBP dip markedly increased in ABMD (+3.2% mean) and was reduced in PBMD (-2.6%; P-interaction=0.017). Fructosamine (P time=0.035) and homeostatic model assessment for β-cell function were improved at week 8 (P time=0.006) in both groups. Glycemic homeostasis was better regulated in the ABMD than PBMD groups as evidenced by interstitial glucose time in range (ABMD median: 94.1% (Q1:87.2%, Q3:96.7%); PBMD: 86.5% (81.7%, 89.4%); P = 0.041). The intervention had no significant effect on the other outcomes examined.

CONCLUSIONS

An 8-wk PBMA diet did not show widespread cardiometabolic health benefits compared with a corresponding meat based diet. Nutritional quality is a key factor to be considered for next generation PBMAs. This trial was registered at https://clinicaltrials.gov/as NCT05446753.

Associations between sodium, potassium, and blood pressure: results from the Hispanic Community Health Study/Study of Latinos, a prospective cohort study

BACKGROUND

Although the subject of numerous studies, the associations between dietary sodium, potassium, and the ratio of dietary sodium to potassium with blood pressure are not clear-cut. In addition, there is a paucity of research on these relationships in prospective cohort studies with representation from diverse Hispanic/Latino adults.

OBJECTIVES

To evaluate the associations between dietary intake of sodium, potassium, and the ratio of dietary sodium to potassium and blood pressure in a diverse sample of Hispanics living in the United States.

METHODS

This analysis included 11,429 Hispanic/Latino participants of the prospective cohort Hispanic Community Health Study/Study of Latinos recruited between 2008 and 2011 in visit 1 who participated in a follow-up visit in 2014-2017. Dietary sodium and potassium intakes were averaged from 2 interviewer-administered 24-h diet recalls collected at visit 1. At both visits, blood pressure was measured 3 times in a seated position and averaged. We assessed the relationship between dietary sodium, potassium, and the sodium-to-potassium ratio with changes in systolic and diastolic blood pressure using survey-weighted multivariable-adjusted regression models.

RESULTS

At visit 1, the mean age was 41 y, and the mean sodium intake was 3203 mg/d. Each 500 mg/d sodium increment in intake was associated with an increase in systolic blood pressure (β: 0.35 [mmHg]; 95% confidence interval: 0.06, 0.63) and diastolic blood pressure (β: 0.45 [mmHg]; 95% confidence interval: 0.08, 0.82). Dietary potassium and the molar ratio of dietary sodium to potassium were not associated with changes in systolic or diastolic blood pressure.

CONCLUSIONS

Among a large sample of diverse United States Hispanic/Latino adults, higher sodium intake was associated with small increases in systolic blood pressure over 6 y. This research underscores the importance of dietary sodium reduction in maintaining lower blood pressure.

Review Article on Molecular Mechanism of Regulation of Hypertension by Macro-elements (Na, K, Ca and Mg), Micro-elements/Trace Metals (Zn and Cu) and Toxic Elements (Pb and As)

Hypertension (HT) is a medical condition arising due to increase in blood pressure (BP) prevalent worldwide. The balanced dietary intakes of macro-elements and micro-elements including Na, K, Ca, Mg, Zn, and Cu have been described to maintain BP in humans by regulating the osmolarity of blood, cells/tissues, prevention of generation of oxidative and nitrosative stress (OANS), and endothelial damage through their functioning as important components of renin-angiotensin-aldosterone system (RAAS), antioxidant enzyme defense system, and maintenance of blood vascular-endothelial and vascular smooth muscle cell (VSMC) functions. However, inadequate/excess dietary intakes of Na/K, Ca/Mg, and Zn/Cu along with higher Pb and As exposures recognized to induce HT through common mechanisms including the followings: endothelial dysfunctions due to impairment of vasodilatation, increased vasoconstriction and arterial stiffness, blood clotting, inflammation, modification of sympathetic activity and higher catecholamine release, increased peripheral vascular resistance, and cardiac output; increased OANS due to reduced and elevated activities of extracellular superoxide dismutase and NAD(P)H oxidase, less nitric oxide bioavailability, decrease in cGMP and guanylate cyclase activity, increase in intracellular Ca2+ ions in VSMCs, and higher pro-inflammatory cytokines; higher parathyroid and calcitriol hormones; activation/suppression of RAAS resulting imbalance in blood Na+, K+, and water regulated by renin, angiotensin II, and aldosterone through affecting natriuresis/kaliuresis/diuresis; elevation in serum cholesterol and LDL cholesterol, decrease in HDL cholesterol due to defect in lipoprotein metabolism. The present study recommends the need to review simple dietary mineral intervention studies/supplementation trials before keeping their individual dietary excess intakes/exposures in consideration because their interactions lead to elevation and fall of their concentrations in body affecting onset of HT.

Comparing a range of potassium-enriched low sodium salt substitutes to common salt: Results of taste and visual tests in South African adults

BACKGROUND AND AIMS

Potassium-enriched low sodium salt substitutes (LSSS), which replace a proportion of sodium chloride (NaCl) with potassium chloride (KCl), have been shown to reduce blood pressure and offer a potential solution to address the high burden of hypertension in South Africa. However, it is unknown which proportions of KCl in LSSS are acceptable. We compared the taste and visual acceptability of various LSSS in South African adults.

METHODS AND RESULTS

Fifty-six adults underwent double-blind taste and visual tests of four LSSS (35%KCl/65%NaCl; 50%KCl/50%NaCl; 66%KCl/34%NaCl; 100%KCl) in comparison to 100%NaCl (common salt). Participants scored each product by taste ranking, taste perception and likeliness to use. Participants then visually inspected the five products and attempted to identify which was which. Almost half (45 %) of participants ranked the taste of 50%KCl/50 %NaCl as fantastic or really good. Furthermore, 62 % of participants liked and would be happy to use the 50 %KCl/50 %NaCl or felt this tasted like common salt. Only 12 % rated the 100%KCl highly for taste, and over half reported being unlikely to use this. Most participants (57.3 % and 36.4 %) were able to visually identify 100%NaCl and 100%KCl, while identification of other blends was generally poor. Responses were similar for 35%KCl/65%NaCl and 66%KCl/34%NaCl throughout.

