Does dietary recall adequately assess sodium, potassium, and calcium intake in hypertensive patients?
Does dietary recall adequately assess sodium, potassium, and calcium intake in hypertensive patients?
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DOI：
10.1016/j.nut.2004.08.021
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发表时间：
2005-04-01
期刊：
影响因子：
4.4
通讯作者：
Grossman, E
中科院分区：
文献类型：
--
作者：
Leiba, A;Vald, A;Grossman, E
目的：推荐低钠、高钾、高钙饮食以降低血压。然而，对这种饮食的依从性很差，可能是因为饮食摄入量被低估了。因此，我们比较了从饮食回忆中估计的电解质摄入量和24小时尿排泄量。方法：36名患者(26名男性和10名女性)，平均年龄46+/-8岁参与研究。所有参与者都有高血压，没有接受药物治疗(n=20)或非利尿剂单一治疗(n=16)。指导患者食用低钠(50 mmol/d)、高钾(补充30~60 mmol/d)和高钙(1000 mg/d)的饮食。在开始饮食后1、2和3个月评估患者对饮食的依从性。结果：钠摄入量估计值与24小时尿排泄量显著相关(R=0.43P<；0.001)。然而，估计的钠摄入量比尿钠排泄量在基线时低34%，在节食3个月后低47%(P<；0.05)。估计的钾摄入量与24小时尿排泄量相关。估计钙摄入量从933+/-83 mg/d显著增加到1029+/-171 mg/d(P<；0.05)。患者记忆中的钙摄入量远远超过24小时尿排泄量，且与24小时尿排泄量仅有轻微相关性(R=0.23，P<；0.01)。结论：患者倾向于低估其钠摄入量30%~50%，因此，尿钠排泄量更能准确地评估钠摄入量。因此，应该在临床实践和临床试验中使用24小时尿钠排泄量，特别是当怀疑饮食不合规时。(C)2005 Elsevier Inc.保留所有权利。
Objective: A diet low in sodium, high in potassium, and high in calcium is recommended to lower blood pressure. However, compliance with this diet is poor, probably because of dietary intake underestimation. Therefore, we compared electrolyte intake as estimated from dietary recall with a 24-h urinary excretion.Methods: Thirty-six patients (26 men and 10 women) with a mean age of 46 +/- 8 y participated in the study. All participants had essential hypertension and were on no drug therapy (n = 20) or non-diuretic monotherapy (n = 16). Patients were instructed to consume a low-sodium (50 mmol/d), high-potassium (supplementation with 30 to 60 mmol/d), and high-calcium (1000 mg/d) diet. Compliance with the diet was assessed at baseline and then 1, 2, and 3 mo after starting the diet. Sodium, potassium, and calcium intakes were carefully estimated from patients' dietary recall and 24-h urinary collection.Results: Estimated sodium intake significantly correlated with 24-h urinary excretion (R = 0.43 P < 0.001). However, estimated sodium intake was lower than urinary sodium excretion by 34% at baseline and by 47% after 3 mo of dieting (P < 0.05). Estimated potassium intake correlated with 24-h urinary excretion. Estimated calcium intake significantly increased from 933 +/- 83 mg/d to 1029 +/- 171 mg/d (P < 0.05). Calcium intake derived from patients' recall far exceeded and only slightly correlated with 24-h urinary excretion (R = 0.23, P < 0.01).Conclusions: Patients tend to underestimate their sodium intake by 30% to 50%; therefore, urinary sodium excretion is more accurate to assess sodium intake. Thus, 24-h urinary sodium excretion should be used in clinical practice and in clinical trials, especially when dietary non-compliance is suspected. (c) 2005 Elsevier Inc. All rights reserved.