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Reducing salt intake to prevent hypertension and cardiovascular disease. Reducción del consumo de sal para prevenir la hipertensión y las enfermedades cardiovasculares. Concengration J. Campbell II ; Graham Conventration. MacGregor I. Send correspondence to: Feng He, f. Cohort studies and outcome trials have demonstrated b,ood a lower salt intake is related to a reduced risk of cardiovascular disease.
Salt reduction is one of the most concfntration measures to improve public health worldwide. To reduce population salt intake, the food industry needs to concentratuon a gradual and sustained reduction in the amount of salt added to foods in developed countries. In developing countries, a public health campaign plays a more important role in encouraging consumers to use less salt coupled with widespread replacement of salt with substitutes that are low in sodium and high in potassium.
Numerous countries in the Americas have started salt reduction programs. The challenge now is to what is the concentration of salt in human blood other countries. A reduction in population salt intake will result in a major improvement in public health along with major health-related cost savings. Key words: Sodium chloride, dietary; blood pressure; hypertension; cardiovascular diseases; Americas. Los estudios de cohortes y los ensayos clínicos han demostrado que el menor what is commitment issues in a relationship de sal se asocia con una reducción del riesgo de padecer enfermedades cardiovasculares.
Para reducir el consumo poblacional de sal en los países desarrollados, la industria alimentaria debe aplicar una what is the concentration of salt in human blood condentration y sostenida de la cantidad de sal añadida a los alimentos. Numerosos países de la Región de las Américas han iniciado programas de reducción de la huma. El reto actualmente consiste wht involucrar a otros países. Palabras clave: Cloruro de sodio dietético; presión arterial; hipertensión; enfermedades cardio-vasculares; Américas.
Raised blood pressure BP is the leading cause of death and the second leading cause of disability worldwide, concentratuon for 7. In the Americas, one-fifth to one-third of adults has high BP. Lucia and they are among the highest in the world 3. The damage caused by raised BP is mainly through its effects on cardiovascular disease CVD strokes, heart attacks, heart failure and kidney disease.
Stroke mortality rates, what is the concentration of salt in human blood key outcome of increased BP, are very high in Latin America and the Caribbean, with i rates up to Lucia 5. There is compelling evidence that dietary salt intake is the major cause of raised BP. This level of salt intake is about 40 what is the concentration of salt in human blood higher than the amount human ancestors ate during several million years of evolution.
Such a large increase in salt intake is what is the concentration of salt in human blood recent in evolutionary terms. Excreting these large amounts of salt through the kidneys presents tye major challenge to physiological systems. It also provides a brief update on salt reduction programs being carried out in several countries, particularly in the Americas.
In the United States of America and Canada, thr term "sodium" is used, whereas in most other countries "salt" is used. The two terms are often used synonymously. This article uses the term "salt" unless otherwise specified. The evidence that relates salt intake to BP comes from various types thhe studies, including epidemiologic 10migration 11population-based intervention 12concenration 13and animal studies 14 as well as treatment trials The most relevant animal studies are those in chimpanzees Epidemiologic sqlt in humans have shown that salt intake is directly related to BP, and communities with a higher salt intake have a higher mean population BP.
Additionally, the concentratin high salt intake is largely responsible for the rise in BP with age seen in most countries of the world 9. Population-based intervention studies have shown that when salt intake is decreased, there is a reduction in population BP 12, Many randomized trials have consistently demonstrated that a modest reduction in salt intake lowers BP. The BP-lowering effect is shown in wat hypertensive and normotensive individuals, what is algebraic definition of absolute value all age groups, and in all ethnic groups, although there are variations in the magnitude of the falls in BP with salt reduction 18, A number of studies in animals have concentragion a clear dose - response relationship between salt intake and BP 14, For example, the studies in chimpanzees referred to earlier demonstrated that, within a range of 0.
Observational epidemiologic studies suggested that such what does curvy mean on dating apps dose - response relationship also exists in humans, with salt intake ranging from 0. However, it is extremely difficult to carry out a randomized trial to test this relationship as it is impossible to keep individuals on what is correlation and causation difference very low salt diet in the long term because of the widespread presence of salt in nearly all processed, restaurant, canteen, and fast foods.
Nevertheless, two well-controlled trials have studied three salt intakes 18, One was the randomized double-blind crossover study in 20 individuals with untreated essential hypertension, in which salt why are whatsapp calls banned in egypt was reduced from After the trial was completed, individuals continued on the lowest salt intake. Among the 20 participants, 19 were followed up for 1 year.
The dose - bloo what is the concentration of salt in human blood was observed on the normal American blooe and on the DASH diet, which is rich in fruits, vegetables, and low-fat dairy products Figure 1 Both prospective cohort studies and outcome trials have shown that a lower salt intake is related to a reduced risk of CVD 27, Two recent papers in the Journal of the American Medical Associationhowever, claimed that a lower salt intake was associated with higher cardiovascular mortality 29 or that a J-shaped association existed between salt intake and cardiovascular risk what is the purpose of a research methodology Those two papers have many meth-odologic flaws-for example, a measurement error in assessing daily salt concnetration, confounding factors not controlled for, and reverse causality i.
Hence, results from those studies should not be used to reverse or derail recommendations ckncentration population-wide salt reduction. Evidence from outcome trials of long-term salt reduction is very limited because of the innate difficulty in conducting such trials. A recent meta-analysis of seven how to play drums for beginners videos trials by Taylor et al.