CONCLUSION

Our findings suggest that the taste of the 50%KCl salt substitute would be well tolerated by South African adults, most of which could not visually differentiate between this salt substitute and common salt.

Using Genetics to Inform Interventions Related to Sodium and Potassium in Hypertension

BACKGROUND

Hypertension is a key risk factor for major adverse cardiovascular events but remains difficult to treat in many individuals. Dietary interventions are an effective approach to lower blood pressure (BP) but are not equally effective across all individuals. BP is heritable, and genetics may be a useful tool to overcome treatment response heterogeneity. We investigated whether the genetics of BP could be used to identify individuals with hypertension who may receive a particular benefit from lowering sodium intake and boosting potassium levels.

METHODS

In this observational genetic study, we leveraged cross-sectional data from up to 296 475 genotyped individuals drawn from the UK Biobank cohort for whom BP and urinary electrolytes (sodium and potassium), biomarkers of sodium and potassium intake, were measured. Biologically directed genetic scores for BP were constructed specifically among pathways related to sodium and potassium biology (pharmagenic enrichment scores), as well as unannotated genome-wide scores (conventional polygenic scores). We then tested whether there was a gene-by-environment interaction between urinary electrolytes and these genetic scores on BP.

RESULTS

Genetic risk and urinary electrolytes both independently correlated with BP. However, urinary sodium was associated with a larger BP increase among individuals with higher genetic risk in sodium- and potassium-related pathways than in those with comparatively lower genetic risk. For example, each SD in urinary sodium was associated with a 1.47-mm Hg increase in systolic BP for those in the top 10% of the distribution of genetic risk in sodium and potassium transport pathways versus a 0.97-mm Hg systolic BP increase in the lowest 10% (P=1.95×10-3). This interaction with urinary sodium remained when considering estimated glomerular filtration rate and indexing sodium to urinary creatinine. There was no strong evidence of an interaction between urinary sodium and a standard genome-wide polygenic score of BP.

CONCLUSIONS

The data suggest that genetic risk in sodium and potassium pathways could be used in a precision medicine model to direct interventions more specifically in the management of hypertension. Intervention studies are warranted.

Nutritional Quality and Safety Assessment of Pork Meat Cuts from Romania: Fatty Acids and Elemental Profile

In this study, the fatty acids and elemental profiles of 53 pork cut samples were determined. To offer insights into their potential health implications, we computed 18 key nutritional indices. These indices included parameters such as saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), unsaturated fatty acids (UFAs), the MUFAs/SFAs ratio, PUFAs/SFAs ratio, atherogenic index (AI), thrombogenic index (TI), the hypocholesterolemic to hypercholesterolemic ratio (h/H), health-promoting index (HPI), hypocholesterolemic index (HI), unsaturation index (UI), saturation index (SI), peroxidizability index (PI), nutritional value index (NVI), hypocholesterolemic index of fatty acids (DFAs), hypercholesterolemic index of fatty acids (OFAs), and the DFAs/OFAs ratio. These indices were calculated based on their fatty acid composition to provide comprehensive nutritional information. A health risk assessment revealed the safety and minimum health risk for the population from consuming the investigated pork cuts using the Target Hazard Quotient (THQ), Hazard Index (HI), and target cancer risk (TR). The ANOVA test showed significant differences in the levels of K, Fe, Mn, Zn, MUFAs, and AI among the pork cut samples. It was noted that by employing the correlation between the fatty acids profile, nutritional indices, and elemental concentrations and an unsupervised statistical method, such as PCA, a perfect separation from the different pork cuts could not be obtained.

Fatty Acid Profile and Mineral Composition of Red-Toothed Triggerfish (Odonus niger) Landed in Karnataka, Southeastern Arabian Sea

The seasonal and sex-wise variations in fatty acid and mineral composition in the tissue of Odonus niger collected from the Karnataka coast, southeastern Arabian Sea, were evaluated for the first time. The fatty acid profile was assessed using gas chromatography, nutritional indices were employed to evaluate lipid quality, and standard methods were utilized to estimate mineral composition and heavy metals. Palmitic acid (20.2-45.9%), oleic acid (10.0-19.2%), and docosahexaenoic acid (10.9-36.7%) were found in the highest proportions. The amount of ω3 fatty acids was significantly higher than ω6 fatty acids indicating the healthiest food fish and a promising source for nutrient supplementation. The P/S (PUFA/SFA) and ω3/ω6 ratios of the species were greater than those recommended by the UK Dept. of Health. Index of atherogenicity (IA) and thrombogenicity (IT) was low, and hypocholesterolemic to the hypercholesterolemic ratio (HH), unsaturation index (UI), health-promoting index (HPI), fish lipid quality (FLQ), and polyene index (PI) were high. The relationship between the quantities of macronutrients and trace elements was calculated as K > P > Na > Mg > Ca and B > Fe > Zn > Ga > Al respectively. Heavy metals like Be, Bi, Co, and Hg were found below the detection level. Benefit-risk ratio value indicates that the species is safe for consumption.

Planting the Seed for Blood Pressure Control: The Role of Plant-Based Nutrition in the Management of Hypertension

PURPOSE OF REVIEW

Hypertension results in significant morbidity, mortality, and healthcare expenditures. Fortunately, it is largely preventable and treatable by implementing dietary interventions, though these remain underutilized. Here, we aim to explore the role of healthy dietary patterns in hypertension management and describe approaches for busy clinicians to address nutrition effectively and efficiently with patients.

RECENT FINDINGS

DASH, Mediterranean, vegetarian, and vegan diets that include minimally processed, plant-based foods as core elements have consistently shown positive effects on hypertension. Recommendations that distill the most healthful components of these diets can significantly impact patient outcomes. Clinicians can harness evidence-based dietary assessment and counseling tools to implement and support behavioral changes, even during brief office visits. Healthful plant-based dietary patterns can often effectively prevent and treat hypertension. Clinicians may help improve patient outcomes by discussing evidence-based nutrition with their patients. Future work to promote infrastructural change that supports incorporating evidence-based nutrition into medical education, clinical care, and society at large can support these efforts.

