Background/Objectives: Blood pressure (BP) is characterized by a circadian rhythm (Circr) with lower nighttime values, called dipping. Non-dipping is associated with higher CVD risk. The Circr of urinary sodium excretion (NaCle), peaking during the day, is linked to BP patterns. Physical activity (PA) is known to improve BP control and enhance the dipping phenomenon, but its possible effect on NaCle remains unclarified. This study aimed to investigate the correlation between PA and the Circr of NaCle and to determine if the relationship is independent of age, sex, BP values, dipping pattern, and salt intake. Methods: A pilot cross-sectional analysis was conducted using data from the Ticino Epidemiological Stiffness Study, involving 953 participants in Switzerland. Data collection included standardized questionnaires, blood samples, 24 h urine collections, and ambulatory BP monitoring. Participants were categorized into sedentary, partially active, and active. The effect of PA, NaCl intake, and dipping on the day/night NaCle ratio was assessed with multivariable linear regressions. Results: Participants\' median age was 49 years, with 78% having normal BP values and 47% exhibiting a dipping pattern; 51% were classified as sedentary and 22% as partially active. The median NaCl intake was 7.9 g/day. The youngest subjects had a higher hourly NaCle ratio compared to older subjects. Higher NaCl intake correlated with increased BP, a phenomenon more pronounced in men and younger subjects. The hourly day/night NaCle ratio positively correlates with dipping; however, PA did not show a significant correlation with the NaCle ratio. Conclusions: This study indicates that while the day/night NaCle ratio correlates with the dipping pattern, PA is unrelated to the circadian rhythm of renal sodium handling. The beneficial effects of PA on BP and cardiovascular health thus appear to be mediated through mechanisms other than NaCle. These are explorative findings only but relativize the need for further investigations on the topic.

BACKGROUND: The updated status of hypertension and its risk factors are poorly evaluated in Tibetan highland areas. We initiated a large-scale cross-sectional survey to provide updated status of hypertension and its risk factors (especially salt intake) in the Ganzi Tibetan Plateau, China.
METHODS: Stratified multistage random sampling was performed to obtain a representative sample of 4,036 adult residents from 4 counties in the Ganzi Tibetan area. The whole survey population was used to present the epidemiology and risk factors of hypertension. The participants with blood and urine biochemistry data were used to analyze the relationship between salt intake parameters and hypertension.
RESULTS: Stratified multistage random sampling was performed to obtain a representative sample of 4,036 adult residents. The overall prevalence rate of hypertension was 33.5% (the age-adjusted prevalence rate was 28.9%). A total of 50.9% of the hypertensive patients knew their conditions; 30.1% of them received antihypertensive treatment; and 11.2% of them had their blood pressure controlled. Age, male sex, living altitude ≥ 3500 m, overweight and abdominal obesity were positively correlated with hypertension. In addition, the adjusted odds ratio (OR) for hypertension was 1.33 (95% CI: 1.01-1.74) for drinking tea with salt, and 1.51 (95% CI: 1.32-1.72) for per SD increase in the estimation of 24-hour urinary sodium excretion (e24hUSE). Furthermore, per 100mmol/day increase in e24hUSE was associated with elevation of blood pressure (+ 10.16, 95% CI: 8.45-11.87 mmHg for SBP; +3.83, 95% CI: 2.74-4.93 mmHg for DBP) in this population.
CONCLUSIONS: Our survey suggests a heavy disease burden of hypertension in the Ganzi Tibetan Plateau. Age, male sex, altitude of residence ≥ 3500 m, overweight, abdominal obesity, and excessive salt intake (shown as drinking tea with adding salt and a higher level of e24hUSE) all increased the risk of hypertension in this highland area.

