Shufa Du1, Huijun Wang2, Bing Zhang2, Barry M Popkin1. 1. Department of Nutrition and Carolina Population Center, CB #8120 Carolina Square, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 2. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Abstract
BACKGROUND: Intervention strategies to reduce sodium intake and increase potassium intake may decrease blood pressure; however, most are focused on reducing sodium in processed food globally. OBJECTIVES: We attempt to fill important gaps in understanding the dynamics of these dietary determinants of hypertension in China. METHODS: We used data on 29,926 adults aged ≥20 y between 1991 and 2015 from an ongoing cohort, the China Health and Nutrition Survey. We collected detailed diet data with use of weighing methods with 3 consecutive 24-h recalls. With panel data random-effects models, we analyzed factors associated with sodium and potassium intakes and sodium to potassium (Na/K) ratios. RESULTS: Sodium intake decreased from 6.3 g/d in 1991 to 4.1 g/d in 2015, still twice the tolerable upper intake recommended by the WHO. Potassium intake was 1.7 g/d in 1991 and 1.5 g/d in 2015, below half that recommended by the WHO. The Na/K ratio decreased from 4.1 (ratios in g) in 1991 to 3.1 in 2015, 5 times the recommendation of the WHO. More than two-thirds (67%) of sodium intake was from salt added during food preparation, with 8.8% from processed foods in 2015, up from 5.0% in 1991. The most at-risk populations lived in China's central region and rural areas, were middle aged, had lower educations, or were farmers. CONCLUSIONS: Sodium intake is very high across all regions in China. As part of sodium reduction efforts, China should target people living in the central region and adults aged above 60 whose sodium intakes are much higher. Strategies to decrease sodium intake and increase potassium intake should be different from those applied in the Western world where the major source is processed food. Reduced sodium higher potassium salts should become a major policy initiative in China.
BACKGROUND: Intervention strategies to reduce sodium intake and increase potassium intake may decrease blood pressure; however, most are focused on reducing sodium in processed food globally. OBJECTIVES: We attempt to fill important gaps in understanding the dynamics of these dietary determinants of hypertension in China. METHODS: We used data on 29,926 adults aged ≥20 y between 1991 and 2015 from an ongoing cohort, the China Health and Nutrition Survey. We collected detailed diet data with use of weighing methods with 3 consecutive 24-h recalls. With panel data random-effects models, we analyzed factors associated with sodium and potassium intakes and sodium to potassium (Na/K) ratios. RESULTS: Sodium intake decreased from 6.3 g/d in 1991 to 4.1 g/d in 2015, still twice the tolerable upper intake recommended by the WHO. Potassium intake was 1.7 g/d in 1991 and 1.5 g/d in 2015, below half that recommended by the WHO. The Na/K ratio decreased from 4.1 (ratios in g) in 1991 to 3.1 in 2015, 5 times the recommendation of the WHO. More than two-thirds (67%) of sodium intake was from salt added during food preparation, with 8.8% from processed foods in 2015, up from 5.0% in 1991. The most at-risk populations lived in China's central region and rural areas, were middle aged, had lower educations, or were farmers. CONCLUSIONS: Sodium intake is very high across all regions in China. As part of sodium reduction efforts, China should target people living in the central region and adults aged above 60 whose sodium intakes are much higher. Strategies to decrease sodium intake and increase potassium intake should be different from those applied in the Western world where the major source is processed food. Reduced sodium higher potassium salts should become a major policy initiative in China.
Authors: Lisa J Harnack; Mary E Cogswell; James M Shikany; Christopher D Gardner; Cathleen Gillespie; Catherine M Loria; Xia Zhou; Keming Yuan; Lyn M Steffen Journal: Circulation Date: 2017-05-09 Impact factor: 29.690
Authors: Matti Marklund; Gitanjali Singh; Raquel Greer; Frederick Cudhea; Kunihiro Matsushita; Renata Micha; Tammy Brady; Di Zhao; Liping Huang; Maoyi Tian; Laura Cobb; Bruce Neal; Lawrence J Appel; Dariush Mozaffarian; Jason H Y Wu Journal: BMJ Date: 2020-04-22