2 results
Effect of salt reduced bread alone or with dietary counselling on 24-hour excretion of sodium, potassium and sodium/potassium ratio
- Nanna Louise Riis, Kirsten Bjørnsbo, Anne Dahl Lassen, Ellen Trolle, Amalie Frederiksen, Anne Helms Andreasen, Ulla Toft
-
- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E166
-
- Article
-
- You have access Access
- Export citation
-
Excess dietary sodium plays an important role in hypertension, a leading risk factor for cardiovascular disease (CVD). To counteract some of the negative effects of sodium, an increased intake of potassium has shown beneficial effects on blood pressure. In fact, the sodium to potassium ratio might be a stronger risk factor for CVD than either sodium or potassium alone. The objective of the present study was to estimate the effect of A) a salt reduction strategy (providing salt reduced bread) and B) a salt reduction and potassium promoting strategy (providing salt reduced bread combined with dietary counselling), on intake of sodium, potassium and the sodium/potassium ratio. The study is a 4-month cluster randomized controlled trial with families randomly assigned to either intervention A, intervention B or control. Participants in intervention A received bread gradually reduced in salt content from 1.2 g salt/100 g to 0.6 g salt/100 g in ryebread and 0.4 g salt/100 g in wheat bread. Participants in intervention B received the same salt reduced bread and in addition dietary counselling on how to eat food with less salt and more potassium. The control group received standard bread (1.2 g salt/100g). Sodium and potassium intake were measured through three consecutive 24-hour urine measurements in adults and one in children at baseline and follow-up. Changes in outcomes were assessed using linear mixed models. Eighty-nine families, including 155 adults (46.5 % men) and 156 children (51.9 % boys), from the suburb of Copenhagen, Denmark, participated in the study. The sodium/potassium ratio was significantly reduced by -0.57 ± 0.19 mmol/L (P = 0.003) in intervention B compared to control group, resulting from a non-significant lower sodium and increased potassium intake. No significant differences were found between intervention A and control group (preliminary results). These findings support future actions to reduce salt intake, focusing on a combination of structural and educational strategies.
Effects of salt reduction on cardiovascular risk factors. The STRIVE-study. A 4-month randomized controlled study among healthy families
- Ulla Toft, Nanna Louise Riis, Anne Dahl Lassen, Ellen Trolle, Kirsten Schroll Bjoernsbo, Anne Helms Andreasen
-
- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E715
-
- Article
-
- You have access Access
- Export citation
-
Dietary salt intake in most countries is far beyond the recommended level and many countries have initiated national programs to decrease salt intake. However, potential adverse effects of reducing salt intake in the general population are currently discussed. Hence some randomized studies have shown adverse effects on plasma lipids, the renin-angiotensin-aldosterone system and the sympathetic nervous system, which may again increase risk of CVD. These findings are however mainly based on short-term studies with a very large acute salt reduction. This study aims to explore the effect of gradually reducing salt intake in a real life setting according to recommendations, and to examine the effect of different salt reduction strategies among families.
The study was a 4-month cluster randomized controlled trial with families randomly assigned to either A) salt reduced bread, B) salt reduced bread and dietary counselling or C) standard bread (control) Participants in intervention A received bread gradually reduced in salt content from 1.2 g salt/100 g (regular) to 0.6 g salt/100 g in ryebread and 0.4 g salt/100 g in wheat bread. Participants in intervention B received the same salt reduced bread and in addition, they received dietary advise on how to further reduce their salt intake and promote potassium. The control group received regular bread. Changes in outcomes were assessed using linear mixed models.
Results: A total of 89 families (155 adults; 156 children) from the suburb of Copenhagen, Denmark, participated in the study (February-July 2018). A total of 291 (94%) participants completed the intervention. Results presented are preliminary.
Intention to treat analyses showed no significant effects of the salt reduction intervention on changes in systolic and diastolic blood pressure, plasma triglyceride. A small, but significant (-0.26 mmol/l; P = 0.02) decrease in total plasma cholesterol was shown in intervention group A. A similar, but non-significant, tendency was found in intervention group B. (more results will follow).
Subgroup analyses, including only participants in the intervention groups that decreased their salt intake by at least 20% from baseline to 4-month follow-up, showed a significant decrease in diastolic (-3.5 mmHg; P < 0.0001) and systolic (-6.3 mmHg; P < 0.0001) blood pressure, total plasma cholesterol (-0.25 mmol/l; P = 0.0009), LDL plasma cholesterol (logarithm transformed) (-6%; P = 0.03) and plasma triglyceride (logarithm transformed) (-17%; P = 0.04). No significant effects were found for HDL plasma cholesterol, aldosterone, renin, plasma glucose and HbA1c.
Conclusion: Reduced salt intake were associated with beneficial changes in cardiovascular risk factors. No adverse effects were observed.