Sodium and potassium intakes among individuals undergoing physical examinations in Changsha City
LÜ Jing1, HE Yongmei2, LI Lijun3, YIN Minghui3, LI Xiaohui3, WANG Jiangang1, LI Ying1
1. Center of Health Management, the Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, China; 2. Aerospace Center Hospital, Beijing 100049, China; 3. Central South University, Changsha, Hunan 410078, China
Abstract：Objective To investigate sodium and potassium intakes among individuals undergoing physical examinations in Changsha City, so as provide the evidence for developing nutritional interventions. Methods The individuals undergoing physical examinations in the Center for Health Management, The Third Xiangya Hospital of Central South University from February 2017 to March 2020 were selected, and their gender, age, history of diseases, history of medications, smoking and drinking behaviors were collected through questionnaire surveys. The blood pressure, height and body weight were measured, and the body mass index (BMI) was calculated. The levels of blood glucose, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and serum creatinine were detected, and the 24-h urinary excretions of sodium and potassium were measured using the Kawasaki method to estimate sodium and potassium intakes. According to the recommended intakes for preventing chronic diseases (PI values) in the Chinese Dietary Reference Intakes (2013 revised version), the gender-, age- and BMI-specific intakes of sodium and potassium were analyzed. Results Totally 50 543 subjects were enrolled, with a mean age of (45.64±11.89) years. There were 28 555 men (56.50%) and 21 988 women (43.50%), and there were 19 405 overweight individuals (38.39%), 6 276 obese individuals (12.42%), 13 410 smokers (26.53%), 14 740 drinkers (29.16%), 9 217 individuals with hypertension (18.24%), 3 589 individuals with diabetes (7.10%), 18 232 individuals with dyslipidemia (36.07%). The mean sodium intake was (4 143.29±1 216.46) mg/d among the study subjects, and there were 49 277 participants with sodium intakes that exceeded the PI value (97.50%). Higher sodium intakes were found in men [ (4 345.52±1 231.45) mg/d ], individuals at ages of 36 to 45 years [ (4 185.41±1 202.95) mg/d ], obese individuals [ (4 578.94±1 282.66) mg/d ], smokers [ (4 191.71±1 219.91) mg/d ], drinkers [ (4 325.12±1 245.65) mg/d ], individuals with hypertension [ (4 358.89±1 265.70) mg/d ] and individuals with dyslipidemia [ (4 261.60±1 228.86) mg/d ]. The mean potassium intake was (1 986.26±526.42) mg/d among the study subjects, and there were 50 440 participants with potassium intakes that exceeded the PI value (99.80%). Higher potassium intakes were seen in men [ (2 061.94±556.91) mg/d ], individuals at ages of 35 years and below [ (2 027.24±533.37) mg/d ], obese individuals [ (2 133.27±580.25) mg/d ], smokers [ (2 023.08±557.72) mg/d ], drinkers [ (2 048.43±557.53) mg/d ], individuals without hypertension [ (1 994.65±552.63) mg/d ] and individuals with dyslipidemia [ (2 038.22±546.52) mg/d ]. Conclusions Higher sodium intakes and lower potassium intakes than the PI values are found among individuals undergoing health examinations in Changsha City. Health education is recommended to be reinforced to improve sodium and potassium intakes.
[1] GROENLAND ELINE H,VENDEVILLE JEAN-PAUL,BOTS MICHIEL L,et al.The relation between urinary sodium and potassium excretion and risk of cardiovascular events and mortality in patients with cardiovascular disease[J/OL].PLoS One,2022,17(3)(2022-03-17)[2022-04-18].https://doi.org/10.1371/journal.pone.0265429. [2] 程义勇. 《中国居民膳食营养素参考摄入量》2013修订版简介[J].营养学报,2014,36(4):313-317. CHENG Y Y.Introduction to 2013 revision of Chinese Dietary Reference Intakes[J].Acta Nutrimenta Sin,2014,36(4):313-317. [3] DU S,WANG H,ZHANG B,et al.Dietary potassium intake remains low and sodium Intake remains high,and most sodium is derived from home food preparation for Chinese adults,1991-2015 trends[J].J Nutr,2020,150(5),1230-1239. [4] 中华人民共和国国家卫生健康委员会.中国居民营养与慢性病状况报告(2020年)[J].营养学报,2020,42(6):521. National Health Commission of the People's Republic of China.A report on nutrition and chronic diseases of China (2020)[J].Acta Nutrimenta Sin,2020,42(6):521. [5] 中华医学会健康管理学分会,中华健康管理学杂志编委会.