Dietary Sodium Intake and Mortality

Results of a recent study of data from the National Health and Nutrition Examination Survey (NHANES I) on sodium intake and all-cause and cardiovascular mortality may call into question current recommendations to limit salt intake. Further research is needed to explore the relationship between sodium, cardiovascular disease, and mortality.     

Trends in Dietary Intake among US 2- to 6-Year-Old Children, 1989-2008

BackgroundBetween 1989 and 2008, obesity increased markedly in children of all ages. We examined changes in the diets of children ages 2 to 6 years in the United States between 1989 and 2008. Our study provides new insight into diet changes that might have contributed to the sharp rise in obesity during this period.ObjectiveOur aim was to describe changes in diet among 2- to 6-year-old children from 1989 to 2008 related to sharp rises in obesity during this period.ParticipantsThis analysis included 10,647 children ages 2 to 6 years from the following five nationally representative surveys of dietary intake in the United States: Continuing Survey of Food Intake in Individuals 1989-1991 and 1994-1998 and the What We Eat In America, National Health and Nutrition Examination Surveys 2003-2004, 2005-2006, and 2007-2008. Diet data were categorized into groupings using the University of North Carolina-Chapel Hill approach.Statistical analysesAnalyses were carried out using a single 24-hour dietary recall with appropriate survey weighting. T tests were used to compare means across survey years, with P<0.05 considered significant.ResultsDuring the 20-year period, there were increases in per capita intake of savory snacks (+51 kcal; P<0.01), pizza/calzones (+32 kcal; P<0.01), sweet snacks and candy (+25 kcal; P<0.01), mixed Mexican dishes (+22 kcal; P<0.01), and fruit juice (+18 kcal; P<0.01), and total daily energy intake increased by 109 kcal (from 1,475 to 1,584 kcal) (P<0.05). Fruit intake increased marginally (+24 kcal; P<0.01). Six of the 10 greatest absolute changes in per capita intake between sequential survey years occurred between Continuing Survey of Food Intake in Individuals 1994-1998 and National Health and Nutrition Examination Surveys 2003-2004 (P<0.05).ConclusionsFoods high in added sugars and solid fats, such as savory snacks, pizza/calzones, mixed Mexican dishes, sweet snacks and candy, and fruit juice, predominated the top changes in per capita consumption between 1989 and 2008.     

2011年高密市居民膳食钠摄入量调查

目的了解高密市居民膳食钠摄入量及来源分布,为制定减盐防控高血压措施提供依据。方法2011年6月18日采用分阶段抽样抽取18～69岁居民,使用24h膳食称重法和调查问卷进行调查,收集膳食钠摄入量及来源分布。结果高密市18～69岁居民人均每日膳食钠摄人量为6065mg,其中来自日常调味品的为5024mg,占82．83％。膳食钠来源前三位的为精盐、其他食品、酱油,分别占膳食钠总量的56．67％、17．11％、16．81％。结论高密市居民膳食钠摄入量超标严重,应采取有效减盐措施。     

Dietary Protein Intake in Dutch Elderly People: A Focus on Protein Sources

Introduction: Sufficient high quality dietary protein intake is required to prevent or treat sarcopenia in elderly people. Therefore, the intake of specific protein sources as well as their timing of intake are important to improve dietary protein intake in elderly people. Objectives: to assess the consumption of protein sources as well as the distribution of protein sources over the day in community-dwelling, frail and institutionalized elderly people. Methods: Habitual dietary intake was evaluated using 2- and 3-day food records collected from various studies involving 739 community-dwelling, 321 frail and 219 institutionalized elderly people. Results: Daily protein intake averaged 71 ± 18 g/day in community-dwelling, 71 ± 20 g/day in frail and 58 ± 16 g/day in institutionalized elderly people and accounted for 16% ± 3%, 16% ± 3% and 17% ± 3% of their energy intake, respectively. Dietary protein intake ranged from 10 to 12 g at breakfast, 15 to 23 g at lunch and 24 to 31 g at dinner contributing together over 80% of daily protein intake. The majority of dietary protein consumed originated from animal sources (≥60%) with meat and dairy as dominant sources. Thus, 40% of the protein intake in community-dwelling, 37% in frail and 29% in institutionalized elderly originated from plant based protein sources with bread as the principle source. Plant based proteins contributed for >50% of protein intake at breakfast and between 34% and 37% at lunch, with bread as the main source. During dinner, >70% of the protein intake originated from animal protein, with meat as the dominant source. Conclusion: Daily protein intake in these older populations is mainly (>80%) provided by the three main meals, with most protein consumed during dinner. More than 60% of daily protein intake consumed is of animal origin, with plant based protein sources representing nearly 40% of total protein consumed. During dinner, >70% of the protein intake originated from animal protein, while during breakfast and lunch a large proportion of protein is derived from plant based protein sources.     