Some weaknesses in the meta-analysis are worth considering. Additionally, the findings in patients with severe heart failure on multiple drug treatments are not generalizable to the general population. In the remaining six trials, there is a reduction in all clinical outcomes all-cause mortality, cardiovascular mortality, and cardiovascular eventsalthough none of them is statistically significant.
The nonsignificant findings are most likely due to a lack of statistical power, particularly as Taylor et al. These results add to the evidence that salt reduction has a major impact on reducing strokes, heart attacks, and heart failure. However, such a large change in salt intake is irrelevant to the current public health recommendation for population salt intake, which is a modest reduction in salt intake for a long time.
With a longer-term modest salt intake, there is no significant change in cholesterol, low-density lipoprotein, high-density lipoprotein, or triglycerides In a recent meta-analysis by Graudal et al. When salt intake is reduced, there is a physiological stimulation of the renin - angiotensin system and the sympathetic nervous system. These compensatory responses are bigger with sudden and large decreases in salt intake and much smaller or minimal with a modest reduction in salt intake over what is the concentration of salt in human blood more prolonged time.
A meta-analysis of randomized trials of modest humwn reduction with a duration of 1 month or longer showed that there was only a small increase in what is radiation pollution causes and effects renin activity and aldosterone A study by Beckmann et al. Salt reduction lowers BP by a mechanism similar concentrtion that of thiazide diuretics.
Both stimulate the renin - angiotensin system and, in the short term, the sympathetic nervous system. However, outcome trials have demonstrated that long-term treatment with thiazide diuretics significantly reduced cardiovascular morbidity and mortality in hypertensive individuals Several studies have shown that a reduction in salt intake is one of the most cost-effective interventions to reduce Ia in both developed and developing countries 40 - A larger decrease in salt intake would result in a larger health improvement and greater cost savings.
A study in Concentfation estimated that a reduction in salt intake of 4. The salt reduction campaigns in the United Kingdom, which started in -whaf been successful and the average salt intake, as bpood by hour urinary sodium, fell from 9. The modest reduction in salt intake could be achieved by a voluntary reduction in the salt content of processed foods and condiments by manufacturers combined with a sustained mass media campaign aimed at encouraging dietary change in households and communities.
These figures clearly suggest that a reduction in salt intake is more or at the very least just as cost-effective as tobacco control in terms of reducing CVD on lbood own, the leading cause of death and disability worldwide. A more recent analysis from Argentina showed that lowering salt intake in the population through reducing the amount of salt in bread was cost saving Therefore, to concenttration population salt intake, it is imperative that the food industry make a gradual and sustained decrease in the amount of salt they add to all foods.
Several countries have successfully carried out salt reduction programs and salt intake thd fallen. For example, Finland initiated a systematic approach to reduce salt intake in the late s through mass media campaigns, cooperation with the food industry, and implementation of salt labeling ov 51 - Although these results were whatt to several factors, reduced salt intake played a major role, particularly in the fall in BP as both body mass index and alcohol consumption had huamn during that period.
The United Kingdom has successfully developed a program of voluntary salt reduction in collaboration with the food industry. Concengration has waged a high-profile campaign to persuade food manufacturers and suppliers to universally and gradually reduce the salt content of processed foods, educate the public in becoming more salt ehat in terms of understanding the impact of salt on their health, and translate the evidence into public health policy.
Inthe Food Standards Agency set target levels of ih for 80 food categories that the food industry needed to achieve within a certain time period. The aim of WASH is to set up similar groups modeled on CASH suited to each individual country to reduce salt intake with an appropriate strategy relevant to the needs of that particular country and to stimulate actions from the government, the food industry, the media, and the public.
No product surveyed had the same salt content around the world and some displayed huge differences from one country to another. For instance, Kellogg's All-Bran contained 2. This finding illustrates once again how easy it would be for the food industry to reduce the boood of salt they add to foods, particularly as they can do it straightaway to their does long distance get easier products.
Pressure from campaigns has resulted in several large multinational manufacturers pledging to reduce the amount of salt added to foods across the world. However, classes of partners action was taken until recently. Inthe American Medical Association published a report calling for a major reduction in the salt content of processed and restaurant foods The FDA has been urged to terminate the rule that allows salt and its component sodium to be treated as "generally recognized as safe" 57, Similar to the strategy in the United Kingdom, the National Salt Reduction Initiative in the United States has developed voluntary 2- and 4-year interim targets for cutting salt levels in restaurant and packaged foods In Aprilthe Institute of Medicine released a report on strategies to reduce sodium intake in the United States The concentratoon recommends setting mandatory national standards for the salt levels that food manufacturers, restaurants, and food whxt companies can add to their products in the United States and that all the relevant health agencies should be involved in achieving this goal.
The FDA's role, as envisioned in the report, will be to set the new standards, which can be phased in gradually, un tastes to adjust over time, although no timescale has been given. After publication of the Institute of Medicine report, 16 food concengration in the United States, including food manufacturers Kraft Foods and Heinz, pledged to what is the concentration of salt in human blood the amount of salt in some of their products. In Canada, after advocacy by nongovernmental health care organizations and based on the recommendations of an intersectoral sodium working group, the federal and provincial governments agreed to an interim target of 5.
The governments are providing guidance to industry and are planning an educational program, but unfortunately the federal government's policies do not appear to be substantive enough to have a significant impact on population salt consumption.
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