Higher urinary sodium, a proxy for intake, is associated with increased calcium excretion and lower hip bone density in healthy young women with lower calcium intakes

We assessed 24-h urinary sodium (Na) and its relationship with urinary calcium (Ca) and areal bone mineral density (aBMD) at the whole body, lumbar spine and total hip in a cross-sectional study. 102 healthy non-obese women completed timed 24-h urine collections which were analyzed for Na and Ca. Dietary intakes were estimated using a validated food frequency questionnaire. Participants were grouped as those with lower vs. higher calcium intake by median split (506 mg/1000 kcal). Dietary Na intake correlated with 24-h urinary loss. Urinary Na correlated positively with urinary Ca for all participants (r = 0.29, p < 0.01) and among those with lower (r = 0.37, p < 0.01) but not higher calcium intakes (r = 0.19, p = 0.19). Urinary Na was inversely associated with hip aBMD for all participants (r = -0.21, p = 0.04) and among women with lower (r = -0.36, p < 0.01) but not higher (r = -0.05, p = 0.71) calcium intakes. Urinary Na also entered a regression equation for hip aBMD in women with lower Ca intakes, contributing 5.9% to explained variance. In conclusion, 24-h urinary Na (a proxy for intake) is associated with higher urinary Ca loss in young women and may affect aBMD, particularly in those with lower calcium intakes.     

The effect of salt usage behavior on sodium intake and excretion among Korean women

This study was done to explore the effect of Korean women''s salt usage behavior on their sodium intake and excretion according to aging. Dietary sodium intake and salt usage behavior were analyzed to compare the difference between young and middle-aged women. One hundred fifty six young women and 77 middle-aged women without hypertension or any current medication were recruited. Body mass index, waist hip ratio, blood pressure were measured from each subject. Salt usage behaviors were surveyed with questionnaire, sodium intake with 24-hr recall method, and sodium excretion with spot urine. Middle-aged women were more obese than young women according to body mass index and waist hip ratio. Blood pressure was significantly higher for the middle-aged. Young women consumed more fats and middle-aged women more carbohydrates. Middle-aged women consumed more sodium and potassium, and excreted more sodium. Among questionnaire items, kimchi, soup or pot stew, or salted vegetables were found to be related with high sodium diet. Salted vegetables and salted nuts and potato chips were significantly correlated with young women''s high sodium diet, while soy sauce on fried food, kimchi, salted vegetables accounted for middle-aged women''s high sodium diet. With these results, we concluded that middle-aged women consumed more carbohydrates, less fat, and more sodium and potassium than young women. Middle-aged women frequently choose kimchi, soup or pot stew, or salted vegetables, and they contribute to high sodium intake. We recommend to choose low-salt kimchi, less soup or pot stew, and more fresh vegetables for lower sodium diet.     

Reduction in sodium chloride intake: effects on urinary Na, K and aldosterone output in healthy free-living adults

Eleven healthy free-living adults (six women, five men) weighed and recorded all food and drink consumed and collected all urine for two non-consecutive 7-day periods whilst eating their usual diet (Period 1) and attempting to reduce salt intake (Period 2). Bread (including pitta bread) provided on average a quarter of total Na intake of subjects in Period 1 so that wholemeal bread made without added salt was made available in Period 2. All subjects achieved substantial reductions (mean 65%) in Na intake in Period 2 with no change in K intake so that the Na:K molar ratio fell from 1.3 to 0.5. Urinary Na output closely followed intakes and there was a large increase (mean 11.2 μg/d) in aldosterone excretion with a non-significant increase in K output. Simple linear relationships which allow prediction of Na and K intake from the more easily measured urinary output were derived.     

