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Dietary Sodium and Human Health

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (10 August 2021) | Viewed by 32641

Special Issue Editor


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Guest Editor
Division of Nephrology and Hypertension, Department of Medicine, Geneva University Hospitals, 1205 Geneva, Switzerland
Interests: chronic kidney disease; hypertension, epidemiology; salt; arterial stiffness

Special Issue Information

Dear Colleagues,

Salt is essential for life. However, excessive salt consumption has long been known to have detrimental effects on health mostly in the cardiovascular field. Salt consumption is generally estimated by questionnaires or sodium excretion using 24h urine collection. Sodium is believed to have a proper effect on vessels independently of blood pressure. This Special Issue on salt and health is a great opportunity to make a contribution in understanding sodium intake determinants and to provide new insight into the cardiovascular effects of salt. Therefore, we encourage authors exploring sodium intake epidemiology, as well as the interplay between salt in vessels, to submit their research. 

Dr. Belen Ponte
Guest Editor

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Keywords

  • Salt intake
  • Sodium to potassium ratio
  • Sodium determinants
  • Cardiovascular

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Published Papers (8 papers)

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Editorial

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3 pages, 195 KiB  
Editorial
Dietary Sodium and Human Health
by David A. Jaques and Belen Ponte
Nutrients 2023, 15(17), 3696; https://doi.org/10.3390/nu15173696 - 24 Aug 2023
Cited by 3 | Viewed by 2239
Abstract
Sodium, contained in dietary salt, is essential to human life [...] Full article
(This article belongs to the Special Issue Dietary Sodium and Human Health)

