Lee Jounghee, Sohn Cheongmin, Kim Oh-Yoen, Lee Young-Min, Yoon Mi Ock, Lee Myoungsook
Department of Food and Nutrition, Kunsan National University, Gunsan 54150, Korea.
Department of Food and Nutrition, Wonkwang University, Iksan 54538, Korea.
Nutr Res Pract. 2023 Apr;17(2):175-191. doi: 10.4162/nrp.2023.17.2.175. Epub 2023 Jan 20.
BACKGROUND/OBJECTIVES: The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults.
SUBJECTS/METHODS: A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool.
This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m; 95% confidence interval [CI], 1.59-2.51; < 0.001; I = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m; 95% CI, 1.13-1.55; < 0.001; I = 95%) and dietary methods (mean difference = 0.85 kg/m; 95% CI, 0.1-1.51; < 0.05; I = 95%).
Quantitative synthesis of the systematic reviews has shown that cross-sectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.
背景/目的：钠与肥胖关联的科学证据受钠摄入量评估的限制。我们的具体目标是综合成年人系统评价所证实的不同钠摄入量评估方法下膳食钠摄入量与肥胖之间的关联。
对象/方法：通过系统检索，找出比较膳食钠摄入量与肥胖相关结局（如体重指数（BMI）、体重、腰围以及（腹部）肥胖风险）之间关联的系统评价。我们于2022年10月24日在PubMed上进行了检索。为评估系统评价中的偏倚风险（ROBIS），我们使用了ROBIS工具。
本综述纳入了3篇系统评价，包括39项独特的观察性研究（35项横断面研究和4项纵向研究）以及15项随机对照试验（RCT）。我们发现横断面研究中膳食钠摄入量与肥胖相关结局之间始终存在正相关。与使用随机尿样（平均差值 = 1.34 kg/m²；95%置信区间[CI]，1.13 - 1.55；P < 0.001；I² = 95%）和膳食方法（平均差值 = 0.85 kg/m²；95% CI，0.1 - 1.51；P < 0.05；I² = 95%）的研究相比，使用24小时尿样收集的研究显示，钠摄入量较高者的BMI更高（平均差值 = 2.27 kg/m²；95% CI，1.59 - 2.51；P < 0.001；I² = 77%）。
系统评价的定量综合分析表明，不同钠摄入量评估方法下，膳食钠摄入量与肥胖结局之间的横断面关联存在显著差异。我们需要更多高质量的前瞻性队列研究以及使用24小时尿样收集的随机对照试验，以研究钠摄入量对肥胖的因果效应。