Measuring dietary sodium intake in infancy: a review of available methods

It has been hypothesised that infancy may be a particularly sensitive period with respect to the effect of dietary sodium (salt) intake on later blood pressure. If this is the case, interventions to reduce dietary sodium intake in infancy could have major public health impact by reducing cardiovascular disease in the future. However, research in this area is hampered by difficulties of how to measure dietary sodium intake in infancy. Here we review the literature with an aim to describe different methods that have been used for research purposes, how these have been used and their relative strengths and limitations. We identified five studies that were relevant to our aim. In epidemiological and intervention studies sodium intake in infancy has been assessed via parents using diet diaries, which appear to be feasible and acceptable to parents. In these studies, sodium concentration in breast milk is assumed not to vary from one woman to the next, which may not be correct but has been poorly studied. The gold standard method - 24 h urinary excretion of sodium - was used in only one study and there is debate about the most appropriate way to collect urine for research purposes in infants. None of the studies directly compared different methods for determining infant dietary sodium intake. We conclude that research is required to determine the best methods of estimating dietary sodium intake in infants in different research contexts.     

Combining food records with in-depth probing interviews improves quality of dietary intake reporting in a group of South Asian women

Objective: To investigate if the addition of an in‐depth interview focused on cultural dietary practices could improve the quality of dietary data from food records among South Asian women in New Zealand. Methods: Cross‐sectional data were collected from 134 South Asian women (≥20 years), living in Auckland. Dietary data were collected using four‐day food records. Nutritional analysis revealed 33.6% under‐reporting of energy intakes. All women were recalled for an in‐depth probing interview focused on culture‐specific foods and dietary practices. Results: The interview revealed extensive use of dairy products and plant oils. The nutrient content of the food record alone and the food record plus interview were compared; median energy intakes were 6,852 kJ vs 7,246 kJ (p<0.001); under‐reporting decreased by 14.2%, and total fat and protein intakes (g/day) increased (p<0.001). Estimates of poly‐ and mono‐unsaturated fatty acids increased significantly (p<0.001) due to greater use of plant oils due to greater use of plant oils replacing saturated fatty acid‐rich fats in food preparation. A significant increase (17%) (p<0.001) in calcium intake reflects the higher dairy intake identified with the interview. Conclusion: The addition of an in‐depth probing interview to a four‐day food record enhanced food intake reporting. Self‐reported dietary assessments in immigrant population groups require quality control for accuracy. Implications: Methods to ensure high‐quality dietary data are essential to assess health outcomes and to inform public health interventions, especially in immigrant populations.     

Exploring weight status,dietary intake and acculturation in South Asian women living in Brisbane,Queensland

Aim: To investigate the relationship between socio‐demographic characteristics, acculturation, weight status and dietary intake among a group of women from India and Pakistan living in Brisbane, Australia. Methods: Cross‐sectional survey of a convenience sample of 22 women that collected: socio‐demographic details; levels of acculturation; food intake using a specifically designed food frequency questionnaire and food diary; and anthropometric measurements. Data were compared with women from South Australia. Results: Women had a mean age of 38 years (24–50) and had been in Australia for an average of 4 years (1–25). Half (50%) of the women were categorised as overweight or obese and over two‐thirds (68%) had a waist measurement indicative of a high risk of chronic disease. A higher proportion of women from Pakistan were overweight and obese compared with Indian women. Women in this sample appeared to have a higher consumption of dairy, bread and cereals, vegetables and baked goods/snacks and were more likely to consume full‐fat milk compared with other Australian women. Breakfast was the meal most likely to have been ‘Australianised’. Conclusion: Despite the results not reaching statistical significance, these findings do point to areas worthy of further investigation. These include the relationship between acculturation factors with dietary intake and the prevalence of overweight and obesity. Given the high prevalence of overweight and obesity in this small sample, there appears to be a need to investigate diet and physical activity in specific groups to inform the development of culturally relevant chronic disease identification and management programmes.     

Culture and sex education: the acquisition of sexual knowledge for a group of Vietnamese Australian young women

Background. This paper explores how a group of Vietnamese Australian young women acquire knowledge of sexual issues, and the impact the traditional Vietnamese culture has on the acquisition of this knowledge. It is based on a qualitative study that examined the factors which shape the sexual behaviour of Vietnamese Australian young women living in Australia.

