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      Relation of iron and red meat intake to blood pressure: cross sectional epidemiological study

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          Abstract

          Objective To investigate associations of dietary iron (total, haem, and non-haem), supplemental iron, and red meat with blood pressure.

          Design Cross sectional epidemiological study.

          Setting 17 population samples from Japan, China, the United Kingdom, and the United States participating in the international collaborative study on macro-/micronutrients and blood pressure (INTERMAP).

          Participants 4680 adults aged 40-59.

          Main outcome measure Average of eight blood pressure readings.

          Results In multiple linear regression analyses dietary total iron and non-haem iron were consistently inversely associated with blood pressure. With adjustment for potential non-dietary and dietary confounders, dietary total iron intake higher by 4.20 mg/4.2 MJ (2 SD) was associated with −1.39 mm Hg (P<0.01) lower systolic blood pressure. Dietary non-haem iron intake higher by 4.13 mg/4.2 MJ (2 SD) was associated with −1.45 mm Hg (P<0.001) lower systolic blood pressure. Differences were smaller for diastolic blood pressure. In most models haem iron intake from food was positively, non-significantly associated with blood pressure. Iron intake from combined diet and supplements yielded smaller associations than dietary iron alone. Red meat intake was directly associated with blood pressure; 102.6 g/24 h (2 SD) higher intake was associated with 1.25 mm Hg higher systolic blood pressure. Associations between red meat and blood pressure persisted after adjustment for multiple confounders.

          Conclusion Non-haem iron has a possible role in the prevention and control of adverse blood pressure levels. An unfavourable effect of red meat on blood pressure was observed. These results need confirmation including in prospective studies, clinical trials, and from experimental evidence on possible mechanisms.

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          Most cited references38

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          CIRCULATION

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            Comparison of dietary assessment methods in nutritional epidemiology: weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records.

            Women (n 160) aged 50 to 65 years were asked to weigh their food for 4 d on four occasions over the period of 1 year, using the PETRA (Portable Electronic Tape Recorded Automatic) scales. Throughout the year, they were asked to complete seven other dietary assessment methods: a simple 24 h recall, a structured 24 h recall with portion size assessments using photographs, two food-frequency questionnaires, a 7 d estimated record or open-ended food diary, a structured food-frequency (menu) record, and a structured food-frequency (menu) record with portion sizes assessed using photographs. Comparisons between the average of the 16 d weighed records and the first presentation of each method indicated that food-frequency questionnaires were not appreciably better at placing individuals in the distribution of habitual diet than 24 h recalls, due partly to inaccuracies in the estimation of frequency of food consumption. With a 7 d estimated record or open-ended food diary, however, individual values of nutrients were most closely associated with those obtained from 16 d weighed records, and there were no significant differences in average food or nutrient intakes.
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              Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials.

              To assess the effects of supplementation with oral potassium on blood pressure in humans. Meta-analysis of randomized controlled trials. English-language articles published before July 1995. Thirty-three randomized controlled trials (2609 participants) in which potassium supplementation was the only difference between the intervention and control conditions. Using a standardized protocol, 2 of us independently abstracted information on sample size, duration, study design, potassium dose, participant characteristics, and treatment results. By means of a random-effects model, findings from individual trials were pooled, after results for each trial were weighted by the inverse of its variance. An extreme effect of potassium in lowering blood pressure was noted in 1 trial. After exclusion of this trial, potassium supplementation was associated with a significant reduction in mean (95% confidence interval) systolic and diastolic blood pressure of -3.11 mm Hg (-1.91 to -4.31 mm Hg) and -1.97 mm Hg (-0.52 to -3.42 mm Hg), respectively. Effects of treatment appeared to be enhanced in studies in which participants were concurrently exposed to a high intake of sodium. Our results support the premise that low potassium intake may play an important role in the genesis of high blood pressure. Increased potassium intake should be considered as a recommendation for prevention and treatment of hypertension, especially in those who are unable to reduce their intake of sodium.
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                Author and article information

                Contributors
                Role: lecturer in epidemiology
                Role: research assistant
                Role: senior research officer
                Role: professor of preventive medicine
                Role: professor of medicine
                Role: professor of epidemiology
                Role: professor emeritus
                Role: professor
                Journal
                BMJ
                bmj
                BMJ : British Medical Journal
                BMJ Publishing Group Ltd.
                0959-8138
                1468-5833
                2008
                : 337
                : a258
                Affiliations
                [1 ]Department of Epidemiology and Public Health, Imperial College London, St Mary’s Campus, London W2 1PG
                [2 ]Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
                [3 ]Department of Health Science, Shiga University of Medical Science, Shiga, Japan
                [4 ]Cardiovascular Institute, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
                Author notes
                Correspondence to: I Tzoulaki I.Tzoulaki@ 123456imperial.ac.uk
                Article
                tzoi544841
                10.1136/bmj.a258
                2658466
                18632704
                50a8dc37-d93f-4f08-898d-da0cc2206ed3
                © BMJ Publishing Group Ltd 2008
                History
                : 7 May 2008
                Categories
                Research

                Medicine
                Medicine

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