Abstract P190: Associations of 24-h Urinary Sodium/potassium (Na/K) Ratio with Recommended Intakes of Na and K: The INTERMAP Study

Background: High dietary sodium (Na), low dietary potassium (K) and high dietary sodium/potassium (Na/K) ratio are associated with adverse blood pressure levels and excess risks of cardiovascular diseases. 24-h urine collection is the gold standard for measuring dietary Na, K and Na/K ratio. Recommended levels of Na and K intakes are suggested in WHO guidelines; less than 85 mmol/day for Na; at least 90 mmol/day for K; there is no definitive guideline for Na/K ratio. Objective: Our primary aim was to compare the level of urinary Na/K ratio with the current recommended levels of Na and K intakes suggested in WHO guidelines. Methods: INTERMAP is an international study on associations of multiple dietary variables with blood pressure (BP), based on two timed 24-hr urine collections and dietary data from 4 in-depth 24-h dietary recalls in 4,680 men and women ages 40-59 years in China, Japan, United Kingdom and United States (US). Na/K ratio of 24-hr urine stratified in 1 unit intervals was compared with the current recommended levels of Na and K intakes suggested in WHO guidelines. Na intake was evaluated by urinary Na excretion; K intake by dietary K intake. Results: Thirty-one of the 4,680 INTERMAP participants (0.7%) had urinary Na/K ratio less than 1. The proportions of participants with Na excretion less than 2 g/day (85 mmol/day) among all 4,680 individuals were 77% (n=24), 19% (n=117), and 0.2% (n=11) in those with urinary Na/K ratio less than 1, 1 to 2, and more than 4, respectively. In US samples (n=2,195) the proportions were 88% (n=15), 19% (n=70), and 0.3% (n=6), respectively. The proportions of participants with dietary K intake more than 3.51 g/day (90 mmol/day) among all 4,680 individuals were 71% (n=22), 38% (n=233), and 2.4% (n=111) in those with urinary Na/K ratio less than 1, 1 to 2, and more than 4, respectively. In US samples the proportions were 59% (n=10), 38% (n=138), and 2.1% (n=47), respectively. Conclusions: WHO recommends Na intake less than 85 mmol/day, and K intake more than 90 mmol/day. Urinary Na/K ratio less than 1 is needed to ensure reasonable compliance with these recommendations. Currently, very few people satisfy urinary Na/K ratio less than 1, so population-wide efforts are needed to reduce salt (sodium chloride) and increase K intake.

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Association between egg intake and blood pressure in the USA: the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP)

Public Health Nutrition ◽

10.1017/s1368980021002949 ◽

2021 ◽

pp. 1-9

Author(s):

Thanh-Huyen T Vu ◽

Linda Van Horn ◽

Martha L Daviglus ◽

Queenie Chan ◽

Alan R Dyer ◽

...

Keyword(s):

Blood Pressure ◽

Dietary Cholesterol ◽

International Study ◽

Obese Women ◽

Linear Regression Models ◽

Cross Sectional ◽

Men And Women ◽

The Usa ◽

Underlying Mechanisms

Abstract Objectives: To investigate associations of egg intake with blood pressure (BP) and the role of dietary variables and other macro- and micro-nutrients in the association. Design: We used cross-sectional data for the USA as part of the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). INTERMAP was surveyed between 1996 and 1999, including four 24-h dietary recalls, two 24-h urine collections and eight measurements of systolic BP and diastolic BP (SBP, DBP). Average egg intake (g/d) was calculated. Multivariable linear regression models were used to estimate the association between egg intake (per each 50 g/d or per quintile) and BP. The roles of dietary variables and other macro- and micro-nutrients in this association were also investigated. Setting: In the USA. Participants: In total, 2195 US INTERMAP men and women aged 40–59 years. Results: Participants were 50 % female, 54 % non-Hispanic White and 16 % non-Hispanic Black. Mean egg intake (sd) in men and women was 30·4(29·8) and 21·6(20·5) g/d, respectively. Adjusting for demographics, socio-economics, lifestyle and urinary Na:K excretion ratios, we found non-linear associations with BP in non-obese women (P-quadratic terms: 0·004 for SBP and 0·035 for DBP).The associations remained after adjusting for dietary variables, macro/micro nutrients or minerals. Dietary cholesterol was highly correlated with egg intake and may factor in the association. No association was found in obese women and in obese or non-obese men. Conclusion: Egg intake was non-linearly associated with SBP and DBP in non-obese women, but not in obese women or men. Underlying mechanisms require additional study regarding the role of obesity and sex.

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Dietary Sodium, Potassium, and Sodium to Potassium Ratio in Patients With Systemic Lupus Erythematosus

Biological Research For Nursing ◽

10.1177/10998004211065491 ◽

2022 ◽

pp. 109980042110654

Author(s):

María Correa-Rodríguez ◽

Sara DelOlmo-Romero ◽

Gabriela Pocovi-Gerardino ◽

José-Luis Callejas-Rubio ◽

Raquel Ríos-Fernández ◽

...

