1
|
Kujovic M, Lipka T, Zalman M, Baumann L, Jänner M, Baumann B. Treatment of hypertension and obstructive sleep apnea counteracts cognitive decline in common neurocognitive disorders in diagnosis-related patterns. Sci Rep 2023; 13:7556. [PMID: 37160982 PMCID: PMC10169815 DOI: 10.1038/s41598-023-33701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/18/2023] [Indexed: 05/11/2023] Open
Abstract
The aim of this study was to investigate the effect of arterial hypertension (AH) and of obstructive sleep apnea (OSA) on cognitive course in the neurocognitive disorder (NCD) cohort RIFADE which enrolled patients with NCD due to Alzheimer's disease (AD), vascular NCD (vNCD), and mixed NCD (AD + vNCD = mNCD). Multiple risk factors (RF), including AH and OSA, that contribute to the development of various kinds of dementia have been identified in previous studies. Studies that observed AH lacked investigation of long-term effects and did not isolate it from other RF. Studies involving OSA as a risk factor did not include participants with all stages of NCD. 126 subjects were screened for AH and OSA. Repeated cognitive measurements were performed with the DemTect as primary outcome and the clock drawing test as secondary outcome measure. 90 patients had AH (71.4%) and 40 patients had OSA (31.7%). RF-status had a significant effect on cognitive outcome in models with RF as single factors (AH p = 0.027, OSA p < 0.001), a 2-factor analysis with AH × OSA (AH as main factor p = 0.027) as well as a model including the 3 factors AH × OSA × diagnosis (p = 0.038). Similarly, a 3-factor model was significant for the clock-drawing test, whereas single factor-models remained insignificant. AH and OSA appear to be risk factors in common NCD and cognitive decline can be mitigated by treatment of these RF.
Collapse
Affiliation(s)
- Milenko Kujovic
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
- Department of Neuropsychiatry, Centre for Neurology and Neuropsychiatry, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
| | - Tim Lipka
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Mark Zalman
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Leonie Baumann
- Department of Mental Health, University Hospital of Münster, Munster, Germany
| | - Michaela Jänner
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Bruno Baumann
- Department of Mental Health, University Hospital of Münster, Munster, Germany
| |
Collapse
|
2
|
Kenao TS, Sossa JC, Paraiso MN, Belo M, Sopoh GE, Tchankoni KM, Agueh V. Sodium, potassium food intake and global cardiovascular risks in Togo. J Public Health Afr 2023; 14:2301. [PMID: 37441118 PMCID: PMC10334439 DOI: 10.4081/jphia.2023.2301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/04/2022] [Indexed: 07/15/2023] Open
Abstract
Objectives To assess urinary sodium/potassium intake and identify its links with global cardiovascular risk (GCVR) according to the WHOPEN approach to WHO/ISH (International High Blood Pressure Society). Methods It was a cross-sectional and analytical study that took place from July 6, 2020, to September 17, 2021, in Togo, in the Aneho, Notse and Dapaong localities. It focused on 400 adults selected by sampling. The analysis of two urine samples was done. Cardiovascular risk scores were determined from specific graphs that take into account age, gender, systolic blood pressure, diabetes status, and smoking behavior. Results Among the 400 respondents, 49% lived in rural areas. The average age was 41 (30; 51) years. The average sodium and potassium intakes were respectively 3.2 g (1.04-5.99) or 7.95 g of salt and 1.4 g (1.89-5.62) per day. The risk of excessive sodium intake was 2.39 times higher in urban areas than in rural ones (P=0.049). Residing in rural areas was associated with high potassium intakes compared to urban ones [OR=3,2 IC (1.89-5.62)]. Thirteen percent (13%) of respondents were likely to develop at least a deadly or non-deadly cardiovascular disease in the next 10 years 'time, of whom 5% present a high risk. Excessive sodium intake increases by 2.10 times the risk of a deadly cardiovascular disease occurrence. Conclusions Sodium intakes are high while potassium intakes are low with a subsequent GCVR in the three cities. Sodium intakes were associated with GCVR. It is necessary to take steps to reduce excessive sodium intake and improve potassium intake.
