Mary E Cogswell

Le Centre de Recherche en Nutrition Humaine Rhône-Alpes, Pierre-Bénite, Rhône-Alpes, France

Are you Mary E Cogswell?

Claim your profile

Publications (112)649.93 Total impact

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: High US sodium intake and national reduction efforts necessitate developing a feasible and valid monitoring method across the distribution of low-to-high sodium intake. We examined a statistical approach using timed urine voids to estimate the population distribution of usual 24-h sodium excretion. A sample of 407 adults, aged 18-39 y (54% female, 48% black), collected each void in a separate container for 24 h; 133 repeated the procedure 4-11 d later. Four timed voids (morning, afternoon, evening, overnight) were selected from each 24-h collection. We developed gender-specific equations to calibrate total sodium excreted in each of the one-void (e.g., morning) and combined two-void (e.g., morning + afternoon) urines to 24-h sodium excretion. The calibrated sodium excretions were used to estimate the population distribution of usual 24-h sodium excretion. Participants were then randomly assigned to modeling (n = 160) or validation (n = 247) groups to examine the bias in estimated population percentiles. Median bias in predicting selected percentiles (5th, 25th, 50th, 75th, 95th) of usual 24-h sodium excretion with one-void urines ranged from -367 to 284 mg (-7.7 to 12.2% of the observed usual excretions) for men and -604 to 486 mg (-14.6 to 23.7%) for women, and with two-void urines from -338 to 263 mg (-6.9 to 10.4%) and -166 to 153 mg (-4.1 to 8.1%), respectively. Four of the 6 two-void urine combinations produced no significant bias in predicting selected percentiles. Our approach to estimate the population usual 24-h sodium excretion, which uses calibrated timed-void sodium to account for day-to-day variation and covariance between measurement errors, produced percentile estimates with relatively low biases across low-to-high sodium excretions. This may provide a low-burden, low-cost alternative to 24-h collections in monitoring population sodium intake among healthy young adults and merits further investigation in other population subgroups. This study was registered at clinicaltrials.gov as NCT01631240. © 2015 American Society for Nutrition.
    Journal of Nutrition 04/2015; DOI:10.3945/jn.114.206250 · 4.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Sodium intake is high in US children. Data are limited on the dietary sources of sodium, especially from birth to age 24 mo. We identified top sources of dietary sodium in US children from birth to age 24 mo. Data from the NHANES 2003-2010 were used to examine food sources of sodium (population proportions and mean intakes) in 778 participants aged 0-5.9 mo, 914 participants aged 6-11.9 mo, and 1219 participants aged 12-23.9 mo by sociodemographic characteristics. Overall, mean dietary sodium intake was low in 0-5.9-mo-old children, and the top contributors were formula (71.7%), human milk (22.9%), and commercial baby foods (2.2%). In infants aged 6-11.9 mo, the top 5 contributors were formula (26.7%), commercial baby foods (8.8%), soups (6.1%), pasta mixed dishes (4.0%), and human milk (3.9%). In children aged 12-23.9 mo, the top contributors were milk (12.2%), soups (5.4%), cheese (5.2%), pasta mixed dishes (5.1%), and frankfurters and sausages (4.6%). Despite significant variation in top food categories across racial/ethnic groups, commercial baby foods were a top food contributor in children aged 6-11.9 mo, and frankfurters and sausages were a top food contributor in children aged 12-23.9 mo. The top 5 food categories that contributed to sodium intake also differed by sex. Most of the sodium consumed (83-90%) came from store foods (e.g., from the supermarket). In children aged 12-23.9 mo, 9% of sodium consumed came from restaurant foods, and 4% of sodium came from childcare center foods. The vast majority of sodium consumed comes from foods other than infant formula or human milk after the age of 6 mo. Although the majority of sodium intake was from store foods, after age 12 mo, restaurant foods contribute significantly to intake. Reducing the sodium content in these settings would reduce sodium intake in the youngest consumers. © 2015 American Society for Nutrition.