Digitally Supported Dietary Protein Counseling Changes Dietary Protein Intake,Sources, and Distribution in Community-Dwelling Older Adults

Digitally supported dietary counselling may be helpful in increasing the protein intake in combined exercise and nutritional interventions in community-dwelling older adults. To study the effect of this approach, 212 older adults (72.2 ± 6.3 years) were randomised in three groups: control, exercise, or exercise plus dietary counselling. The dietary counselling during the 6-month intervention was a blended approach of face-to-face contacts and videoconferencing, and it was discontinued for a 6-month follow-up. Dietary protein intake, sources, product groups, resulting amino acid intake, and intake per eating occasion were assessed by a 3-day dietary record. The dietary counselling group was able to increase the protein intake by 32% at 6 months, and the intake remained 16% increased at 12 months. Protein intake mainly consisted of animal protein sources: dairy products, followed by fish and meat. This resulted in significantly more intake of essential amino acids, including leucine. The protein intake was distributed evenly over the day, resulting in more meals that reached the protein and leucine targets. Digitally supported dietary counselling was effective in increasing protein intake both per meal and per day in a lifestyle intervention in community-dwelling older adults. This was predominantly achieved by consuming more animal protein sources, particularly dairy products, and especially during breakfast and lunch.     

Amount and Food Sources of Sodium Intake by Individuals 62 Years and Older

Results on sources of sodium intake in diets of elderly populations were reviewed and accompanied by an examination of previously unreported results on dietary sources of sodium. Results from NFCS, NHANES I, NHANES II and this study showed average sodium intake levels (excluding discretionary salt) were in the range of 2,00 to 2,900 mg/day. Assessment of data from three sources strongly indicated that grain products were the major source of sodium in elderly individuals' diets. Meats and mixed protein dishes and milk and milk products were identified as two other food categories contributing large portions of sodium to diets. Individuals who were identified as having had greater than average daily sodium consumption intakes had the same principal food sources of sodium. Their increased sodium intakes were attributed to increased intake of all foods and to heavier usage of condiments, sauces and dips, and salted snack foods.     

Dietary Intake and Sources of Added Sugars in Various Food Environments in Costa Rican Adolescents

Consumption of added sugars, especially from sugar-sweetened beverages (SSBs), has been associated with several negative health outcomes during adolescence. This study aimed to identify dietary intake and food sources of added sugars in the home, school, and neighborhood environments of Costa Rican adolescents. Dietary intake of added sugars was determined using 3-day food records in a cross-sectional study of 818 adolescents aged 12 to 19 and enrolled in rural and urban schools in the province of San José. On average, 90% of adolescents consumed more than 10% of their total energy intake from added sugars. Furthermore, 74.0% of added sugars were provided at home, 17.4% at school, and 8.6% in the neighborhood. Added sugars were primarily provided by frescos (29.4%), fruit-flavored still drinks (22.9%), and sugar-sweetened carbonated beverages (12.3%), for a total contribution of 64.6%. Our findings suggest that Costa Rican adolescents have a plethora of added sugar sources in all food environments where they socialize. However, it is relevant for public health to consider the home and school environments as fundamental units of interventions aimed at reducing added sugars in the adolescent diet. Frescos prepared at home and school and fruit-flavored still drinks must be the focus of these interventions.     

Estimated Dietary Polyphenol Intake and Major Food and Beverage Sources among Elderly Japanese

Estimating polyphenol intake contributes to the understanding of polyphenols’ health benefits. However, information about human polyphenol intake is scarce, especially in the elderly. This study aimed to estimate the dietary intake and major sources of polyphenols and to determine whether there is any relationship between polyphenol intake and micronutrient intake in healthy elderly Japanese. First, 610 subjects (569 men, 41 women; aged 67.3 ± 6.1 years) completed food frequency questionnaires. We then calculated their total polyphenol intake using our polyphenol content database. Their average total polyphenol intake was 1492 ± 665 mg/day, the greatest part of which was provided by beverages (79.1%). The daily polyphenol intake differed largely among individuals (183–4854 mg/day), also attributable mostly to beverage consumption. Coffee (43.2%) and green tea (26.6%) were the major sources of total polyphenol; the top 20 food items accounted for >90%. The polyphenol intake did not strongly correlate with the intake of any micronutrient, suggesting that polyphenols may exert health benefits independently of nutritional intake. The polyphenol intake in this elderly population was slightly higher than previous data in Japanese adults, and beverages such as coffee and green tea contributed highly to the intake.     

Estimation of Dietary Sources and Flavonoid Intake in a Spanish Adult Population (EPIC-Spain)

Background

Epidemiologic studies have suggested associations between flavonoid intake and health benefits. Traditional Mediterranean diets consist of a high consumption of plant products rich in flavonoids.

Objective

This study estimates dietary flavonoid intake and main food sources in a Mediterranean population (Spanish adults).

Design

The study included 40,683 subjects aged 35 to 64 years from northern and southern regions of Spain who were included in the European Prospective Investigation into Cancer and Nutrition study Spanish cohort. Usual food intake was assessed by personal interviews using a computerized version of a validated diet history method. Expanded US Department of Agriculture databases for the flavonoid, isoflavone, and proanthocyanidin content were used.