Collapse
Affiliation(s)
- Tchasso Serge Kenao
- Health Promotion Department, Regional Institute of Public Health, University of Abomey-Calavi, Benin
| | - Jerome Charles Sossa
- Health Promotion Department, Regional Institute of Public Health, University of Abomey-Calavi, Benin
| | - Moussiliou Noël Paraiso
- Health Promotion Department, Regional Institute of Public Health, University of Abomey-Calavi, Benin
| | - Mofou Belo
- University of Lomé, Faculty of Medicine, Togo
| | - Ghislain Emmanuel Sopoh
- Department of Policy and Health Policy, Regional Institute of Public Health, University of Abomey-Calavi, Benin
| | | | - Victoire Agueh
- Health Promotion Department, Regional Institute of Public Health, University of Abomey-Calavi, Benin
| |
Collapse
|
3
|
Strauss-Kruger M, Wentzel-Viljoen E, Ware LJ, Van Zyl T, Charlton K, Ellis S, Schutte AE. Early evidence for the effectiveness of South Africa's legislation on salt restriction in foods: the African-PREDICT study. J Hum Hypertens 2023; 37:42-49. [PMID: 35091704 DOI: 10.1038/s41371-021-00653-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/13/2021] [Accepted: 12/21/2021] [Indexed: 01/31/2023]
Abstract
South Africa was among the first countries to adopt mandatory regulation in 2016 to lower the salt content in processed foods, aiming to reduce population salt intake to <5 g/day. To assess the effectiveness of this regulation in 20-30 year-old adults, we determined the change in salt intake over a mean follow-up time of 4.56-years spanning the implementation of the regulation. This observational study included baseline (2013-2016; N = 668; 24.9 ± 3 years; 47.8% black; 40.7% men) and follow-up data (2018-ongoing; N = 311; 25.4 ± 3.05 years; 51.1% black; 43.4% men) for participants of the African-PREDICT study. Salt intake was estimated from 24-h urinary sodium excretion. Median salt intake at baseline (N = 668) was 7.88 g/day (IQR: 5.67). In those followed (N = 311), salt intake reduced from baseline [median (IQR): 7.91 g/day (5.83)] to follow-up [7.26 g/day (5.30)] [unadjusted median: -0.82 g/day]. After adjusting for baseline salt intake to address regression to the mean, the mean salt reduction was -1.2 g/day. The greatest reductions were in men [mean difference: -1.47 g/day], black adults [mean difference: -2.04 g/day], and participants from low [mean difference: -1.89 g/day] or middle [mean difference: -1.84 g/day] socio-economic status groups, adjusting for baseline salt intake. Our preliminary findings suggest that South Africa's salt regulation has been effective in lowering salt intake in young adults by ~1.2 g salt/day. Our study supports the effectiveness of upstream interventions to lower population salt intake, particularly for vulnerable groups who may typically consume more processed foods. It needs to be determined if the legislation has the anticipated population health gains.
Collapse
Affiliation(s)
- Michél Strauss-Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, 2520, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, 2520, South Africa
| | | | - Lisa J Ware
- DSI-NRF Centre of Excellence in Human Development and SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Tertia Van Zyl
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, 2520, South Africa
| | - Karen Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia
| | - Suria Ellis
- Pure and Applied Analytics, North-West University, Potchefstroom, 2520, South Africa
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, 2520, South Africa. .,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, 2520, South Africa. .,DSI-NRF Centre of Excellence in Human Development and SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa. .,School of Population Health, University of New South Wales, Sydney, NSW, 2052, Australia. .,The George Institute for Global Health, Sydney, NSW, 2042, Australia.
| |
Collapse
|
4
|
Ojo AE, Jones A, Okoro CE, Alfa VO, Okoli R, Shedul GL, Orji IA, Osagie S, Chopra A, Van Horn LV, Hirschhorn LR, Trieu K, Taylor F, Howes K, Ilias M, Williams MJ, Tutse-Tonwe V, Neal B, Huffman MD, Ojji DB. Sodium Content and Labelling of Packaged Foods and Beverages in Nigeria: A Cross-Sectional Study. Nutrients 2022; 15. [PMID: 36615685 DOI: 10.3390/nu15010027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Increased consumption of unhealthy processed foods, particularly those high in sodium, is a major risk factor for cardiovascular diseases. The nutrition information on packaged foods can help guide consumers toward products with less sodium and support government actions to improve the healthiness of the food supply. The aims of this study were to estimate the proportion of packaged foods displaying nutrition information for sodium and other nutrients specified by Nigerian nutrition labelling regulations and to determine the amount of sodium in packaged foods sold in Nigeria using data from the nutritional information panel. Data were collected from November 2020 to March 2021 from in-store surveys conducted in supermarkets in three states. A total of 7039 products were collected. Overall, 91.5% (n = 6439) provided only partial nutrition information, 7.0% (n = 495) provided no nutritional information, and only 1.5% (n = 105) displayed a nutrient declaration that included all nutrients specified by 2019 Nigerian regulations. Some form of sodium content information was displayed for 86% of all products (n = 6032), of which around 45% (n = 2689) expressed this as 'salt' and 59% (n = 3559) expressed this as 'sodium', while a small number of food products had both 'salt' and 'sodium' content (3.6%). Provision of sodium or salt information on the label varied between food categories, ranging from 50% (vitamins and supplements, n = 2/4) to 96% (convenience foods, n = 44/46). Food categories with the highest median sodium content were 'meat and meat alternatives' (904 mg/100 g), 'sauces, dressings, spreads, and dips' (560 mg/100 g), and 'snack foods' (536 mg/100 g), although wide variation was often observed within categories. These findings highlight considerable potential to improve the availability and consistency of nutrition information on packaged products in Nigeria and to introduce further policies to reduce the amount of sodium in the Nigerian food supply.