健康体检基本项目专家共识[J].中华健康管理学杂志,2014,8(2):81-90. Chinese Health Management Society,Editorial Board of Chinese Journal of Health Management.Expert consensus on basic items of physical examination[J].Chin J Health Manag,2014,8(2):81-90. [6] 陈春明,孔灵芝.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006. CHEN C M,KONG L Z.Guidelines for prevention and control of overweight and obesity in adults in China[M].Beijing:People's Medical Publishing House,2006. [7] 中国高血压防治指南修订委员会,高血压联盟(中国),中华医学会心血管病学分会,等. 中国高血压防治指南(2018 年修订版)[J].中国心血管杂志,2019,24(1):24-56. Writing Group of 2018 Chinese Guidelines for the Management of Hypertension, Chinese Hypertension League, Chinese Society of Cardiology,et al. 2018 Chinese guidelines for the management of hypertension[J].Chin J Cardiovasc Med,2019,24(1):24-56. [8] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.血脂异常基层诊疗指南(2019年)[J].中华全科医师杂志,2019,18(5):406-416. Chinese Medical Association,Chinese Medical Association Publishing House,Chinese Society of General Practice.Guideline for primary care of dyslipidemias(2019)[J].Chin J Gen Pract,2019,18(5):406-416. [9] JIA W,WENG J,ZHU D,et al.Standards of medical care for type 2 diabetes in China2019[J/OL].Diabetes Metab Res Rev,2019,35(6)[2022-04-18].https://doi.org/10.1002/dmrr.3158. [10] CLARK A J,MOSSHOLDER S.Sodium and potassium intake measurements:dietary methodology problems[J].Am J Clin Nutr,1986,43(3):470-476. [11] TANAKA T,OKAMURA T,MIURA K,et al.A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen[J].J Hum Hypertens,2002,16:97-103. [12] KAWASAKI T,ITOH K,UEZONO K,et al.A simple method for estimating 24 h urinary sodium and potassium excretion from second morning voiding urine specimen in adults[J].Clin Exp Pharmacol Physiol,1993,20:7-14. [13] BROWN I J,DYER A R,CHAN Q,et al.Estimating 24-hour urinary sodium excretion from casual urinary sodium concentrations in Western populations:the INTERSALT study[J].Am J Epidemiol,2013,177:1180-1192. [14] MENTE A,O' DONNELL M J,RANGARAJAN S,et al.Association of urinary sodium and potassium excretion with blood pressure[J].N Engl J Med,2014,371(7):601-611. [15] PENG Y,LI W,WANG Y,et al.Validation and assessment of three methods to estimate 24-h urinary sodium excretion from spot urine samples in Chinese adults[J/OL].PLoS One,2016,11(2)[2022-04-18].https://doi.org/10.1371/journal.pone.0149655. [16] XU A,MA J,GUO X,et al.Association of a province-wide intervention with salt intake and hypertension in Shandong Province,China,2011-2016[J].JAMA Intern Med,2020,180(6):877-886. [17] MILLS K T,STEFANESCU A,HE J.The global epidemiology of hypertension[J].Nat Rev Nephrol,2020,16:223-237. [18] GE Z,GUO X L,CHEN X R, et al.Association between 24 h urinary sodium and potassium excretion and the metabolic syndrome in Chinese adults:the Shandong and Ministry of Health Action on Salt and Hypertension(SMASH)study[J].Br J Nutr,2015,113(6):996-1002. [19] PENG S,WANG J,XIAO Y,et al.The association of carotid artery atherosclerosis with the estimated excretion levels of urinary sodium and potassium and their ratio in Chinese adults[J/OL].Nutr J,2021,20[2022-04-18].https://doi.org/10.1186/s12937-021-00710-8. [20] CHATTERJEE R,DAVENPORT C A,SVETKEY L P,et al.Serum potassium is a predictor of incident diabetes in African Americans with normal aldosterone:the Jackson Heart Study[J].Am J Clin Nutr,2017,105(2):442-449. [21] PENG Y,ZHONG G C,MI Q,et al.Potassium measurements and risk of type 2 diabetes:a dose-response meta-analysis of prospective cohort studies[J].Oncotarget,2017,8(59):100603-100613. [22] HAO G,LIU K,HALBERT J D,et al.Dietary sodium and potassium and risk of diabetes:a prospective study using data from the China Health and Nutrition Survey[J].Diabetes Metab,2020,46:377-383. [23] NDANUKO R N,IBRAHIM R,HAPSARI R A,et al.Association between the urinary sodium to potassium ratio and blood pressure in adults:a systematic review and meta-analysis[J].Adv Nutr,2021,12:1751-1767. [24] STONE M S,MARTYN L,WEAVER C M.Potassium intake,bioavailability,hypertension,and glucose control[J/OL].Nutrients,2016,8(7)[2022-04-18].https://doi.org/10.3390/nu8070444.
