Salt intake assessment in adults and elderly : population-based study in Artur Nogueira municipality, Sao Paulo

Orientadores: Marilia Estevam Cornélio, Maria Cecília Bueno Jayme GallaniDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de EnfermagemResumo: Diversos estudos têm constatado que, apesar das amplas recomendações para a sua redução, o consumo de sal permanece elevado em diferentes populações no mundo. Evidências demonstram, ainda, a relação entre a elevada ingestão deste nutriente e o desenvolvimento e agravamento de doenças tanto cardiovasculares como de doenças crônicas não transmissíveis e doenças renais. Sabe-se que o consumo de sal é proveniente de diferentes fontes e, portanto, sua mensuração é complexa, exigindo o emprego de diferentes métodos de avaliação. Entretanto, verifica-se que poucos estudos têm utilizado a combinação de medidas bioquímica e de autorrelato na investigação do consumo de sal e, no Brasil, inexistem estudos com esta abordagem. Desta forma, este estudo teve como objetivo avaliar o consumo de sal na população do município de Artur Nogueira por meio da utilização de medidas bioquímica e de autorrelato. Trata-se de uma pesquisa transversal de base populacional, realizada em Artur Nogueira, município da região metropolitana de Campinas, São Paulo. Participaram do estudo 517 indivíduos, residentes do município com idade igual ou superior a 20 anos. O consumo de sal foi avaliado por meio de medidas de autorrelato (Recordatório Alimentar de 24 horas, Questionário de Frequência Alimentar de Sódio, uso do sal adicionado, uso de temperos prontos e consumo total de sal) e de medida bioquímica (excreção urinária de sódio de 24h). A análise dos dados foi realizada de forma analítica, por testes de correlação, associação, comparação e regressão. Os resultados demonstraram média de consumo de sal de 10,5g/dia por meio do sódio urinário de 24h e 11g/dia pela soma das medidas de autorrelato. Quanto às fontes de consumo, o sal adicionado nas refeições contribuiu com 68,2% do sal total consumido. Constatou-se que homens consomem mais sal que mulheres (11,7 e 9,6g/dia), resultado também encontrado em participantes profissionalmente ativos e com renda familiar mensal acima de 1900 reais por dia. Hipertensos adicionam mais sal nas refeições, porém, consomem menos alimentos salgados; a circunferência da cintura em ambos os sexos e o índice de massa corpórea foram correlacionados positivamente com o sódio urinário de 24h e nas análises de regressão observou-se que homens jovens e elevada circunferência da cintura foram preditores do consumo de sal. Intervenções relacionadas ao consumo de sal, na população estudada, devem considerar a medida da circunferência da cintura e o comportamento da adição do sal no preparo dos alimentos para direcionar orientações de redução do seu consumoAbstract: Several studies have found that, despite extensive recommendations for its reduction, salt intake remains high in different populations around the world. Evidence also shows the relationship between high intake of this nutrient and the development and worsening of cardiovascular and non-cardiovascular diseases. It is known that salt intake comes from different sources and, therefore, its measurement is complex, requiring the use of different methods of evaluation. However, few studies have used the combination of biochemical and self-report methods in the investigation of salt intake, and in Brazil, there are no studies with this approach. Thus, this study aimed to evaluate salt intake in the population of the town of Artur Nogueira through the use of biochemical and self-report methods. This is a cross-sectional population-based survey, conducted in Artur Nogueira, a town in the metropolitan region of Campinas, São Paulo. A total of 517 individuals, residents of the town aged 20 or over, participated in the study. Salt intake was evaluated through self-report measures (24-hour Dietary Recall, Sodium Food Frequency questionnaire, use of added salt, use of salty spices and total reported salt intake) and biochemical measurement (24-hour urinary sodium excretion). Data analysis was performed in a analytical way, by correlation, association, comparison and regression tests. The results showed a mean of salt intake of 10.5g/day by 24-hour urinary sodium excretion and 11g/day by the total reported salt intake. As to the sources of their consumption, the salt added in meals contributed 68.2% of the salt consumed. It was found that men consume more salt than women (11.7 and 9.6g/day), a result also found in professionally active participants with family monthly income above 1900 reais per day. Hypertensive participants add more salt to meals, but consume less salty foods; waist circumference in both sexes and body mass index were positively correlated with 24-hour urinary sodium excretion and in the regression analyzes it was observed that young men and high waist circumference were predictors of salt intake. Interventions related to salt intake in the study population should consider the measurement of waist circumference and salt addition behavior in the meals preparation to guide guidelines for reducing their consumptionMestradoEnfermagem e TrabalhoMestra em Ciências da Saúd

Caracterizacao do consumo de sal entre hipertensos segundo fatores sociodemograficos e clinicos

