IoT-Based Smart-Toilet and Mobile App for Passively Quantifying Objective Urinary Biomarkers of Dietary Intake and Personalizing Nutrition Guidance

根据美国心脏协会（AHA）的数据，大约46%的美国成年人患有糖尿病

According to the American Heart Association (AHA), roughly 46% of the U.S. adult population suffers from high blood pressure (hypertension). Hypertension is a modifiable risk factor for heart disease, stroke, and renal failure. It has been estimated that improving preventative clinical care for hypertension, compared to all other preventative health measures, would prevent the largest number of deaths in the U.S. In addition to high morbidity and mortality, hypertension exhibits a major economic burden on the U.S. healthcare system. Hypertension is the costliest of all cardiovascular diseases, inflicting an estimated $131B annually. Guidelines recommend “healthy lifestyle interventions,” including a healthier diet and a reduction in dietary sodium intake, before starting pharmaceutical interventions. Current methods for monitoring compliance rely on burdensome and inaccurate methods. The 24-hour recall possesses well-established inaccuracies and individuals tend to do a poor job of estimating the salt content of foods. Roughly a third of American adults are actively trying to lower their dietary sodium intake. However, few meet this goal. When surveyed as to why it is difficult to maintain a low sodium diet, individuals report the lack of dietary feedback mechanisms as one of the most significant barriers. Medications are typically prescribed next, but nearly 50% of patients stop taking medications within 6-12 months. As to why this happens, survey’s show most hypertensives want to avoid side-effects and taking a pill forever. In addition to value for the physician for monitoring compliance to lifestyle interventions, self-monitoring provides significant value for the patient. Self-monitoring improves self-efficacy and has routinely demonstrated its ability to lead to better dietary and other lifestyle behavior change outcomes. For example, a 2018 study demonstrated urinary sodium tracking helped a Japanese cohort decrease sodium intake and reduce systolic blood pressure in a randomized trial. Even this modest degree of sodium reduction (1 g) would “result in large declines in annual rates of cardiovascular events and deaths (with new cases of CHD declining by 20,000 to 40,000, new and recurrent cases of myocardial infarction by 18,000 to 35,000, new cases of stroke by 11,000 to 23,000, and deaths from any cause by 15,000 to 32,000)” and save billions in healthcare costs.