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Geographic and socioeconomic variation of sodium and potassium intake in Italy: results from the MINISAL-GIRCSI programme.
BMJ Open. 2015 Sep 10; 5(9):e007467.BO

Abstract

OBJECTIVES

To assess geographic and socioeconomic gradients in sodium and potassium intake in Italy.

SETTING

Cross-sectional survey in Italy.

PARTICIPANTS

3857 men and women, aged 39-79 years, randomly sampled in 20 regions (as part of a National cardiovascular survey of 8714 men and women).

PRIMARY OUTCOME MEASURES

Participants' dietary sodium and potassium intakes were measured by 24 h urinary sodium and potassium excretions. 2 indicators measured socioeconomic status: education and occupation. Bayesian geoadditive models were used to assess spatial and socioeconomic patterns of sodium and potassium intakes accounting for sociodemographic, anthropometric and behavioural confounders.

RESULTS

There was a significant north-south pattern of sodium excretion in Italy. Participants living in southern Italy (eg, Calabria, Basilicata and Puglia >180 mmol/24 h) had a significantly higher sodium excretion than elsewhere (eg, Val d'Aosta and Trentino-Alto Adige <140 mmol/24 h; p<0.001). There was a linear association between occupation and sodium excretion (p<0.001). When compared with occupation I (top managerial), occupations III and IV had a 6.5% higher sodium excretion (coefficients: 0.054 (90% credible levels 0.014, 0.093) and 0.064 (0.024, 0.104), respectively). A similar relationship was found between educational attainment and sodium excretion (p<0.0001). When compared with those with a university degree, participants with primary and junior school education had a 5.9% higher urinary sodium (coefficients: 0.074 (0.031, 0.116) and 0.038 (0.001, 0.075), respectively). The socioeconomic gradient explained the spatial variation. Potassium excretion was higher in central regions and in some southern regions. Those in occupation V (low-skill workers) showed a 3% lower potassium excretion compared with those in occupation I. However, the socioeconomic gradient only partially explained the spatial variation.

CONCLUSIONS

Salt intake in Italy is significantly higher in less advantaged social groups. This gradient is independent of confounders and explains the geographical variation.

Authors+Show Affiliations

University of Warwick, WHO Collaborating Centre for Nutrition, ESH Hypertension Excellence Centre, Warwick Medical School, Coventry, UK.University of Warwick, WHO Collaborating Centre for Nutrition, ESH Hypertension Excellence Centre, Warwick Medical School, Coventry, UK.Istituto Superiore di Sanità, National Center of Epidemiology, Rome, Italy.Istituto Superiore di Sanità, National Center of Epidemiology, Rome, Italy.Federico II University of Naples Medical School, ESH Hypertension Excellence Center, Naples, Italy.ANMCO (National Association of Hospital Cardiologists), Fondazione per il Tuo Cuore, Florence, Italy.Istituto Superiore di Sanità, National Center of Epidemiology, Rome, Italy.Federico II University of Naples Medical School, ESH Hypertension Excellence Center, Naples, Italy.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26359282

Citation

Cappuccio, Francesco P., et al. "Geographic and Socioeconomic Variation of Sodium and Potassium Intake in Italy: Results From the MINISAL-GIRCSI Programme." BMJ Open, vol. 5, no. 9, 2015, pp. e007467.
Cappuccio FP, Ji C, Donfrancesco C, et al. Geographic and socioeconomic variation of sodium and potassium intake in Italy: results from the MINISAL-GIRCSI programme. BMJ Open. 2015;5(9):e007467.
Cappuccio, F. P., Ji, C., Donfrancesco, C., Palmieri, L., Ippolito, R., Vanuzzo, D., Giampaoli, S., & Strazzullo, P. (2015). Geographic and socioeconomic variation of sodium and potassium intake in Italy: results from the MINISAL-GIRCSI programme. BMJ Open, 5(9), e007467. https://doi.org/10.1136/bmjopen-2014-007467
Cappuccio FP, et al. Geographic and Socioeconomic Variation of Sodium and Potassium Intake in Italy: Results From the MINISAL-GIRCSI Programme. BMJ Open. 2015 Sep 10;5(9):e007467. PubMed PMID: 26359282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Geographic and socioeconomic variation of sodium and potassium intake in Italy: results from the MINISAL-GIRCSI programme. AU - Cappuccio,Francesco P, AU - Ji,Chen, AU - Donfrancesco,Chiara, AU - Palmieri,Luigi, AU - Ippolito,Renato, AU - Vanuzzo,Diego, AU - Giampaoli,Simona, AU - Strazzullo,Pasquale, Y1 - 2015/09/10/ PY - 2015/9/12/entrez PY - 2015/9/12/pubmed PY - 2016/7/30/medline KW - EPIDEMIOLOGY KW - NUTRITION & DIETETICS KW - PREVENTIVE MEDICINE SP - e007467 EP - e007467 JF - BMJ open JO - BMJ Open VL - 5 IS - 9 N2 - OBJECTIVES: To assess geographic and socioeconomic gradients in sodium and potassium intake in Italy. SETTING: Cross-sectional survey in Italy. PARTICIPANTS: 3857 men and women, aged 39-79 years, randomly sampled in 20 regions (as part of a National cardiovascular survey of 8714 men and women). PRIMARY OUTCOME MEASURES: Participants' dietary sodium and potassium intakes were measured by 24 h urinary sodium and potassium excretions. 2 indicators measured socioeconomic status: education and occupation. Bayesian geoadditive models were used to assess spatial and socioeconomic patterns of sodium and potassium intakes accounting for sociodemographic, anthropometric and behavioural confounders. RESULTS: There was a significant north-south pattern of sodium excretion in Italy. Participants living in southern Italy (eg, Calabria, Basilicata and Puglia >180 mmol/24 h) had a significantly higher sodium excretion than elsewhere (eg, Val d'Aosta and Trentino-Alto Adige <140 mmol/24 h; p<0.001). There was a linear association between occupation and sodium excretion (p<0.001). When compared with occupation I (top managerial), occupations III and IV had a 6.5% higher sodium excretion (coefficients: 0.054 (90% credible levels 0.014, 0.093) and 0.064 (0.024, 0.104), respectively). A similar relationship was found between educational attainment and sodium excretion (p<0.0001). When compared with those with a university degree, participants with primary and junior school education had a 5.9% higher urinary sodium (coefficients: 0.074 (0.031, 0.116) and 0.038 (0.001, 0.075), respectively). The socioeconomic gradient explained the spatial variation. Potassium excretion was higher in central regions and in some southern regions. Those in occupation V (low-skill workers) showed a 3% lower potassium excretion compared with those in occupation I. However, the socioeconomic gradient only partially explained the spatial variation. CONCLUSIONS: Salt intake in Italy is significantly higher in less advantaged social groups. This gradient is independent of confounders and explains the geographical variation. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/26359282/Geographic_and_socioeconomic_variation_of_sodium_and_potassium_intake_in_Italy:_results_from_the_MINISAL_GIRCSI_programme_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&amp;pmid=26359282 DB - PRIME DP - Unbound Medicine ER -