Effect of nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults

Lee, You-Sin; Rhee, Moo-Yong; Lee, Sim-Yeol

doi:10.4162/nrp.2020.14.5.540

Cited by 6 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One possible reason for the lack of a significant increase in potassium intake may be that reducing sodium intake is known to help lower BP, but the important role of a high intake of potassium is often overlooked. Lee et al [30] evaluated the effects of nutrition education on decreasing sodium intake and increasing potassium intake in prehypertensive or untreated hypertensive Korean patients and found that education was effective in reducing sodium intake but not in increasing potassium. A recent meta-analysis also reported that global mean potassium intake (2.25 g/day) falls below the recommended intake level of >3.5 g/day, with the lowest mean potassium intake reported in Asia (1.89 g/day) and the highest mean intake in Eastern and Western Europe (3.53 g/day and 3.29 g/day, respectively) [31].…”

Section: Discussionmentioning

confidence: 99%

Home blood pressure measurement days and changes in urinary sodium-to-potassium ratio, estimated salt and potassium intakes and blood pressure: 1-year prospective study

Kinuta,

Hisamatsu,

Fukuda

et al. 2024

Blood Pressure Monitoring

View full text Add to dashboard Cite

Objective Current international guidelines recommend home blood pressure (BP) measurement and low sodium and high potassium intakes for the management of hypertension. We hypothesized that increased home BP measurement may result in more effective management of sodium and potassium intakes and BP. Methods We examined associations of home BP measurement days with changes in the urinary sodium-to-potassium (Na/K) ratio, estimated salt and potassium intakes and BP. We included 209 healthy participants (mean age, 55.9 years; 56.5% women) from a prospective cohort study. We examined 1-year data on self-measured home BP and spot urine samples. Results Median (interquartile range) days of home BP measurement was 324 (225–358) over 1-year. Baseline mean (SD) Na/K ratio, salt and potassium intakes, morning and evening SBP, and morning and evening DBP were 3.8 (2.3), 8.5 (1.9) g/day, 1833.5 (416.5) mg/day, 120.4 (14.0) mmHg, 118.2 (14.2) mmHg, 79.2 (10.1) mmHg, and 76.2 (10.1) mmHg, respectively. In multivariable-adjusted linear regression , β (standard error) per 10 days increase in number of home BP measurement were −0.031 (0.017) for Na/K ratio, −0.036 (0.015) for salt intake, −1.357 (2.797) for potassium intake, −0.178 (0.064) for morning SBP, −0.079 (0.041) for morning DBP, −0.109 (0.067) for evening SBP and −0.099 (0.045) for evening DBP. Additionally, relationships persisted for men and women, but changes in salt intake were more pronounced among participants taking antihypertensive medication (interaction P = 0.002). Conclusion Continuous measurement of home BP may lead not only to self-monitoring of BP, but also to declines in salt intakes and some BP indices.

show abstract

Section: Discussionmentioning

confidence: 99%

Home blood pressure measurement days and changes in urinary sodium-to-potassium ratio, estimated salt and potassium intakes and blood pressure: 1-year prospective study

Kinuta,

Hisamatsu,

Fukuda

et al. 2024

Blood Pressure Monitoring

View full text Add to dashboard Cite

show abstract

“…Excess sodium in the diet can lead to fluid retention and increased blood volume, exerting undue strain on the heart and blood vessels, a particularly relevant consideration for elderly individuals who may be more sensitive to the effects of sodium. 23 After engaging with the calendarbased program, the intervention group demonstrated increased consumption of fruits and vegetables, with particular emphasis on those rich in potassium and antioxidants like vitamins A and C. These minerals facilitate the relaxation of blood vessel walls, thereby reducing blood pressure and counteracting the effects of sodium. Specifically, increased potassium intake has been associated with lower blood pressure levels, making it an indispensable dietary component for elderly individuals.…”

Section: Effectiveness Of the Calendar-based Interventionmentioning

confidence: 99%

“…Specifically, increased potassium intake has been associated with lower blood pressure levels, making it an indispensable dietary component for elderly individuals. 23 Furthermore, physical activity, especially aerobic exercise, has been shown to enhance the functioning of blood vessels. It stimulates the release of nitric oxide, a molecule that induces vasodilation, reducing resistance to blood flow and lowering blood pressure.…”

