Whelton Paul K, He Jiang
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
Curr Opin Lipidol. 2014 Feb;25(1):75-9. doi: 10.1097/MOL.0000000000000033.
Review new articles that clarify the health consequences of changes in dietary sodium and potassium and that characterize adherence to sodium and potassium intake guideline recommendations.
New clinical trials meta-analyses provide additional documentation of the blood pressure (BP) lowering effects of Na reduction and K supplement, with no adverse effects of Na reduction on cholesterol in steady-state settings. BP is the leading preventable risk factor for worldwide mortality and disability-adjusted life years. A preponderance of cohort studies has identified a direct relationship between dietary sodium and cardiovascular disease (CVD), specially stroke, and an inverse relationship between dietary potassium and CVD. However, these studies are of insufficient quality to support firm conclusions. Modeling studies of sodium reduction in the general population have identified an enormous potential for health benefits. Current intake of dietary sodium and potassium fails to meet guideline recommendations.
There is abundant evidence that a reduction in dietary sodium and increase in potassium intake decreases BP, incidence of hypertension, and morbidity and mortality from CVD. However, there is no credible evidence that existing policies have been effective in achieving population goals for dietary sodium and potassium intake in the USA.
回顾新的文章,这些文章阐明了饮食中钠和钾变化对健康的影响,并描述了对钠和钾摄入指南建议的依从性。
新的临床试验荟萃分析提供了更多关于减少钠摄入和补充钾对血压(BP)降低作用的文献,在稳态情况下,减少钠摄入对胆固醇没有不良影响。血压是全球死亡率和伤残调整生命年中主要的可预防风险因素。大量队列研究已确定饮食中的钠与心血管疾病(CVD),特别是中风之间存在直接关系,而饮食中的钾与心血管疾病之间存在反比关系。然而,这些研究质量不足以支持确凿结论。对普通人群减少钠摄入的模型研究已确定了巨大的健康益处潜力。目前饮食中钠和钾的摄入量未达到指南建议。
有充分证据表明,减少饮食中的钠和增加钾摄入量可降低血压、高血压发病率以及心血管疾病的发病率和死亡率。然而,没有可靠证据表明现有政策在美国实现饮食中钠和钾摄入的人群目标方面有效。