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Population Sodium Intake: Impacts on Cardiovascular Health
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Population Sodium Intake: Impacts on Cardiovascular Health

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: 25 July 2025 | Viewed by 5549

Special Issue Editors

Dr. Zrinka Mihaljević

E-Mail Website
Guest Editor
Institute and Department of Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
Interests: physiology; vascular health; micro- and macro- circulation; endothelium; salt intake; polyunsaturated fatty acid; oxidative stress
Dr. Ana Stupin

E-Mail Website
Guest Editor
Institute and Department of Physiology and Immunology, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
Interests: microcirculation; body composition; endothelial function; vascular physiology; nutrition; cardiovascular physiology; arteries; endothelium; salt intake

Special Issue Information

Dear Colleagues,

For nearly half a century, there has been controversy over the contribution of sodium consumption as a risk factor for non-communicable diseases, including cardiovascular disease. Numerous national and international organizations and governments have discouraged high sodium consumption in various populations. As many researchers have used models based on blood pressure reductions to predict the number of deaths that could be saved in the general population by reducing sodium consumption, the evidence for blood pressure as a surrogate endpoint for cardiovascular disease and stroke risk is widely recognized and accepted. However, sodium can exert its functions not only through blood pressure, but also other processes. Therefore, any strategy to reduce sodium consumption should include studies that demonstrate a link between sodium consumption and direct health effects.

This Special Issue includes manuscripts that address sodium intake in different populations and the potential of reducing sodium intake as a dietary treatment to prevent various diseases. The materials presented are the result of an international scientific collaboration of experts specializing in these topics. The content may be useful for clinical practitioners and stimulate further innovative research.

Dr. Zrinka Mihaljević
Dr. Ana Stupin
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sodium intake
  • nutrition
  • sodium/potassium ratio
  • cardiovascular health
  • blood pressure

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Published Papers (3 papers)

