Food sources of dietary sodium in the Japanese adult population: the international study of macro-/micronutrients and blood pressure (INTERMAP)

Okuda, Nagako; Okayama, Akira; Miura, Katsuyuki; Yoshita, Katsushi; Sasaki, Shigeyuki; Nakagawa, Hideaki; Sakata, Kiyomi; Miyagawa, Naoko; Chan, Queenie; Elliott, Paul; Ueshima, Hirotsugu; Stamler, Jeremiah

doi:10.1007/s00394-016-1177-1

Cited by 22 publications

(25 citation statements)

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“…Another option may be the use of condiments with potassium-enriched salt, which may reduce sodium intake and improve the dietary Na/K ratio [23][24][25]. The major source of sodium in Japan is soy sauce, which we previously reported to account for 806 mg of the daily sodium intake [13]. Habitual use of potassium-enriched soy sauce, miso, and other prepared foods will be useful for sodium reduction and potassium increase, without advising people to improve their diet.…”

Section: Resultsmentioning

confidence: 99%

“…Two timed 24-hr urine collections were performed to assess urinary sodium and potassium excretion. Using the Japanese results collected between 1996 and 1998 (574 men and 571 women), we examined food intake patterns associated with 24-hr urinary sodium excretion, and found that people with higher sodium excretion ate more Japanese-style foods, including miso-soup, salted fish, and rice, and ate fewer Western foods, i.e., bread and milk [13]. In the present study, we investigate potassium source foods and evaluate differences in food consumption patterns among participants with a higher/lower potassium intake evaluated by 24-hr urinary potassium excretion per unit of body weight (UK/BW).…”

Section: Introductionmentioning

confidence: 99%

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Food Sources of Dietary Potassium in the Adult Japanese Population: The International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP)

Okuda

Okayama²,

Miura

et al. 2020

Nutrients

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A lower-than-recommended potassium intake is a well-established risk factor for increased blood pressure. Although the Japanese diet is associated with higher sodium intake and lower potassium intake, few studies have examined the source foods quantitatively. Studies on dietary patterns in association with potassium intake will be useful to provide dietary advice to increase potassium intake. Twenty-four-hour (hr) dietary recall data and 24-hr urinary potassium excretion data from Japanese participants (574 men and 571 women) in the International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) were used to calculate food sources of potassium and compare food consumption patterns among quartiles of participants categorized according to 24-hr urinary potassium excretion per unit of body weight (UK/BW). The average potassium intake was 2791 mg/day per participant, and the major sources were vegetables and fruits (1262 mg/day), fish (333 mg/day), coffee and tea (206 mg/day), and milk and dairy products (200 mg/day). Participants in the higher UK/BW quartile consumed significantly more vegetables and fruits, fish, and milk and dairy products, and ate less rice and noodles. Conclusion: Advice to increase the intake of vegetables and fruits, fish, and milk may be useful to increase potassium intake in Japan.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Food Sources of Dietary Potassium in the Adult Japanese Population: The International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP)

Okuda

Okayama²,

Miura

et al. 2020

Nutrients

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“…Because of this, BP levels and stroke mortality have substantially decreased in Japan. 32 Recently, we reported sources of dietary sodium in the Japanese diet, 33 with soy sauce, miso (fermented soybean seasoning), salted fish and salted pickles being the main sources. Although varieties of salt-reduced soy sauce and miso have been produced, 34 trends for both salt intake and stroke mortality have recently reached a plateau.…”

Section: Discussionmentioning

confidence: 99%

“…However, we have previously reported that intake of more fruit and vegetable, which are major sources of potassium, had lower risk of CVD mortality. 36 Since considerable amounts of dietary vegetable are consumed as salted pickles among Japanese people, 33 a decrease in dietary sodium by reducing the intake of these pickles may not give enough of a beneficial effect on lowering Na–K ratio. A high Na–K ratio has also been observed in Korea and China.…”

