scholarly journals Reducing Sodium Intake in Children: A Public Health Investment

2015 ◽  
Vol 17 (9) ◽  
pp. 657-662 ◽  
Author(s):  
Lawrence J. Appel ◽  
Alice H. Lichtenstein ◽  
Emily A. Callahan ◽  
Alan Sinaiko ◽  
Linda Van Horn ◽  
...  
Keyword(s):  
Public Health ◽  
Sodium Intake ◽  
Health Investment

scholarly journals Evidence-Based Policy Making for Public Health Interventions in Cardiovascular Diseases: Formally Assessing the Feasibility of Clinical Trials

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Kathryn Foti ◽  
Randi E. Foraker ◽  
Pamela Martyn-Nemeth ◽  
Cheryl A.M. Anderson ◽  
Nancy R. Cook ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Outcomes ◽  
Sodium Intake ◽  
Cardiovascular Outcomes ◽  
Health Interventions ◽  
Evidence Based ◽  
Sodium Reduction ◽  
Public Health Interventions ◽  
Antihypertensive Medications ◽  
Evidence Based Policy

Implementation of prevention policies has often been impeded or delayed due to the lack of randomized controlled trials (RCTs) with hard clinical outcomes (eg, incident disease, mortality). Despite the prominent role of RCTs in health care, it may not always be feasible to conduct RCTs of public health interventions with hard outcomes due to logistical and ethical considerations. RCTs may also lack external validity and have limited generalizability. Currently, there is insufficient guidance for policymakers charged with establishing evidence-based policy to determine whether an RCT with hard outcomes is needed before policy recommendations. In this context, the purpose of this article is to assess, in a case study, the feasibility of conducting an RCT of the oft-cited issue of sodium reduction on cardiovascular outcomes and then propose a framework for decision-making, which includes an assessment of the feasibility of conducting an RCT with hard clinical outcomes when such trials are unavailable. We designed and assessed the feasibility of potential individual- and cluster-randomized trials of sodium reduction on cardiovascular outcomes. Based on our assumptions, a trial using any of the designs considered would require tens of thousands of participants and cost hundreds of millions of dollars, which is prohibitively expensive. Our estimates may be conservative given several key challenges, such as the unknown costs of sustaining a long-term difference in sodium intake, the effect of differential cotreatment with antihypertensive medications, and long lag time to clinical outcomes. Thus, it would be extraordinarily difficult to conduct such a trial, and despite the high costs, would still be at substantial risk for a spuriously null result. A robust framework, such as the one we developed, should be used to guide policymakers when establishing evidence-based public health interventions in the absence of trials with hard clinical outcomes.

Need for National Commitments to Cancer Research to Guide Public Health Investment and Practice

2015 ◽  
pp. 249-262 ◽  
Author(s):  
Edward L. Trimble ◽  
Preetha Rajaraman ◽  
Ann Chao ◽  
Thomas Gross ◽  
Carol Levin ◽  
...  
Keyword(s):  
Public Health ◽  
Cancer Research ◽  
Health Investment

scholarly journals Where Do Nutrients of Public Health Concern Come From in US Rural Food Pantry Clients?

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 227-227
Author(s):  
Yibin Liu ◽  
Heather Eicher-Miller
Keyword(s):  
Public Health ◽  
Sodium Intake ◽  
Saturated Fat ◽  
Health Concern ◽  
Food Outlet ◽  
Public Health Concern ◽  
Added Sugar ◽  
Food Pantry ◽  
Food Pantries ◽  
Before And After