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Research

17 pages, 1277 KiB  
Article
Oral Carnosine Supplementation Preserves Vascular Function of Sprague Dawley Rats on a High-Salt Diet via Restored Antioxidative Defence
by Ines Drenjančević, Ana Stupin, Ivana Jukić, Nikolina Kolobarić, Petar Šušnjara, Nataša Kozina, Lora Kovač and Zrinka Mihaljević
Nutrients 2025, 17(1), 36; https://doi.org/10.3390/nu17010036 - 26 Dec 2024
Viewed by 1094
Abstract
Backgrounds/Objectives: Following previous findings on high-salt (HS)-intake-related increase of oxidative stress, this study explored whether carnosine (CAR; β-alanyl-L-histidine), a reactive oxygen species (ROS) scavenger, enhanced antioxidative defence and vascular function following HS, potentially via the NRF2 or HIF-1α signalling pathway. Methods: [...] Read more.
Backgrounds/Objectives: Following previous findings on high-salt (HS)-intake-related increase of oxidative stress, this study explored whether carnosine (CAR; β-alanyl-L-histidine), a reactive oxygen species (ROS) scavenger, enhanced antioxidative defence and vascular function following HS, potentially via the NRF2 or HIF-1α signalling pathway. Methods: Sprague Dawley rats (64, 8–10 weeks old, both sexes) were divided into four groups (n = 6/group): CTRL (0.4% NaCl), HS (4% NaCl for 7 days), CTRL + CAR (0.4% NaCl and 150 mg/kg/day oral CAR supplementation), and HS + CAR (4% NaCl and CAR). Acetylcholine-induced relaxation (AChIR) and hypoxia-induced relaxation (HIR) were evaluated in norepinephrine-precontracted (NE, 10−7 M) aortic rings. HIR was also tested with NRF2 (ML-385, 5 × 10−6 M) and HIF-1α (LW6, 10−4 M) inhibitors. Gene expression of superoxide dismutases 1, 2, and 3 (SOD1, 2 and 3), glutathione peroxidases (GPx1 and 4), catalase (CAT), NRF2, and NAD(P)H dehydrogenase (quinone 1) (NQO1) in aortic tissue was measured by RT-qPCR. Ferric reducing antioxidant power (FRAP) and advanced oxidation protein products (AOPPs) assays were performed on serum samples. All experimental procedures conformed to the European Guidelines (directive 86/609) and were approved by the local and national Ethical Committees (#2158-61-46-23-36, EP355/2022). Results: HS impaired AChIR and HIR, both preserved by CAR. NRF2 and HIF-1α inhibitors suppressed HIR in the HS and HS + CAR groups. CAR significantly increased SOD1 and 2, NRF2, and NQO1 expression and SOD activity compared to the CTRL and HS groups. GPx1 and GPx4 were upregulated in HS + CAR compared to HS. CAR prevented an increase in AOPPs, which were elevated in HS, while FRAP was highest in HS + CAR. Conclusions: Carnosine enhances antioxidative defence by upregulating antioxidant enzymes and activities and preserves vascular relaxation, likely via NRF2 signalling. Full article
(This article belongs to the Special Issue Population Sodium Intake: Impacts on Cardiovascular Health)
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19 pages, 2118 KiB  
Article
Assessment of Salt, Potassium, and Iodine Intake in the Croatian Adult Population Using 24 h Urinary Collection: The EH-UH 2 Study
by Mihaela Marinović Glavić, Lovorka Bilajac, Marta Bolješić, Marija Bubaš, Krunoslav Capak, Marija Domislović, Aleksandar Džakula, Mirjana Fuček, Lana Gellineo, Ana Jelaković, Josipa Josipović, Tomislav Jukić, Denis Juraga, Ivan Pećin, Vladimir Prelević, Danilo Radunović, Željko Reiner, Tomislav Rukavina, Petar Šušnjara, Vanja Vasiljev, Valentina Vidranski and Bojan Jelakovićadd Show full author list remove Hide full author list
Nutrients 2024, 16(16), 2599; https://doi.org/10.3390/nu16162599 - 7 Aug 2024
Cited by 4 | Viewed by 1733
Abstract
Cardiovascular diseases, which are the leading cause of death in Croatia, are linked to the high prevalence of hypertension. Both are associated with high salt intake, which was determined almost two decades ago when Croatian Action on Salt and Health (CRASH) was launched. [...] Read more.
Cardiovascular diseases, which are the leading cause of death in Croatia, are linked to the high prevalence of hypertension. Both are associated with high salt intake, which was determined almost two decades ago when Croatian Action on Salt and Health (CRASH) was launched. The main objective of the present study was to evaluate salt, potassium, and iodine intake using a single 24 h urine sample in a random sample of the adult Croatian population and to analyse trends in salt consumption after the CRASH was intensively started. Methods: In this study, we analysed data on 1067 adult participants (mean age 57.12 (SD 13.9), men 35%). Results: Mean salt and potassium intakes were 8.6 g/day (IQR 6.2–11.2) and 2.8 g/day (IQR 2.1–3.5), respectively, with a sodium-to-potassium ratio of 2.6 (IQR 1.8–3.3). We detected a decrease of 17.6% (2 g/day less) in salt consumption compared with our previous salt-mapping study. However, only 13.7% and 8.9% met the WHO salt and potassium recommended targets of 5 g/day and 3.5 g/day, respectively. Salt intake was higher, and potassium ingestion was lower, in rural vs. urban regions and in continental vs. Mediterranean parts of Croatia. Moderate to severe iodine insufficiency was determined in only 3% of the adult participants. Conclusion: In the last fifteen years, salt consumption has been significantly reduced in the Croatian adult population because of the intensive and broad CRASH program. However, salt intake is still too high, and potassium ingestion is too low. Salt reduction programs are the most cost-effective methods of cardiovascular disease prevention and merit greater consideration by the government and health policy makers. Full article
(This article belongs to the Special Issue Population Sodium Intake: Impacts on Cardiovascular Health)
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21 pages, 1896 KiB  
Article
Association between Salt-Related Knowledge, Attitudes, and Behaviours and 24 h Urinary Salt Excretion in Nepal
by Kamal Ghimire, Shiva Raj Mishra, Dinesh Neupane, Per Kallestrup and Craig S. McLachlan
Nutrients 2024, 16(12), 1928; https://doi.org/10.3390/nu16121928 - 18 Jun 2024
Viewed by 1875
Abstract
This study examined the association between salt-related knowledge, attitudes, and behaviors (KAB) and salt excretion using the 24-hour (24 h) urinary collection method. Data were utilized from the Community-Based Management of Non-Communicable Diseases in Nepal (COBIN) Salt Survey, a community-based cross-sectional study conducted [...] Read more.
This study examined the association between salt-related knowledge, attitudes, and behaviors (KAB) and salt excretion using the 24-hour (24 h) urinary collection method. Data were utilized from the Community-Based Management of Non-Communicable Diseases in Nepal (COBIN) Salt Survey, a community-based cross-sectional study conducted among a sub-sample of COBIN cohort in Pokhara Metropolitan City, Western Nepal, from July to December 2018, among adults aged 25–70 years. A total of 451 adults participated in the study, and a single 24 h urine sample was collected from each participant. The mean [(standard deviation (SD)] age of the participants was 49.6 (9.82) years, and the majority were female (65%). The mean urinary salt excretion was 13.28 (SD: 4.72) g/day, with 98% of participants consuming ≥5 g of salt/day. Although 83% of participants knew the risks of high salt intake and 87% believed it was important to reduce their intake, only 10% reported doing so. Salt-related attitude i.e., self-perceived salt intake was significantly associated with urinary salt excretion, adding extra salt to food, consuming processed foods, and taking actions to salt control. Participants who perceived themselves as consuming high salt had higher urinary salt excretion [(14.42 g/day; 95% confidence interval (95% CI): 13.45, 15.39, p = 0.03)], were more likely to add extra [(Odds ratio (OR) = 3.59; 95% CI: 2.03, 6.33, p < 0.001)], and consume processed foods more often (OR = 1.90; 95% CI: 1.06, 3.40, p < 0.05) compared to those who self-perceived consuming a normal amount of salt. Conversely, participants who perceived themselves as consuming low salt were more likely to take actions to control salt intake (OR = 4.22; 95% CI: 1.90, 9.37, p < 0.001) compared to their counterparts who perceived consuming a normal amount of salt. There existed a gap between salt-related knowledge, attitudes, and actual behaviors, resulting in a high salt intake among the Nepalese population. Nepal urgently requires tailored national salt reduction programs that comprise both policy and community-level interventions to achieve a 30% reduction in mean population salt intake by 2025. Further validation studies are needed to assess the effectiveness of community-based intervention in Nepal. Full article
(This article belongs to the Special Issue Population Sodium Intake: Impacts on Cardiovascular Health)
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