Methods. A Grounded Theory methodology was employed in this investigation, and involved in-depth interviews with 15 Vietnamese Australian young women aged 18–25 years, who reside in Victoria, Australia.

Results. The findings illustrated three key elements involved in the acquisition of knowledge of sexual issues: ‘Accepting parental silence’, ‘Exploring sources of knowledge’ and ‘Needing culturally targeted information’. The young women desired discussion about sexual issues but accepted that cultural ‘barriers’ were formidable. Their desire conflicted with the traditional familial norm of ‘silence’ regarding sexual matters. Consequently, knowledge was sought outside the home, specifically from peers and the media. The importance of culturally appropriate and adequate sexual discussions for Vietnamese Australian young people was stressed, so that informed decisions could be made about their sexual lives.

Conclusion. It is imperative for young people to have adequate and appropriate sexual education so that informed and safe sexual choices can be made. For young people from diverse cultural backgrounds, this education must be culturally appropriate and accessible, taking into consideration cultural mores regarding gender and sexual matters, as well as current beliefs in the ‘mainstream’ youth culture.     

Subjective evaluation of the frequency of salty food intake and its relationship to urinary sodium excretion and blood pressure in a middle-aged population

Objectives

The aim of this study was to examine the relationship between subjective evaluations of the frequency of salty food intake and both urinary sodium excretion and blood pressure (BP) in a middle-aged population.

Methods

Urinary sodium and creatinine concentrations in a spot sample and brachial BP were measured in 419 subjects (mean age 37 ± 9 years, 385 men) during a health examination at a company in Kanagawa, Japan, 2011. Twenty-four-hour urinary sodium excretion was estimated from sodium and creatinine concentrations in the spot sample. The subjects were asked about the frequency of salty food intake on a self-reported questionnaire, choosing their answer from ‘seldom’, ‘sometimes’, or ‘always’ based on their own subjective evaluation. The amount of daily salt intake was converted from 24-h urinary sodium excretion.

Results

The prevalence of high salt intake, defined as greater than the daily average salt intake of Japanese according to the National Health and Nutrition Survey in 2010, gradually increased from the ‘seldom’ to the ‘sometimes’, and then ‘always’ categories (10.3, 13.4, and 24.0 %, respectively; P = 0.013 for trend). The 24-h urinary sodium excretion among these groups also tended to be different; however, the differences did not reach a significantly significant level (145 ± 41, 152 ± 34, and 160 ± 40 mEq/day, respectively; P = 0.076). Both systolic and diastolic BP were similar among the groups.

Conclusions

Although some of our findings raise the possibility of a relationship between a subjective evaluation of the frequency of salty food intake and urinary sodium excretion, further studies are needed to confirm the relationship. In contrast, no relationship with BP was found.     

Estimating nitrate intake in the Australian diet: Design and validation of a food frequency questionnaire

Background

Dietary nitrates may play a role in mediating several key physiological processes impacting health and/or exercise performance. However, current methods for assessing dietary nitrate (NO₃⁻) consumption are inadequate. The present study aimed to examine the dietary nitrate intake in a sample of 50 healthy adults, as well as test the validity of a purposefully developed food frequency questionnaire (FFQ).

Methods

Dietary nitrate intake was estimated over a week using (i) three 24-h dietary recalls; (ii) a short-term (7-day) FFQ; and (iii) a biomarker (urinary nitrate), in conjunction with a nitrate reference database.

Results

Daily dietary nitrate intake estimates were 130.94 mg (average of three 24-h recalls) and 180.62 mg (FFQ). The mean urinary NO₃⁻ excretion was 1974.79 µmol day^–1 (or 917.9 µmol L^–1). Despite the difference between the two dietary assessment methods, there was a moderate positive correlation (r = 0.736, ρ < 0.001) between the two tools. There was also a positive correlation between urinary NO₃⁻ and 24-h recall data (r = 0.632, ρ < 0.001), as well as between urinary NO₃⁻ and FFQ (r = 0.579, ρ < 0.001).