    American Journal of Clinical Nutrition 03/2015; DOI:10.3945/ajcn.114.099770 · 6.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although evidence shows that reduced sodium intake lowers blood pressure, some studies suggest that sodium reduction may adversely affect insulin resistance and glucose tolerance. The objectives were to assess the effects of sodium reduction on glucose tolerance, evaluate strengths and weaknesses of the relevant scientific literature, and provide direction for future research. We searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, and Web of Science through August 2014. Both randomized and nonrandomized intervention trials were included in our meta-analyses. The effects of sodium reduction on glucose tolerance were evaluated in 37 articles, but because of a lack of comparable data, 8 trials were excluded from the meta-analyses. Participants were 10-79 y old, either primarily healthy or with hypertension. In meta-analyses of 20 randomized, crossover trials (n = 504 participants) and 9 nonrandomized crossover trials (n = 337), circulating glucose concentrations of fasting participants were not affected by reduction in sodium intake. In contrast, in meta-analyses of 19 of the 20 randomized, crossover trials (n = 494), fasting insulin concentrations were 9.53 pmol/L higher (95% CI: 5.04, 14.02 pmol/L higher) with sodium reduction. In 9 nonrandomized trials (n = 337), fasting insulin did not differ with reduced sodium intake. Results differed little when the analyses were restricted to studies with a low risk of bias and duration of ≥7 d. This meta-analysis revealed no evidence that, in trials with a short intervention and large reductions in sodium, circulating glucose concentrations differed between groups. Recommendations for future studies include extending intervention durations, ensuring comparability of groups at baseline through randomization, and assessing sodium intakes relevant to population sodium reduction. In addition, analyses on other metabolic variables were limited because of the number of trials reporting these outcomes and lack of consistency across measures, suggesting a need for comparable measures of glucose tolerance across studies. © 2015 American Society for Nutrition.
    Journal of Nutrition 03/2015; 145(3):505-13. DOI:10.3945/jn.114.195982 · 4.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Iodized salt has been an important source of dietary iodine, a trace element important for regulating human growth, development, and metabolic functions. This analysis identified iodized table salt sales as a percentage of retail salt sales using Nielsen ScanTrack. We identified 1117 salt products, including 701 salt blends and 416 other salt products, 57 of which were iodized. When weighted by sales volume in ounces or per item, 53% contained iodized salt. These findings may provide a baseline for future monitoring of sales of iodized salt.
    Nutrients 03/2015; 7(3):1691-1695. DOI:10.3390/nu7031691 · 3.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Most sodium in the US diet comes from commercially processed and restaurant foods. Sodium reduction in these foods is key to several recent public health efforts. The objective was to provide an overview of a program led by the USDA, in partnership with other government agencies, to monitor sodium contents in commercially processed and restaurant foods in the United States. We also present comparisons of nutrients generated under the program to older data. We track ∼125 commercially processed and restaurant food items ("sentinel foods") annually using information from food manufacturers and periodically by nationwide sampling and laboratory analyses. In addition, we monitor >1100 other commercially processed and restaurant food items, termed "priority-2 foods" (P2Fs) biennially by using information from food manufacturers. These foods serve as indicators for assessing changes in the sodium content of commercially processed and restaurant foods in the United States. We sampled all sentinel foods nationwide and reviewed all P2Fs in 2010-2013 to determine baseline sodium concentrations. We updated sodium values for 73 sentinel foods and 551 P2Fs in the USDA's National Nutrient Database for Standard Reference (releases 23-26). Sodium values changed by at least 10% for 43 of the sentinel foods, which, for 31 foods, including commonly consumed foods such as bread, tomato catsup, and potato chips, the newer sodium values were lower. Changes in the concentrations of related nutrients (total and saturated fat, total sugar, potassium, or dietary fiber) that were recommended by the 2010 Dietary Guidelines for Americans for reduced or increased consumption accompanied sodium reduction. The results of sodium reduction efforts, based on resampling of the sentinel foods or re-review of P2Fs, will become available beginning in 2015. This monitoring program tracks sodium reduction efforts, improves food composition databases, and strengthens national nutrition monitoring. © 2015 American Society for Nutrition.
