Dietary Sodium Intake and Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis

Wang, Yijie; Yeh, Tzu-Lin; Shih, Ming‐Chieh; Tu, Yu–Kang; Chien, Kuo–Liong

doi:10.3390/nu12102934

Cited by 100 publications

(65 citation statements)

References 84 publications

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“…The modifiable risk factors of CVD included unhealthy dietary habits, physical inactivity and smoking (3) . Previous studies found that high Na consumption was associated with CVD risk in both high-v.-low and dose-response meta-analyses (4) . The WHO recommends that dietary Na intake should be <2 g/d (5) .…”

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confidence: 94%

Urinary sodium excretion and the risk of CVD: a community-based cohort study in Taiwan

et al. 2021

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Urinary sodium excretion is a potential risk factor for cardiovascular diseases (CVD). However, the underlying biological mechanisms and effects of salt sensitivity are unclear. The purpose of this study was to characterize the relative contribution of biological factors to the sodium-CVD association. A total of 2112 participants were enrolled in this study. Structured questionnaires and blood and urine samples were obtained. Twenty-four-hour sodium excretion was estimated using a single overnight urine sample. Hypertension, metabolic syndrome, and overweight status were considered to indicate salt sensitivity. Cox proportional hazard models were used to investigate the effects of salt sensitivity on urinary sodium excretion and CVD risk. The traditional mediation approach was used to calculate the proportion of mediation. The mean age (standard deviation) of the 2112 participants was 54.5 (12.2) years, and they were followed up for a mean of 14.1 [8.1] years. Compared with those in the lowest quartile, the highest baseline urinary sodium excretion (>4.2g/24 hours) was associated with a 43% higher CVD risk (hazard ratio, 1.43; 95% confidence interval, 1.02-1.99). Participants with high urinary sodium excretion, hypertension, or metabolic syndrome had a significantly high risk of CVD. The carotid intima-media thickness had the largest mediating effect (accounting for 35% of the sodium-CVD association), followed by systolic blood pressure (33%), left ventricular mass (28%), and diastolic blood pressure (14%). Higher urinary sodium excretion increased the risk of CVD, which was explained largely by carotid media-thickness and systolic blood pressure.

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confidence: 94%

Urinary sodium excretion and the risk of CVD: a community-based cohort study in Taiwan

et al. 2021

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“…In humans, an increase in potassium intake has been linked to decreasing blood pressure levels and stroke incidence, with an indication of a possible U-shape relationship with minimum risk at 3.5 g/day (i.e., 90 mmol/day) of potassium excretion [ 10 , 11 ]. Conversely, a decrease in sodium intake showed an approximately linear association with blood pressure levels [ 12 ], cardiovascular diseases [ 13 ], and stroke [ 14 ], with beneficial effects of sodium reduction in both subjects with and without hypertension [ 12 , 15 , 16 ].…”

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confidence: 99%

Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake

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High sodium and low potassium intakes are associated with increased levels of blood pressure and risk of cardiovascular diseases. Assessment of habitual dietary habits are helpful to evaluate their intake and adherence to healthy dietary recommendations. In this study, we determined sodium and potassium food-specific content and intake in a Northern Italy community, focusing on the role and contribution of adherence to Mediterranean diet patterns. We collected a total of 908 food samples and measured sodium and potassium content using inductively coupled plasma mass spectrometry. Using a validated semi-quantitative food frequency questionnaire, we assessed habitual dietary intake of 719 adult individuals of the Emilia-Romagna region. We then estimated sodium and potassium daily intake for each food based on their relative contribution to the overall diet, and their link to Mediterranean diet patterns. The estimated mean sodium intake was 2.15 g/day, while potassium mean intake was 3.37 g/day. The foods contributing most to sodium intake were cereals (33.2%), meat products (24.5%, especially processed meat), and dairy products (13.6%), and for potassium they were meat (17.1%, especially red and white meat), fresh fruits (15.7%), and vegetables (15.1%). Adherence to a Mediterranean diet had little influence on sodium intake, whereas potassium intake was greatly increased in subjects with higher scores, resulting in a lower sodium/potassium ratio. Although we may have underestimated dietary sodium intake by not including discretionary salt use and there may be some degree of exposure misclassification as a result of changes in food sodium content and dietary habits over time, our study provides an overview of the contribution of a wide range of foods to the sodium and potassium intake in a Northern Italy community and of the impact of a Mediterranean diet on intake. The mean sodium intake was above the dietary recommendations for adults of 1.5–2 g/day, whilst potassium intake was only slightly lower than the recommended 3.5 g/day. Our findings suggest that higher adherence to Mediterranean diet patterns has limited effect on restricting sodium intake, but may facilitate a higher potassium intake, thereby aiding the achievement of healthy dietary recommendations.

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“… 63) Herein, we will focus on 2 staple foods, fish and salt, that characterize the East Asian diet 64) and were previously suggested as risk factors for CVDs. 65) 66) On the other hand, consuming red meat, 67) 68) rice, 69) 70) and alcohol 71) 72) showed no or faint associations with the risk of CVDs among Korean and Japanese populations, and thus were not discussed in depth.…”

Section: Modifiable Cardiovascular Risk Factors In Korea and Japan In The Literaturementioning

confidence: 99%

“…Dietary sodium intake is a potential risk factor for CVD. 66) In a case-control study of 304 cases with stroke and 249 age-matched controls conducted in Korea, high sodium intake was associated with 40% and 50% higher odds of stroke in men and women, respectively. 76) Another case-control study from Korea (n=146) revealed that a substantially higher proportion of stroke cases (60.3%) preferred salty foods than their counterparts (20.5%).…”

Section: Modifiable Cardiovascular Risk Factors In Korea and Japan In The Literaturementioning

confidence: 99%

Modifiable Risk Factors for Cardiovascular Disease in Korea and Japan

et al. 2021

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Author's summary Hypertension, diabetes, dyslipidemia, cigarette smoking, physical inactivity, obesity, and poor-quality diet are major modifiable risk factors for cardiovascular disease (CVD) in Korean and Japanese populations. In both Korea and Japan, physical inactivity exhibits the highest prevalence among the risk factors, followed by hypertension in Japan or obesity in Korea. Implementation of the primordial prevention strategies focused on the above-mentioned risk factors should be the priority of the health policymakers to tackle the growing burden of CVD in both countries.

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Dietary Sodium Intake and Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis

Cited by 100 publications

References 84 publications

Urinary sodium excretion and the risk of CVD: a community-based cohort study in Taiwan

Urinary sodium excretion and the risk of CVD: a community-based cohort study in Taiwan

Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake

Modifiable Risk Factors for Cardiovascular Disease in Korea and Japan

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