Conclusions

The ability to accurately estimate nitrate intakes depends on having suitable reference methods to estimate the concentrations of nitrate in the food supply, coupled with valid and reliable dietary assessment tools. Based on the findings from the present study, at an individual level, dietary recalls or records may be more accurate in estimating intakes of NO₃⁻. However, given the lower cost and time needed for administration relative to recalls, the FFQ has merit for estimating NO₃⁻ intakes in health interventions, dietary surveys and surveillance programs.

     

The effect of dietary caffeine on urinary excretion of calcium,magnesium, sodium and potassium in healthy young females

Twelve female college students drank decaffeinated coffee or tea to which 0, 150 or 300 mg caffeine had been added. Each subject had fasted at least ten hours before drinking each of the three test beverages. Urine samples were collected at one, two and three hours after caffeine consumption. Total urinary three hour excretion of calcium, magnesium and sodium, but not potassium, increased significantly after caffeine intake. The increased output of calcium and sodium was mainly due to significantly increased urinary calcium and sodium concentrations, while the increased output of magnesium appeared to be due to the combination of both a slightly increased urinary magnesium concentration and volume. Total urine volume correlated significantly with dose of caffeine per body weight when 300 mg of caffeine was consumed. The effects of caffeine on mineral excretion were primarily due to changes in mineral concentration and increased urinary volume at one and two hours.     

A nutrition study involving a group of pregnant women in Assisi, Italy. Part 1: Anthropometry, dietary intake and nutrition knowledge, practices and attitudes

A study was conducted on a group of full term pregnant women in the gynaecology and obstetrics ward of the Assisi Hospital. The study included the anthropometric evaluation and a survey including information on eating habits, life styles, nutrition knowledge, food preferences and aversions during pregnancy, use of oral contraceptives, and cigarette smoking. A subset of 20 pregnant women was examined periodically from the beginning of the 2nd trimester until the end of pregnancy to ascertain anthropometric status and food consumption. In the same hospital the anthropometric measurements of 83 newborns were taken. In some cases there was a relatively small weight gain and therefore gain in body fat during pregnancy (6.3 kg), with obvious effects on the weight of their respective newborns. Eating habits showed notable quantitative and qualitative irrationalities and nutrition knowledge was poor. Oral contraceptives were not widely used.     

Urinary excretion of phthalate metabolites in 129 healthy Danish children and adolescents: estimation of daily phthalate intake

Background

Phthalates are a group of chemicals with widespread use in the industrial production of numerous consumer products. They are suspected to be involved in male reproductive health problems and have also been associated with several other health problems in children including obesity and asthma.

Objectives

To study the urinary excretion of phthalate metabolites in Danish children recruited from the general population, and to estimate the daily intake of phthalates in this segment of the population.

Method

One 24 h urine sample and to consecutive first morning urine samples were collected from 129 healthy Danish children and adolescents (range 6–21 yrs). The concentrations of 11 phthalate metabolites of 5 different phthalate diesters were analyzed by liquid chromatography–tandem mass spectrometry.

Results

The analyzed metabolites were detectable in almost all 24 h urine samples. The median concentrations of monoethyl phthalate (MEP), monobenzyl phthalate (MBzP) and the sums of the two monobutyl phthalate isoforms (∑MBP(i+n)), metabolites of di-(2-ethylhexyl) phthalate (∑DEHPm) and of di-iso-nonyl phthalate (∑DiNPm) were 29, 17, 111, 107 and 31 ng/mL, respectively. The youngest children were generally more exposed to phthalates than older children and adolescents (except diethyl phthalate (DEP)). Boys were more exposed than girls. The median estimated daily intake of phthalate diesters was: 4.29 (dibutyl phthalate isoforms (DBP(i+n))), 4.04 (DEHP), 1.70 (DiNP), 1.09 (DEP) and 0.62 (butylbenzyl phthalate (BBzP)), all calculated as μg/kg body weight/24 h. Between 40% and 48% of the absolute amount of phthalate metabolites excreted over 24 h were excreted in first morning urine voids.