    American Journal of Clinical Nutrition 03/2015; 101(3):622-31. DOI:10.3945/ajcn.114.084954 · 6.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the sodium and sugar content of US commercial infant and toddler foods. We used a 2012 nutrient database of 1074 US infant and toddler foods and drinks developed from a commercial database, manufacturer Web sites, and major grocery stores. Products were categorized on the basis of their main ingredients and the US Food and Drug Administration's reference amounts customarily consumed per eating occasion (RACC). Sodium and sugar contents and presence of added sugars were determined. All but 2 of the 657 infant vegetables, dinners, fruits, dry cereals, and ready-to-serve mixed grains and fruits were low sodium (≤140 mg/RACC). The majority of these foods did not contain added sugars; however, 41 of 79 infant mixed grains and fruits contained ≥1 added sugar, and 35 also contained >35% calories from sugar. Seventy-two percent of 72 toddler dinners were high in sodium content (>210 mg/RACC). Toddler dinners contained an average of 2295 mg of sodium per 1000 kcal (sodium 212 mg/100 g). Savory infant/toddler snacks (n = 34) contained an average of sodium 1382 mg/1000 kcal (sodium 486 mg/100 g); 1 was high sodium. Thirty-two percent of toddler dinners and the majority of toddler cereal bars/breakfast pastries, fruit, and infant/toddler snacks, desserts, and juices contained ≥1 added sugar. Commercial toddler foods and infant or toddler snacks, desserts, and juice drinks are of potential concern due to sodium or sugar content. Pediatricians should advise parents to look carefully at labels when selecting commercial toddler foods and to limit salty snacks, sweet desserts, and juice drinks. published in the public domain by the American Academy of Pediatrics.
    Pediatrics 02/2015; DOI:10.1542/peds.2014-3251 · 5.30 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Limited data are available on the accuracy of 24-h dietary recalls used to monitor US sodium and potassium intakes. We examined the difference in usual sodium and potassium intakes estimated from 24-h dietary recalls and urine collections. We used data from a cross-sectional study in 402 participants aged 18-39 y (∼50% African American) in the Washington, DC, metropolitan area in 2011. We estimated means and percentiles of usual intakes of daily dietary sodium (dNa) and potassium (dK) and 24-h urine excretion of sodium (uNa) and potassium (uK). We examined Spearman's correlations and differences between estimates from dietary and urine measures. Multiple linear regressions were used to evaluate the factors associated with the difference between dietary and urine measures. Mean differences between diet and urine estimates were higher in men [dNa - uNa (95% CI) = 936.8 (787.1, 1086.5) mg/d and dK - uK = 571.3 (448.3, 694.3) mg/d] than in women [dNa - uNa (95% CI) = 108.3 (11.1, 205.4) mg/d and dK - uK = 163.4 (85.3, 241.5 mg/d)]. Percentile distributions of diet and urine estimates for sodium and potassium differed for men. Spearman's correlations between measures were 0.16 for men and 0.25 for women for sodium and 0.39 for men and 0.29 for women for potassium. Urinary creatinine, total caloric intake, and percentages of nutrient intake from mixed dishes were independently and consistently associated with the differences between diet and urine estimates of sodium and potassium intake. For men, body mass index was also associated. Race was associated with differences in estimates of potassium intake. Low correlations and differences between dietary and urinary sodium or potassium may be due to measurement error in one or both estimates. Future analyses using these methods to assess sodium and potassium intake in relation to health outcomes may consider stratifying by factors associated with the differences in estimates from these methods. This trial was registered at clinicaltrials.gov as NCT01631240. © 2015 American Society for Nutrition.