Abstract Objectives Food pantry clients receive foods from food pantries, stores, restaurants and other food outlets. Intake of nutrients of public health concern, added sugar and saturated fats, is recommended to be limited to <10% total energy intake (%TEI), and sodium not to exceed 2300 mg. The objective was to determine the largest contributing food outlet for added sugar, saturated fat, and sodium before and after a food pantry visit among rural food pantry clients (n = 473). Methods English speaking participants ≥18 years (or ≥19 years in Nebraska) were recruited from 24 food pantries in rural, high-poverty counties in Indiana, Michigan, Missouri, Nebraska, Ohio, and South Dakota. Participants at the food pantry were interviewed regarding their characteristics and dietary intake using the Automated Self-Administered 24-h Dietary Recall. Foods and beverages were reported as originating from food pantries, stores, restaurants, and other. An additional recall was collected within 1 week of the pantry visit on a non-consecutive day. The mean amount of sodium and %TEI from saturated fat and added sugar from each food outlet before and after the pantry visit was calculated for each participant and analyzed using Analysis of Variance. Results Stores, including supermarket, convenience store, and other stores, were the largest contributing outlet to sodium intake (mg, 1544.7 ± 50.2) and %TEI intake from added sugar (11.1 ± 0.4) and saturated fat (7.3 ± 0.2) before visiting the food pantry. The after-pantry intakes were not significantly different from the before-pantry intakes except for sodium. The after-pantry intake of sodium (mg) from food pantries increased from 513.8 ± 50.2 to 755.8 ± 50.2. Conclusions The largest contributing outlet to added sugar, saturated fat, and sodium intake were stores. Findings signal the need for offering nutrition education programs among food pantry clients to support healthy food choices and limit intake of nutrients of public health concern from various outlets, especially from supermarket, convenience stores, and other stores. Funding Sources This project is supported by the USDA NIFA Agriculture and Food Research Initiative competitive grant no. 2013–69,004-20,401.

Return on Public Health Investment

2012 ◽  
Vol 59 (3) ◽  
pp. 281-286 ◽  
Author(s):  
Angela B. Hutchinson ◽  
Paul G. Farnham ◽  
Nadezhda Duffy ◽  
Richard J. Wolitski ◽  
Stephanie L. Sansom ◽  
...  
Keyword(s):  
Public Health ◽  
Health Investment

scholarly journals Dietary Sodium and Blood Pressure in Older Adults

2006 ◽  
Vol 4 (2) ◽  
pp. 25-46
Author(s):  
Courtney B. Johnson
Keyword(s):  
Public Health ◽  
Blood Pressure ◽  
Older Adults ◽  
Healthy Aging ◽  
Sodium Intake ◽  
Urinary Sodium ◽  
Dietary Sodium ◽  
Food Sources ◽  
Major Food ◽  
Increased Risk

Given the proportion of older adults who are hypertensive and the population of older adults who are at risk for hypertension, the U.S. must mobilize public health efforts aimed at prevention. Scientific evidence has demonstrated the efficacy of sodium reduction to lower blood pressure. Translating this evidence into practice involves knowledge about the food sources of sodium so effective interventions can be designed and implemented. The purpose of this essay was to examine major food group sources of sodium in a cohort of older adults, with and without high blood pressure, in an urban community in Southwestern Pennsylvania. The University of Pittsburgh's "Center for Healthy Aging" promotes healthy aging in the community with the "10 Keys to Healthy Aging" campaign. One of the keys aims to lower systolic blood pressure to ≤140 mmHg. A low sodium intervention was implemented by the CHA project in hypertensive individuals. The sodium intake of the 521 community volunteers, mean age 74.5 years, 60% male, 94.1% white, who completed a FFQ, was compared to a sub-sample of hypertensives (n=214) who, in addition, collected one 24-hour urinary sodium. Mean baseline dietary sodium for the entire cohort was 1,796 mg per day compared to 1,821 mg per day in hypertensives. Urinary sodium was 1.8 times higher (141 mmol/24 hrs [3,240 mg]) than self-reported intake and decreased to 130 mmol/24 hrs (2,990 mg) at 6-months. The correlation between dietary and urinary sodium at baseline was weak (r=0.16) and remained weak (0.23) at 6-months. Major food sources of sodium were soups, breads, tomato sauce, salad dressings, and prepared cereals. Data indicate that the sodium intake of the group exceeds the 2005 Dietary Guidelines of ≤1500 mg per day by approximately 200% for individuals at increased risk using urinary sodium values. Even the most successful dietary interventions to reduce sodium intake to the recommended levels would be ineffective without the food industry’s help in reducing sodium added to foods during processing. This prevention strategy, in combination with stronger public health messages, would help to reduce the sodium intake in the population and help to achieve reductions in blood pressures.

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