Juraschek Stephen P, Millar Courtney L, Foley Abby, Shtivelman Misha, Cohen Alegria, McNally Virginia, Crevatis Robert, Post Stephen M, Mukamal Kenneth J, Lipsitz Lewis A, Cluett Jennifer L, Davis Roger B, Sahni Shivani
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Harvard Medical School, Boston, MA 02115, USA.
Nutrients. 2021 Mar 16;13(3):964. doi: 10.3390/nu13030964.
Reduced sodium meal plans are recommended by the Centers of Disease Control to lower blood pressure in older adults; however, this strategy has not been tested in a clinical trial. The Satter House Trial of Reduced Sodium Meals (SOTRUE) was an individual-level, double-blind, randomized controlled pilot study of adults living in a congregate living facility subsidized by the Federal Department of Housing and Urban Development (HUD). Adults over age 60 years ate 3 isocaloric meals with two snacks daily for 14 days. The meal plans differed in sodium density (<0.95 vs. >2 mg/kcal), but were equivalent in potassium and macronutrients. Seated systolic BP (SBP) was the primary outcome, while urine sodium-creatinine ratio was used to measure compliance. Twenty participants were randomized (95% women; 95% white; mean age 78 ± 8 years), beginning in 7 October 2019. Retention was 100% with the last participant ending 4 November 2019. Mean baseline SBP changed from 121 to 116 mmHg with the typical sodium diet (-5 mmHg; 95% CI: -18, 8) and from 123 to 112 mmHg with the low sodium diet (-11 mmHg; 95% CI: -15.2, -7.7). Compared to the typical sodium meal plan, the low sodium meal plan lowered SBP by 4.8 mmHg (95% CI: -14.4, 4.9; = 0.31) and urine sodium-creatinine ratio by 36% (-36.0; 95% CI: -60.3, 3.4; = 0.07), both non-significant. SOTRUE demonstrates the feasibility of sodium reduction in federally mandated meal plans. A longer and larger study is needed to establish the efficacy and safety of low sodium meals in older adults.
美国疾病控制中心推荐采用减少钠摄入的饮食计划来降低老年人的血压；然而，这一策略尚未在临床试验中得到验证。“减少钠摄入饮食的萨特豪斯试验”（SOTRUE）是一项针对居住在由美国住房和城市发展部（HUD）补贴的集体生活设施中的成年人开展的个体层面、双盲、随机对照试验性研究。60岁以上的成年人连续14天每天食用3顿等热量餐食并搭配两份零食。这些饮食计划的钠密度不同（<0.95 vs. >2毫克/千卡），但钾含量和常量营养素含量相当。坐位收缩压（SBP）是主要观察指标，而尿钠肌酐比值用于衡量依从性。从2019年10月7日起，20名参与者被随机分组（95%为女性；95%为白人；平均年龄78±8岁）。最后一名参与者于2019年11月4日结束试验，保留率为100%。采用典型钠饮食时，平均基线收缩压从121毫米汞柱降至116毫米汞柱（-5毫米汞柱；95%置信区间：-18, 8），采用低钠饮食时从123毫米汞柱降至112毫米汞柱（-11毫米汞柱；95%置信区间：-15.2, -7.7）。与典型钠饮食计划相比，低钠饮食计划使收缩压降低了4.8毫米汞柱（95%置信区间：-14.4, 4.9；P = 0.31），尿钠肌酐比值降低了36%（-36.0；95%置信区间：-60.3, 3.4；P = 0.07），两者均无统计学意义。SOTRUE证明了在联邦规定的饮食计划中减少钠摄入的可行性。需要开展一项规模更大、时间更长的研究来确定低钠饮食对老年人的有效性和安全性。
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