Section: Effectiveness Of the Calendar-based Interventionmentioning

confidence: 99%

Applying the transtheoretical model of health behavior change: using calendars for hypertension management in elderly individuals during the COVID-19 pandemic in Phrae Province, Thailand

Jumneansuk,

Dechboon,

Arsa

et al. 2023

J Public Hlth Dev

View full text Add to dashboard Cite

Hypertension is a persistent global public health concern, particularly affecting elderly individuals and is further compounded by the challenges posed by the COVID-19 pandemic. Innovative interventions are essential to effectively manage blood pressure in this vulnerable demographic group. This quasi-experimental study implemented a calendar-based intervention among 84 elderly individuals in Phrae Province, Thailand. The intervention integrated dietary recommendations, physical activity guidelines, and hypertension education. Over eight weeks, the intervention group exhibited a significant reduction in systolic blood pressure (6.59 mmHg) and diastolic blood pressure (2.52 mmHg) levels (p-value<0.05), contrasting with the comparison group's increase. The calendar-based program effectively enhanced hypertension knowledge, empowering participants to make informed health decisions. The study's holistic approach, grounded in health behavior change models, effectively promoted hypertension awareness and facilitated healthier lifestyles. Results suggest the calendar-based program's suitability for elderly individuals at high risk of hypertension, especially during the COVID-19 pandemic, due to its cost-effectiveness and accessibility. This research underscores the potential of calendar-based interventions in supporting blood pressure management among elderly populations, with broader implications for public health strategies, especially during challenging circumstances such as pandemics.

show abstract

“…More recently, several lines of evidence have suggested that high salt intake is associated with an increased risk of development and progression of obesity, insulin resistance and metabolic diseases, even though causal association has not been proven 7,8,9 . A recent systematic review concluded that additional data from longitudinal cohort studies and experimental studies are needed to confirm a potential causal effect of sodium intake on the risk of obesity 10 . By contrast, several cohort studies have shown that high dietary potassium intake is related to a lower blood pressure and reduced risk of cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Swiss Salt Study 2, second survey on salt consumption in Switzerland: Main results