BACKGROUND: Heart failure is the leading cause of death in patients undergoing hemodialysis (HD), with fluid overload being the most common cause. Therefore, it is important for patients undergoing HD to reduce salt intake. We recently developed a highly accurate and simple self-administered salt questionnaire. Using this salt questionnaire, we aimed to determine whether salt intake and inter-HD weight gain decrease when patients with HD are instructed to reduce their salt intake.
METHODS: Seventy-eight outpatients at a maintenance HD facility were assessed for dietary salt intake using a salt questionnaire. After one month of dietary guidance, salt intake was assessed again using the salt questionnaire.
RESULTS: The mean age of the patients was 72.2 ± 11.9 years; 47 (60.3%) were men, 23 had diabetic nephropathy as the primary disease, and the median HD vintage was 74 months. Salt intake significantly decreased from 8.41 ± 2.43 g/day before the salt questionnaire intervention to 7.67 ± 2.60 g/day after the intervention (p = 0.010). Changes in salt intake before and after the intervention were significantly positively correlated with changes in weight gain before the start of HD sessions with an interval of 2 days (r = 0.24, p = 0.037). Furthermore, changes in salt intake significantly and positively correlated with changes in weight gain after adjusting for age, sex, and dry weight.
CONCLUSIONS: The salt questionnaire may be an effective tool for reducing salt intake and controlling weight gain during HD.

BACKGROUND: Malnutrition in cirrhosis is associated with poor outcomes, leading to guidelines for a high protein, low sodium diet; however, there is no guidance regarding the implementation of diet education in clinical practice.
METHODS: A mixed methods study enrolled 21 patients with cirrhosis and their caregivers. Semi-structured interviews on barriers and facilitators of dietary education and adherence were conducted. Demographic and clinical data were obtained, along with quantitative measures of dietary adherence, including 24-h food recall and spot urine sodium. Combined deductive and inductive coding was used to identify qualitative themes, along with a quantitative assessment of interviews. Quantitative data was reported using descriptive statistics with frequencies, mean and confidence intervals.
RESULTS: Participants were mostly male (16/21) with a mean age 57.8 years (SE 2.8) and MELD-Na 9 (SE 1.2). 4 themes emerged: 1. More than 50% of participants and caregivers endorsed no or inadequate diet education 2. They reported mostly negative experiences with dietary adherence with largest impact on social life 3. Facilitators of adherence included the presence of household support and fear of complications of cirrhosis 4. Overwhelmingly desired non-generic handouts and information. Dietary adherence was poor with only one participant meeting protein and sodium requirements based on food recall. Four participants who adhered to < 2000 mg sodium had inadequate daily caloric intake.
CONCLUSIONS: Dietary education is inadequate, and adherence to dietary recommendations is poor in patients with cirrhosis. Future studies should use these barriers and facilitators for intervention development.

BACKGROUND: High salt intake is a major risk factor for hypertension and its complications such as chronic kidney disease (CKD) and cardiovascular diseases. The present study aimed to determine level of sodium consumption and its relation with kidney function in the rural populations of Ferlo (centre of Senegal).
METHODS: We performed a cross-sectional study including 400 volunteers aged > 18 years. Clinical, biological and dietary data were collected during household visits. Daily sodium intake was measured in the 24 h-urine outpout and CKD was defined as eGFR < 60 ml/min. Linear regression analysis was used to assess association between sodium intake and covariates.
RESULTS: Mean age was 46.42 ± 15.60 and sex-ratio was 1.05. Prevalence of hypertension, CKD and overweight were 21.5, 11.7 and 20.5%, respectively. The median daily salt intake was 11.7 g with interquartile range of 14.8 g. Only 11.25% of participants consumed less than 5 g/day. After multivariate analysis, high salt intake was associated with age > 60 years, overweight and CKD. However, gender and hypertension were not significantly associated with salt intake. Industrial broths (91.5%) and bread (85%) represented the main sources of dietary salt.
CONCLUSIONS: This study revealed high levels of daily salt intake contrasting with low potassium intakes in the majority of participants. Participants with CKD, overweight and age > 60 years presented higher salt consumption. Stategies to reduce salt consumption are urgently needed to reduce burden of CKD in rural Senegalese populations.

