An Analysis of the Mineral Composition of Pink Salt Available in Australia

Little is known about the mineral composition of pink salt. The aim of this study was to evaluate for the first time the mineral composition of pink salt available for purchase in Australia and its implications for public health. Pink salt samples were purchased from retail outlets in two metropolitan Australian cities and one regional town. Color intensity, salt form, and country of origin were coded. A mass spectrometry scan in solids was used to determine the amount of 25 nutrients and non-nutritive minerals in pink salt (n = 31) and an iodized white table salt control (n = 1). A wide variation in the type and range of nutrients and non-nutritive minerals across pink salt samples were observed. One pink salt sample contained a level of lead (>2 mg/kg) that exceeded the national maximum contaminant level set by Food Standards Australia New Zealand. Pink salt in flake form, pink salt originating from the Himalayas, and darker colored pink salt were generally found to contain higher levels of minerals (p < 0.05). Despite pink salt containing nutrients, >30 g per day (approximately 6 teaspoons) would be required to make any meaningful contribution to nutrient intake, a level that would provide excessive sodium and potential harmful effects. The risk to public health from potentially harmful non-nutritive minerals should be addressed by Australian food regulations. Pink salt consumption should not exceed the nutrient reference values for Australia and New Zealand guidelines of <5 g of salt per day.

Impact of providing walnut samples in a lifestyle intervention for weight loss: a secondary analysis of the HealthTrack trial

Background: Being more specific about individual food choices may be advantageous for weight loss. Including a healthy food (e.g. walnuts) may help to expose effects.

Objective: To examine the impact of including walnuts in diets for weight loss.

Design: Secondary analysis of the HealthTrack lifestyle intervention trial. Overweight and obese participants were randomized to: usual care (C), interdisciplinary intervention including individualized dietary advice (I), or interdisciplinary intervention including 30 g walnuts/day (IW). Changes in body weight, energy intake, intake of key foods, physical activity, and mental health over three and 12 months were explored.

Results: A total of 293 participants completed the intensive three-month study period, and 175 had data available at 12 months. The IW group achieved the greatest weight loss at three months. IW reported significant improvements in healthy food choices, and decreased intakes of discretionary foods/beverages, compared to C. Weight loss remained greatest in IW at 12 months.

Discussion: Significant effects were seen after three months, with the IW group achieving greater weight loss and more favorable changes in food choices.

Conclusions: Including 30 grams walnuts/day in an individualized diet produced weight loss and positive changes in food choice.

Changes in diet quality during a 12 month weight loss randomised controlled trial

Background

Reductions in energy intake are seen in weight loss trials, but whether this occurs with improvements to diet quality (DQ) is less established. The aim of this study was to evaluate changes in diet quality in a sample of volunteers in a weight loss trial.

Methods

This was a secondary analysis of dietary data from a lifestyle intervention trial (the HealthTrack study) which advised on dietary guidelines. The trial ran for 12 months with three treatment groups: control (general advice C), intervention (individualised advice, I), and intervention plus a supplement of walnuts (IW). Both the published a priori diet quality score (APDQS, maximum score 164) and a study specific Diet Quality Tracker (DQT, maximum score 44) indicated compliance to dietary advice. DQ scores calculated at 0, 3months and 12months were evaluated using two-way RMANOVA, one-way ANOVA and one-way RMANOVA. Changes in intakes of food groups and nutrients were analysed using Kruskal-Wallis and Friedman’s tests.

Results

There were no differences between groups at baseline, but at 3months IW recorded higher DQ scores (APDQS:96 ± 10; DQT:22 ± 5, P < 1 × 10⁻³ for both) compared to I (APDQS:91 ± 13, P < 1 × 10⁻³; DQT:21 ± 4, P < 1 × 10⁻²) and C (APDQS:87 ± 12, P < 5 × 10⁻²; DQT:19 ± 4, P > 5 × 10⁻²), and a higher consumption of nuts at 3 months (P < 1 × 10⁻³), and 12months (P < 1 × 10⁻²). All groups reported decreased intakes of discretionary foods/beverages assessed by the DQT (P < 1 × 10⁻³ for IW and I; P < 1 × 10⁻² for C). The APDQS showed this as reduced intakes of grain based desserts (P < 1 × 10⁻³ at 3 and 12months), and salty snacks at 12months (P < 1 × 10⁻³ for IW and I; P < 5 × 10⁻² for C). Intakes of monounsaturated and saturated fatty acids were lowest, and polyunsaturated fatty acids highest for IW (P < 1 × 10⁻³), resulting in a higher dietary polyunsaturated:saturated fat ratio (P < 1 × 10⁻³).

Conclusions

Lifestyle intervention addressing dietary guidelines can lead to significant reductions in consumption of discretionary foods and saturated fat, but individualised advice may have a greater impact on improving overall DQ regardless of DQI used. Providing a healthy food supplement may help assure higher DQ and where the food is walnuts, produce commensurate differences in dietary fatty acid profiles.

Trial registration

ANZCTRN 12614000581662. Date of registration: 30th May 2014.

Electronic supplementary material

The online version of this article (doi:10.1186/s40795-017-0157-z) contains supplementary material, which is available to authorized users.

Ten-year single-center experience of the ketogenic diet: factors influencing efficacy, tolerability, and compliance

OBJECTIVES

To evaluate the efficacy, tolerability, and compliance of 3 ketogenic diets, the classical ketogenic diet, medium-chain triglyceride (MCT), and modified Atkins diet.

STUDY DESIGN

A single-center, retrospective study of 48 children with intractable epilepsy receiving ketogenic diets from 2003 to 2012. Patient demographics, epilepsy history, nutritional management, and side effects were collated. Compliance and tolerability were assessed by recording reasons for diet modification and cessation. The value of potassium citrate supplementation for preventing nephrolithiasis was reviewed.

RESULTS

Median age at ketogenic diet initiation was 3.8 years (IQR: 2.3-7 years). The majority had intractable epilepsy, and 33 of the 48 children (69%) had epileptic encephalopathies. Three (6%) patients became seizure free, 35 (73%) reported <50%-90% reduction, and 10 (21%) had 0%-50% reduction during a 2-year period. Diet duration or ketogenic diet type did not predict reduction in seizures (P = .381; P = .272). Constipation (n = 31, 65%) was very common. Food refusal (n = 3, 6%) and poor parental compliance (n = 5, 10%) were common reasons cited for cessation. There were lower rates of side effects for modified Atkins diet. Diet cessation was greatest for MCT; however, 3 patients on MCT ceased therapy because adequate seizure control was achieved. Nephrolithiasis was reported in 1 patient before potassium citrate was used and 2 patients noncompliant with potassium citrate supplementation developed hypercalciuria.

CONCLUSION

The 3 ketogenic diets were comparably effective in seizure control and generally well-tolerated. Potassium citrate supplementation is an effective prophylactic supplement for the prevention of nephrolithiasis.