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Sodium and potassium intake in healthy adults in Thessaloniki greater metropolitan area – the SING (Salt Intake in Northern Greece) study.

Eleni Vasara, Georgios Marakis, Joao Breda, Petros Skepastianos, Maria Hassapidou, Anthony Kafatos, Nikolaos Rodopaios, Alexandra A Koulouri, Francesco P Cappuccio.

Nutrients 2017, 9, 417; doi:10.3390/nu9040417

Abstract: A reduction in population sodium (as salt) consumption is one of the most cost-effective strategies to reduce the burden of cardiovascular disease and it is a global health priority. High potassium intake is also recommended to reduce cardiovascular disease. To establish effective policies for setting targets and monitoring effectiveness within each country, the current level of consumption should be known. Greece lacks data on actual sodium and potassium intakes. The aim of the present study was therefore to assess dietary salt (using sodium as biomarker) and potassium intakes in a sample of healthy adults in northern Greece and to determine whether adherence to a Mediterranean diet is related to different sodium intakes or sodium-to-potassium ratio. A cross-sectional survey was carried out in Thessaloniki greater metropolitan area (northern Greece) (n=252, aged 18-75 years, 45.2% males). Participants’ dietary sodium and potassium intakes were determined by 24h urinary sodium and potassium excretions. In addition, we estimated their adherence to Mediterranean diet by the use of an 11-item MedDietScore (range 0-55). The mean sodium excretion was 175 (SD 72) mmol/day, equivalent to 4,220 (1,745) mg of sodium or 10.7 (4.4) g of salt per day and potassium excretion was 65 (25) mmol/day, equivalent to 3,303 (1,247) mg/day. Men had higher sodium and potassium excretions compared to women. Only 5.6% of the sample had salt intake <5g/d, which is the target intake recommended by the WHO. Mean sodium-to-potassium intake ratio was 1.34 (0.51). There was no significant difference in salt or potassium intake or their ratio across MedDietScore quartiles. No significant relationships were found between salt intake and adherence to Mediterranean diet, suggesting that the perception of the health benefits of the Mediterranean diet does not hold when referring to salt consumption. These results suggest the need for a larger nation-wide survey on salt intake in Greece and underline the importance of continuation of salt reduction initiatives in Greece.


Sodium and Potassium intake from Food Diaries and 24-h Urine collections from 7 Days in a sample of healthy Greek adults

Adelais Athanasatou, Aikaterini Kandyliari, Olga Malisova, Alex Pepa, Maria Kapsokefalou

Frontiers in Nutrition 2018; 5: 13. doi: 10.3389/fnut.2018.00013

Abstract

Objective: The main objective of the present study was to evaluate sodium and potassium intake, employing 24 h and spot urine samples and food diaries for seven consecutive days.

Methods: For seven consecutive days subjects recorded their food and drink intakes, and recorded and collected all urinations. Food sodium and potassium intake were analyzed in 24- and 6-h intervals from wake-up time. Urine indices were analyzed in first morning, 24- and 6-h intervals samples over the day from wake-up time. The study took place in Agricultural University of Athens, Greece. In total, 163 healthy subjects (age 39 ± 12 years; 74 females) were enrolled in the study.

Results: Mean urine sodium excretion was 2,803.3 ± 1,249.0 mg/day (121.9 ± 54.3 mmol/day) and mean urine potassium excretion was 2,152.2 ± 913.3 mg/day (55.2 ± 23.4 mmol/day). The highest potassium concentration was measured in the afternoon, while the lowest sodium concentration was measured in the overnight 6-h interval. Food sodium intake was 1,983.2 ± 814.1 mg/day and food potassium was 2,264.5 ± 653.3 mg/day. The sources that contribute most in food sodium intake are dairy products 24%, breads 22%, and savory snacks 17%.

Conclusion: Strategies should encourage the Greek population to moderate sodium intake and promote potassium intake, thus adopting a healthier dietary and lifestyle pattern.


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Salt intake (g/day) in Northern Greece (2015-16)

  Mean SD
Men (n=114) 11.9 4.7
Women (n=138) 9.7 3.9
All (n=252) 10.7 4.4

Method: 24h urine collection


Frontiers in Nutrition (2018)

Nutrients (2017)

Greece moves to raise awareness about salt consumption (2016)

Infographic (2016)

Salt in bread in Greece (2016)

Knowledge, Attitudes and Behaviours towards salt consumption in Greece (2014)