Collapse
|
5
|
Masenga SK, Pilic L, Hamooya BM, Nzala S, Heimburger DC, Mutale W, Koethe JR, Kirabo A, Munsaka SM, Elijovich F. Immediate pressor response to oral salt and its assessment in the clinic: a time series clinical trial. Clin Hypertens 2022; 28:25. [PMID: 36104796 PMCID: PMC9476589 DOI: 10.1186/s40885-022-00209-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 05/06/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND High blood pressure (BP) is associated with high-salt consumption especially in sub-Saharan Africa. Although the pressor effect of salt is viewed as a chronic effect, some studies suggest that a salty meal may increase BP immediately in some individuals, and that this effect may cause endothelial dysfunction. Therefore, the aim of our research was to study the immediate pressor response to oral salt (IPROS) and its determinants, with the expectation that a simple methodology may be devised to diagnose it in the clinic or in low-resource environments. METHODS We conducted a time series trial at Livingstone Central Hospital. We present data in 127 normotensive participants who ingested 2 g of sodium chloride; their BP was monitored for 120 minutes in intervals of 10 minutes. Sociodemographic and clinical data were collected. Descriptive and inferential statistics were used for analyses of data. RESULTS Median age was 30 years (interquartile range, 22-46 years) and 52% were female patients. An increase of ≥10 mmHg in mean arterial pressure (MAP), considered a clinically significant IPROS, was present in 62% of participants. Systolic BP 30 minutes after the salt load was a significant predictor of IPROS, avoiding the need to calculate MAP in the clinic setting. CONCLUSIONS We confirm the presence of an IPROS in a high proportion (62%) of otherwise normotensive participants. The average time course for this response was 30 minutes and its duration was sustained for the 120-minutes period of study in most of the participants. Prediction of IPROS by ∆SBP (change in systolic blood pressure) at 30 minutes allows for easy assessment of possible responder status in the clinic. Our data indicate that the IPROS to oral salt-loads in the range currently consumed by the Western world and African populations in single meals may increase the 24-hour BP load, which is a risk factor for hypertension and target organ damage. The relevance of our findings indicates the need to include dietary sodium assessment in the diagnosis, prevention, and management of high BP.
Collapse
Affiliation(s)
- Sepiso K. Masenga
- grid.442660.20000 0004 0449 0406HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Akapelwa street, LUTH Premises, Livingstone, Zambia ,grid.12984.360000 0000 8914 5257Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Leta Pilic
- grid.417907.c0000 0004 5903 394XFaculty of Sport, Health and Applied Science, St. Mary’s University, Twickenham, London, UK
| | - Benson M. Hamooya
- grid.442660.20000 0004 0449 0406HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Akapelwa street, LUTH Premises, Livingstone, Zambia ,grid.12984.360000 0000 8914 5257School of Public Health and School of Medicine, University of Zambia, Lusaka, Zambia
| | - Selestine Nzala
- grid.12984.360000 0000 8914 5257School of Public Health and School of Medicine, University of Zambia, Lusaka, Zambia
| | - Douglas C. Heimburger
- grid.12984.360000 0000 8914 5257School of Public Health and School of Medicine, University of Zambia, Lusaka, Zambia ,grid.412807.80000 0004 1936 9916Department of Medicine, Vanderbilt Institute for Global Health and Vanderbilt University Medical Center, Nashville, TN USA
| | - Wilbroad Mutale
- grid.12984.360000 0000 8914 5257School of Public Health and School of Medicine, University of Zambia, Lusaka, Zambia
| | - John R. Koethe
- grid.412807.80000 0004 1936 9916Department of Medicine, Vanderbilt Institute for Global Health and Vanderbilt University Medical Center, Nashville, TN USA
| | - Annet Kirabo