BACKGROUND: High salt intake may play a critical role in the etiology of psoriasis. Yet, evidence on the association of high salt intake with risk of psoriasis is limited.
OBJECTIVE: To estimate the association between frequency of adding salt to foods and risk of psoriasis.
METHODS: We conducted a prospective cohort study of 433,788 participants from the UK Biobank. Hazard ratios (HRs) and their 95 % confidence intervals (CIs) for risk of psoriasis in relation to frequency of adding salt to foods were estimated using multivariable Cox proportional hazards models. We further evaluated the joint association of adding salt to foods and genetic susceptibility with risk of psoriasis. We conducted a mediation analysis to assess how much of the effect of adding salt to foods on risk of psoriasis was mediated through several selected mediators.
RESULTS: During a median of 14.0 years of follow-up, 4279 incident cases of psoriasis were identified. In the multivariable-adjusted model, a higher frequency of adding salt to foods was significantly associated with an increased risk of psoriasis (\"always\" versus \"never/rarely\" adding salt to foods, HR = 1.25, 95 % CI: 1.10, 1.41). The observed positive association was generally similar across subgroups. In the joint association analysis, we observed that participants with a high genetic risk (above the second tertile) and the highest frequency of adding salt to foods experienced 149 % higher risk of psoriasis, when compared with participants with a low genetic risk (below the first tertile) and the lowest frequency of adding salt to foods (HR = 2.49, 95 % CI: 2.05, 3.02). Mediation analysis revealed that 1.8 %-3.2 % of the positive association between frequency of adding salt and risk of psoriasis was statistically significantly mediated by obesity and inflammatory biomarkers such as C-reactive protein and systemic immune-inflammation index (all P values < 0.004).
CONCLUSIONS: Our study demonstrated a positive association between frequency of adding salt to foods and risk of psoriasis. The positive association was independent of multiple other risk factors, and may be partially mediated through obesity and inflammation.

OBJECTIVE: This study aimed to objectively evaluate the diet consumed in a workplace cafeteria to group Japanese workers according to vegetables and salt intake and estimate the association of these groups with changes in cardiometabolic measurements.
METHODS: This longitudinal observational study estimated the food and nutrient intake of Japanese workers from data recorded in the cafeteria system of their workplace. The primary outcomes included cardiometabolic measures obtained via regular health check-ups conducted at the workplace. The participants were divided into four groups according to high or low vegetables and salt intake based on their respective medians and the association of each group with cardiometabolic measurement changes was estimated using robust regression with MM-estimation.
METHODS: A Japanese automobile manufacturing factory.
METHODS: The study included 1,140 men and women workers with available cafeteria and health check-up data.
RESULTS: An inverse marginal association was observed between changes in triglyceride levels and high vegetables and low salt intake (β: -9.93, 95% confidence interval [CI]: -20.45, 0.59, p: 0.065) with reference to low vegetables and high salt intake. This association was stronger in participants who used the cafeteria more frequently (>71 days; β: -13.55, 95% CI: -25.51, -1.60, p: 0.027).
CONCLUSIONS: The participants in the higher vegetables and lower salt intake group were more likely to exhibit decreased triglyceride levels. These findings encourage using workplace cafeteria meals to promote the health of workers.