Conclusion

Danish children are exposed simultaneously to multiple phthalates. The highest exposure levels were found for DBP(i+n) and DEHP, which in animal models are the known most potent anti-androgenic phthalates. The combined exposure to the two isoforms of DBP, which have similar endocrine-disrupting potencies in animal models, exceeded the TDI for di-n-butyl phthalate (DnBP) in several of the younger children.     

Urinary excretion of 13 dietary flavonoids and phenolic acids in free-living healthy subjects - variability and possible use as biomarkers of polyphenol intake

OBJECTIVE: Estimation of dietary intake of polyphenols is difficult, due to limited availability of food composition data and bias inherent to dietary assessment methods. The aim of the present study was to evaluate whether we could detect polyphenols and their metabolites in a spot urine sample in a free-living human population and whether it was related to those observed in 24-h urine samples, for potential use as a biomarkers of polyphenol intake. SUBJECTS: Four 24-h urine samples and two spot urine samples were collected from 154 participants of the SU.VI.MAX cohort (a randomized primary-prevention trial evaluating the effect of daily antioxidant supplementation on chronic diseases) in two separate studies over, respectively, a 7- and 2-day periods. Thirteen polyphenols and metabolites (chlorogenic acid (CGA), caffeic acid (CA), m-coumaric acid (mCOU), gallic acid (GA), 4-O-methylgallic acid (MeGA), quercetin (Q), isorhamnetin (MeQ), kaempferol (K), hesperetin (HESP), naringenin (NAR), phloretin (PHLOR), enterolactone (ENL) and enterodiol (END) were measured using HPLC-ESI-MS-MS. RESULTS: Correlations between the urinary excretion levels were observed. The most significant were explained by metabolic filiations (CGA/CA, CA/mCOU, GA/MeGA, Q/MeQ, NAR/PHLOR, ENL/END) or co-occurrence in a same food source (NAR/HESP). Concentrations in spot samples correlated with those in 24-h urine sample (P<0.02, except for CA and for MeQ). Intra-individual variations were smaller than inter-individual variations for all polyphenols (P<0.01) except for MeGA and for PHLOR. CONCLUSION: These results show that these polyphenols and metabolites are useful biomarkers for polyphenol intake.     

Termination of pregnancy: associations with partner violence and other factors in a national cohort of young Australian women

OBJECTIVE: To examine the associations between termination and other reproductive events, socio-demographic characteristics and experience of violence among a community-based national sample of young Australian women. METHODS: Using multiple logistic regression, we analysed data from the Younger cohort of the Australian Longitudinal Study on Women's Health comprising 14,776 young women aged 18-23 in survey 1 (1996), of whom 9,683 aged 22-27 also responded to survey 2 (2000). We stratified respondents into those aged below 20 and those who were older at survey 1. We compared the characteristics associated with terminations among teenage women in 1996 (survey 1) with those of women aged over 20 in 1996 who had not then reported a termination and who responded to survey 2 in 2000. Finally, we compared the characteristics of women reporting terminations, births, preterm births and miscarriages. RESULTS: Women reporting teenage terminations were more likely to be in a de facto relationship (OR = 1.94, 95% CI 1.17-3.21), less well educated (OR = 2.32, 95% CI 1.44-3.74), have no private health insurance, and be a victim of partner violence (OR = 3.11, 95% CI 1.76-5.49). Women reporting later terminations were also more likely to be abused by a partner (OR = 3.52, 95% CI 2.14-5.81).The relationship with violence held for the other reproductive events. CONCLUSION AND IMPLICATIONS: Partner violence is a strong predictor of termination and other reproductive outcomes among young Australian women. Education has a protective effect. Prevention and reduction of partner violence may reduce the rate of unwanted pregnancy.     