OBJECTIVE: to evaluate the relationship between the behaviors of salt consumption and socio-demographic and clinical variables. METHOD: sodium consumption was evaluated using the methods: self-reporting (considering 3 different behaviors related to salt consumption), 24- hr dietary recall, discretionary salt, food frequency questionnaire, estimation of total sodium intake and 24-hr urinary excretion of sodium (n=108). RESULTS: elevated salt intake according to the different measurements of consumption of the nutrient was associated with the variables: male sex, low level of schooling and monthly income, being Caucasian, and being professionally inactive; and with the clinical variables: elevated Body Mass Index, tensional levels, ventricular hypertrophy and the number of medications used. CONCLUSION: the data obtained shows a heterogenous association between the different behaviors related to salt consumption and the socio-demographic and clinical variables. This data can be used to optimize the directing of educational activities with a view to reducing salt consumption among hypertensives.OBJETIVO: evaluar la relación entre los comportamientos de consumo de sal y variables sociodemográficas y clínicas. MÉTODO: el consumo de sodio fue evaluado según los métodos: de autorrelato (objetivando 3 diferentes comportamientos relacionados al consumo de sal), recordatorio de 24h, sal per cápita, cuestionario de frecuencia alimentaria, estimativa de consumo total de sodio y excreción urinaria de sodio (n=108). RESULTADOS: el consumo elevado de sal según las diferentes medidas de consumo del nutriente fue asociado a las variables: sexo masculino, bajo nivel de escolaridad y de renta mensual, color blanco, inactividad profesional y a las variables clínicas: Índice de Masa Corporal elevada, niveles de tensión, indicadores de hipertrofia ventricular y número de medicaciones utilizadas. CONCLUSIÓN: los datos obtenidos muestran una asociación heterogénea entre los diferentes comportamientos relacionados al consumo de sal y a las variables sociodemográficas y clínicas. Estos datos pueden ser utilizados para optimizar la orientación de las actividades educativas objetivando la reducción del consumo de sal entre hipertensos.OBJETIVO: avaliar a relação entre os comportamentos de consumo de sal e variáveis sociodemográficas e clínicas. MÉTODO: o consumo de sódio foi avaliado segundo os métodos: de autorrelato (visando 3 diferentes comportamentos relacionados ao consumo de sal), recordatório de 24h, sal per capita, questionário de frequência alimentar, estimativa de consumo total de sódio e excreção urinária de sódio (n=108). RESULTADOS: o consumo elevado de sal, segundo as diferentes medidas de consumo do nutriente foi associado às variáveis: sexo masculino, baixo nível de escolaridade e de renda mensal, cor branca, inatividade profissional e às variáveis clínicas: índice de massa corpórea elevada, níveis tensionais, indicadores de hipertrofia ventricular e número de medicações utilizadas. CONCLUSÃO: os dados obtidos mostram uma associação heterogênea entre os diferentes comportamentos relacionados ao consumo de sal e às variáveis sociodemográficas e clínicas. Esses dados podem ser utilizados para otimizar o direcionamento das atividades educativas, visando a redução do consumo de sal entre hipertensos

A Mobile Phone App Intervention to Promote Healthy Salt Intake Among Adults: Protocol for a Randomized Controlled Study

Background: There is sound evidence associating high salt intake and a greater risk of cardiovascular and noncardiovascular diseases. High salt intake has been observed in several populations worldwide. Therefore, promoting healthier salt consumption has been encouraged as a low-cost strategy to reduce this risk factor. However, these strategies need to be sound, built on theoretical and methodological bases, and consider the target population’s context. Objective: This protocol aims to describe a mobile phone app intervention to promote healthy salt intake among adults. Methods: This is an experimental and longitudinal study protocol conducted in three modules. Module 1 refers to the planning of the intervention based on the Behaviour Change Wheel framework. Module 2 is the development of the mobile phone app intervention based on the date of module 1. In module 3, the intervention will be evaluated using a randomized controlled study, with three steps of data collection in a 2-month follow-up in a sample of 86 adults (43 participants for each group: the control group and intervention group) recruited from the primary health care centers of a Brazilian town. The discretionary salt intake questionnaire will assess salt consumption, the app usability will be assessed using the System Usability Scale, and psychosocial variables (habit, intention, and self-efficacy) will also be measured. Results: Recruitment began in October 2021, and the follow-up will end in August 2022. The results of this study are expected to be published in 2023. Conclusions: Results from this study will help people to control salt intake when cooking at home, will stimulate self-care, will work as an alternative or supportive method in the relationship between health care professionals and patients, and will contribute to implementing the app intervention to promote healthy salt intake on a large scale

Characterization of salt consumption among hypertensives according to socio-demographic and clinical factors

OBJECTIVE: to evaluate the relationship between the behaviors of salt consumption and socio-demographic and clinical variables. METHOD: sodium consumption was evaluated using the methods: self-reporting (considering 3 different behaviors related to salt consumption), 24- hr dietary recall, discretionary salt, food frequency questionnaire, estimation of total sodium intake and 24-hr urinary excretion of sodium (n=108). RESULTS: elevated salt intake according to the different measurements of consumption of the nutrient was associated with the variables: male sex, low level of schooling and monthly income, being Caucasian, and being professionally inactive; and with the clinical variables: elevated Body Mass Index, tensional levels, ventricular hypertrophy and the number of medications used. CONCLUSION: the data obtained shows a heterogenous association between the different behaviors related to salt consumption and the socio-demographic and clinical variables. This data can be used to optimize the directing of educational activities with a view to reducing salt consumption among hypertensives