    American Journal of Clinical Nutrition 02/2015; 101(2):376-86. DOI:10.3945/ajcn.113.081604 · 6.92 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Most Americans consume more sodium than is recommended, the vast majority of which comes from commercially packaged and restaurant foods. In 2010 the Institute of Medicine recommended that manufacturers reduce the amount of sodium in their products. The aim was to assess the sodium content in commercially packaged food products sold in US grocery stores in 2009. With the use of sales and nutrition data from commercial sources, we created a database with nearly 8000 packaged food products sold in major US grocery stores in 2009. We estimated the sales-weighted mean and distribution of sodium content (mg/serving, mg/100 g, and mg/kcal) of foods within food groups that contribute the most dietary sodium to the US diet. We estimated the proportion of products within each category that exceed 1) the Food and Drug Administration's (FDA's) limits for sodium in foods that use a "healthy" label claim and 2) 1150 mg/serving or 50% of the maximum daily intake recommended in the 2010 Dietary Guidelines for Americans. Products in the meat mixed dishes category had the highest mean and median sodium contents per serving (966 and 970 mg, respectively). Products in the salad dressing and vegetable oils category had the highest mean and median concentrations per 100 g (1072 and 1067 mg, respectively). Sodium density was highest in the soup category (18.4 mg/kcal). More than half of the products sold in 11 of the 20 food categories analyzed exceeded the FDA limits for products with a "healthy" label claim. In 4 categories, >10% of the products sold exceeded 1150 mg/serving. The sodium content in packaged foods sold in major US grocery stores varied widely, and a large proportion of top-selling products exceeded limits, indicating the potential for reduction. Ongoing monitoring is necessary to evaluate the progress in sodium reduction. © 2015 American Society for Nutrition.
    American Journal of Clinical Nutrition 02/2015; 101(2):344-53. DOI:10.3945/ajcn.113.078980 · 6.92 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Comparing nutrition labels and choosing lower sodium foods are tactics to help reduce excessive sodium intake, a major risk factor for hypertension. Our objective was to assess US adult consumers' reported use and perceived understanding of sodium information on nutrition labels by sociodemographic and health status. We analyzed responses to questions from 3,729 adults aged 18 years or older participating in 2 national cross-sectional mail panel surveys in 2010. We found that 19.3% (95% confidence interval [CI], 17.2%-21.6%) of respondents agreed they were confused about how to figure out how much sodium is in the foods they eat; 57.9% (95% CI, 55.4%-60.5%) reported that they or the person who shops for their food buy items labeled low salt or low sodium; and 46.8% (95% CI, 44.3%-49.4%) reported they check nutrition labels for sodium content as a tactic to limit salt. Consumers with a high school education or less were more likely than college graduates to report they were confused about sodium content on labels (adjusted odds ratio [AOR], 1.9; 95% CI, 1.4-2.8) and less likely to check labels for sodium as a tactic to limit salt intake (AOR, 0.7; 95% CI, 0.6-0.98). Most survey respondents in our study reported buying low sodium food items. However, a higher proportion of respondents with low education than respondents with high education reported confusion with and less use of sodium content information, suggesting enhanced efforts may be needed to assist this group. Opportunity exists for health care professionals to educate patients about using and understanding nutrition labels and consuming a diet consistent with the Dietary Approaches to Stop Hypertension (DASH) eating plan.
    Preventing chronic disease 01/2015; 12:E48. DOI:10.5888/pcd12.140522 · 1.96 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The vast majority of Americans consume too much sodium, primarily from packaged and restaurant foods. The evidence linking sodium intake with direct health outcomes indicates a positive relationship between higher levels of sodium intake and cardiovascular disease risk, consistent with the relationship between sodium intake and blood pressure. Despite communication and educational efforts focused on lowering sodium intake over the last three decades data suggest average US sodium intake has remained remarkably elevated, leading some to argue that current sodium guidelines are unattainable. The IOM in 2010 recommended gradual reductions in the sodium content of packaged and restaurant foods as a primary strategy to reduce US sodium intake, and research since that time suggests gradual, downward shifts in mean population sodium intake are achievable and can move the population toward current sodium intake guidelines. The current paper reviews recent evidence indicating: (1) significant reductions in mean population sodium intake can be achieved with gradual sodium reduction in the food supply, (2) gradual sodium reduction in certain cases can be achieved without a noticeable change in taste or consumption of specific products, and (3) lowering mean population sodium intake can move us toward meeting the current individual guidelines for sodium intake.