The Association between Urinary Sodium-Potassium Ratio, Kidney Function, and Blood Pressure in a Cohort from the General Population

INTRODUCTION

Subclinical kidney dysfunction may contribute to salt-sensitive hypertension. We assessed the association between the urinary sodium-potassium ratio (Na/K ratio) and blood pressure (BP) in a general population cohort without diabetes, chronic kidney disease, cardiovascular disease, or treated hypertension. We investigated whether any such association was mediated by the kidney function markers measured glomerular filtration rate (mGFR), urinary albumin-creatinine ratio (ACR), and urinary epidermal growth factor-creatinine ratio (EGF-Cr).

METHODS

The Tromsø Study is a population-based study of inhabitants of the municipality of Tromsø, Northern Norway. Participants aged 50-62 years, without diabetes, chronic kidney disease, or cardiovascular disease, were invited to the substudy Renal Iohexol Clearance Survey in Tromsø 6 (RENIS-T6; 2007-09). For the present study, we excluded participants reporting the use of 1 or more antihypertensive agents, leaving 1,311 RENIS-T6 participants for a cross-sectional analysis. We measured office BP, 24-h ambulatory blood pressure (ABP), and mGFR using iohexol clearance. Na/K ratio, ACR, and EGF-Cr were measured in morning urine samples.

RESULTS

Urinary Na/K ratio was significantly associated with systolic office BP and ABP independently of cardiovascular risk factors and kidney function markers. A one-standard deviation unit increase in the Na/K ratio was associated with increased systolic ABP by 1.0 (0.3-1.6) mm Hg. Urinary Na/K ratio showed a stronger association with office BP than ABP. EGF-Cr, ACR, and mGFR did not mediate the relationship between urinary Na/K ratio and systolic BP.

CONCLUSIONS

In a representative sample of the middle-aged North-European population without diabetes, chronic kidney disease, cardiovascular disease, or treated hypertension, there was a consistent association between urinary Na/K ratio and BP. The association with BP was not mediated through kidney function measures, suggesting a relationship between a diet with high sodium and low potassium and higher BP regardless of kidney function.

Protocol for the combined cardiometabolic deep phenotyping and registry-based 20-year follow-up study of the Inter99 cohort

INTRODUCTION

The population-based Inter99 cohort has contributed extensively to our understanding of effects of a systematic screening and lifestyle intervention, as well as the multifactorial aetiology of type 2 diabetes (T2D) and cardiovascular disease. To understand causes, trajectories and patterns of early and overt cardiometabolic disease manifestations, we will perform a combined clinical deep phenotyping and registry follow-up study of the now 50-80 years old Inter99 participants.

METHODS AND ANALYSIS

The Inter99 cohort comprises individuals aged 30-60 years, who lived in a representative geographical area of greater Copenhagen, Denmark, in 1999. Age-stratified and sex-stratified random subgroups were invited to participate in either a lifestyle intervention (N=13 016) or questionnaires (N=5264), while the rest served as a reference population (N=43 021). Of the 13 016 individuals assigned to the lifestyle intervention group, 6784 (52%) accepted participation in a baseline health examination in 1999, including screening for cardiovascular risk factors and prediabetic conditions. In total, 6004 eligible participants, who participated in the baseline examination, will be invited to participate in the deep phenotyping 20-year follow-up clinical examination including measurements of anthropometry, blood pressure, arterial stiffness, cardiometabolic biomarkers, coronary artery calcification, heart rate variability, heart rhythm, liver stiffness, fundus characteristics, muscle strength and mass, as well as health and lifestyle questionnaires. In a subsample, 10-day monitoring of diet, physical activity and continuous glucose measurements will be performed. Fasting blood, urine and faecal samples to be stored in a biobank. The established database will form the basis of multiple analyses. A main purpose is to investigate whether low birth weight independent of genetics, lifestyle and glucose tolerance predicts later common T2D cardiometabolic comorbidities.

ETHICS AND DISSEMINATION

The study was approved by the Medical Ethics Committee, Capital Region, Denmark (H-20076231) and by the Danish Data Protection Agency through the Capital Region of Denmark's registration system (P-2020-1074). Informed consent will be obtained before examinations. Findings will be disseminated in peer-reviewed journals, at conferences and via presentations to stakeholders, including patients and public health policymakers.

TRIAL REGISTRATION NUMBER

NCT05166447.

Sodium, potassium intake, and all-cause mortality: confusion and new findings

BACKGROUND

The World Health Organization (WHO) has established recommended daily intakes for sodium and potassium. However, there is currently some controversy regarding the association between sodium intake, potassium intake, the sodium-to-potassium ratio, and overall mortality. To assess the correlations between sodium intake, potassium intake, the sodium-to-potassium ratio, and overall mortality, as well as the potential differences in sodium and potassium intake thresholds among different population groups, we analyzed data from NHANES 2003-2018.

METHODS

NHANES is an observational cohort study that estimates sodium and potassium intake through one or two 24-h dietary recalls. Hazard ratios (HR) for overall mortality were calculated using multivariable adjusted Cox models accounting for sampling design. A total of 13855 out of 26288 participants were included in the final analysis. Restricted cubic spline analyses were used to examine the relationship between sodium intake, potassium intake, and overall mortality. If non-linearity was detected, we employed a recursive algorithm to calculate inflection points.

RESULTS

Based on one or two 24-h dietary recalls, the sample consisted of 13,855 participants, representing a non-institutionalized population aged 40-80 years, totaling 11,348,771 person-months of mean follow-up 99.395 months. Daily sodium intake and daily potassium intake were inversely associated with all-cause mortality. Restrictive cubic spline analysis showed non-linear relationships between daily sodium intake, potassium intake, sodium-potassium ratio, and total mortality. The inflection point for daily sodium intake was 3133 mg/d, and the inflection point for daily potassium intake was 3501 mg/d, and the inflection point for daily sodium-potassium ratio intake was 1.203 mg/mg/d. In subgroup analyses, a significant interaction was found between age and high sodium intake, which was further confirmed by the smooth curves that showed a U-shaped relationship between sodium intake and all-cause mortality in the elderly population, with a inflection point of 3634 mg/d.