Results

The median and mean of total flavonoids were 269.17 and 313.26 mg/day, respectively. The most abundant flavonoid subgroup was proanthocyanidins (60.1%), followed by flavanones (16.9%), flavan-3-ols (10.3%), flavonols (5.9%), anthocyanidins (5.8%), flavones (1.1%), and isoflavones (<0.01%). The main sources of total flavonoid intake were apples (23%), red wine (21%), unspecified fruit (12.8%), and oranges (9.3%).

Conclusions

These results should be very useful for evaluating the relationships between flavonoid intake and several diseases.     

Assessing U.S. Sodium Intake through Dietary Data and Urine Biomarkers

Sodium intake is related to blood pressure, an established risk factor for heart disease and stroke. Reducing intake may save billions in United States health care dollars annually. Efforts targeting sodium reductions make accurate monitoring vital, yet limited information exists on the accuracy of the current data to assess sodium intake in the United States population. In this symposium, new findings were presented on the accuracy of estimating population 24-h urinary excretion of sodium from spot urine specimens or sodium intake from 24-h dietary recalls. Differences in accuracy by sex, BMI, and race were apparent as well as by timing of spot urine collections. Although some published equations appear promising for estimating group means, others are biased. Individual estimates of sodium intake were highly variable and adjustment for within-individual variation in intake is required for estimating population prevalence or percentiles. Estimates indicated United States sodium intake remains high.     

Regression Equation Predicts Dietary Phosphorus Intake from Estimate of Dietary Protein Intake

Objective To develop a predictive equation for dietary phosphorus intake.

Design In this clinic-based, cross-sectional study, a dietitian-administered food frequency questionnaire provided dietary intake estimates for a population of patients with chronic renal failure. A prediction equation for dietary phosphorus intake was developed and was validated on another sample of patients with CRF from the same clinic.

Subjects Outpatients treated for chronic renal failure at the E. Wolfson Medical Center Institute of Nephrology in Holon, Israel, participated in the study (N=104, 73 men and 31 women, mean AGE=65.6 years). The validation sample consisted of 53 outpatients with chronic renal failure (38 men and 15 women, mean AGE=64.2 years) from the same clinic.

Main outcome measures Dietary variables (ie, energy, protein, carbohydrate, fat, phosphorus) were examined in terms of crude intake, as percentage of total energy intake, and per kilogram of body weight.

Statistical analyses performed Stepwise linear regression analysis and Student's t tests were used to examine relationships between dietary phosphorus and other variables. Results Dietary phosphorus (milligrams)=128+14 (protein intake [grams]) was the best-fitting equation and explained 84% of the variance in dietary phosphorus intake.

Applications The prediction equation for dietary phosphorus intake is especially useful for renal dietitians who calculate patient diets by hand. J Am Diet Assoc. 1996; 96:1268-1270.     

Dietary Sodium Intake Is Positively Associated with Sugar-Sweetened Beverage Consumption in Chinese Children and Adolescents

Sugar-sweetened beverage (SSB) consumption among children and adolescents is steadily increasing in China, while the main taste of Chinese food is salty. The present study aimed to determine the relationships between SSB and total fluid consumption and dietary sodium and salt intake among children and adolescents in China. The data were obtained from a cross-sectional investigation in 2015. A total of 3958 participants were included. A 24-h dietary record for three consecutive days was collected to determine the SSB intake and food consumption across school days and rest days. After adjusting for age, sex, yearly household income, maternal education, intentional physical exercise, and instances of eating out in the last week, the dietary sodium intake was positively associated with the SSB consumption (p < 0.05), but salt was not. After stratifying by sex, grades, and puberty status, the associations between dietary sodium intake and SSB consumption were significant in girls, in grades 1–5 and before puberty (p < 0.05). Dietary sodium intake was positively associated with SSB consumption in Chinese children and adolescents, particularly in young children. A reduction of the sodium intake might help reduce SSB consumption among children and adolescents.     

Peer Reviewed: Dietary Intake of Minerals and the Risk of Ischemic Stroke in Guangdong Province,China, 2007-2008

Introduction

Previous studies have investigated the association between mineral intake and the risk of ischemic stroke, but results are inconsistent. We conducted a case-control study to ascertain the associations between intake of dietary potassium, calcium, magnesium, sodium, and iron and the ischemic stroke risk in the southern Chinese population.

Methods

Information on lifestyle and typical food consumption was obtained from 374 hospital inpatients with ischemic stroke and 464 hospital-based control patients. Added sodium from salt or soy sauce could not be reliably quantified, but participants were asked to characterize their diet as low in salt, normal, or high in salt. Logistic regression analyses were performed to assess possible associations between the effects of mineral intake and ischemic stroke risk.

Results

The mean weekly intakes of potassium, calcium, magnesium, and iron were lower among case patients than among control patients. Sodium was an exception. Lower stroke risk was associated with higher weekly dietary calcium or magnesium levels (adjusted odds ratio, 0.32) for the highest versus lowest category of intake, and significant dose-response relationships were seen. No significant associations were found for potassium, iron, or sodium. However, patients who consumed a salty diet were more than twice as likely as those whose diet was light in salt to experience an ischemic stroke.

Conclusion

The findings suggest that lowering sodium intake while maintaining high levels of dietary calcium and magnesium may help prevent ischemic stroke in southern Chinese adults.