Contenido de sodio en minutas del Programa Nacional de Alimentación Escolar, su relación con el estado nutricional y presión arterial de escolares de primero básico de Quillota, Chile  <span class="so-article-trans-title" dir="auto"> Translated title: Sodium content of meals provided by the National Public Schools Feeding Program and its realtionship with nutritional status and blood pressure in children from first grade, Quillota, Chile </span>

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Abstract

Los escolares chilenos presentan alta prevalencia de sobrepeso y obesidad, y podrían presentar hipertensión arterial asociada al consumo excesivo de sodio. El objetivo del estudio fue medir el sodio de las minutas del Programa de Alimentación Escolar entregadas a primero básico en las escuelas municipalizadas de Quillota en el año 2011, comparar los resultados con la recomendación de ingesta de la OMS, evaluar el estado nutricional y la presión arterial (PA) de escolares. Se midió el contenido de sodio de las minutas (ICP), se evaluó el estado nutricional (IMC) y se midió la PA (esfigmomanómetro) de 333 escolares. Las minutas contenían 3,53+1,42 g de sodio por ración 19,2% de escolares presentaban sobrepeso y 21,3% eran obesos, 7 escolares eran pre-hipertensos y 1 hipertenso. El estudio aporta antecedentes de exposición temprana al sodio, útiles para diseñar estrategias dirigidas a disminuir el consumo de sodio en Chile como medida de reducción del riesgo cardiovascular.

Translated abstract

Chilean children attending basic schools exhibit a high prevalence of overweight and obesity, and may present hypertension associated with an excessive sodium intake. The aim of the study was to measure the sodium content of the servings provided by the National Schools Feeding Program to first grade children attending public schools in Quillota during the year 2011, compare the results with the sodium intake recommendation established by WHO, and evaluate the nutritional status and blood pressure (BP). Sodium content of servings (ICP), nutritional status (BMI) and BP (sphingomanometer) of 333 children were measured. Meals contained 3.53+1.42 g sodium per serving. 19.2% of the children were overweight and 21.3% were obese, 7 exhibited prehypertension and I presented hypertension. The study provides background data related to early sodium exposure that is useful for designing strategies towards the reduction of sodium intake in Chile in order to reduce cardiovascular risk.

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Links between dietary salt intake, renal salt handling, blood pressure, and cardiovascular diseases.

Graham MacGregor, Pierre Meneton, Eelco J.P. de Koning … (2005)

Epidemiological, migration, intervention, and genetic studies in humans and animals provide very strong evidence of a causal link between high salt intake and high blood pressure. The mechanisms by which dietary salt increases arterial pressure are not fully understood, but they seem related to the inability of the kidneys to excrete large amounts of salt. From an evolutionary viewpoint, the human species is adapted to ingest and excrete <1 g of salt per day, at least 10 times less than the average values currently observed in industrialized and urbanized countries. Independent of the rise in blood pressure, dietary salt also increases cardiac left ventricular mass, arterial thickness and stiffness, the incidence of strokes, and the severity of cardiac failure. Thus chronic exposure to a high-salt diet appears to be a major factor involved in the frequent occurrence of hypertension and cardiovascular diseases in human populations.

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Effect of longer-term modest salt reduction on blood pressure.

Feng He, Jiafu Li, Graham MacGregor (2013)