CONCLUSION

Nonlinear associations of daily sodium intake, daily potassium intake and daily sodium-potassium ratio intake with all-cause mortality were observed in American individuals. The inflection point for daily sodium intake was 3133 mg/d. And the inflection point for daily sodium intake was 3634 mg/d in elderly population. The inflection point for daily potassium intake was 3501 mg/d. The inflection point for daily sodium-potassium ratio intake was 1.203 mg/mg/d, respectively, A healthy diet should be based on reasonable sodium intake and include an appropriate sodium-to-potassium ratio.

A sodium/potassium switch for G4-prone G/C-rich sequences

Metal ions are essential components for the survival of living organisms. For most species, intracellular and extracellular ionic conditions differ significantly. As G-quadruplexes (G4s) are ion-dependent structures, changes in the [Na+]/[K+] ratio may affect the folding of genomic G4s. More than 11000 putative G4 sequences in the human genome (hg19) contain at least two runs of three continuous cytosines, and these mixed G/C-rich sequences may form a quadruplex or a competing hairpin structure based on G-C base pairing. In this study, we examine how the [Na+]/[K+] ratio influences the structures of G/C-rich sequences. The natural G4 structure with a 9-nt long central loop, CEBwt, was chosen as a model sequence, and the loop bases were gradually replaced by cytosines. The series of CEB mutations revealed that the presence of cytosines in G4 loops does not prevent G4 folding or decrease G4 stability but increases the probability of forming a competing structure, either a hairpin or an intermolecular duplex. Slow conversion to the quadruplex in vitro (in a potassium-rich buffer) and cells was demonstrated by NMR. 'Shape-shifting' sequences may respond to [Na+]/[K+] changes with delayed kinetics.

Association between sodium and potassium intake levels and body compositions of Chinese college students

BACKGROUND AND OBJECTIVES

To investigate the relationship between sodium (Na) and potassium (K) nutritional condition and body compositions in youth aiming to give target population reasonable diet recommendations.

METHODS AND STUDY DESIGN

The cross-sectional study was conducted involving 512 healthy youth aged 18 to 31 years from universities in Beijing. Food frequency questionnaire (FFQ) and bioelectrical impedance analyzer (BIA) were used to collect dietary intake information and body compositions.

RESULTS

There was an increasing tendency in fat-related indicators and muscle-related indicators of the dietary Na tertile group (p <0.05). Additionally, Weight, body mass index (BMI), waist circumference (WC), and muscle-related indicators increased with the dietary K tertile group (p <0.05). Across increasing tertiles of dietary Na intake, the odds ratio (OR) was increased significantly (p < 0.05) in fat-related indicators. On the contrary, with the increased dietary Na intake, the OR decreased (p < 0.05) in appendicular skeletal muscle mass index (ASMI) and body lean mass. As tertiles of dietary K intake increased, the OR in both skeletal muscle mass index (SMMI) and lean mass index (LMI) decreased.

CONCLUSIONS

High dietary Na is a risk factor for abnormal lipid distribution in college students. High dietary K can maintain skeletal muscle mass and reduce the risk of obesity. Na in the diet has a greater impact on the body composition of young people than K. Low dietary Na and high dietary K still need to be strengthened in science popularization and practice among more college students.

Influence of Geographical Origin on Isotopic and Elemental Compositions of Pork Meat

Pigs are a primary source of meat, accounting for over 30% of global consumption. Consumers' preferences are determined by health considerations, paying more attention to foodstuffs quality, animal welfare, place of origin, and swine feeding regime, and being willing to pay a higher price for a product from a certain geographical region. In this study, the isotopic fingerprints (δ2H, δ18O, and δ13C) and 29 elements of loin pork meat samples were corroborated with chemometric methods to obtain the most important variables that could classify the samples' geographical origin. δ2H and δ18O values ranged from -71.0 to -21.2‱, and from -9.3 to -2.8‱, respectively. The contents of macro- and micro-essential elements are presented in the following order: K > Na > Mg > Ca > Zn > Fe > Cu > Cr. The LDA model assigned in the initial classification showed 91.4% separation of samples, while for the cross-validation procedure, a percentage of 90% was obtained. δ2H, K, Rb, and Pd were identified as the most representative parameters to differentiate the pork meat samples coming from Romania vs. those from abroad. The mean values of metal concentrations were used to estimate the potential health risks associated with the consumption of pork meat The results showed that none of the analyzed metals (As, Cd, Sn, Pb, Cu, and Zn) pose a carcinogenic risk.

Interaction of Dietary Sodium-to-potassium Ratio and Dinner Energy Ratio on Prevalence of Hypertension in Inner Mongolia, China

BACKGROUND

Hypertension is one of the most common chronic diseases, and dietary factors play an important role in hypertension. We examined the interaction of dietary sodium-to-potassium (Na/K) ratio and dinner energy ratio on hypertension.

METHODS

We conducted this study using data from the cross-sectional National Survey for Nutrition and Adult Chronic Disease in 2015 in Inner Mongolia, China. Dietary data were collected using 24-hour diet records with food weights across 3 consecutive days. Logistic regression was used to determine the interaction of dinner energy ratio and dietary Na/K ratio on hypertension.

RESULTS

A total of 1,861 participants were included in this study, and 914 individuals were hypertensive (49.1%). Dinner energy ratio and high dietary Na/K ratio were independently related to high prevalence of hypertension. A formal test showed that dinner energy ratio interacted significantly with dietary Na/K ratio on hypertension (P < 0.001), with an adjusted odds ratio (OR) of 1.119 (95% confidence interval [CI], 1.040-1.203). Participants whose dinner energy ratio greater than 39.1% and dietary Na/K ratio of 3.625-6.053 had the highest OR of hypertension prevalence, with an adjusted OR of 2.984 (95% CI, 1.758-5.066), compared with participants with dinner energy ratio of 30.2-39.1%, and dietary Na/K ratio less than 2.348.