Research

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10 pages, 1382 KiB  
Article
Melatonin Prevents T Lymphocyte Infiltration to the Kidneys of Hypertensive Rats, Induced by a High-Salt Diet, by Preventing the Expression of CXCR3 Ligand Chemokines
by Ariel Bier, Rawan Khashab, Yehonatan Sharabi, Ehud Grossman and Avshalom Leibowitz
Nutrients 2021, 13(10), 3577; https://doi.org/10.3390/nu13103577 - 13 Oct 2021
Cited by 7 | Viewed by 2297
Abstract
In a previous study, we demonstrated that melatonin prevents kidney damage in a salt-induced hypertension model by decreasing oxidative stress. We hypothesized that this effect involves melatonin’s immunomodulatory properties. In vivo Study-Dahl salt-sensitive (DSS) rats were fed normal chow, a high-salt diet (HSD), [...] Read more.
In a previous study, we demonstrated that melatonin prevents kidney damage in a salt-induced hypertension model by decreasing oxidative stress. We hypothesized that this effect involves melatonin’s immunomodulatory properties. In vivo Study-Dahl salt-sensitive (DSS) rats were fed normal chow, a high-salt diet (HSD), or a HSD and melatonin (30 mg/kg/day) in their water for eight weeks. Kidneys were harvested for immediate lymphocyte isolation and characterization by Flow cytometry (CD3+CD4+ and CD3+CD8+) and for lymphocyte chemoattractant (mainly CXCL chemokines) gene expression studies. In vitro study-rat mesangial cells (RMC) were cultured in a high-salt medium without and with melatonin. A HSD was associated with significant renal infiltration of CD4+ and CD8+ T lymphocytes compared to control. Melatonin significantly reduced renal lymphocyte infiltration. A HSD significantly increased mRNA expression of CXCL chemokines. Adding melatonin to the HSD abolished this effect. Treating RMC cells with salt increased the expression of CXCL10 and CXCL11 but not CXCL9. Adding melatonin to the culture media prevented this increase. Treating HSD-fed rats with melatonin decreased renal lymphocyte chemoattractant mRNA expression and is associated with significantly reducing renal T lymphocyte infiltration. Salt may have a direct effect on chemokine-producing renal cells, which is blunted by melatonin treatment. Full article
(This article belongs to the Special Issue Dietary Sodium and Human Health)
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11 pages, 1613 KiB  
Article
Impact of Hyponatremia after Renal Transplantation on Decline of Renal Function, Graft Loss and Patient Survival: A Prospective Cohort Study
by Lena Berchtold, Anja Filzer, Rita Achermann, Vasileios Devetzis, Suzan Dahdal, Marco Bonani, Aurelia Schnyder, Dela Golshayan, Patrizia Amico, Uyen Huynh-Do, Sophie de Seigneux, Spyridon Arampatzis and on behalf of Swiss Transplant Cohort Study Collaborators
Nutrients 2021, 13(9), 2995; https://doi.org/10.3390/nu13092995 - 27 Aug 2021
Cited by 1 | Viewed by 3091
Abstract
Background: Hyponatremia is one of the most common electrolyte disorders observed in hospitalized and ambulatory patients. Hyponatremia is associated with increased falls, fractures, prolonged hospitalisation and mortality. The clinical importance of hyponatremia in the renal transplant field is not well established, so the [...] Read more.
Background: Hyponatremia is one of the most common electrolyte disorders observed in hospitalized and ambulatory patients. Hyponatremia is associated with increased falls, fractures, prolonged hospitalisation and mortality. The clinical importance of hyponatremia in the renal transplant field is not well established, so the aim of this study was to determine the relationships between hyponatremia and mortality as main outcome and renal function decline and graft loss as secondary outcome among a prospective cohort of renal transplant recipients. Methods: This prospective cohort study included 1315 patients between 1 May 2008 and 31 December 2014. Hyponatremia was defined as sodium concentration below 136 mmol/L at 6 months after transplantation. The main endpoint was mortality. A secondary composite endpoint was also defined as: rapid decline in renal function (≥5 mL/min/1.73 m2 drop of the eGFR/year), graft loss or mortality. Results: Mean sodium was 140 ± 3.08 mmol/L. 97 patients displayed hyponatremia with a mean of 132.9 ± 3.05 mmol/L. Hyponatremia at 6 months after transplantation was associated neither with mortality (HR: 1.02; p = 0.97, 95% CI: 0.47–2.19), nor with the composite outcome defined as rapid decline in renal function, graft loss or mortality (logrank test p = 0.9). Conclusions: Hyponatremia 6 months after transplantation is not associated with mortality in kidney allograft patients. Full article
(This article belongs to the Special Issue Dietary Sodium and Human Health)
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17 pages, 3235 KiB  
Article
Aerobic Exercise Training Prevents Insulin Resistance and Hepatic Lipid Accumulation in LDL Receptor Knockout Mice Chronically Fed a Low-Sodium Diet
by Guilherme da Silva Ferreira, Ana Paula Garcia Bochi, Paula Ramos Pinto, Vanessa Del Bianco, Letícia Gomes Rodrigues, Mychel Raony Paiva Teixeira Morais, Edna Regina Nakandakare, Ubiratan Fabres Machado, Sergio Catanozi and Marisa Passarelli
Nutrients 2021, 13(7), 2174; https://doi.org/10.3390/nu13072174 - 24 Jun 2021
Cited by 9 | Viewed by 3804
Abstract
Background: A low-sodium (LS) diet reduces blood pressure, contributing to the prevention of cardiovascular diseases. However, intense dietary sodium restriction impairs insulin sensitivity and worsens lipid profile. Considering the benefits of aerobic exercise training (AET), the effect of LS diet and AET in [...] Read more.
Background: A low-sodium (LS) diet reduces blood pressure, contributing to the prevention of cardiovascular diseases. However, intense dietary sodium restriction impairs insulin sensitivity and worsens lipid profile. Considering the benefits of aerobic exercise training (AET), the effect of LS diet and AET in hepatic lipid content and gene expression was investigated in LDL receptor knockout (LDLr-KO) mice. Methods: Twelve-week-old male LDLr-KO mice fed a normal sodium (NS) or LS diet were kept sedentary (S) or trained (T) for 90 days. Body mass, plasma lipids, insulin tolerance testing, hepatic triglyceride (TG) content, gene expression, and citrate synthase (CS) activity were determined. Results were compared by 2-way ANOVA and Tukey’s post-test. Results: Compared to NS, LS increased body mass and plasma TG, and impaired insulin sensitivity, which was prevented by AET. The LS-S group, but not the LS-T group, presented greater hepatic TG than the NS-S group. The LS diet increased the expression of genes related to insulin resistance (ApocIII, G6pc, Pck1) and reduced those involved in oxidative capacity (Prkaa1, Prkaa2, Ppara, Lipe) and lipoprotein assembly (Mttp). Conclusion: AET prevented the LS-diet-induced TG accumulation in the liver by improving insulin sensitivity and the expression of insulin-regulated genes and oxidative capacity. Full article
(This article belongs to the Special Issue Dietary Sodium and Human Health)