    Nutrients 10/2014; 6(10):4354-4361. DOI:10.3390/nu6104354 · 3.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: A national health objective is to reduce average U.S. sodium intake to 2,300 mg daily to help prevent high blood pressure, a major cause of heart disease and stroke. Identifying common contributors to sodium intake among children can help reduction efforts.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine whether macronutrient intake differs by awareness of glycemic status among people with diabetes and prediabetes.
    Diabetes Care 09/2014; DOI:10.2337/dc14-1342 · 8.57 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND In a recent study, high maternal periconceptional intake of vitamin E was found to be associated with risk of congenital heart defects (CHDs). To explore this association further, we investigated the association between total daily vitamin E intake and selected birth defects. METHODS: We analyzed data from 4525 controls and 8665 cases from the 1997 to 2005 National Birth Defects Prevention Study. We categorized estimated periconceptional energy-adjusted total daily vitamin E intake from diet and supplements into quartiles (referent, lowest quartile). Associations between quartiles of energy-adjusted vitamin E intake and selected birth defects were adjusted for demographic, lifestyle, and nutritional factors. RESULTS: We observed a statistically significant association with the third quartile of vitamin E intake (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.01–1.35) and all CHDs combined. Among CHD sub-types, we observed associations with left ventricular outflow tract obstruction defects, and its sub-type, coarctation of the aorta and the third quartile of vitamin E intake. Among defects other than CHDs, we observed associations between anorectal atresia and the third quartile of vitamin E intake (OR, 1.66; 95% CI, 1.01–2.72) and hypospadias and the fourth quartile of vitamin E intake (OR, 1.42; 95% CI, 1.09–1.87). CONCLUSION: Selected quartiles of energy-adjusted estimated total daily vitamin E intake were associated with selected birth defects. However, because these few associations did not exhibit exposure-response patterns consistent with increasing risk associated with increasing intake of vitamin E, further studies are warranted to corroborate our findings. Birth Defects Research (Part A), 2014. © 2014 Wiley Periodicals, Inc.
    Birth Defects Research Part A Clinical and Molecular Teratology 09/2014; 100(9). DOI:10.1002/bdra.23247 · 2.21 Impact Factor
  • Journal of the American Academy of Nutrition and Dietetics 09/2014; 114(9):A48. DOI:10.1016/j.jand.2014.06.148 · 2.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Current recommendations target sodium reduction in the food supply and intake; however, information is limited on consumer readiness for these actions. Prevalence and determinants of consumer agreement for government restriction of manufacturers and restaurants putting excess salt in food and support for policies limiting sodium content of quick service restaurant (QSR) foods were examined. Data were analyzed from 9,579 adults aged ≥18 years who responded to consumer readiness for sodium reduction questions in the 2010 ConsumerStyles survey. Responses were collapsed into three categories. Consumer agreement was determined and logistic regression was used to estimate ORs. Analyses were conducted in 2012. The majority of consumers agree that it is a good idea for government to restrict food manufacturers (55.9%) from putting excess salt in foods. About half agreed that it is a good idea for government to restrict restaurants from putting excess salt in foods and 81.5% supported sodium reduction policies in QSRs. Odds of agreement/support were higher for non-Hispanic blacks compared with non-Hispanic whites, and those with incomes <$40,000 compared with ≥$60,000. Those reporting "neutral" or "yes" to wanting to eat a diet low in sodium were more likely to agree/support government action compared to those answering "no." Nearly half of consumers agree with government actions to reduce sodium in manufactured and restaurant foods, with even greater support for QSRs. These findings could inform industry and public health partners about consumer preferences to lower the sodium content of the food supply.
