Effects of dietary salt restriction on home blood pressure in diabetic patients with excessive salt intake: a pilot study

Abstract

The aim of the present study was to examine whether dietary salt restriction guidance is beneficial for dietary salt restriction and lowering of home blood pressure in patients with diabetes with excessive salt intake. We performed an intervention trial of 37 people with type 2 diabetes and excessive salt intake. National registered dietitians provided dietary salt restriction guidance to each patient at the start of the study. All participants were instructed to perform triplicate morning and evening home blood pressure measurements using home blood pressure telemonitoring system. Daily salt intake at 2 months and 6 months was significantly lower than that at baseline; the difference was 0.8 [95% confidence interval (CI): 0.2–1.4, p = 0.009] g and 0.7 (95% CI: 0.1–1.3, p = 0.009) g, respectively. Morning systolic blood pressure at 2 months and 6 months was significantly lower than that at baseline; the difference was 2.7 (95% CI: 0.2–5.1, p = 0.034) mmHg and 5.8 (95% CI: 0.5–11.1, p = 0.034) mmHg, respectively. This intervention study revealed, for the first time, that dietary salt restriction guidance provided by a national registered dietitian is beneficial for reducing daily salt intake and home blood pressure in people with diabetes with excessive salt intake.

Randomized Controlled Trial of Simple Salt Reduction Instructions by Physician for Patients with Type 2 Diabetes Consuming Excessive Salt

“…The difference between the two groups was shown by the 95% confidence interval and the p -value. Previous studies reported that salt intake decreased from 10.3 ± 1.6 g to 9.3 ± 1.9 g/day after salt reduction guidance for type 2 diabetes [ 10 ]. From this result, the sample size was calculated based on the assumption that the daily salt intake would be reduced by 1 g in the IG and the intake would not change in the CG.…”

“…In a previous single-arm trial, we reported that a national registered dietitian’s guidance on salt reduction is beneficial for blood pressure management at home and for lowering the salt intake in patients with type 2 diabetes who consume it in excess [ 10 ]. In that study, daily salt intake was significantly reduced to 0.8 g/day and 0.7 g/day at 2 months and 6 months after guidance, respectively.…”

Validation of computer software to estimate dietary intake among patients with type 2 diabetes

“…(12,(20)(21)(22)(23)(24) Second, the subjects were all outpatients in a university hospital, and thus might not represent the presentation of typical Japanese type 2 diabetes. Third, we validated only total energy intake and macronutrients (protein, fat, and carbohydrate), but not the other nutrients which are beneficial (26) or unfavorable (27) for type 2 diabetes.…”

Increased salt intake is associated with diabetes and characteristic dietary habits: a community-based cross-sectional study in Japan

“…In Japan, the number of patients with metabolic syndrome and diabetes mellitus has increased with the westernization of dietary habits. Although excessive salt intake has gained consensus as a risk factor for hypertension, the association between excessive salt intake and obesity, dyslipidemia, and diabetes has remained controversial.‍ ( 6 – 9 ) Although the Japanese diet is well recognized to be one of the world’s healthiest, overconsumption of soy sauce, miso, pickles and salted fish can be responsible for excessive salt intake.‍ ( 10 ) To avoid excessive salt intake, it is necessary to clarify the dietary habits that are associated with it.…”