心力衰竭患者钠摄入量显著降低与饮食摄入及营养状况的变化:SODIUM-HF试点研究的亚组分析
Changes in dietary intake and nutritional status associated with a significant reduction in sodium intake in patients with heart failure. A sub-analysis of the SODIUM-HF pilot study.
作者信息
Colin-Ramirez Eloisa, McAlister Finlay A, Zheng Yinggan, Sharma Sangita, Ezekowitz Justin A
机构信息
Medicine Department, University of Alberta, Edmonton, Canada.
Division of General Internal Medicine, University of Alberta, Edmonton, Canada.
出版信息
Clin Nutr ESPEN. 2016 Feb;11:e26-e32. doi: 10.1016/j.clnesp.2015.11.002. Epub 2015 Dec 29.
BACKGROUND & AIMS: Concerns have been raised about the impact of dietary sodium restriction on the overall dietary intake and nutritional status in patients with heart failure (HF). The objective of this study was to evaluate the association between a significant reduction in sodium intake and dietary changes and nutritional status in patients with chronic HF.
METHODS
This is a secondary analysis of 38 patients enrolled in a pilot study of dietary sodium reduction. Patients were classified into two groups according to a level of sodium reduction achieved (≥25% [n = 21 patients] and <25% [n = 14 patients]) at 6 months. Between group changes in energy, nutrient intake, weight loss, and hand grip strength from baseline to 6 months were compared.
RESULTS
Patients had a median age of 65 years, 51% were male, median body mass index was 30.7 kg/m and median ejection fraction was 39%. Over 6 months, the group with ≥25% sodium reduction exhibited a greater increase in folate intake [median change 50 mcg/day (25th-75th percentiles: -101, 167) vs. -31 mcg/day (25th-75th percentiles: -221, 51), p = 0.04 between groups] and a larger reduction in calcium intake [median change -262 (25th-75th percentiles: -585, -9) vs. 91 (25th-75th percentiles: -114, 210), p = 0.01 between groups], and were more likely to meet the parameters of the DASH diet compared to the <25% sodium reduction group. No significant differences between groups were seen for caloric intake and other relevant nutrients and no significant weight loss was found in either group.
CONCLUSIONS
Dietary sodium reduction may be achieved without compromising overall dietary intake and nutritional status in patients with HF when an individualized and comprehensive dietary approached is used.
CLINICAL TRIAL IDENTIFIER
Clinicaltrials.gov identifier: NCT01480401.
背景与目的
人们对心力衰竭(HF)患者饮食中限制钠摄入对整体饮食摄入和营养状况的影响表示担忧。本研究的目的是评估慢性心力衰竭患者钠摄入量显著减少与饮食变化及营养状况之间的关联。
方法
这是一项对38名参与饮食钠减少试点研究患者的二次分析。根据6个月时实现的钠减少水平(≥25%[n = 21例患者]和<25%[n = 14例患者])将患者分为两组。比较两组从基线到6个月时能量、营养摄入、体重减轻和握力的组间变化。
结果
患者的中位年龄为65岁,51%为男性,中位体重指数为30.7kg/m,中位射血分数为39%。在6个月期间,钠减少≥25%的组叶酸摄入量增加更多[中位变化50mcg/天(第25 - 75百分位数:-101,167) vs. -31mcg/天(第25 - 75百分位数:-221,51),组间p = 0.04],钙摄入量减少幅度更大[中位变化-262(第25 - 75百分位数:-585,-9) vs. 91(第25 - 75百分位数:-114,210),组间p = 0.01],与钠减少<25%的组相比,更有可能符合DASH饮食的参数。两组在热量摄入和其他相关营养素方面无显著差异,两组均未发现显著体重减轻。
结论
当采用个性化和综合饮食方法时,心力衰竭患者在不影响整体饮食摄入和营养状况的情况下可以实现饮食钠减少。
临床试验标识符
Clinicaltrials.gov标识符:NCT01480401。