Chelbi,

Gianini,

Gagliano

et al. 2024

EFS4

View full text Add to dashboard Cite

Context The Swiss Federal Food Safety and Veterinary Office (FSVO) commissioned in 2021 the second National Survey on Salt Consumption in the Swiss general adult population, namely the Swiss Salt Study 2 (SSS2), with a design similar to SSS1 (2010‐2011) for comparability. Methods This second survey, conducted in 2022‐2023 includes a random sample of 863 adult permanent residents in Switzerland (450 men and 413 women) covering the three main linguistic regions (French, German, and Italian) of Switzerland. Dietary salt (NaCl), potassium (K), and sodium‐to‐potassium (Na:K) ratio intakes were estimated using 24‐hour urine collections. Participants’ knowledge, attitude, and behavior regarding salt, as well as their self‐perception of daily salt consumption, were assessed through a questionnaire. Anthropometry and blood pressure were measured using standardized validated methods during study visits. Main results The urinary NaCl excretion (mean ± SD, serving as proxy for dietary salt intake), was 8.7 ± 3.6 g/24h overall, 9.9 ± 3.9 g/24h in men and 7.4 ± 2.8 g/24h in women. Only 20.9% (95%CI: 17.3 ‐ 25.1) of women and 7.8% (95%CI: 5.7 ‐ 10.7) of men had a urinary NaCl excretion below the WHO recommended maximal level of 5 g/24h. Accordingly, women were found about three times more likely to reach the recommended target than men. Dietary salt intake was similar across linguistic regions and tended to be lower in the older age group than in the younger ones, in both men and women. The urinary K excretion (mean ± SD, serving as proxy for potassium intake) was 2.73 ± 0.98 g/24h overall, 2.95 ± 1.00 g/24h in men, and 2.49 ± 0.92 g/24h in women. The mean potassium intake was below the recommended minimal intake of 3.5 g (equivalent to at least 2.7 g/24h excreted in urine) in all age groups for women and in the 18‐29 age group for men. The mean 24h urinary molar Na:K ratio (mean ± SD) was 2.25 ± 0.92 overall, 2.12 ± 0.85 in women, and 2.37 ± 0.96 in men. Most participants did not comply with the optimal (≤ 1.0) and suboptimal (≤ 2.0) Na:K ratio targets, with 96.0% (95%CI: 94.5 ‐ 97.2) of participants presenting a ratio above 1.0, and 54.1% (95%CI: 50.7 ‐ 57.5) presenting a ratio above 2.0. Women were more likely to adhere to the suboptimal target than men, and older individuals more likely than younger individuals. Knowledge of salt‐related health risks among the population was high, with 81.8% (95% CI: 79.1 ‐ 84.2) of participants aware that excessive salt intake negatively impacts health. Among participants, 49.5% (95% CI: 46.1 ‐ 52.8) reported never adding salt to their food at home, while 40.9% (95% CI: 37.7 ‐ 42.2) occasionally added salt, 7.8% (95% CI: 6.2 ‐ 9.8) usually added salt, and 1.9% (95% CI: 1.1 ‐ 3.0) always added salt. When eating out, 69.1% (95% CI: 65.9 ‐ 72.1) of participants reported never adding salt, while 26.7% (95% CI: 23.8 ‐ 29.7) occasionally added salt, 3.1% (95% CI: 2.2 ‐ 4.5) usually added salt, and 1.2% (95% CI: 0.06 ‐ 2.1) always added salt. Overall, 36.0% (95% CI: 32.9 ‐ 39.3) of participants reported that they were currently watching or limiting their dietary salt intake, with no significant difference between men and women. Most participants (59.9%, 95%CI: 56.6 ‐ 63.1) categorized their salt consumption as medium irrespective of the sex, age group or linguistic region. The proportion of participants classifying their salt consumption as low was 25.7% (95%CI: 22.9 ‐ 28.8) whereas 14.4% (95%CI: 12.2 ‐ 16.9) classified it as high. Hypertension prevalence was 24.0% (95%CI: 21.3 ‐ 27.0) overall, with 15.3% (95%CI: 12.1 ‐ 19.1) in women and 32.1% (95%CI: 27.9 ‐ 36.5) in men. The percentage of hypertensive individuals increased with age in both sexes, ranging from 1.7% (95%CI: 0.2 ‐ 11.3) and 1.9% (95%CI: 0.3 ‐ 12.2) in the 15–29 year old group to 33.3% (95%CI: 25.5 ‐ 42.2) and 55.7% (95%CI: 47.6 ‐ 65.5) in the ≥60 year old group, in women and men, respectively. In this cross‐sectional study, blood pressure was positively associated with urinary NaCl excretion, and this relationship was stronger in men than in women and stronger in older than in younger people. The prevalence of overweight and obesity was 33.7% and 11.9% overall, with 41.1% of men being overweight and 11.3% being obese, and 25.7% of women being overweight and 12.6% being obese, respectively. Between the first (2010‐2011) and second (2022‐2023) surveys, a slight, statistically significant, decrease of 0.42 g/24h in daily mean dietary NaCl intake was observed, which corresponds to a 4.6% intake decrease over the last 10 years. However, the prevalence of individuals with urinary NaCl excretion below 5 g/24h was similar in the first and second surveys overall, in men and in women. Conclusions and public health implications Despite an encouraging slight decrease in the mean dietary salt intake between the first and second national surveys, salt intake remains clearly above the international recommendation of 5 g/day in Swiss adults, while potassium intake is well below the recommended intake of at least 3.50 g/day. Efforts must be continued to reduce dietary salt consumption and improve overall diet quality in the general Swiss population. These results underscore the need for a national strategy that does not require region‐specific approaches, yet sex‐ and age‐specific messages might be considered to better consider the observed differences. The survey suggests that interventions lowering dietary salt intake and increasing potassium intake hold promise for mitigating high blood pressure and reduce the burden of arterial hypertension in the adult population. Additionally, a decrease in obesity prevalence is likely to be associated with reduced blood pressure and decreased salt intake. Therefore, a comprehensive strategy that aims to improve dietary quality and promote weight reduction should be considered for the prevention of hypertension and its associated complications.

show abstract

Effect of nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults

Cited by 6 publications

References 25 publications

Home blood pressure measurement days and changes in urinary sodium-to-potassium ratio, estimated salt and potassium intakes and blood pressure: 1-year prospective study

Home blood pressure measurement days and changes in urinary sodium-to-potassium ratio, estimated salt and potassium intakes and blood pressure: 1-year prospective study

Applying the transtheoretical model of health behavior change: using calendars for hypertension management in elderly individuals during the COVID-19 pandemic in Phrae Province, Thailand

Swiss Salt Study 2, second survey on salt consumption in Switzerland: Main results

Contact Info

Product

Resources

About