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16 pages, 1614 KiB  
Article
Geospatial Analysis of Sodium and Potassium Intake: A Swiss Population-Based Study
by David De Ridder, Fabiën N. Belle, Pedro Marques-Vidal, Belén Ponte, Murielle Bochud, Silvia Stringhini, Stéphane Joost and Idris Guessous
Nutrients 2021, 13(6), 1798; https://doi.org/10.3390/nu13061798 - 25 May 2021
Cited by 3 | Viewed by 2992
Abstract
Inadequate sodium and potassium dietary intakes are associated with major, yet preventable, health consequences. Local public health interventions can be facilitated and informed by fine-scale geospatial analyses. In this study, we assess the existence of spatial clustering (i.e., an unusual concentration of individuals [...] Read more.
Inadequate sodium and potassium dietary intakes are associated with major, yet preventable, health consequences. Local public health interventions can be facilitated and informed by fine-scale geospatial analyses. In this study, we assess the existence of spatial clustering (i.e., an unusual concentration of individuals with a specific outcome in space) of estimated sodium (Na), potassium (K) intakes, and Na:K ratio in the Bus Santé 1992–2018 annual population-based surveys, including 22,495 participants aged 20–74 years, residing in the canton of Geneva, using the local Moran’s I spatial statistics. We also investigate whether socio-demographic and food environment characteristics are associated with identified spatial clustering, using both global ordinary least squares (OLS) and local geographically weighted regression (GWR) modeling. We identified clear spatial clustering of Na:K ratio, Na, and K intakes. The GWR outperformed the OLS models and revealed spatial variations in the associations between explanatory and outcome variables. Older age, being a woman, higher education, and having a lower access to supermarkets were associated with higher Na:K ratio, while the opposite was seen for having the Swiss nationality. Socio-demographic characteristics explained a major part of the identified clusters. Socio-demographic and food environment characteristics significantly differed between individuals in spatial clusters of high and low Na:K ratio, Na, and K intakes. These findings could guide prioritized place-based interventions tailored to the characteristics of the identified populations. Full article
(This article belongs to the Special Issue Dietary Sodium and Human Health)
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16 pages, 982 KiB  
Article
Is There Association between Altered Adrenergic System Activity and Microvascular Endothelial Dysfunction Induced by a 7-Day High Salt Intake in Young Healthy Individuals
by Ana Stupin, Ines Drenjančević, Petar Šušnjara, Željko Debeljak, Nikolina Kolobarić, Ivana Jukić, Zrinka Mihaljević, Goran Martinović and Kristina Selthofer-Relatić
Nutrients 2021, 13(5), 1731; https://doi.org/10.3390/nu13051731 - 20 May 2021
Cited by 7 | Viewed by 3650
Abstract
This study aimed to test the effect of a 7-day high-salt (HS) diet on autonomic nervous system (ANS) activity in young healthy individuals and modulation of ANS on microvascular endothelial function impairment. 47 young healthy individuals took 7-day low-salt (LS) diet (3.5 g [...] Read more.
This study aimed to test the effect of a 7-day high-salt (HS) diet on autonomic nervous system (ANS) activity in young healthy individuals and modulation of ANS on microvascular endothelial function impairment. 47 young healthy individuals took 7-day low-salt (LS) diet (3.5 g salt/day) followed by 7-day high-salt (HS) diet (~14.7 g salt/day). ANS activity was assessed by 24-h urine catecholamine excretion and 5-min heart rate variability (HRV). Skin post-occlusive reactive hyperemia (PORH) and acetylcholine-induced dilation (AChID) were assessed by laser Doppler flowmetry (LDF). Separately, mental stress test (MST) at LS and HS condition was conducted, followed by immediate measurement of plasma metanephrines’ level, 5-min HRV and LDF microvascular reactivity. Noradrenaline, metanephrine and normetanephrine level, low-frequency (LF) HRV and PORH and AChID significantly decreased following HS compared to LS. MST at HS condition tended to increase HRV LF/HF ratio. Spectral analysis of PORH signal, and AChID measurement showed that MST did not significantly affect impaired endothelium-dependent vasodilation due to HS loading. In this case, 7-day HS diet suppressed sympathetic nervous system (SNS) activity, and attenuated microvascular reactivity in salt-resistant normotensive individuals. Suppression of SNS during HS loading represents a physiological response, rather than direct pathophysiological mechanism by which HS diet affects microvascular endothelial function in young healthy individuals. Full article
(This article belongs to the Special Issue Dietary Sodium and Human Health)
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13 pages, 3446 KiB  
Article
Clinical Profiles and Factors Associated with a Low Sodium Intake in the Population: An Analysis of the Swiss Survey on Salt
by Michel Burnier, Fred M. Paccaud and Murielle Bochud
Nutrients 2020, 12(11), 3591; https://doi.org/10.3390/nu12113591 - 23 Nov 2020
Cited by 5 | Viewed by 2930
Abstract
As a part of the salt controversy, it has been suggested that people with a low sodium intake have an increased risk of cardiovascular events. However, there is no clear explanation for this increased risk. We examined the socio-demographic, clinical profile, and behavioral [...] Read more.
As a part of the salt controversy, it has been suggested that people with a low sodium intake have an increased risk of cardiovascular events. However, there is no clear explanation for this increased risk. We examined the socio-demographic, clinical profile, and behavioral factors associated with a low sodium intake in the Swiss subjects who participated in the Swiss Survey on Salt. Only 13.3% of the Swiss population eat less than 5 g of salt daily and among them 78.2% are women. Subjects with a low sodium intake eat and drink less as reflected by lower intakes of proteins, potassium, and calcium and a smaller urine volume. In addition, a low blood pressure, a normal body mass index, a low prevalence of obesity, a low serum uric acid, and less alcohol and cigarette consumption characterized this group, suggesting a rather low cardiovascular risk profile. Being single and doing most of the cooking at home are associated with a low intake of sodium, as well as a less frequent consumption of meat and fish when eating less than 5 g salt per day. However, the awareness of the effects of salt on health and cardiovascular risk, health concerns, and physical activity are similar in subjects eating more or less salt. In conclusion, we could not evidence clinical or behavioral factors that could significantly increase the risk of developing cardiovascular events in low salt eaters. Full article
(This article belongs to the Special Issue Dietary Sodium and Human Health)
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Review