A reduction in salt intake lowers blood pressure (BP) and, thereby, reduces cardiovascular risk. A recent meta-analysis by Graudal implied that salt reduction had adverse effects on hormones and lipids which might mitigate any benefit that occurs with BP reduction. However, Graudal's meta-analysis included a large number of very short-term trials with a large change in salt intake, and such studies are irrelevant to the public health recommendations for a longer-term modest reduction in salt intake. We have updated our Cochrane meta-analysis. To assess (1) the effect of a longer-term modest reduction in salt intake (i.e. of public health relevance) on BP and whether there was a dose-response relationship; (2) the effect on BP by sex and ethnic group; (3) the effect on plasma renin activity, aldosterone, noradrenaline, adrenaline, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides. We searched MEDLINE, EMBASE, Cochrane Hypertension Group Specialised Register, Cochrane Central Register of Controlled Trials, and reference list of relevant articles. We included randomised trials with a modest reduction in salt intake and duration of at least 4 weeks. Data were extracted independently by two reviewers. Random effects meta-analyses, subgroup analyses and meta-regression were performed. Thirty-four trials (3230 participants) were included. Meta-analysis showed that the mean change in urinary sodium (reduced salt vs usual salt) was -75 mmol/24-h (equivalent to a reduction of 4.4 g/d salt), the mean change in BP was -4.18 mmHg (95% CI: -5.18 to -3.18, I (2)=75%) for systolic and -2.06 mmHg (95% CI: -2.67 to -1.45, I (2)=68%) for diastolic BP. Meta-regression showed that age, ethnic group, BP status (hypertensive or normotensive) and the change in 24-h urinary sodium were all significantly associated with the fall in systolic BP, explaining 68% of the variance between studies. A 100 mmol reduction in 24 hour urinary sodium (6 g/day salt) was associated with a fall in systolic BP of 5.8 mmHg (95%CI: 2.5 to 9.2, P=0.001) after adjusting for age, ethnic group and BP status. For diastolic BP, age, ethnic group, BP status and the change in 24-h urinary sodium explained 41% of the variance between studies. Meta-analysis by subgroup showed that, in hypertensives, the mean effect was -5.39 mmHg (95% CI: -6.62 to -4.15, I (2)=61%) for systolic and -2.82 mmHg (95% CI: -3.54 to -2.11, I (2)=52%) for diastolic BP. In normotensives, the mean effect was -2.42 mmHg (95% CI: -3.56 to -1.29, I (2)=66%) for systolic and -1.00 mmHg (95% CI: -1.85 to -0.15, I (2)=66%) for diastolic BP. Further subgroup analysis showed that the decrease in systolic BP was significant in both whites and blacks, men and women. Meta-analysis of hormone and lipid data showed that the mean effect was 0.26 ng/ml/hr (95% CI: 0.17 to 0.36, I (2)=70%) for plasma renin activity, 73.20 pmol/l (95% CI: 44.92 to 101.48, I (2)=62%) for aldosterone, 31.67 pg/ml (95% CI: 6.57 to 56.77, I (2)=5%) for noradrenaline, 6.70 pg/ml (95% CI: -0.25 to 13.64, I (2)=12%) for adrenaline, 0.05 mmol/l (95% CI: -0.02 to 0.11, I (2)=0%) for cholesterol, 0.05 mmol/l (95% CI: -0.01 to 0.12, I (2)=0%) for LDL, -0.02 mmol/l (95% CI: -0.06 to 0.01, I (2)=16%) for HDL, and 0.04 mmol/l (95% CI: -0.02 to 0.09, I (2)=0%) for triglycerides. A modest reduction in salt intake for 4 or more weeks causes significant and, from a population viewpoint, important falls in BP in both hypertensive and normotensive individuals, irrespective of sex and ethnic group. With salt reduction, there is a small physiological increase in plasma renin activity, aldosterone and noradrenaline. There is no significant change in lipid levels. These results provide further strong support for a reduction in population salt intake. This will likely lower population BP and, thereby, reduce cardiovascular disease. Additionally, our analysis demonstrates a significant association between the reduction in 24-h urinary sodium and the fall in systolic BP, indicating the greater the reduction in salt intake, the greater the fall in systolic BP. The current recommendations to reduce salt intake from 9-12 to 5-6 g/d will have a major effect on BP, but are not ideal. A further reduction to 3 g/d will have a greater effect and should become the long term target for population salt intake.

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Hipertensión arterial sistémica en el niño y adolescente

Catalina Lomelí, Martín Rosas, Celso Mendoza-González … (2008)

La pandemia de obesidad en el niño y adolescente, el riesgo de desarrollar hipertrofia ventricular y la evidencia del desarrollo temprano de la aterosclerosis en niños, hace necesaria una detección temprana y una intervención oportuna en la hipertensión de la niñez para reducir riesgos de salud a largo plazo; sin embargo, los datos epidemiológicos de apoyo a las cifras de referencia son escasos. La hipertensión secundaria es más común en niños preadolescentes, y una buena proporción está en relación a enfermedad renal. La hipertensión arterial sistémica esencial es más común en adolescentes y tiene múltiples factores de riesgo asociados, incluyendo obesidad, y antecedentes familiares. La evaluación clínica integral implica una historia cuidadosa y un examen físico completo, pruebas de laboratorio y estudios especiales. Los tratamientos no farmacológicos incluyen la reducción del peso, ejercicio, y modificaciones dietéticas. Las recomendaciones para el tratamiento farmacológico se basan sobre todo en la hipertensión sintomática, evidencia de daño a órganos blancos y la hipertensión arterial que no reduce con las modificaciones de la forma de vida, o bien, la hipertensión arterial asociada con diabetes mellitus en donde la búsqueda de microalbuminuria está justificada.

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Journal

Journal ID (publisher-id): rchnut

Title: Revista chilena de nutrición

Abbreviated Title: Rev. chil. nutr.

Publisher: Sociedad Chilena de Nutrición, Bromatología y Toxicología (Santiago, , Chile )

ISSN (Electronic): 0717-7518

Publication date (Print and electronic): June 2015

Volume: 42

Issue: 2

Pages: 114-120

Affiliations

[04] Valparaíso orgnameUniversidad de Valparaíso orgdiv1Facultad de Farmacia orgdiv2Centro de Investigación y Desarrollo de Alimentos Funcionales Chile

[03] Valparaíso orgnameUniversidad de Valparaíso orgdiv1Facultad de Ciencias orgdiv2Instituto de Estadística Chile

[02] Santiago orgnameMinisterio de Salud orgdiv1Departamento de Alimentos y Nutrición Chile

[01] Valparaíso orgnameUniversidad de Valparaíso orgdiv1Facultad de Farmacia orgdiv2CIDAF Chile

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Publisher ID: S0717-75182015000200001 Publisher ID: S0717-7518(15)04200200001

SO-VID: c4ab9584-593c-4242-9d12-d475292d2cbc

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Date accepted : 26 May 2015

Date received : 13 October 2014

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Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 7

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Most cited references 19

Links between dietary salt intake, renal salt handling, blood pressure, and cardiovascular diseases.

Effect of longer-term modest salt reduction on blood pressure.

Hipertensión arterial sistémica en el niño y adolescente

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