Trend in potassium intake and Na/K ratio in the Italian adult population between the 2008 and 2018 CUORE project surveys

Donfrancesco, Chiara; Noce, Cinzia Lo; Russo, Ornella; Buttari, Brigitta; Profumo, Elisabetta; Minutoli, Daniela; Lonardo, Anna Di; Iacone, Roberto; Vespasiano, Francesca; Vannucchi, Serena; Onder, Graziano; Galletti, Ferruccio; Galeone, Daniela; Bellisario, Paolo; Lenarda, Andrea Di; Giampaoli, Simona; Palmieri, Luigi; Strazzullo, Pasquale

doi:10.1016/j.numecd.2020.11.015

Cited by 12 publications

(21 citation statements)

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“…The most recent 2008–2012 CUORE survey showed substantially similar intakes with values of 2.3 and 1.9 g/day for men and women, respectively [ 24 ]. As regards potassium, our results were similar to intakes reported in the recent surveys which generally reported a potassium intake >3 g/day [ 24 , 27 , 47 ], although differences between sexes were less marked compared to other surveys, without an appreciably higher intake in men compared to women [ 27 , 28 ]. As a consequence, it is not surprising that higher adherence to the Mediterranean and MIND diets is associated with a general decrease of Na/K ratio.…”

Section: Discussionsupporting

confidence: 88%

“…As regards potassium, a slight increase in its intake was seen in the past years, from 3.2 g/day and 2.8 g/day in men and women, respectively, during the Third Italian National Consumption Survey in 2005–2006 using a 3-day semi-structured diary [ 27 ], to 3.3 g/day and 3.0 g/day in men and women, respectively, during the Cardiovascular Epidemiology Observatory/Health Examination Survey (CUORE) in 2008–2012 using 24 h urine collection carried out by the Italian National Institute of Health [ 24 ]. However, the latest 2018–2019 data from the CUORE project conducted by the Italian National Institute of Health highlighted that the potassium intake of the Italian general adult population has fallen to 3.043 g/day for men and 2.561 g/day for women [ 28 ]. This highlights the importance of increasing potassium intake in order to meet the adequate intakes of 3.5 g/day or 3.9 g/day suggested by the EFSA and SINU, respectively [ 9 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake

et al. 2021

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High sodium and low potassium intakes are associated with increased levels of blood pressure and risk of cardiovascular diseases. Assessment of habitual dietary habits are helpful to evaluate their intake and adherence to healthy dietary recommendations. In this study, we determined sodium and potassium food-specific content and intake in a Northern Italy community, focusing on the role and contribution of adherence to Mediterranean diet patterns. We collected a total of 908 food samples and measured sodium and potassium content using inductively coupled plasma mass spectrometry. Using a validated semi-quantitative food frequency questionnaire, we assessed habitual dietary intake of 719 adult individuals of the Emilia-Romagna region. We then estimated sodium and potassium daily intake for each food based on their relative contribution to the overall diet, and their link to Mediterranean diet patterns. The estimated mean sodium intake was 2.15 g/day, while potassium mean intake was 3.37 g/day. The foods contributing most to sodium intake were cereals (33.2%), meat products (24.5%, especially processed meat), and dairy products (13.6%), and for potassium they were meat (17.1%, especially red and white meat), fresh fruits (15.7%), and vegetables (15.1%). Adherence to a Mediterranean diet had little influence on sodium intake, whereas potassium intake was greatly increased in subjects with higher scores, resulting in a lower sodium/potassium ratio. Although we may have underestimated dietary sodium intake by not including discretionary salt use and there may be some degree of exposure misclassification as a result of changes in food sodium content and dietary habits over time, our study provides an overview of the contribution of a wide range of foods to the sodium and potassium intake in a Northern Italy community and of the impact of a Mediterranean diet on intake. The mean sodium intake was above the dietary recommendations for adults of 1.5–2 g/day, whilst potassium intake was only slightly lower than the recommended 3.5 g/day. Our findings suggest that higher adherence to Mediterranean diet patterns has limited effect on restricting sodium intake, but may facilitate a higher potassium intake, thereby aiding the achievement of healthy dietary recommendations.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake

et al. 2021

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“…Even nowadays, most salty food products do not contain iodized salt. The major weaknesses of the current legislation hamper the possibility to further increase the population iodine intake, more so at a time when, thanks to the efforts of the same health institutions, the average total salt intake of the population tends to decrease [ 37 ]. This point is crucial, since non-discretionary salt intake, given by the salt added by the industry for food processing and storage (bread, pizza, cheese, ham and salami, sauces, snacks, etc.)…”