- grid.412807.80000 0004 1936 9916Department of Medicine, Vanderbilt Institute for Global Health and Vanderbilt University Medical Center, Nashville, TN USA
| | - Sody M. Munsaka
- grid.12984.360000 0000 8914 5257Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Fernando Elijovich
- grid.412807.80000 0004 1936 9916Department of Medicine, Vanderbilt Institute for Global Health and Vanderbilt University Medical Center, Nashville, TN USA
| |
Collapse
|
6
|
Abstract
Cancer is a major cause of morbidity and mortality in many sub-Saharan African countries, but the field of psycho-oncology is underdeveloped. This article reviews the literature on psychosocial oncology in sub-Saharan African with a view to developing a research and practice agenda in the field. The search engines used were Google Scholar, Psych Info, Web of Science, and PubMed and articles were focused on but not limited to the past 10 years. The search terms were ‘Africa, psycho-oncology, psychosocial oncology, mental health, and cancer’. The review is structured as follows: cancer surveillance in sub-Saharan African, behavioural risk factors, cancer screening, and psychosocial issues related to various types of cancers. Psychological reactions in the context of cancer including adjustment, depression, and anxiety disorders are also discussed. It is suggested that sub-Saharan African countries require appropriate funding to support improved systems of surveillance and implementation of cancer registries. Public health and behavioural interventions are needed to increase the awareness of cervical cancer and preventive health-seeking behaviour among high-risk women. Restrictive laws on opioids need to be reconsidered and behavioural health campaigns to control obesity, limit salt intake, and increase awareness of the risks of ultra-violet light are necessary to reduce the incidence of various cancers. Psychosocial support is necessary to ameliorate depressed mood, anxiety, and anticipation and fear of death among persons living with cancer and their families in sub-Saharan Africa. To this end, the training of practitioners to strengthen psychosocial aspects of care, especially palliative care, is a priority.
Collapse
Affiliation(s)
- Ashraf Kagee
- Department of Psychology, Stellenbosch University, South Africa
| |
Collapse
|
7
|
Archer NS, Cochet-Broch M, Mihnea M, Garrido-Bañuelos G, Lopez-Sanchez P, Lundin L, Frank D. Sodium Reduction in Bouillon: Targeting a Food Staple to Reduce Hypertension in Sub-saharan Africa. Front Nutr 2022; 9:746018. [PMID: 35187028 PMCID: PMC8847432 DOI: 10.3389/fnut.2022.746018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/10/2022] [Indexed: 12/13/2022] Open
Abstract
Bouillon cubes are a staple ingredient used in Sub-saharan African countries providing flavor enhancement to savory foods. Bouillon has been identified as a vehicle for fortification to overcome micronutrient deficiencies in Sub-saharan Africa. However, bouillon has a high sodium content (and in addition with other foods) contributes to dietary sodium intake above recommended guidelines. High dietary sodium intake is a key risk factor for hypertension and cardiovascular disease (CVD). Africa has the highest rates of hypertension and CVD globally with nearly half the adult population above 25 years affected. This review presents current state of research on sodium reduction strategies in bouillon. The key challenge is to reduce sodium levels while maintaining optimal flavor at the lowest possible production cost to ensure bouillon continues to be affordable in Sub-saharan Africa. To produce lower sodium bouillon with acceptable flavor at low cost will likely involve multiple sodium reduction strategies; direct reduction in sodium, sodium replacement and saltiness boosting flavor technologies. Efforts to reduce the sodium content of bouillon in Sub-saharan Africa is a worthwhile strategy to: (i) lower the overall sodium consumption across the population, and (ii) deliver population-wide health benefits in a region with high rates of hypertension and CVD.
