Objective: The aim of the study was to examine the adherence to a salt restriction diet and the effect of salt restriction on blood pressure in free living subjects with mildly elevated blood pressure. Design: Subjects with mildly elevated blood pressure participated in a controlled study on the effect of salt restriction on blood pressure. Subjects received oral and written instructions by a clinical nutritionist to reduce sodium chloride intake to ®ve grams per day. A low sodium bread (0.5%) was supplied free of charge for the subjects during the whole low-sodium period (between weeks 4 ± 24). Subjects and methods: Subjects were recruited from previous studies at the Kuopio Research Institute of Exercise Medicine and from local occupational health care services. Twenty-four men and 15 women aged 28 ± 65 y with the mean daytime ambulatory diastolic blood pressure between 90 ± 105 mmHg and of®ce diastolic blood pressure between 95 ± 115 mmHg were included in the study. Salt intake was monitored by 4-d food diaries and 24-h urinary sodium excretion. Results: Twenty percent of the subjects achieved a urinary sodium excretion level of less than 74 mmola24 h corresponding to a salt intake of ®ve grams per day. There was a signi®cant decline (7.1 AE 12.7a4.2 AE 7.5) in systolic and diastolic blood pressure levels during the salt restriction diet. Conclusions: Even moderate salt restriction seems to be effective in the treatment of mildly elevated blood pressure. However, the recommended salt intake level of less than ®ve grams per day is dif®cult to achieve even after intensive counselling and regular use of low salt bread.

Regular moderate intensity physical activity and habitual diet providing no more than one third of energy from fats have been recommended for the prevention of atherosclerotic diseases. The background for these guidelines is the key role of plasma lipids. However, the importance of thrombogenesis in acute myocardial infarction has become obvious during the last decade. Hyperlipidaemia and excess of adipose tissue increase platelet aggregability and blood coagulation, and decrease fibrinolysis. Both regular physical activity and dietary fat reduction decrease blood lipids and body fat thereby diminishing the risk of thrombosis. Currently, data on interactions between physical activity and diet on haemostasis are scarce, and the few studies available have not demonstrated additional effects when these two lifestyle modifications have been combined. This paper is restricted only to studies using controlled randomized design. Regular moderate intensity physical activity as well as diet rich in omega-3 fatty acids decrease platelet aggregability. The effects of regular physical activity on plasma fibrinogen remain contradictory, while the impact of diet is even less clear. Plasminogen activator inhibitor-1, a possible link between insulin resistance syndrome and coronary heart disease, may decrease due to physical training or low fat diet. It can be hypothesized that moderation in physical activity and diet carries a more powerful impact on blood coagulation and fibrinolysis than either lifestyle modification alone. Studies focusing on the interactions of regular moderate physical activity and fat-modified diet are needed in efforts to optimize the preventive actions by lifestyle changes.