Thout Sudhir Raj, Yu Jie, Santos Joseph Alvin, Hameed Md, Coyle Daisy H
The George Institute for Global Health India, Punjagutta, Hyderabad, India.
The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Dialogues Health. 2023 Feb 3;2:100109. doi: 10.1016/j.dialog.2023.100109. eCollection 2023 Dec.
Hypertension is highly prevalent in India; however, little is known about the dietary intakes of those living with hypertension, particularly in rural areas. The primary aim was to assess the dietary intakes of individuals living in rural India with self-reported history of hypertension. As secondary analyses, we explored the dietary impact of a salt substitute in this population group.
This study used data from a large randomised controlled trial conducted in seven villages across rural India. Participants received either regular salt (100% sodium chloride) or the salt substitute (70% sodium chloride/30% potassium chloride) to replace all home salt use. Dietary intake at baseline and end-of-trial was assessed using 24-h dietary recalls. A range of dietary outcomes were assessed including energy intake, macronutrient intake and overall diet quality according to the Alternate Healthy Eating Index (AHEI).
A total of 454 participants were included in the analysis. At baseline, mean (SE) energy intakes in regular salt group and salt substitute group were similar at 5240 (110) kJ/day and 5120 (106) kJ/day, respectively. This was largely attributable to intakes of carbohydrates (74.4% of total energy intakes for regular salt group vs 75.4% for the salt substitute group) followed by total fat (15.8% vs 15.4%) and protein (10.4% vs 10.3%). Both groups also had similar AHEI scores at baseline, with mean (SE) total scores equating to 33.0 (0.4) (out of a total 90) for the regular salt group and 32.7 (0.4) for the salt substitute group. Both groups received lowest AHEI scores across the following components: vegetables, fruit and wholegrains. At baseline, the mean (SE) intakes of sodium across the regular salt and salt substitute groups were similar at 2349 (67) mg/day and 2396 (64) mg/day, respectively. In the salt substitute group, there was a significant reduction in total sodium intakes over time (-264 mg/day, 95% CI, -442 to -85), driven by the use of the salt substitute.
This study found individuals with hypertension living in rural India had poor dietary intakes, including low intakes of fruits, vegetables and wholegrains, and high intakes of sodium. Salt substitutes may be an effective strategy for reducing sodium intake in this population group.
高血压在印度极为普遍；然而，对于高血压患者的饮食摄入情况，尤其是农村地区患者的情况，人们了解甚少。主要目的是评估印度农村地区有自我报告高血压病史的个体的饮食摄入情况。作为次要分析，我们探讨了盐替代品对该人群的饮食影响。
本研究使用了在印度农村七个村庄进行的一项大型随机对照试验的数据。参与者被给予普通盐（100%氯化钠）或盐替代品（70%氯化钠/30%氯化钾）以取代所有家庭用盐。使用24小时饮食回顾法评估基线和试验结束时的饮食摄入情况。根据替代健康饮食指数（AHEI）评估了一系列饮食结果，包括能量摄入、宏量营养素摄入和整体饮食质量。
共有454名参与者纳入分析。在基线时，普通盐组和盐替代品组的平均（标准误）能量摄入量相似，分别为5240（110）千焦/天和5120（106）千焦/天。这主要归因于碳水化合物的摄入量（普通盐组占总能量摄入的74.4%，盐替代品组为75.4%），其次是总脂肪（15.8%对15.4%）和蛋白质（10.4%对10.3%）。两组在基线时的AHEI得分也相似，普通盐组的平均（标准误）总得分相当于33.0（0.4）（满分90分），盐替代品组为32.7（0.4）。两组在以下成分方面的AHEI得分最低：蔬菜、水果和全谷物。在基线时，普通盐组和盐替代品组的钠平均（标准误）摄入量相似，分别为2349（67）毫克/天和2396（64）毫克/天。在盐替代品组中，由于使用盐替代品，随着时间推移总钠摄入量显著降低（-264毫克/天，95%置信区间，-442至-85）。
本研究发现，印度农村地区的高血压患者饮食摄入不佳，包括水果、蔬菜和全谷物摄入量低，钠摄入量高。盐替代品可能是降低该人群钠摄入量的有效策略。