    American journal of preventive medicine 05/2014; 46(5):516-24. DOI:10.1016/j.amepre.2013.12.012 · 4.28 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Little information is available on temporal trends in sodium intake in the U.S. population using urine sodium excretion as a biomarker. Our aim was to assess 1988-2010 trends in estimated 24-h urine sodium (24hUNa) excretion among U.S. adults (age 20-59 y) participating in the cross-sectional NHANES. We used subsamples from a 1988-1994 convenience sample, a 2003-2006 one-third random sample, and a 2010 one-third random sample to comply with resource constraints. We estimated 24hUNa excretion from measured sodium concentrations in spot urine samples by use of calibration equations (for men and women) derived from the International Cooperative Study on Salt, Other Factors, and Blood Pressure study. Estimated 24hUNa excretion increased over the 20-y period [1988-1994, 2003-2006, and 2010; means ± SEMs (n): 3160 ± 38.4 mg/d (1249), 3290 ± 29.4 mg/d (1235), and 3290 ± 44.4 mg/d (525), respectively; P-trend = 0.022]. We observed significantly higher mean estimated 24hUNa excretion in each survey period (P < 0.001) for men compared with women (31-33%) and for persons with a higher body mass index (BMI; 32-35% for obese vs. normal weight) or blood pressure (17-26% for hypertensive vs. normal blood pressure). After adjusting for age, sex, and race-ethnicity, temporal trends in mean estimated 24hUNa excretion remained significant (P-trend = 0.004). We observed no temporal trends in mean estimated 24hUNa excretion among BMI subgroups, nor after adjusting for BMI. Although several limitations apply to this analysis (the use of a convenience sample in 1988-1994 and using estimated 24hUNa excretion as a biomarker of sodium intake), these first NHANES data suggest that mean estimated 24hUNa excretion increased slightly in U.S. adults over the past 2 decades, and this increase may be explained by a shift in the distribution of BMI.
    Journal of Nutrition 03/2014; 144(5). DOI:10.3945/jn.113.187914 · 4.23 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Median urine iodine concentration (UIC; µg/L) in spot urine samples is recommended for monitoring population iodine status. Other common measures are iodine:creatinine ratio (I/Cr; µg/g) and estimated 24-hr urine iodine excretion (UIE; I/Cr*predicted 24-hr Cr; µg/d). Despite different units, these measures are often used interchangeably, and it is unclear how they compare with the reference standard 24-hr UIE. Methods: Volunteers aged 18-39y collected all their urine samples for 24-hours (n=400); voids from morning, afternoon, evening, overnight, and a composite 24-h sample were analyzed for iodine. We calculated median observed 24-hr UIE and 24-hr UIC, and spot UIC, I/Cr, and 2 measures of estimated UIE calculated using predicted 24-hr Cr from published estimates by Kesteloot & Joosens (varies by age and sex) and published equations by Mage (varies by age, sex, race, and anthropometric measures). We examined mean differences and relative difference across iodine excretion levels using Bland-Altman plots. Results: Median 24-hr UIE was 173.6 µg/d and 24-hr UIC was 144.8 µg/L. From timed spot urine samples, estimates were UIC: 147.3-156.2 µg/L, I/Cr: 103.6-114.3 µg/g, estimated 24-hr UIE (Kesteloot & Joosens): 145.7-163.3 µg/d, and estimated 24-hr UIE (Mage): 176.5-187.7 µg/d. Iodine measures did not vary consistently by timing of spot urine collection. Compared with observed 24-hr UIE, on average, estimated (Mage) 24-hr UIE was not significantly different, while estimated 24-hr UIE (Kesteloot& Joosens) was significantly different for some race/sex groups. Compared with 24-hr UIC, on average, spot UIC did not differ. Conclusions: Estimates of UIC, I/Cr, and estimated 24h-hr UIE (I/Cr*predicted 24-hr Cr) from spot urine samples should not be used interchangeably. Estimated 24-hr UIE, where predicted 24-hr Cr varies by age, sex, race, and anthropometric measures and was calculated with prediction equations using data from the sample, was more comparable to observed 24-hr UIE than when predicted 24-hr Cr was from published estimates from a different population. However, currently no cutoffs exist to interpret population estimated 24-hr UIE values.