Section: Discussionmentioning

confidence: 99%

Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study

Okayama¹,

et al. 2016

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ObjectivesTo evaluate the impact of dietary sodium and potassium (Na–K) ratio on mortality from total and subtypes of stroke, cardiovascular disease (CVD) and all causes, using 24-year follow-up data of a representative sample of the Japanese population.SettingProspective cohort study.ParticipantsIn the 1980 National Cardiovascular Survey, participants were followed for 24 years (NIPPON DATA80, National Integrated Project for Prospective Observation of Non-communicable Disease And its Trends in the Aged). Men and women aged 30–79 years without hypertensive treatment, history of stroke or acute myocardial infarction (n=8283) were divided into quintiles according to dietary Na–K ratio assessed by a 3-day weighing dietary record at baseline. Age-adjusted and multivariable-adjusted HRs were calculated using the Mantel-Haenszel method and Cox proportional hazards model.Primary outcome measuresMortality from total and subtypes of stroke, CVD and all causes.ResultsA total of 1938 deaths from all causes were observed over 176 926 person-years. Na–K ratio was significantly and non-linearly related to mortality from all stroke (p=0.002), CVD (p=0.005) and total mortality (p=0.001). For stroke subtypes, mortality from haemorrhagic stroke was positively related to Na–K ratio (p=0.024). Similar relationships were observed for men and women. The observed relationships remained significant after adjustment for other risk factors. Quadratic non-linear multivariable-adjusted HRs (95% CI) in the highest quintile versus the lowest quintile of Na–K ratio were 1.42 (1.07 to 1.90) for ischaemic stroke, 1.57 (1.05 to 2.34) for haemorrhagic stroke, 1.43 (1.17 to 1.76) for all stroke, 1.39 (1.20 to 1.61) for CVD and 1.16 (1.06 to 1.27) for all-cause mortality.ConclusionsDietary Na–K ratio assessed by a 3-day weighing dietary record was a significant risk factor for mortality from haemorrhagic stroke, all stroke, CVD and all causes among a Japanese population.

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“…It is attributable to habitual consumption of higher salt Japanese foods, such as dried fish, canned tuna, and fish paste products (34). In a recent epidemiologic study (35), it is also reported that Japanese adults with higher urinary sodium excretion consumed a significantly greater amount of salty Japanese foods, such as salted fish, miso soup, and Japanese pickles. These salty foods are included in the jMD scores as the fish component, legume component, and vegetable component, respectively.…”

Section: Discussionmentioning

confidence: 99%

Development of a Mediterranean diet score adapted to Japan and its relation to obesity risk

Kanauchi

2016

Food & Nutrition Research

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BackgroundThe Mediterranean diet (MD) is well known as a healthy diet that protects against several chronic diseases. However, there is no appropriate and easy index to assess adherence to the MD pattern in Japan.ObjectiveThe aim of this study was to develop a novel instrument to measure MD adherence adapted to a Japanese diet and to examine its association with overweight/obesity risk.MethodsA cross-sectional nutritional survey provided the data for construction of a novel MD score. In total, 1,048 subjects who were employees and university students, aged 18–68 years (645 men and 403 women), completed a 58-item brief-type self-administered dietary history questionnaire. We constructed a Japanese-adapted MD score (jMD score) focusing on 13 components. Adherence to the jMD was categorized as low (score 0–4), moderate (5–7), or high (8–13).ResultsMen had higher jMD scores than women, and adherence to the jMD score increased with age. Only 11.6% of subjects showed high adherence to the jMD, whereas 29.6% showed low adherence. A higher jMD adherence was associated with a higher intake of favorable nutrients with the exception of salt. The jMD adherence was significantly associated with a reduced likelihood of having overweight/obesity for the highest category compared with lowest category (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.30–0.85, p-trend=0.017) after adjusting for age, sex, smoking, physical activity, alcohol intake, and hypertension. A two-point increment in jMD score was related to a reduced likelihood of having overweight/obesity with an odds ratio of 0.76 (95% CI 0.65–0.90, p=0.002).ConclusionsOur novel jMD score confirmed reasonable associations with nutrient intakes, and higher MD adherence was associated with a lower prevalence of overweight/obesity.

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Food sources of dietary sodium in the Japanese adult population: the international study of macro-/micronutrients and blood pressure (INTERMAP)

Abstract: Detailed analyses of various Japanese and western food intakes in addition to Na intake were performed. These results can be used to help draw up effective programs for the reduction in Na intake and prevention of prehypertension/hypertension in the Japanese population.

Cited by 22 publications

References 36 publications

Food Sources of Dietary Potassium in the Adult Japanese Population: The International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP)

Food Sources of Dietary Potassium in the Adult Japanese Population: The International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP)

Dietary sodium-to-potassium ratio as a risk factor for stroke, cardiovascular disease and all-cause mortality in Japan: the NIPPON DATA80 cohort study

Development of a Mediterranean diet score adapted to Japan and its relation to obesity risk

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