Okuda Nagako, Stamler Jeremiah, Brown Ian J, Ueshima Hirotsugu, Miura Katsuyuki, Okayama Akira, Saitoh Shigeyuki, Nakagawa Hideaki, Sakata Kiyomi, Yoshita Katsushi, Zhao Liancheng, Elliott Paul
aDepartment of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan bDepartment of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA cDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College of London, London, UK dDepartment of Public Health, Shiga University of Medical Science eCenter for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu fResearch Institute of Strategy for Prevention, Tokyo gDivision of Medical and Behavioral Subjects, Sapporo Medical University School of Health Science, Sapporo hDepartment of Public Health, Kanazawa Medical University, Kanazawa iDepartment of Hygiene and Preventive Medicine, Iwate Medical University, Morioka jDepartment of Food Science and Nutrition, Graduate School of Human Life Science, Osaka City University, Osaka, Japan kState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China lMRC-PHE Centre for Environment and Health, Imperial College London, London, UK.
J Hypertens. 2014 Dec;32(12):2385-92. doi: 10.1097/HJH.0000000000000341.
Habitual high-salt intake raises blood pressure and risk of cardiovascular diseases. To prevent/control these risks, reduced salt diet (RSD) is recommended in many countries and some people report practicing it; however, little is known about actual achievement. This population-based study assessed level of 24-h dietary sodium intake of participants reporting RSD and others.
Participants were 4680 men and women ages 40-59 years randomly selected from 17 populations in People's Republic of China (PRC), Japan, UK and USA, for an observational study on diet and blood pressure (INTERMAP). Daily sodium intake was determined by two timed 24-h urine collections. Antihypertensive treatment status and RSD were ascertained by questionnaire.
Participants reporting RSD were few; 3.1% (Japan), 1.3% (PRC), 2.5% (UK), 7.2% (USA); 15.1, 7.9, 16.7 and 16.8% of people with treated hypertension. For those reporting RSD, 24-h urinary sodium excretion was significantly, but only modestly lower than for others, by 17.9 mmol/day (Japan), 56.7 (PRC) and 14.7 (USA), but higher by 10.5 in UK. Sodium intakes for participants reporting RSD remained higher than recommended; 181.0 mmol/day (Japan), 171.5 (PRC), 155.2 (UK) and 148.9 (USA). For these people, as for others, main sources of salt were processed foods in Japan, UK and USA; in PRC, salt added in preparation at home.
Enhanced sustained efforts are needed to raise general awareness of the harmful effects of salt on health and the benefits of salt reduction. Population approaches are needed to reduce salt content of processed foods and restaurant meals.
习惯性高盐摄入会升高血压并增加心血管疾病风险。为预防/控制这些风险，许多国家推荐低钠饮食（RSD），一些人也报告称在践行该饮食方式；然而，实际达成情况却鲜为人知。这项基于人群的研究评估了报告采用RSD的参与者及其他参与者的24小时膳食钠摄入量水平。
参与者为从中国、日本、英国和美国的17个人群中随机选取的4680名年龄在40 - 59岁之间的男性和女性，参与一项关于饮食与血压的观察性研究（INTERMAP）。通过两次定时收集24小时尿液来测定每日钠摄入量。通过问卷调查确定抗高血压治疗状况和RSD情况。
报告采用RSD的参与者较少；在日本为3.1%，在中国为1.3%，在英国为2.5%，在美国为7.2%；在接受治疗的高血压患者中分别为15.1%、7.9%、16.7%和16.8%。对于报告采用RSD的人，24小时尿钠排泄量显著低于其他人，但降低幅度不大，在日本低17.9毫摩尔/天，在中国低56.7，在美国低14.7，但在英国高10.5。报告采用RSD的参与者的钠摄入量仍高于推荐水平；在日本为181.0毫摩尔/天，在中国为171.5，在英国为155.2，在美国为148.9。对于这些人和其他人来说，在日本、英国和美国，盐的主要来源是加工食品；在中国，盐的主要来源是在家烹饪时添加的盐。
需要加大持续努力，以提高公众对盐对健康有害影响以及减盐益处的认识。需要采取人群干预措施来降低加工食品和餐馆饭菜的盐含量。