CONCLUSION

Our study highlighted the interactive effect of dinner energy ratio and dietary Na/K ratio on hypertension among adults in Inner Mongolia. We advocated a balanced diet (dinner energy ratio not small or large) and a low dietary Na/K ratio for reducing the prevalence of hypertension.

India's tryst with salt: Dandi march to low sodium salts

Salt plays a critical role in India's past as well as its present, from Dandi March to its role as a vehicle for micronutrient fortification. However, excess salt intake is a risk factor for high blood pressure and cardiovascular diseases (CVDs). Indians consume double the World Health Organization recommended daily salt (<5 g). India has committed to a 30 per cent reduction in sodium intake by 2025. Evidence based strategies for population sodium intake reduction require a moderate reduction in salt in - home cooked foods, packaged foods and outside-home foods. Reducing the sodium content in packaged food includes policy driven interventions such as front-of-package warning labels, food reformulation, marketing restrictions and taxation on high sodium foods. For foods outside of the home, setting standards for foods purchased and served by schemes like mid-day meals can have a moderate impact. For home cooked foods (the major source of sodium), strategies include advocacy for reducing salt intake. In addition to mass media campaigns for awareness generation, substituting regular salt with low sodium salt (LSS) has the potential to reduce salt intake even in the absence of a major shift in consumer behaviour. LSS substitution effectively lowers blood pressure and thus reduces the risk of CVDs. Further research is required on the effect of LSS substitutes on patients with chronic kidney disease. India needs an integrated approach to sodium reduction that uses evidence based strategies and can be implemented sustainably at scale. This will be possible only through scientific research, governmental leadership and a responsive evidence-to-action approach through a multi-stakeholder coalition.

Blood pressure variation and ultra-processed food consumption in children with obesity

To investigate the influence of ultra-processed food (UPF) consumption on systolic (SBP) and diastolic (DBP) blood pressure in children with obesity, using dietary and urinary markers. We conducted a secondary analysis of a randomized clinical trial involving children with obesity, aged 7 to 12 years. Over a period of six months, the children and their guardians attended monthly individual consultations and educational activities aimed at promoting a reduction in UPF consumption. During each visit, measurements of blood pressure, body weight, height, and 24-h dietary recall were recorded. Additionally, spot urine samples were collected at baseline, and at the second and fifth-month follow-ups. A total of 96 children were included in the analysis. Energy intake, UPF intake and blood pressure showed a quadratic pattern of change, with a decrease in the first two months and an increase thereafter. There was an association between UPF consumption and DBP. The intake of UPF was correlated with the urinary sodium-to-potassium (Na/K) ratio (r = 0.29; p = 0.008) and the dietary Na/K ratio (r = 0.40; p < 0.001). For every 100 g increase in UPF, DBP increased by 0.28 mmHg (p-value = 0.01). After further adjustment for changes in body mass index (BMI), and physical activity, the increase in DBP was 0.22 mmHg.    Conclusion: Our findings indicate that reducing UPF consumption may have an impact on blood pressure in children with obesity. Additional adjustment for BMI and physical activity did not influence the results. Therefore, reducing UPF consumption can be considered as a strategy against hypertension. What is Known: • Ultra-processed food consumption is associated with an increased risk of cardiovascular disease; however, this evidence is still limited in children. • Intake of calories from ultra-processed food in relation to the total calories is increasing worldwide. What is New: • Ultra-processed food consumption has an effect on the diastolic blood pressure, independent of changes in weight. • The intake of ultra-processed food was correlated to the dietary sodium-to-potassium ratio (r = 0.40; p < 0.001).

Photoacoustic and absorption spectroscopy imaging analysis of human blood

Photoacoustic and absorption spectroscopy imaging are safe and non-invasive molecular quantification techniques, which do not utilize ionizing radiation and allow for repeated probing of samples without them being contaminated or damaged. Here we assessed the potential of these techniques for measuring biochemical parameters. We investigated the statistical association between 31 time and frequency domain features derived from photoacoustic and absorption spectroscopy signals and 19 biochemical blood parameters. We found that photoacoustic and absorption spectroscopy imaging features are significantly correlated with 14 and 17 individual biochemical parameters, respectively. Moreover, some of the biochemical blood parameters can be accurately predicted based on photoacoustic and absorption spectroscopy imaging features by polynomial regression. In particular, the levels of uric acid and albumin can be accurately explained by a combination of photoacoustic and absorption spectroscopy imaging features (adjusted R-squared > 0.75), while creatinine levels can be accurately explained by the features of the photoacoustic system (adjusted R-squared > 0.80). We identified a number of imaging features that inform on the biochemical blood parameters and can be potentially useful in clinical diagnosis. We also demonstrated that linear and non-linear combinations of photoacoustic and absorption spectroscopy imaging features can accurately predict some of the biochemical blood parameters. These results demonstrate that photoacoustic and absorption spectroscopy imaging systems show promise for future applications in clinical practice.

A Longitudinal Investigation on the Effects of Sodium and Potassium Intake on the Development of Hypertension and Abdominal Obesity from Childhood to Young Adulthood amongst Ellisras Rural Population, South Africa

BACKGROUND

Hypertension (HT) and obesity have both been on the rise in children. Each is associated with an increase in cardiovascular disease risk, and both track into adulthood.

OBJECTIVES

This study aimed to identify the association of sodium intake (Na), potassium (K) intake, and sodium-to-potassium (Na/K) ratio with the development of HT and abdominal obesity amongst the Ellisras rural population over time.

METHODS

In this longitudinal study, data on dietary intake of Na and K were collected using a 24 h recall questionnaire from a total of 325 participants tracked from 1999 (5-12 years), 2001 (7-14 years), and 2015 (18-30 years). The averages of Na and K intake were analysed using local food tables and the South African Food Composition Database System (SAFOODS). In addition, blood pressure (BP) and anthropometric measurements (waist circumference (WC) and height) were also examined. Parametric (independent t-test) and Chi-square/Fishers exact tests were conducted to determine the difference between the years for numerical data and categorical variables. A generalised estimating equation (GEE) was used to assess the association of Na intake, K intake and their ratio on BP, WC, and waist-to-height ratio (WHtR).