    Thyroid: official journal of the American Thyroid Association 12/2013; DOI:10.1089/thy.2013.0404 · 3.84 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Studies indicate high sodium and low potassium intake can increase blood pressure suggesting the ratio of sodium-to-potassium may be informative. Yet, limited studies examine the association of the sodium-to-potassium ratio with blood pressure and hypertension. We analyzed data on 10,563 participants aged ≥20 years in the 2005-2010 National Health and Nutrition Examination Survey who were neither taking anti-hypertensive medication nor on a low sodium diet. We used measurement error models to estimate usual intakes, multivariable linear regression to assess their associations with blood pressure, and logistic regression to assess their associations with hypertension. The average usual intakes of sodium, potassium and sodium-to-potassium ratio were 3,569 mg/d, 2,745 mg/d, and 1.41, respectively. All three measures were significantly associated with systolic blood pressure, with an increase of 1.04 mmHg (95% CI, 0.27-1.82) and a decrease of 1.24 mmHg (95% CI, 0.31-2.70) per 1,000 mg/d increase in sodium or potassium intake, respectively, and an increase of 1.05 mmHg (95% CI, 0.12-1.98) per 0.5 unit increase in sodium-to-potassium ratio. The adjusted odds ratios for hypertension were 1.40 (95% CI, 1.07-1.83), 0.72 (95% CI, 0.53-0.97) and 1.30 (95% CI, 1.05-1.61), respectively, comparing the highest and lowest quartiles of usual intake of sodium, potassium or sodium-to-potassium ratio. Our results provide population-based evidence that concurrent higher sodium and lower potassium consumption are associated with hypertension.
    PLoS ONE 10/2013; 8(10):e75289. DOI:10.1371/journal.pone.0075289 · 3.53 Impact Factor
  • American Journal of Hypertension 10/2013; 26(10):1178-80. DOI:10.1093/ajh/hpt143 · 3.40 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Collecting a 24-h urine sample is recommended for monitoring the mean population sodium intake, but implementation can be difficult. The objective was to assess the validity of published equations by using spot urinary sodium concentrations to predict 24-h sodium excretion. This was a cross-sectional study, conducted from June to August 2011 in metropolitan Washington, DC, of 407 adults aged 18-39 y, 48% black, who collected each urine void in a separate container for 24 h. Four timed voids (morning, afternoon, evening, and overnight) were selected from each 24-h collection. Published equations were used to predict 24-h sodium excretion with spot urine by specimen timing and race-sex subgroups. We examined mean differences with measured 24-h sodium excretion (bias) and individual differences with the use of Bland-Altman plots. Across equations and specimens, mean bias in predicting 24-h sodium excretion for all participants ranged from -267 to 1300 mg (Kawasaki equation). Bias was least with International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT) equations with morning (-165 mg; 95% CI: -295 mg, 36 mg), afternoon (-90; -208, 28), and evening (-120; -230, -11) specimens. With overnight specimens, mean bias was least when the Tanaka (-23; 95% CI: -141, 95) or Mage (-145; -314, 25) equations were used but was statistically significant with the Tanaka equations in females (216-243 mg) and the Mage equations in races other than black (-554, -372 mg). Significant over- and underprediction occurred across individual sodium excretion concentrations. Using a single spot urine, INTERSALT equations may provide the least biased information about population mean sodium intakes among young US adults. None of the equations evaluated provided unbiased estimates of individual 24-h sodium excretion. This trial was registered at clinicaltrials.gov as NCT01631240.
    American Journal of Clinical Nutrition 09/2013; 98(6). DOI:10.3945/ajcn.113.059436 · 6.92 Impact Factor

Publication Stats

4k Citations
649.93 Total Impact Points

Institutions

  • 2015
    • Le Centre de Recherche en Nutrition Humaine Rhône-Alpes
      Pierre-Bénite, Rhône-Alpes, France
  • 1995–2015
    • Centers for Disease Control and Prevention
      • • Division for Heart Disease and Stroke Prevention
      • • National Center for Chronic Disease Prevention and Health Promotion
      • • Division of Birth Defects and Developmental Disabilities
      • • National Center on Birth Defects and Developmental Disabilities
      • • Division of Nutrition, Physical Activity, and Obesity
      • • Division of Reproductive Health
      Атланта, Michigan, United States
  • 2005
    • Harvard University
      Cambridge, Massachusetts, United States
  • 2004
    • Magee-Womens Hospital
      Pittsburgh, Pennsylvania, United States
  • 2001
    • University of North Carolina at Chapel Hill
      • Department of Nutrition
      Chapel Hill, NC, United States