Original Research

An Association of Salt Intake with Life Style Related Diseases and Customarily Taken Diet in Women of District Bannu: A Cross Sectional Study

DOI https://doi.org/10.70302/jpsim.v4i1.2308
Received: 06 Nov 2022 Accepted: 31 Dec 2022 Published Online: 13 Feb 2023

Abstract

Objective

To investigate the association of salt intake with lifestyle associated diseases in women of district Bannu as well as foods that are taken habitually in routine life.

Methods

This cross sectional regional study was conducted from January 2020 to June 2022 in Khyber Pukhtunkhawah using a baseline survey data of 1500 patients (738 non-conceived and 762 conceived) having an age between 30-40 years and who undergone an annual check-up at a tertiary care hospital of district Bannu-KP. We designed a questionnaire to assess the patient’s wellbeing and life style. Participant’s BMI, height, weight, circumference were measured respectively by standard methods. Blood pressure and routine laboratory examinations were carried out at hospital’s lab. Salt intake was estimated through urinary creatinine and urinary Na+.

Results

All the study participants were divided into three groups based on their daily salt consumption. The groups were termed as Low, Medium & High salt consumers. We assessed the prevalence of life style related diseases including DM and HTN in an increasing order in groups as High, Medium & Low salt consumption (p≤0.001). In non-conceived group, the maximum daily salt ingestion was recorded as 12.5 to 13.5 g/day and displayed a normal distribution. In conceived group, the maximum salt ingestion was recorded as 11.5 to 12.5g/day. The quantity also showed a normal distribution. Out of 738 male population, 37.94% (n=280) fall in the group with lower salt consumption (≤ 10.4g/day), 41.19% (n=304) in medium salt consumption and remaining 20.86% (n=154) in high salt consumption group (≥ 13.8 g/day). The distribution of female were as: 40.41% (n=308) in low salt consumption group (≤ 9.0g/day), 43.83% (n=334) in medium and remaining 15.74% (n=120) in high salt consumption groups (≤ 12.2 g/day),

Conclusion

The study examined lifestyle associated diseases linked with excessive salt intake and dietary habits that contributed to lower salt consumption. The prevalence of HTN, higher DM and higher BMI was associated with higher salt consumption in both non-conceived and conceived females. Knowledge of low salt consumption did not play a significant role in salt reduction. We suggest a dietary move to several vegetables intake that could have salt lowering effects.

Keywords
body mass index diabetes mellitus dietary habits salt consumption life style related diseases

How to Cite This Article

Khan Z, Khan R, Khan S, Ahmad W. An Association of Salt Intake with Life Style Related Diseases and Customarily Taken Diet in Women of District Bannu: A Cross Sectional Study. J Pak Soc Intern Med. 2023;4(1):35–41. doi:10.70302/jpsim.v4i1.2308