Collapse
Affiliation(s)
- Nicholas S. Archer
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Agriculture and Food, Sydney, NSW, Australia
- *Correspondence: Nicholas S. Archer
| | - Maeva Cochet-Broch
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Agriculture and Food, Sydney, NSW, Australia
| | - Mihaela Mihnea
- RISE Research Institutes of Sweden, Agriculture and Food, Gothenburg, Sweden
| | | | | | - Leif Lundin
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Agriculture and Food, Melbourne, VIC, Australia
| | - Damian Frank
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Agriculture and Food, Sydney, NSW, Australia
| |
Collapse
|
8
|
Ndanuko R, Maganja D, Kibet A, Coyle DH, Kimiywe J, Raubenheimer D, Marklund M, Wu JHY. Sodium Content and Labelling Completeness of Packaged Foods and Beverages in Kenya. Nutrients 2021; 13:1385. [PMID: 33924065 PMCID: PMC8074286 DOI: 10.3390/nu13041385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/14/2021] [Accepted: 04/18/2021] [Indexed: 11/19/2022] Open
Abstract
Increased consumption of unhealthy processed foods, particularly those high in sodium, is a major risk factor for cardiovascular diseases. Nutrition information on packaged foods can help guide consumers toward products with less sodium, however the availability of nutrition information on foods sold in Kenya is currently unknown. The aims of this study were to estimate the proportion of packaged foods and beverages displaying nutrition information for sodium and determine the amount of sodium in packaged foods available for sale in Kenya. Data was collected in 2019 from five retail supermarkets in Nairobi. The availability of sodium information provided on packaged products and the sodium content were recorded. As secondary analyses, we compared sodium content labelling of products in Kenya by manufacturing location and the sodium content of products available in Kenya and South Africa. A total of 6003 packaged products in 56 food categories were identified. Overall, 39% of products displayed sodium content, though the availability of labelling varied widely between food categories, with coverage in main categories ranging from 0% (yoghurts and yoghurt drinks) to 86% (breakfast cereals). Food categories with the highest median sodium content were herbs and spices (9120 mg/100 g), sauces (1200 mg/100 g) and meat alternatives (766 mg/100 g) although wide variabilities were often observed within categories. Imported products were more likely to provide information on sodium than locally produced products (81% compared to 26%) and reported higher median sodium levels (172 mg/100 g compared to 96 mg/100 g). Kenyan products reported a higher median sodium content than South African products in six categories while South African products had higher median sodium in 20 categories, with considerable variation in median sodium content between countries in some categories. These findings highlight considerable potential to improve the availability of sodium information on packaged products in Kenya and to introduce reformulation policies to reduce the amount of sodium in the Kenyan food supply.
Collapse
Affiliation(s)
- Rhoda Ndanuko
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia; (D.H.C.); (M.M.); (J.H.Y.W.)
| | - Damian Maganja
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia; (D.H.C.); (M.M.); (J.H.Y.W.)
| | - Alex Kibet
- Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi 00100, Kenya; (A.K.); (J.K.)
| | - Daisy H. Coyle
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia; (D.H.C.); (M.M.); (J.H.Y.W.)
| | - Judith Kimiywe
- Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi 00100, Kenya; (A.K.); (J.K.)
| | - David Raubenheimer
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Matti Marklund
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia; (D.H.C.); (M.M.); (J.H.Y.W.)
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Public Health and Caring Sciences, Uppsala University, 751 22 Uppsala, Sweden
| | - Jason H. Y. Wu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia; (D.H.C.); (M.M.); (J.H.Y.W.)
| |
Collapse
|
9
|
Tekle DY, Santos JA, Trieu K, Thout SR, Ndanuko R, Charlton K, Hoek AC, Huffman MD, Jan S, Webster J. Monitoring and implementation of salt reduction initiatives in Africa: A systematic review. J Clin Hypertens (Greenwich) 2020; 22:1355-1370. [PMID: 32770701 PMCID: PMC7496579 DOI: 10.1111/jch.13937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 01/18/2023]
Abstract
This systematic review aims to document salt consumption patterns and the implementation status and potential impact of salt reduction initiatives in Africa, from studies published between January 2009 and November 2019. Studies were sourced using MEDLINE, Embase, Cochrane Library electronic databases, and gray literature. Of the 887 records retrieved, 38 studies conducted in 18 African countries were included. Twelve studies measured population salt intake, 11 examined salt level in foods, 11 assessed consumer knowledge, attitudes, and behaviors, 1 study evaluated a behavior change intervention, and 3 studies modeled potential health gains and cost savings of salt reduction interventions. The population salt intake studies determined by 24‐hour urine collections showed that the mean (SD) salt intake in African adults ranged from 6.8 (2.2) g to 11.3 (5.4) g/d. Salt levels in foods were generally high, and consumer knowledge was fairly high but did not seem to translate into salt lowering behaviors. Modeling studies showed that interventions for reducing dietary sodium would generate large health gains and cost savings for the health system. Despite this evidence, adoption of population salt reduction strategies in Africa has been slow, and dietary consumption of sodium remains high. Only South Africa adopted legislation in 2016 to reduce population salt intake, but success of this intervention has not yet been fully evaluated. Thus, rigorous evaluation of the salt reduction legislation in South Africa and initiation of salt reduction programs in other African countries will be vital to achieving the targeted 30% reduction in salt intake by 2025.
Collapse
Affiliation(s)
- Dejen Yemane Tekle
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,School of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | | | - Rhoda Ndanuko
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Karen Charlton
- Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Annet C Hoek
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Mark D Huffman
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|