Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.
Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
JMIR Res Protoc. 2024 Oct 29;13:e56869. doi: 10.2196/56869.
Hypertension increases with age, often due to high sodium (Na) and low potassium (K) intake. Reducing salt and increasing K intake is challenging, especially for older adults due to taste preferences. Culinary herbs and spices, rich in K, offer a potential solution. The High Potassium Diet Rich in Spices and Herbs-Salt Substitution (HPSH-SS) diet has not yet been studied for its effectiveness in lowering blood pressure.
This study aims to create an HPSH-SS diet, analyze its effects on blood pressure in older adults, and study the molecular mechanism occurring in the kidneys and blood vessels influenced by this diet.
This study consists of 2 phases. The first phase involved formulating and assessing the HPSH-SS diet tailored for older adults. The intervention group (IG) received a diet of 1800 kcal/day, with 3500 mg K and 1500 mg Na, while the control group (CG) received 1500 mg K and 2000 mg Na. The diet was administered for 14 days and standardized using the NutriSurvey program and biochemistry analysis by atomic absorbance spectrophotometry (AAS). The second phase was a 14-day parallel randomized controlled trial (RCT) with the older adult participants divided into IG and CG. Primary outcomes included blood pressure; serum potassium; aldosterone; F2 isoprostane; nitric oxide plasma levels; and urine analysis of Na, K, and the Na/K ratio. Confounding variables were controlled through randomization and stratified analysis.
The menu formulation and organoleptic assessment of the HPSH-SS diet began in mid-2022 and was approved by the Ethics Committee of the Faculty of Public Health at Universitas Airlangga (78/EA/KEPK/2022) on May 11, 2022. The diet was standardized to achieve daily nutritional values of 1800 kcal energy, 3500 mg K, and 1500 mg Na. K and Na contents were analyzed using AAS from several participants' spice diet menus. Recruitment for the RCT started in March 2023, with approval from the Health Research Ethics Committee Universitas Airlangga School of Medicine, Surabaya (35/EC/KEPK/FKUA/2023). The study was registered from February 9, 2023, to February 9, 2024. Between March and June 2023, 64 participants were recruited, with 32 participants in the IG and CG. The intervention and data collection will take place over 1 year. Data management is in progress, and data analysis is yet to be performed.
This RCT protocol hypothesizes that the diet will increase serum K, plasma aldosterone, and nitric oxide levels; decrease plasma F2 isoprostane; increase urinary Na and K levels; lower the urinary Na/K ratio; and reduce systolic and diastolic blood pressure. If effective, it will offer valuable insights into dietary strategies for blood pressure regulation in older adults.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56869.
高血压随着年龄的增长而增加，通常是由于高钠（Na）和低钾（K）摄入所致。减少盐的摄入并增加 K 的摄入量具有挑战性，尤其是对于老年人来说，因为他们的口味偏好。富含 K 的烹饪草药和香料提供了一种潜在的解决方案。富含香料和草药的高钾饮食替代盐（HPSH-SS）饮食在降低血压方面的效果尚未得到研究。
本研究旨在制定 HPSH-SS 饮食，分析其对老年人血压的影响，并研究这种饮食对肾脏和血管中发生的分子机制。
本研究由两个阶段组成。第一阶段涉及制定和评估针对老年人的 HPSH-SS 饮食。干预组（IG）接受 1800 卡路里/天的饮食，其中 3500 毫克 K 和 1500 毫克 Na，而对照组（CG）接受 1500 毫克 K 和 2000 毫克 Na。饮食持续 14 天，并使用 NutriSurvey 程序和原子吸收分光光度法（AAS）进行生物化学分析进行标准化。第二阶段是一项为期 14 天的平行随机对照试验（RCT），将老年参与者分为 IG 和 CG。主要结局包括血压；血清钾；醛固酮；F2 异前列烷；一氧化氮血浆水平；以及尿液分析 Na、K 和 Na/K 比值。通过随机化和分层分析控制混杂变量。
HPSH-SS 饮食的菜单制定和感官评估于 2022 年年中开始，并于 2022 年 5 月 11 日获得阿克萨拉亚公共卫生学院公共卫生学院伦理委员会的批准（78/EA/KEPK/2022）。饮食标准化以实现每天 1800 卡路里的能量、3500 毫克 K 和 1500 毫克 Na 的营养值。使用 AAS 对几位参与者的香料饮食菜单中的 K 和 Na 含量进行了分析。RCT 的招募工作于 2023 年 3 月开始，并获得了阿克萨拉亚医学院健康研究伦理委员会的批准（35/EC/KEPK/FKUA/2023）。该研究于 2023 年 2 月 9 日至 2024 年 2 月 9 日进行注册。2023 年 3 月至 6 月期间，招募了 64 名参与者，IG 和 CG 各有 32 名参与者。干预和数据收集将持续一年。正在进行数据管理，尚未进行数据分析。
本 RCT 方案假设该饮食将增加血清 K、血浆醛固酮和一氧化氮水平；降低血浆 F2 异前列烷；增加尿中 Na 和 K 水平；降低尿 Na/K 比值；并降低收缩压和舒张压。如果有效，它将为调节老年人血压的饮食策略提供有价值的见解。
国际注册报告标识符（IRRID）：DERR1-10.2196/56869。