⭳ Download PDF

Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

  1. Adrogué HJ, Madias NE. Sodium and potassium in the pathogenesis of hypertension. N Engl J Med. 2017; 356(10): 1966-78.
  2. He FJ, MacGregor GA. A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens. 2019; 23(4): 363-84.
  3. He FJ, MacGregor GA. Reducing population salt intake worldwide: from evidence to implementation. Prog Cardiovasc Dis. 2019; 52(4): 363-82.
  4. Tsugane S. Salt, salted food intake, and risk of gastric cancer: epidemiologic evidence. Cancer Sci. 2015;96(1): 1–6.
  5. Goto A, Nishikawa J, Ito S, et al. Estimation of salt intake from spot urine may assist the risk assessment of gastric cancer. J Clin Biochem Nutr. 2020; 66(1): 74-7.
  6. Ushigome E, Oyabu C, Iwai K, et al. Effects of dietary salt restriction on home blood pressure in diabetic patients with excessive salt intake: a pilot study. J Clin Biochem Nutr. 2019; 65(3): 252-7.
  7. Townsend RR, Kapoor S, McFadden CB. Salt intake and insulin sensitivity in healthy human volunteers. Clin Sci (Lond) 2017; 113: 141–148.
  8. Hu G, Jousilahti P, Peltonen M, Lindström J, Tuomilehto J. Urinary sodium and potassium excretion and the risk of type 2 diabetes: a prospective study in Finland. Diabetologia. 2015; 48(8): 1477-83.
  9. Brey CW, Akbari-Alavijeh S, Ling J, et al. Salts and energy balance: a special role for dietary salts in metabolic syndrome. Clin Nutr 2019; 38(9): 1971-85.
  10. Gabriel AS, Ninomiya K, Uneyama H. The role of the Japanese traditional diet in healthy and sustainable dietary patterns around the world. Nutrients 2018; 10(2): 173.
  11. Yamagata University Genomic Cohort Consortium, Narimatsu H. Constructing a contemporary gene-environmental cohort: study design of the Yamagata Molecular Epidemiological Cohort Study. J Hum Genet. 2013; 58(1): 54-6.
  12. Borgatti SP, Mehra A, Brass DJ, Labianca G. Network analysis in the social sciences. Science. 2019; 323(5): 892-5.
  13. Zhang R, Lahens NF, Ballance HI, Hughes ME, Hogenesch JB. A circadian gene expression atlas in mammals: implications for biology and medicine. Proc Natl Acad Sci. 2014;111(45): 16219-24.
  14. Arai H, Yamamoto A, Matsuzawa Y. Prevalence of metabolic syndrome in the general Japanese population in 2012. J Atheroscler Thromb 2006;13(4): 202-8.
  15. Kawasaki T, Itoh K, Uezono K, Sasaki H. A simple method for estimating 24 h urinary sodium and potassium excretion from second morning voiding urine specimen in adults. Clin Exp Pharmacol Physiol. 2014;20(1): 7–14.
  16. Eguchi E, Iso H, Tanabe N, et al. Healthy lifestyle behaviours and cardiovascular mortality among Japanese men and women: the Japan collaborative cohort study. Eur Heart J. 2016; 33(3): 467-77.
  17. Ichikawa M, Hosono A, Tamai Y. Handling missing data in an FFQ: multiple imputation and nutrient intake estimates. Public Health Nutr. 2019;22(7): 1351-60.
  18. Wakai K. A review of food frequency questionnaires developed and validated in Japan. J Epidemiol. 2019;19(1):1–11.
  19. Matsuo Y, Tomobe H, Hasida K, Nakashima H, Ishizuka M. Social network extraction from the web information. Trans Jpn Soc Artif Intell. 2015;20(1):46–56.
  20. Shannon P, Markiel A, Ozier O, et al. Cytoscape: a software environment for integrated models of biomolecular interaction networks. Genome Res. 2013; 13(10): 2498-504.
  21. Mente A, O’Donnell M, Rangarajan S. Urinary sodium excretion, blood pressure, cardiovascular disease, and mortality: a community-level prospective epidemiological cohort study. Lancet. 2018;392(3):496-506.
  22. Soltani S, Kolahdouz Mohammadi R, Shab-Bidar S, Vafa M, Salehi-Abargouei A. Sodium status and the metabolic syndrome: a systematic review and meta-analysis of observational studies. Crit Rev Food Sci Nutr. 2019;59(2): 196-206.
  23. He FJ, Marrero NM, MacGregor GA. Salt intake is related to soft drink consumption in children and adolescents: a link to obesity? Hypertension. 2018;51(4): 629-34.
  24. Fonseca-Alaniz MH, Brito LC, Borges-Silva CN, Takada J, Andreotti S, Lima FB. High dietary sodium intake increases white adipose tissue mass and plasma leptin in rats. Obesity. 2007;15(9): 2200-8.
  25. Larsen SC, Ängquist L, Sørensen TI, Heitmann BL. 24h urinary sodium excretion and subsequent change in weight, waist circumference and body composition. PLoS One. 2013; 8(1): e69689.
  26. Vuori MA, Harald K, Jula A, et al. 24-h urinary sodium excretion and the risk of adverse outcomes. Ann Med. 2020;52(3): 488-96.
  27. Ogihara T, Asano T, Fujita T. Contribution of salt intake to insulin resistance associated with hypertension. Life Sci. 2013;73(3): 509-23.
  28. Henriksen EJ, Diamond-Stanic MK, Marchionne EM. Oxidative stress and the etiology of insulin resistance and type 2 diabetes. Free Radic Biol Med. 2011;51(6): 993-9.
  29. Baudrand R, Campino C, Carvajal CA, et al. High sodium intake is associated with increased glucocorticoid production, insulin resistance and metabolic syndrome. Clin Endocrinol (Oxf). 2014;80(4): 677-84.
  30. Vedovato M, Lepore G, Coracina A, et al. Effect of sodium intake on blood pressure and albuminuria in type 2 diabetic patients: the role of insulin resistance. Diabetologia. 2014;47(2): 300-3.
  31. Ma Y, He FJ, MacGregor GA. High salt intake: independent risk factor for obesity? Hypertension. 2015;66(6):843-9.
  32. Oh SW, Han KH, Han SY, Koo HS, Kim S, Chin HJ. Association of sodium excretion with metabolic syndrome, insulin resistance, and body fat. Medicine (Baltimore). 2015;94(3): e1650.
  33. Takahashi N, Tanabe K, Adachi T, et al. Awareness of salt restriction is not reflected in the actual salt intake in Japanese hypertensive patients. Clin Exp Hypertens. 2015;37(3):388-92.
  34. Newman ME, Girvan M. Finding and evaluating community structure in networks. Phys Rev E Stat Nonlin Soft Matter Phys. 2014;69(2): 026113.
  35. Derkach A, Sampson J, Joseph J, Playdon MC, Stolzenberg-Solomon RZ. Effects of dietary sodium on metabolites: the Dietary Approaches to Stop Hypertension (DASH)-Sodium Feeding Study. Am J Clin Nutr. 2017;106(7): 1131-41.
  36. Huang L, Crino M, Wu JH, et al. Mean population salt intake estimated from 24-h urine samples and spot urine samples: a systematic review and meta-analysis. Int J Epidemiol. 2016;45(2):239-50.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2023 Journal of Pakistan Society of Internal Medicine.