Keyword(s):

Disease Activity ◽

Sodium Intake ◽

Dietary Sodium ◽

Complement C3 ◽

Systemic Lupus ◽

Sodium Potassium ◽

Complement C4 ◽

Potassium Intake ◽

Dietary Potassium ◽

Sodium And Potassium

Purpose: The aim of this study was to investigate the association between dietary sodium, potassium, and sodium:potassium ratio and clinical disease activity parameters, damage accrual, and cardiovascular disease risk factors in a population of patients with systemic lupus erythematous (SLE). Research design and study sample: A cross-sectional study including a total of 280 patients was conducted (90.4% females; mean age 46.9 ± 12.85 years). Data collection: The SLE Disease Activity Index (SLEDAI-2K) and the SDI Damage Index were used to assess disease activity and disease-related damage, respectively. A 24-hour diet recall was used to estimate dietary intake of sodium and potassium. Results: Dietary sodium intake was significantly associated with anti-dsDNA ( β = −.005; 95% CI [.002 .008]; p = .001) and complement C4 level ( β = −.002; 95% CI [−.003, .000]; p = .039). Dietary potassium intake was also significantly associated with complement C3 level ( β = −.004; 95% CI [−.007, −.001]; p = .021). Multiple logistic regression models revealed a positive association between dietary sodium intake and the risk of having hsCRP > 3 ( p = .005) and an inverse association between dietary potassium intake and the risk of having hsCRP > 3 ( p = .004). Conclusions: SLE patients with higher dietary sodium and lower dietary potassium intakes had an increased risk of higher hsCRP. Dietary sodium intake was significantly associated with anti-dsDNA and complement C4 level, while dietary potassium intake was associated with complement C3 level, supporting that dietary sodium and potassium intakes might play a key role in markers related to disease activity in SLE patients.

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Abstract P261: Dietary Sodium, Potassium, and Blood Pressure in Normotensive Pregnant Women: The National Health and Nutrition Examination Survey

Circulation ◽

10.1161/circ.139.suppl_1.p261 ◽

2019 ◽

Vol 139 (Suppl_1) ◽

Author(s):

Abbi D Lane-Cordova ◽

Lara R Scheider ◽

William Tucker ◽

James Cook ◽

Sara Wilcox ◽

...

Keyword(s):

Blood Pressure ◽

Pregnant Women ◽

National Health ◽

Dietary Sodium ◽

Nutrition Examination Survey ◽

Sodium Potassium ◽

Health And Nutrition

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Relationship between dietary sodium, potassium, and calcium, anthropometric indexes, and blood pressure in young and middle aged Korean adults

Nutrition Research and Practice ◽

10.4162/nrp.2010.4.2.155 ◽

2010 ◽

Vol 4 (2) ◽

pp. 155 ◽

Cited By ~ 20

Author(s):

Juyeon Park ◽

Jung-Sug Lee ◽

Jeongseon Kim

Keyword(s):

Blood Pressure ◽

Dietary Sodium ◽

Middle Aged ◽

Sodium Potassium ◽

Korean Adults ◽

Anthropometric Indexes

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INFLUENCE OF DIETARY POTASSIUM AND SODIUM/POTASSIUM MOLAR RATIOS ON THE DEVELOPMENT OF SALT HYPERTENSION

Journal of Experimental Medicine ◽

10.1084/jem.136.2.318 ◽

1972 ◽

Vol 136 (2) ◽

pp. 318-330 ◽

Cited By ~ 140

Author(s):

Lewis K. Dahl ◽

George Leitl ◽

Martha Heine

Keyword(s):

Blood Pressure ◽

Dietary Sodium ◽

Molar Ratio ◽

Molar Ratios ◽

Dietary Potassium ◽

Induced Hypertension ◽

Salt Hypertension ◽

Blood Pressures ◽

Absolute Concentrations ◽

Dietary Sodium Chloride

Among genetically hypertension-prone rats, dietary sodium (chloride) was demonstrably hypertensinogenic and potassium (chloride) antihypertensinogenic. On diets containing the same NaCl but different KCl concentrations, mean blood pressure was greater in rats receiving less dietary potassium, i.e., diets with a higher Na/K molar ratio. On diets with different absolute concentrations of NaCl and KCl, but the same Na/K molar ratios, rats on the higher absolute NaCl intakes had the higher blood pressures. On diets with different absolute concentrations of NaCl and KCl, and different Na/K molar ratios, a group on a lower absolute NaCl intake but with a higher Na/K ratio could have more hypertension than a group on a higher absolute NaCl intake but with a lower Na/K ratio. At equivalent molar ratios, the respective effects of these two ions on blood pressure were dominated by that of sodium. It was concluded that the dietary Na/K molar ratio can be an important determinant for the severity, or even development, of salt-induced hypertension. The mechanism of the moderating effect of potassium on sodium-induced hypertension was unclear.

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Aldosterone is a physiologically significant kaliuretic hormone

AJP Renal Physiology ◽

10.1152/ajprenal.1987.252.6.f1048 ◽

1987 ◽

Vol 252 (6) ◽

pp. F1048-F1054

Author(s):

W. R. Adam ◽

A. G. Ellis ◽

B. A. Adams

Keyword(s):

Plasma Potassium ◽

Sodium Content ◽

Plasma Aldosterone ◽

Dietary Sodium ◽

Potassium Excretion ◽

Sodium Potassium ◽

Creatinine Excretion ◽

Dietary Potassium ◽

Food Load

To study the role of aldosterone in the short-term control of potassium excretion, rats were gavaged with a liquid diet containing 10-20% of their daily caloric and potassium intake, with a range of sodium intakes. Levels of (effective) aldosterone at the time of gavage were manipulated by administration of spironolactone, aldosterone, and adrenalectomy. Urinary sodium, potassium, and creatinine excretion were measured in conscious unrestrained rats for 2 h after the food load, and then blood was collected for measurement of plasma potassium, aldosterone, and renin activity. Potassium excretion was dependent on both dietary potassium and a minimum dietary sodium content. Potassium excretion was reduced by spironolactone and adrenalectomy and increased by acute aldosterone treatment in most dietary groups. These results strongly suggest that the ambient levels of aldosterone are important in determining potassium excretion following food ingestion. Plasma aldosterone was higher with the higher potassium and lower sodium content diets. Changes in plasma aldosterone, with variations in dietary potassium or sodium, suggest a role for aldosterone in subsequent potassium excretion.

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