Adherence to the New Chronic Disease Risk Reduction (CDRR) Value of Dietary Sodium Intake among Healthy Jordanian Adults: A Cross-Sectional Study
Palabras clave:Dietary Sodium, Dietary Reference Intake, AI, CDRR, Jordan
Introduction: Excessive intake of sodium in developing countries is highly associated with elevated prevalence of chronic diseases. Studies among Jordanians that compare their dietary sodium intakes with adequate intake (AI) are very rare. The aim of the study was to assess the status of dietary sodium intakes among healthy Jordanians and to find out their adherence to the new value of Dietary Reference Intakes (DRIs), namely chronic disease risk reduction (CDRR) value.
Methods: A cross-sectional study design was conducted on 325 healthy Jordanian adults through face-to face interview. The study questionnaire include information regarding participants’ sociodemographic characteristics, anthropometric measurements, and dietary assessment of sodium intake. SPSS (version 25) was used for statistical analysis and significance set at p-value <0.05.
Results: The study outcomes indicated that 27 participants (8%) had dietary sodium intake less than AI. Moreover, 87 participants had adequate intake between AI and CDRR. Meanwhile the majority of study population (211 participants) had dietary sodium intake higher than CDRR. Variables including gender, education level, BMI, smoking, and major dietary pattern revealed a significant differences between different categories of dietary sodium intake. Higher odds of excessive dietary sodium intake were found among (males, low education level, obese persons, smokers, and participants who followed Western-like pattern) in comparison to other groups for each variable.
Conclusion: This study indicated high percentage of healthy Jordanians consume high amounts of dietary sodium higher than CDRR. Therefore, a weak adherence to the new CDRR value of dietary sodium intake was clear among participants. Obesity, smoking, and following unhealthy dietary pattern high in sodium such as Western-like dietary pattern were among the most alarming risk factors associated with excessive dietary sodium intake. Further studies are recommended among healthy and patients’ population to determine the appropriate intervention strategies needed to enhance awareness regarding healthy eating practices.
Ministry of Health and Welfare. Guide Book of Korean Nutrient Intake Standard 2010; Ministry of Health and Welfare: Seoul, Korea; 2013.
Alawwa I, Dagash R, Saleh A, Ahmad A. Dietary salt consumption and the knowledge, attitudes and behavior of healthy adults: a cross-sectional study from Jordan. Libyan J Med. 2018;13(1): 1479602. doi:10.1080/19932820.2018.1479602
Park DI, Choi-Kwon S, Han K. Health behaviors of Korean female nursing students in relation to obesity and osteoporosis. Nurs Outlook. 2015;63(4):504-511. doi:10.1016/j.outlook.2015.02.001
Kawano Y. Salt, hypertension and cardiovascular diseases. J Korean Soc Hypertens. 2012;18:53–62.
He FJ, Li J, Macgregor GA. Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ. 2013;346:f1325. Published 2013 Apr 3. doi:10.1136/bmj.f1325
Imanuddin I, Sudarsono IMR, Hariani H. Yuningsih P. Correlation of Sodium Intake, Body Mass and Physical Activity with Blood Pressure. Jurnal Penelitian Pendidikan IPA. 2023; 9(3):1187– 1192. doi: 10.29303/jppipa.v9i3.3087.
Lee YS, Rhee MY, Lee SY. Effect of nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults. Nutr Res Pract. 2020;14(5):540-552. doi:10.4162/ nrp.2020.14.5.540
National Academies of Sciences, Engineering, and Medicine. Dietary Reference Intakes for Sodium and Potassium. Washington, D.C.: The National Academies Press; 2019.
Newberry SJ, Chung M, Anderson CAM, et al. Sodium and Potassium Intake: Effects on Chronic Disease Outcomes and Risks. Rockville (MD): Agency for Healthcare Research and Quality (US); June 2018.
Kim HJ, Lee YK, Koo H, Shin MJ. Dietary Reference Intakes of sodium for Koreans: focusing on a new DRI component for chronic disease risk reduction. Nutr Res Pract. 2022;16(Suppl 1):S70-S88. doi:10.4162/nrp.2022.16.S1.S70
Lin Y, Mei Q, Qian X, He T. Salt consumption and the risk of chronic diseases among Chinese adults in Ningbo city. Nutr J.
;19(1):9. Published 2020 Jan 29. doi:10.1186/s12937-0200521-8
Micha R, Peñalvo JL, Cudhea F, Imamura F, Rehm CD, Mozaffarian D. Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States. JAMA. 2017;317(9):912-924. doi:10.1001/jama.2017.0947
Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002;13(1):3-9. doi:10.1097/000 41433-200202000-00002
He FJ, MacGregor GA. Reducing population salt intake worldwide: from evidence to implementation. Prog Cardiovasc Dis. 2010;52(5):363-382. doi:10.1016/j.pcad.2009.12.006
Department of Statistics (DOS), Household Expenditures and Income Survey, DOS, Amman; 2010.
