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），大约46%的美国成年人 高血压（hypertension）。高血压是一种可改变的风险 心脏病中风和肾衰竭的危险因素据估计，改善预防措施 与所有其他预防性健康措施相比，高血压的临床护理可以预防 除了高发病率和死亡率，高血压是美国死亡人数最多的疾病。 这对美国的医疗保健系统造成了巨大的经济负担。高血压是最昂贵的 所有的心血管疾病，每年造成估计1310亿美元。 指南建议“健康的生活方式干预”，包括更健康的饮食和 在开始药物干预之前，减少膳食钠摄入量。当前方法 在监测遵守情况方面，依赖繁琐和不准确的方法。24小时召回 具有公认的不准确性，个人往往做一个穷人的工作，估计盐 食物的内容。大约三分之一的美国成年人正在积极尝试降低他们的饮食。 钠摄入量然而，很少有人能达到这一目标。当被调查为什么难以维持 低钠饮食，个人报告缺乏饮食反馈机制是最重要的因素之一。 重大障碍。接下来通常会开药，但近50%的患者会停药。 在6-12个月内服用药物。 至于为什么会发生这种情况，调查显示， 高血压患者希望避免副作用，永远服用一种药丸。 除了对医生监测对生活方式干预的依从性的价值外， 自我监测为患者提供了重要的价值。自我监控提高自我效能 并且已经证明它有能力改善饮食和其他生活方式 改变结果。例如，2018年的一项研究表明，尿钠跟踪有助于 一项随机试验中日本队列减少钠摄入量并降低收缩压。 即使是这种适度的钠减少（1克）也会“导致年增长率大幅下降 心血管事件和死亡（冠心病新发病例减少20，000至40，000， 心肌梗死复发病例减少18，000至35，000例，新发中风病例减少11，000例 到23，000人，任何原因造成的死亡人数减少15，000至32，000人），并节省数十亿美元的医疗费用。

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.