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15 pages, 1120 KiB  
Review
Sodium Intake as a Cardiovascular Risk Factor: A Narrative Review
by David A. Jaques, Gregoire Wuerzner and Belen Ponte
Nutrients 2021, 13(9), 3177; https://doi.org/10.3390/nu13093177 - 12 Sep 2021
Cited by 34 | Viewed by 10486
Abstract
While sodium is essential for human homeostasis, current salt consumption far exceeds physiological needs. Strong evidence suggests a direct causal relationship between sodium intake and blood pressure (BP) and a modest reduction in salt consumption is associated with a meaningful reduction in BP [...] Read more.
While sodium is essential for human homeostasis, current salt consumption far exceeds physiological needs. Strong evidence suggests a direct causal relationship between sodium intake and blood pressure (BP) and a modest reduction in salt consumption is associated with a meaningful reduction in BP in hypertensive as well as normotensive individuals. Moreover, while long-term randomized controlled trials are still lacking, it is reasonable to assume a direct relationship between sodium intake and cardiovascular outcomes. However, a consensus has yet to be reached on the effectiveness, safety and feasibility of sodium intake reduction on an individual level. Beyond indirect BP-mediated effects, detrimental consequences of high sodium intake are manifold and pathways involving vascular damage, oxidative stress, hormonal alterations, the immune system and the gut microbiome have been described. Globally, while individual response to salt intake is variable, sodium should be perceived as a cardiovascular risk factor when consumed in excess. Reduction of sodium intake on a population level thus presents a potential strategy to reduce the burden of cardiovascular disease worldwide. In this review, we provide an update on the consequences of salt intake on human health, focusing on BP and cardiovascular outcomes as well as underlying pathophysiological hypotheses. Full article
(This article belongs to the Special Issue Dietary Sodium and Human Health)
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