The effect of dietary caffeine on urinary excretion of calcium,magnesium, phosphorus,sodium, potassium,chloride and zinc in healthy males

Fifteen males drank decaffeinated coffee to which 0, 150 or 300 mg caffeine had been added. Each subject had fasted at least ten hours before drinking each of the three test beverages. Urine samples were collected at one, two and three hours after caffeine consumption. Total urinary three hour excretion of calcium, magnesium, sodium and chloride increased significantly after caffeine intake, while zinc, phosphorus, potassium, creatinine and volume were unchanged. The increased outputs were due to increased urinary mineral concentrations.     

Higher levels of serum triglyceride and dietary carbohydrate intake are associated with smaller LDL particle size in healthy Korean women

The aim of this study was to investigate the influencing factors that characterize low density lipoprotein (LDL) phenotype and the levels of LDL particle size in healthy Korean women. In 57 healthy Korean women (mean age, 57.4 ± 13.1 yrs), anthropometric and biochemical parameters such as lipid profiles and LDL particle size were measured. Dietary intake was estimated by a developed semi-quantitative food frequency questionnaire. The study subjects were divided into two groups: LDL phenotype A (mean size: 269.7Å, n = 44) and LDL phenotype B (mean size: 248.2Å, n = 13). Basic characteristics were not significantly different between the two groups. The phenotype B group had a higher body mass index, higher serum levels of triglyceride, total-cholesterol, LDL-cholesterol, apolipoprotein (apo)B, and apoCIII but lower levels of high density lipoprotein (HDL)-cholesterol and LDL particle size than those of the phenotype A group. LDL particle size was negatively correlated with serum levels of triglyceride (r = -0.732, P < 0.001), total-cholesterol, apoB, and apoCIII, as well as carbohydrate intake (%En) and positively correlated with serum levels of HDL-cholesterol and ApoA1 and fat intake (%En). A stepwise multiple linear regression analysis revealed that carbohydrate intake (%En) and serum triglyceride levels were the primary factors influencing LDL particle size (P < 0.001, R² = 0.577). This result confirmed that LDL particle size was closely correlated with circulating triglycerides and demonstrated that particle size is significantly associated with dietary carbohydrate in Korean women.     

Osteoporosis knowledge,calcium intake,and weight-bearing physical activity in three age groups of women

The purpose of this study was to determine the extent and integration of osteoporosis knowledge in three age groups of women and compare knowledge to calcium intake and weight-bearing physical activity (WBPA). In this cross-sectional study, knowledge, calcium intake and WBPA were assessed using probe interviews, a food frequency and an activity questionnaire, respectively. Seventy-five white women were separated into three groups: young (25–35 years), middle aged (36–46 years) and postmenopausal (50+ years). Concept maps were used to assess knowledge (concepts, integration and misconceptions). Calcium intakes from diet, supplements and fortified orange juice were estimated as were minutes of daily WBPA. Analysis of covariance was used to compare knowledge, calcium intake and WBPA by age group. Covariates included education, family history, physical problems making exercise difficult, and lactose intolerance. Chi square analysis was used to determine differences in these covariates across age groups. Correlations and regression analysis were used to determine relationships between knowledge and behaviors. Knowledge scores averaged 32–44 points (183 possible). Average calcium intake in all groups exceeded the Dietary Reference Intake's recommended Adequate Intake but 20–24% consumed less than 60% of the AI. Housework, walking at work, and standing at home and work accounted for 90% of WBPA. Knowledge about osteoporosis was limited and not associated with age, WBPA or calcium intake. Calcium intake and WBPA were not associated with age. Practitioners need to provide explicit information on osteoporosis and risk reducing behaviors to women of all ages.