Section: Discussionmentioning

confidence: 99%

“…In the light of the data so far available and of the current trend to progressive salt intake reduction in many countries including our own [ 37 ], it appears all the more important to step up the efforts to enhance the regular use of iodized salt not only by households and by the public restoration system but also by the food industry and by the thousands of small enterprises of the food production system with particular regard to those involved in the manufacture of bread and other baking products known as a major source of salt intake in Italy and in several other countries. The possibility to make the fortification of animal feed with iodine more widespread in order to increase the iodine content of milk, dairy products, and meats also warrants careful consideration.…”

Section: Discussionmentioning

confidence: 99%

Iodine Intake Estimated by 24 h Urine Collection in the Italian Adult Population: 2008–2012 Survey

Iacone¹,

Idelson²,

Formisano³

et al. 2021

Nutrients

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Monitoring the population iodine status is essential for iodine deficiency eradication. This study assessed the average dietary iodine intake and the iodine status of a random sample of the Italian general adult population. The study population included 2378 adults aged 35–79 years (1229 men and 1149 women) from all 20 Italian regions, participating in the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008–2012 (OEC/HES), and were examined for iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary iodine intake was assessed by the measurement of 24 h urinary iodine excretion. The median daily iodine intake of the whole population was lower (96 µg/d, interquartile range 51–165) than the daily adequate iodine intake according to both EFSA and WHO recommendation (150 µg/d), with a significantly lower value among women (85 µg/d) compared with men (111 µg/d). Iodine intake diminished with age and increased with BMI (body mass index) in male but not in female participants, without achieving the adequate intake in any sex, age, or BMI category. In this random sample of Italian general adult population examined in 2008–2012, iodine intake still remained lower than the recommended values despite the implementation of a strategy of iodoprophylaxis based on salt iodization in 2005. These data represent a valuable reference for future monitoring of iodine status in our country.

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“…The three HESs were conducted by the Italian National Institute of Health (Istituto Superiore di Sanità-ISS); the first and second surveys in collaboration with the national scientific association of hospital cardiologists (ANMCO–Associazione Nazionale Medici Cardiologi Ospedalieri) and its foundation [Fondazione per il Tuo Cuore Heart Care Foundation]. Surveys details were published elsewhere [ 20 – 22 ]. The three HESs were approved by the Ethical Committee of the ISS; all participants received an informative note and signed an informed consent.…”

Section: Methodsmentioning

confidence: 99%

Trends of overweight, obesity and anthropometric measurements among the adult population in Italy: The CUORE Project health examination surveys 1998, 2008, and 2018

et al. 2022

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Background/Objectives Obesity is associated with an increased risk of noncommunicable diseases, such as diabetes, coronary heart disease, stroke, cancers, and conditions, including obstructive sleep apnea and osteoarthritis. Obesity is largely preventable, and halting its rise is one of the World Health Organization Global Action Plan for the Prevention of Noncommunicable Diseases targets. This study aimed to assess trends of anthropometric measurements in Italy using the data collected within the CUORE Project health examination surveys (HESs) 1998, 2008, and 2018. Subjects/Methods Within the HESs 1998–2002, 2008–2012, and 2018–2019, anthropometric measurements were collected in random samples of the resident population aged 35–74 years, stratified by age and sex, from 10 Italian Regions in Northern, Central, and Southern Italy (2984 men and 2944 women, 2224 men and 2188 women, 1035 men and 1065 women, respectively). Weight, height, and waist and hip circumferences were measured using standardized methodologies. A standardized questionnaire was used to collect data on education. Indicators were age standardized. Results For both men and women, mean body mass index in 2018 was comparable with those in 1998 and 2008 (in 1998, 2008, and 2018—men: 26.7, 27.5, and 27.0 kg/m2; women: 26.2, 26.6, and 26.3 kg/m2). In 1998, 2008, 2018 prevalence of overweight resulted 49%, 47%, 46% in men and 33%, 32%, 28% in women respectively; prevalence of obesity resulted 17%, 24% 20% in men and 19%, 23%, 23% in women respectively. All indicators of excess weight worsen with increasing age and are more severe in persons with a lower educational level. Conclusions Although the overall trend of excess weight over the past two decades appeared to be substantially stable in the Italian adult population, the continuous strengthening of undertaken initiatives should continue since there remains a high proportion of overweight or obesity and a gap between educational levels.

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Trend in potassium intake and Na/K ratio in the Italian adult population between the 2008 and 2018 CUORE project surveys

Cited by 12 publications

References 50 publications

Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake

Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake

Iodine Intake Estimated by 24 h Urine Collection in the Italian Adult Population: 2008–2012 Survey

Trends of overweight, obesity and anthropometric measurements among the adult population in Italy: The CUORE Project health examination surveys 1998, 2008, and 2018

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