Caracterizacion del consumo de sal entre hipertensos segun factores sociodemograficos y clinicos

OBJECTIVE:to evaluate the relationship between the behaviors of salt consumption and socio-demographic and clinical variables.METHOD:sodium consumption was evaluated using the methods: self-reporting (considering 3 different behaviors related to salt consumption), 24- hr dietary recall, discretionary salt, food frequency questionnaire, estimation of total sodium intake and 24-hr urinary excretion of sodium (n=108).RESULTS:elevated salt intake according to the different measurements of consumption of the nutrient was associated with the variables: male sex, low level of schooling and monthly income, being Caucasian, and being professionally inactive; and with the clinical variables: elevated Body Mass Index, tensional levels, ventricular hypertrophy and the number of medications used.CONCLUSION:the data obtained shows a heterogenous association between the different behaviors related to salt consumption and the socio-demographic and clinical variables. This data can be used to optimize the directing of educational activities with a view to reducing salt consumption among hypertensives.OBJETIVO:avaliar a relação entre os comportamentos de consumo de sal e variáveis sociodemográficas e clínicas.MÉTODO:o consumo de sódio foi avaliado segundo os métodos: de autorrelato (visando 3 diferentes comportamentos relacionados ao consumo de sal), recordatório de 24h, sal per capita, questionário de frequência alimentar, estimativa de consumo total de sódio e excreção urinária de sódio (n=108).RESULTADOS:o consumo elevado de sal, segundo as diferentes medidas de consumo do nutriente foi associado às variáveis: sexo masculino, baixo nível de escolaridade e de renda mensal, cor branca, inatividade profissional e às variáveis clínicas: índice de massa corpórea elevada, níveis tensionais, indicadores de hipertrofia ventricular e número de medicações utilizadas.CONCLUSÃO:os dados obtidos mostram uma associação heterogênea entre os diferentes comportamentos relacionados ao consumo de sal e às variáveis sociodemográficas e clínicas. Esses dados podem ser utilizados para otimizar o direcionamento das atividades educativas, visando a redução do consumo de sal entre hipertensos.OBJETIVO:evaluar la relación entre los comportamientos de consumo de sal y variables sociodemográficas y clínicas.MÉTODO:el consumo de sodio fue evaluado según los métodos: de autorrelato (objetivando 3 diferentes comportamientos relacionados al consumo de sal), recordatorio de 24h, sal per cápita, cuestionario de frecuencia alimentaria, estimativa de consumo total de sodio y excreción urinaria de sodio (n=108).RESULTADOS:el consumo elevado de sal según las diferentes medidas de consumo del nutriente fue asociado a las variables: sexo masculino, bajo nivel de escolaridad y de renta mensual, color blanco, inactividad profesional y a las variables clínicas: Índice de Masa Corporal elevada, niveles de tensión, indicadores de hipertrofia ventricular y número de medicaciones utilizadas.CONCLUSIÓN:los datos obtenidos muestran una asociación heterogénea entre los diferentes comportamientos relacionados al consumo de sal y a las variables sociodemográficas y clínicas. Estos datos pueden ser utilizados para optimizar la orientación de las actividades educativas objetivando la reducción del consumo de sal entre hipertensos.1013102

Dietary sources of salt intake in adults and older people : a population-based study in a brazilian town

To assess salt intake and its dietary sources using biochemical and self-report methods and to characterize salt intake according to sociodemographic and disease-related variables in a sample of the Brazilian population. Population-based cross-sectional survey. Salt intake was assessed by biochemical (24 h urinary Na excretion) and self-report methods (sodium FFQ, 24 h dietary recall, seasoned-salt questionnaire, discretionary-salt questionnaire and total reported salt intake). Adults and older people (n 517) aged 20-80 years, living in Artur Nogueira, Sao Paulo, Brazil. Mean salt intake based on 24 h urinary Na excretion and total reported salt intake was 10 center dot 5 and 11 center dot 0 g/d, respectively; both measures were significantly correlated. Discretionary salt and seasoned salt were the most important sources of salt intake (68 center dot 2 %). Men in the study consumed more salt than women as estimated by 24 h urinary Na excretion (11 center dot 7 v. 9 center dot 6 g salt/d; P<0 center dot 0001). Participants known to be hypertensive added more salt to their meals but consumed less salty ultra-processed foods. Waist circumference in both sexes and BMI were positively correlated with salt intake estimated by 24 h urinary Na excretion. In addition, regression analysis revealed that being a young male or having a high waist circumference was a predictor of higher salt intake. Salt intake in this population was well above the recommended amount. The main source of salt intake came from salt added during cooking. Salt intake varied according to sex and waist circumference2281388139