Madanat HN, Troutman KP, Al-Madi B. The nutrition transition in Jordan: the political, economic and food consumption contexts.
Promot Educ. 2008;15(1):6-10. doi:10.1177/1025382307088092
Department of Statistics. 2021. Jordan In Figure. Available online: http://dosweb.dos.gov.jo/DataBank/JordanInFigures/Jo rinfo_2021.pdf
Munoz N, Bernstein, M. Nutrition assessment: clinical and research applications. Burlington, MA: Jones & Barlett Learning; 2019.
Nieman DC. Nutritional Assessment. 7th ed. Nutritional Assessment: New York, USA: McGraw-Hill Education; 2019.
Tayyem R, Hammad S, Allehdan S. S, Abdelrahaim D, Djellouli L, Al-Asali F. Exploring of Dietary Patterns, and Possible Association with Educational Level, among Jordanian Pregnant Women. Curr Res Nutr Food Sci 2021; 9(1). doi: http://dx.doi.org/10.12944/ CRNFSJ.9.1.04
Delgado MC. “Potassium in hypertension”, Current Hypertension Reports. 2004; 6(1): 31-35.
Ministry of Health-Jordan. Jordan National Stepwise Survey (STEPs) for Noncommunicable Diseases Risk Factors 2019. 2020. Available online: https://www.moh.gov.jo/Echobusv3.0/SystemAssets/42e9a 4d5-b719-4047-9fb6-c2b60adfee3a.pdf
World Health Organization Global Database on the Implementation of Nutrition Action (GINA). Policy—The National Strategy and Plan of Action Against Diabetes, Hypertension, Dyslipidemia and Obesity in Jordan—Jordan. 2015. Available online: https://extranet.who.int /nutrition/gina/en/node/25926
Al-Jawaldeh A, Taktouk M, Chatila A, et al. Salt Reduction
Initiatives in the Eastern Mediterranean Region and Evaluation of Progress towards the 2025 Global Target: A Systematic Review. Nutrients. 2021;13(8):2676. Published 2021 Jul 31. doi:10.3390/ nu13082676
Chung ML, Moser DK, Lennie TA, et al. Gender differences in adherence to the sodium-restricted diet in patients with heart failure. J Card Fail. 2006;12(8):628-634. doi:10.1016/j.cardfail. 2006.07.007
Park SY, Kwon JS, Kim HK. Effect of a public health center-based nutrition education program for hypertension in women older than 50 years of age. J Nutr Health 2018;51:228-41.
Sim JH. The Effects of Diet Health Education Program for Prehypertension Group on the Diet Habit and Blood Pressure. J Korean Soc Health Educ Promot 2006;23:1-12.
Zhao L, Ogden CL, Yang Q, et al. Association of Usual Sodium Intake with Obesity Among US Children and Adolescents,
NHANES 2009-2016. Obesity (Silver Spring). 2021;29(3):587594. doi:10.1002/oby.23102
Ma Y, He FJ, MacGregor GA. High salt intake: independent risk factor for obesity?. Hypertension. 2015;66(4):843-849. doi:10.1161/ HYPERTENSIONAHA.115.05948
Choi KH, Park MS, Kim JA, Lim JA. Associations Between Excessive Sodium Intake and Smoking and Alcohol Intake Among Korean Men: KNHANES V. Int J Environ Res Public Health. 2015;12(12):15540-15549. Published 2015 Dec 8. doi:10.3390/ ijerph121215001
Lampuré A, Schlich P, Deglaire A, et al. Sociodemographic, psychological, and lifestyle characteristics are associated with a liking for salty and sweet tastes in French adults. J Nutr. 2015; 145(3):587-594. doi:10.3945/jn.114.201269
Vega-Vega O, Fonseca-Correa JI, Mendoza-De la Garza A, et al. Contemporary Dietary Intake: Too Much Sodium, Not Enough Potassium, yet Sufficient Iodine: The SALMEX Cohort Results. Nutrients. 2018;10(7):816. Published 2018 Jun 25. doi:10.3390/ nu10070816
Jobin K, Müller DN, Jantsch J, Kurts C. Sodium and its manifold impact on our immune system. Trends Immunol. 2021;42(6): 469-479. doi:10.1016/j.it.2021.04.002
Derechos de autor 2023 Nutrición Clínica y Dietética Hospitalaria
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Los lectores pueden utilizar los textos publicados de acuerdo con la definición BOAI (Budapest Open Access Initiative)