RESULTS

Our results indicate a significant positive association between K intake and WHtR, and even though the model was adjusted for age and sex, there was still an association with WHtR. The Na/K ratio was associated with both BP measurements and abdominal obesity, respectively. Furthermore, Na/K was shown to be associated with an increased risk of developing HT and abdominal obesity.

CONCLUSIONS

In our study, we observed that an increase in the Na/K ratio is a predictor of HT and abdominal obesity over time compared to Na and K alone. However, more studies are required to further prove this.

Assessment of 24 h Sodium and Potassium Urinary Excretion in Normotensive and Hypertensive Dominican Adults

Higher salt (sodium) intake has been associated with higher blood pressure (BP). The degree of association may be influenced by factors such as age, origin, and dietary components. This study aimed to evaluate the 24 h urinary sodium (Na) and potassium (K) excretion in normotensive and hypertensive Dominican adults and estimate their salt intake. 163 volunteers (18-80 years old) participated in a cross-sectional study. The 24 h Na and K urinary excretion were measured using an ion-selective electrode technique. Na and K urinary excretion (99.4 ± 46.5 and 35.0 ± 17.5 mmol/24 h) did not correlate with BP, except in the normotensive group, in which K correlated with SBP (0.249, p = 0.019). Na and K excretion were similar in normotensive and hypertensive subjects. When considering two age groups (18-45, 46-80 years), the Na-to-K molar ratio (3.1 ± 1.3) was higher in younger subjects (p = 0.040). Na-to-K ratio was associated with DBP in the total group (r = 0.153, p = 0.052), in the hypertensive group (r = 0.395, p < 0.001), and in the older group with SBP (0.350, p = 0.002) and DBP (0.373, p < 0.001). In the older group, Na-to-K ratio and DBP correlated after controlling for subjects with hypertension controlled by treatment (r = 0.236, p = 0.041). The Na-to-K ratio correlated, when salt intake was over 5 g/day (52.2%), with SBP (rho = 0.219, p = 0.044) and DBP (rho = 0.259, p = 0.017). Determinants of BP in the total sample were age (SBP, beta: 0.6 ± 0.1, p < 0.001; DBP, beta: 0.2 ± 0.1, p < 0.002), sex (SBP, beta: 11.2 ± 3.5, p = 0.001), body mass index (BMI) (SBP, beta: 1.0 ± 0.3, p < 0.001; DBP, beta: 0.4 ± 0.2, p = 0.01), and Na-to-K ratio (SBP, beta: 3.0 ± 1.1, p = 0.008; DBP, beta: -12.3 ± 4.0, p = 0.002). Sex and BMI were determinants in the younger group. Na-to-K molar ratio was determinant in the older group (SBP, beta: 6.7 ± 2.4, p = 0.005; DBP, beta: 3.8 ± 1.1, p < 0.001). The mean Na and salt intakes (2.3 and 5.8 g/day) were slightly higher and the K intake lower (1.4 g/day) than WHO recommendations.

Association of Dietary Sodium-to-Potassium Ratio with Cardiometabolic Risk Factors in Korean Adults: Findings from the Korean National Health and Nutrition Examination Survey

High-sodium and low-potassium intakes are interdependently linked to hypertension and cardiovascular diseases. We investigated the associations of dietary sodium-to-potassium (Na/K) ratio with cardiometabolic risk factors in 12,996 Korean adults (≥30 years) from the Korean National Health and Nutrition Examination Survey Ⅶ (2016-2018). Food intake was assessed through 24 h dietary recall data. Participants were divided into thirds based on their dietary Na/K ratio, with mean molar Na/K ratios of 1.11 (low), 1.92 (medium), and 3.21 (high). Although no significant associations were found between the dietary Na/K level and the risk of hypertension, obesity, and diabetes in all participants, the high Na/K ratio group had a higher risk of hypertension compared to the low Na/K ratio group in older adults (≥65 years) after adjusting for confounding factors (odds ratio = 1.38, 95% confidence interval: 1.10-1.72). Moreover, a higher Na/K ratio was associated with an increased risk of metabolic syndrome (MetS) in all participants (p for trend = 0.0020). Within MetS components, abdominal obesity, elevated triglycerides, and elevated blood pressure were positively associated with the Na/K level. The food groups positively associated with a lower Na/K ratio were fruits, unsalted vegetables, nuts, potatoes, and dairy products. These findings suggest that a high dietary Na/K ratio may be an important risk factor for hypertension in older adults and MetS in all adults.

Estimation of Salt Intake in Normotensive and Hypertensive Children: The Role of Body Weight

OBJECTIVE

The connection between increased dietary salt intake and arterial hypertension has been recognized for a long time, even in children. This study aimed to investigate salt consumption in normotensive and hypertensive children and evaluate their dietary habits.

MATERIALS AND METHODS

A total of fifty participants were included in this cross-sectional study: twenty-five normotensive children and 25 children of both sexes with essential arterial hypertension from 12-17 years old. Subjects' body mass index, waist-to-hip ratio, body composition and arterial blood pressure were measured, and their daily salt intake was calculated from 24-h urine samples. Using the food frequency questionnaire (FFQ), the data on the average daily total energy and food intakes were collected and analyzed using a suitable program.

RESULTS

Estimated daily salt intake was significantly higher in hypertensive compared to normotensive children, and this is positively associated with blood pressure and body mass index (BMI). Hypertensive children had significantly higher BMIs, which also positively correlated with blood pressure. Consistently, resting metabolic rate (kcal) is higher in hypertensive children compared to normotensive, and this is also associated with blood pressure. Reported energy intake is also enlarged in hypertensive compared to normotensive children and for both groups, levels are significantly higher than the recommended values.

CONCLUSIONS

Our study results confirm the relationship between daily salt consumption, blood pressure and body weight. Sodium consumption related to blood pressure and body weight among children. Cardiovascular disease prevention should start in early childhood by reducing salt intake and preventing overweight/obesity since these are two of the most important modifiable risk factors for hypertension.

