Public Policy and Dietary Sodium Restriction

Abstract

among children aged 2 to 8 years to rates among the same children 6 years later. We speculate that the increase here largely reflects the detection of most of these problems in middle childhood, rather than at younger ages.We agree that obesity is a risk factor for a range of problems later in life, and treatments for obesity aim to prevent these problems rather than minimize active symptoms. However, there is evidence to support that treating obesity at earlier ages is needed to stave off the adverse effects later in life. 1 This substantiates the argument for ongoing efforts to better prevent, detect, and treat childhood obesity in health care settings and in communities and schools.Although other methods of assessing obesity exist, BMI has had much study and is linked to adverse health outcomes in later childhood and adulthood. 2 Furthermore, BMI is recommended 3 and used 4 for obesity assessment in clinical practice. We acknowledge that some parents reported these measurements, and our study conducted sensitivity analyses using objectively obtained data, which showed that parental report did not substantially change our findings. Financial Disclosures: None reported. 1. Gregg EW. Are children the future of type 2 diabetes prevention? N Engl J Med. 2010;362(6):548-550. 2. Franks PW, Hanson RL, Knowler WC, Sievers ML, Bennett PH, Looker HC. Childhood obesity, other cardiovascular risk factors, and premature death. N Engl J Med. 2010;362(6):485-493. 3. Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P, Styne D. Assessment of child and adolescent overweight and obesity. Pediatrics. 2007;120(suppl 4): S193-S228. 4. Klein JD, Sesselberg TS, Johnson MS, et al. Adoption of body mass index guidelines for screening and counseling in pediatric practice. Pediatrics. 2010;125 (2):265-272.

The Association Between Dietary Sodium Intake, ESRD, and All-Cause Mortality in Patients With Type 1 Diabetes

“…Another strength of this study is the fact that the dietary intake of sodium in our cohort is very similar to that documented in the general population, both in Finland (13,14) and globally (22). We have also recently published dietary surveys on a subset of 817 FinnDiane patients, collected with a 3-day food record completed twice with a 2- to 3-month interval, describing a mean daily sodium consumption of 7.2 ± 2.0 g/day (23).…”

“…Even in the setting of renal impairment, the urinary excretion of sodium is largely maintained along with volume homeostasis, as a result of adaptations in residual nephrons. This has been suggested to be because sodium intake may be physiologically set (22). Second, our data are observational.…”