BACKGROUND: High salt intake has been proposed as a risk factor for dementia. However, causal relationship between salt intake and dementia remains uncertain.
OBJECTIVE: The aim of this study was to employ a mendelian randomization (MR) design to investigate the causal impact of salt intake on the risk of dementia.
METHODS: Genome-wide association study (GWAS) data of exposures and outcomes (any dementia, cognitive performance, different types of dementia, Alzheimer\'s disease [AD], and Parkinson\'s disease) were obtained from the IEU database. MR estimates were generated though inverse-variance weighted model. MR-Egger, weighted median, and MR-Pleiotropy Residual Sum and Outlier (MR-PRESSO) method also used in our study. Sensitivity analyses included Cochran\'s Q test, MR-Egger intercept, MR-PRESSO global test and outlier test, leave-one-out analysis, and funnel plot assessment.
RESULTS: Our MR analysis provided evidence of a causal association between high salt added to food and dementia (odds ratio [OR] = 1.73, 95% confidence interval [CI]: 1.21-2.49, and p = .003), dementia in AD (OR = 2.10, 95% CI: 1.15-3.83, and p = .015), and undefined dementia (OR = 2.61, 95% CI: 1.26-5.39, and p = .009). Higher salt added was also associated with increased risk of AD (OR = 1.80, 95% CI: 1.12-2.87, and p = .014) and lower cognitive performance (β = -.133, 95% CI: -.229 to -.038, and p = .006).
CONCLUSIONS: This study provides evidence suggesting that high salt intake is causally associated with an increased risk of developing dementia, including AD and undefined dementia, highlighting the potential importance of reducing salt consumption as a preventive measure.

UNASSIGNED: Excess salt consumption increases blood pressure, and therefore, this substudy was designed among rural hypertensive individuals to assess the baseline knowledge about hypertension (HTN), and dietary salt intake behavior and identify the potential predictors for urinary salt excretion in Bangladesh.
UNASSIGNED: A total of 420 participants were enrolled after meeting the eligibility criteria during the 12 months of the study period. The participants received behavior changes related to short message services (SMS) and face-to-face education from community health workers.
UNASSIGNED: Our study results found that 80% of the participants had positive knowledge of HTN. This study showed that the mean value of overnight urinary sodium excretion was 10.65 ± 3.00 at the 1st-month follow-up and 10.24 ± 3.03 at the endline. We found that mid-upper arm circumference (MUAC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were significantly related to higher salt intake (P = 0.009, P = 0.011, and P = 0.005, respectively). However, participants had improved their MUAC, SBP, and DBP status in their 1st follow-up period, but still, significant associations were observed between them (P = 0.033, P = 0.011, and P = 0.002, respectively).
UNASSIGNED: This study\'s results found that sodium excretion among hypertensive participants was higher, and higher urinary sodium excretion was associated with overweight and BP in adults. Nonetheless, the real salt intake practice among the Bangladeshi population is still unknown, which demands further research.

OBJECTIVE: Monitoring time trends in salt consumption is important for evaluating the impact of salt reduction initiatives on public health outcomes. There has so far not been available data to indicate if salt consumption in Norway has changed during the previous decade. We aimed to assess whether average 24-h salt intake estimated from spot urine samples in the adult population of mid-Norway changed from 2006-2008 to 2017-2019 and to describe variations by sex, age and educational level.
METHODS: Repeated cross-sectional studies.
METHODS: The population-based Trøndelag Health Study (HUNT).
METHODS: In each of two consecutive waves (HUNT3: 2006-2008 and HUNT4: 2017-2019), spot urine samples were collected from 500 men and women aged 25-64 years, in addition to 250 men and women aged 70-79 years in HUNT4. Based on spot urine concentrations of Na, K and creatinine and age, sex and BMI, we estimated 24-h Na intake using the International Cooperative Study on Salt and Blood Pressure (INTERSALT) equation for the Northern European region.
RESULTS: Mean (95 % CI) estimated 24-h salt intakes in men were 11·1 (95 % CI 10·8, 11·3) g in HUNT3 and 10·9 (95 % CI 10·6, 11·1) g in HUNT4, P = 0·25. Corresponding values in women were 7·7 (95 % CI 7·5, 7·9) g and 7·7 (95 % CI 7·5, 7·9) g, P = 0·88. Mean estimated salt intake in HUNT4 decreased with increasing age in women, but not in men, and it did not differ significantly across educational level in either sex.
CONCLUSIONS: Estimated 24-h salt intake in adult men and women in mid-Norway did not change from 2006-2008 to 2017-2019.