Dietary macrominerals: Updated review of their role and orchestration in human nutrition throughout the life cycle with sex differences

Macrominerals play vital roles in a multitude of physiologic systems. A myriad of biochemical reactions are dependent on or affected by these electrolytes. The current review attempts to identify the role of macrominerals as calcium, phosphorus, magnesium, sodium, potassium and sulfur in human health, in addition to their absorption and homeostasis inside the body. We also focused on their amount in major food sources and the recommended daily intake of each macromineral. In addition, a deep insight into the orchestration of the 6 different macrominerals' requirements is presented across the human life cycle, beginning from fertility and pregnancy, and reaching adulthood and senility, with insight on interactions among them and underlying action mechanisms. The effect of sex is also presented for each mineral at each life stage to highlight the different daily requirements and/ or effects. The current review identified the role of macrominerals in human health, in addition to their absorption and homeostasis in the body. Based on the in-depth understanding of the factors influencing the metabolism of macrominerals, we could better explore their safety and possible therapeutic potential in specific disorders. There is still a need to precisely demonstrate the bioavailability of macrominerals from various types of functional food.

Lifestyle Interventions for Elevated Blood Pressure in Childhood-Approaches and Outcomes

PURPOSE OF REVIEW

The purpose of this review is to provide an overview of existing and emerging lifestyle treatments in the clinical management of primary elevated blood pressure and hypertension in pediatric patients. The authors hope to expand the knowledge base surrounding pediatric hypertension and update clinicians on best practices to improve outcomes.

RECENT FINDINGS

Elevated blood pressure is traditionally addressed with broad lifestyle recommendations such as limiting salt consumption and losing weight. This approach is not well adapted for pediatric patients. Novel and often underutilized approaches to the treatment of hypertension in pediatrics include psychological counseling for behavior modification, circadian nutrition, consistent use of interdisciplinary teams, manipulation of macronutrients, stress management, technology-infused interventions, and systemic changes to the food environment. Elevated blood pressure is a pervasive condition affecting cardiovascular disease and mortality risk. Increasingly, pediatric patients are presenting with elevated blood pressure with etiologies known to be affected by lifestyle behaviors. Weight management, dietary modifications, and daily physical activity are well-researched methods for improving individual blood pressure measurements. These strategies can sometimes be as effective as pharmacological interventions at lowering blood pressure. However, compliance with these individual recommendations is not consistent and has led to unsatisfactory results. There are emerging treatment trends that may provide non-traditional and more effective non-pharmacologic routes to blood pressure management in pediatric patients.

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.

Spreadable plant-based cheese analogue with dry-fractioned pea protein and inulin-olive oil emulsion-filled gel

BACKGROUND

Consumer demand for plant-based cheese analogues (PCA) is growing because of the easy and versatile ways in which they can be used. However, the products available on the market are nutritionally poor. They are low in protein, high in saturated fat and sodium, and often characterized by a long list of ingredients.

RESULTS

A clean label spreadable plant-based cheese analogue was developed using dry-fractionated pea protein and an emulsion-filled gel composed of extra virgin olive oil and inulin, added in different concentrations as fat replacer (10%, 13% and 15% of the formulation). First, nutritional and textural analyses were performed, and the results were compared with two commercial products. The products were high in protein (134 g kg^-1 ) and low in fat (52.2 g kg^-1 ). The formulated PCAs had similar spreadability index to the dairy cheese but lower hardness (15.1 vs. 19.0 N) and a higher elasticity (0.60 vs. 0.35) consequent to their lower fat content (52.2 vs. 250 g kg^-1 ). Then, dry oregano and rosemary (5 g kg^-1 ) were added to the PCA, and sensory evaluation and analysis of volatile compounds were conducted. The addition of spices masked the legume flavor and significantly enriched the final product with aromatic compounds.

CONCLUSION

The use of dry-fractioned pea protein and of the emulsion-filled gel allowed us to develop a clean label and nutritionally valuable spreadable plant-based cheese analogue. Overall, the ingredients and product concepts developed could be used to upgrade the formulation of plant-based cheese on a larger scale. © 2022 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Effect of a Low-Carbohydrate Diet With or Without Exercise on Anxiety and Eating Behavior and Associated Changes in Cardiometabolic Health in Overweight Young Women

Background

The effectiveness of low-carbohydrate diets (LCDs) on weight loss and exercise for improving cardiometabolic fitness have been well documented in the literature, but the effects of LCDs and whether adding exercise to a LCD regime could additionally benefit mental health (e. g., by lowering the level of anxiety) and associated changes in eating behavior are less clear in overweight and obese populations. Therefore, this study aimed to investigate the effects of a 4-week LCD with or without exercise on anxiety and eating behavior, and to explore the associations between changes in the psychological state and physiological parameters (i.e., body composition, aerobic fitness, blood pressure, lipid profile, and metabolic hormones).

Methods

Seventy-four overweight Chinese women [age: 20.8 ± 3.0 years, body mass index (BMI): 25.3 ± 3.3 kg·m-2] completed the 4-week randomized controlled trial, which included a LCD group (i.e., ~50 g daily carbohydrate intake) with exercise training 5 days/week (LC-EXE, n = 26), a LCD group without exercise training (LC-CON, n = 25) and a control group that did not modify their habitual diets and physical activity (CON, n = 23). Levels of anxiety, eating behavior scores and physiological parameters (i.e., body weight, V̇O2peak, blood pressure, fasting glucose, blood lipids, and serum metabolic hormones including insulin, C-peptide, leptin, and ghrelin) were measured before and after the intervention.

Results

There were significant reductions in anxiety levels in the LC-EXE compared with the LC-CON group, while no statistical changes were found in eating behaviors in any conditions after the 4-week intervention. Significant reduction in weight (~3.0 kg or 4%, p < 0.01) and decreases in insulin (~30% p < 0.01), C-peptide (~20% p < 0.01), and leptin (~40%, p < 0.01) were found in both LC-CON and LC-EXE groups, but adding exercise to a LCD regime generated no additional effects. There were significant improvements in V̇O2peak (~15% p < 0.01) and anxiety (~25% p < 0.01) in the LC-EXE compared with the LC-CON group, while no statistical differences were found between CON and LC-CON treatments. Further analysis revealed a negative association (r = -0.32, p < 0.01) between changes in levels of anxiety and changes in V̇O2peak in all participates, no other correlations were found between changes in psychological and physiological parameters.

Conclusion

Although the combination of a LCD and exercise may not induce additional reductions in body weight in overweight young females, exercise could be a useful add-on treatment along with a LCD to improve cardiometabolic health and lower anxiety levels.

Validity of the Food Frequency Questionnaire-Estimated Intakes of Sodium, Potassium, and Sodium-to-Potassium Ratio for Screening at a Point of Absolute Intake among Middle-Aged and Older Japanese Adults

Using Food Frequency Questionnaires (FFQs) to compare dietary references for screening has been in high demand. However, FFQs have been widely used for ranking individuals in a population based on their dietary intake. We determined the validity of sodium (salt equivalent) intake, potassium intake, and sodium-to-potassium (Na/K) ratio obtained using the FFQ for identifying individuals who deviated from the dietary reference intakes (DRIs) measured using multiple 24-h urinary excretion measurements or 12-day weighed food records (WFR). This study included 235 middle-aged subjects. The correlation coefficients (CCs) between the FFQ and WFR estimates were mostly moderate (0.24−0.54); the CCs between the FFQ and 24-h urinary excretion measurements were low or moderate (0.26−0.38). Values of area under the receiver-operating curve (AUC) at the point of DRIs for salt equivalent or potassium were >0.7 with the WFR as the reference standard and 0.60−0.76 with the 24-h urinary excretion as the reference standard. Using both standard measures, the AUC for the Na/K ratio was <0.7. The accuracy of salt equivalent and potassium intake estimation using the FFQ to determine absolute intake point was comparable to that using WFR, allowing for quantified error, but not as good as that of 24-h urinary excretion.

The Perception of Minerals and Their Prevalence in Fortified Foods and Supplements in Japan

People’s intake of some minerals does not meet the nutrient reference values even in high-income countries. Recently, the deficiency of zinc and/or selenium has been considered to cause greater risk of COVID-19 infection and severity. To investigate consumer awareness, we conducted a cross-sectional questionnaire online survey among Japanese people (7500 males and 7500 females) concerning their perceptions of each mineral and the prevalence of mineral-fortified foods and/or mineral supplements. People’s perception of each mineral varied: the highest was for calcium (91.8%) and the lowest was for selenium (44.7%). In addition, only a portion of participants believed that they consumed a sufficient amount of each mineral; the highest was sodium (23.7%), and the lowest was manganese (5.2%). In addition, 18.2% of them felt that they could not consume enough sodium, even though most of the Japanese’s intake is excessive. Among mineral-fortified-food and/or mineral-supplement users, the purposes for these products were to maintain health (80.6%), supplement nutrients (48.0%), and prevent infectious diseases (23.2%). Only 18.4% of participants knew what amount they took. In conclusion, education is needed to prevent not only the insufficiency/deficiency of each mineral but also an excess intake of sodium.

Evaluation of Active Renin Concentration in A Cohort of Adolescents with Primary Hypertension

Our study aimed to assess active renin concentration in children with primary hypertension. Thus, we evaluated active renin concentration, clinical parameters, office and ambulatory blood pressure, and biochemical parameters in 51 untreated adolescents with primary hypertension (median: 14.4 [interquartile range—IQR: 13.8–16.8] years) and 45 healthy adolescents. Active renin concentration did not differ between patients with hypertension and healthy children (median: 28.5 [IQR: 21.9–45.2] vs. 24.9 [IQR: 16.8–34.3] [pg/mL], p = 0.055). In the whole group of 96 children, active renin concentration correlated positively with serum potassium and office and ambulatory systolic and diastolic blood pressures. Among children with hypertension, patients with isolated systolic hypertension had lower renin concentration than patients with systolic-diastolic hypertension (26.2 [IQR: 18.6–34.2] vs. 37.8 [IQR: 27.0–49.6] [pg/mL], p = 0.014). The active renin concentration did not differ between patients with isolated systolic hypertension and healthy children. In multivariate analysis, diastolic blood pressure Z-score (beta = 0.238, 95 confidence interval [0.018–0.458], p = 0.035) was the only predictor of active renin concentration in the studied children. We concluded that active renin concentration is positively associated with blood pressure and potassium in children, and diastolic blood pressure was the strongest predictor of renin level. Patients with isolated systolic hypertension may differ from patients with systolic-diastolic hypertension in less severe activation of the renin-angiotensin-aldosterone system.

Associations of sodium and potassium intake with chronic kidney disease in a prospective cohort study: findings from the Hispanic Community Health Study/Study of Latinos, 2008-2017

BACKGROUND

According to dietary recommendations, reduction of sodium intake has potential to reduce Chronic Kidney Disease (CKD) risk; however the role of dietary potassium and the sodium -to- potassium ratio in the development of CKD is unclear.

METHODS

We studied 9778 participants of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from four US urban communities. Participants were aged 18-74 yrs., free from CKD at baseline in 2008-2011 and re-examined between 2014 and - 2017. Dietary intake of sodium, potassium and the ratio of dietary sodium -to- potassium were measured from two baseline 24-h dietary recalls. Incident CKD was defined as: 1) estimated glomerular filtration rate (eGFR) decline of 1 unit per year and eGFR < 60 ml/min/1.73m2 or 2) albumin to creatinine ratio ≥ 30 mg/g at the follow-up visit. We used multivariable survey weighted Poisson regression to estimate adjusted incident rates of incident CKD.

RESULTS

At baseline, mean age was 41 years. Average follow up time was 6.2 years. From fully adjusted Poisson regression analyses, self-reported sodium intake was not associated with incident CKD. However, for each 500 mg decrement in potassium intake, there was an 11% increase risk of incident CKD (IRR = 1.11, 95% CI = 1.00, 1.24). Additionally, every 1 M ratio increment of sodium -to -potassium ratio was associated with a 21% increased risk of incident CKD (IRR = 1.21, 95% CI = 1.02, 1.45), p < 0.05).

CONCLUSIONS

We conclude that diets low in potassium and high in sodium are associated with increased risk of developing chronic kidney disease among healthy US Hispanic/Latino adults.