Modelling Salt Intake Reduction with Umami Substance’s Incorporation Into Japanese Foods: A Cross-Sectional Study

BackgroundEvidence has demonstrated that excess salt intake is associated with the development of several non-communicable diseases. Therefore, reformulating the sodium content of foods is an important global public health effort to achieve salt reduction and improve health. This study aimed to model sodium replacement with 'umami' substances and estimate the possible reduction effects of the umami substances on the daily salt intake among Japanese adults. The umami substances considered in this study include glutamate or monosodium glutamates (MSG), calcium diglutamate (CDG), inosinate, and guanilate.MethodsA sample of 21,805 participants aged 57.8 years on average from the National Health and Nutrition Survey (NHNS) were used in the analysis. First, we employed a multivariable linear regression approach, with overall salt intake (g/day) as a dependent variable, adjusting for intake (g/day) from food items and other covariates, to estimate the contributions of each food item to daily salt intake. We then considered three hypothetical scenarios with varying market share percentages of umami substitute foods (30%, 60%, and 100%). We estimated the population-level salt reduction for each scenario, by age and gender, based on the contribution of each food to salt intake estimated by the regression model and the estimated salt reduction rates by food item based on an extensive literature review. Under the 100% scenario, the achievement rates for national and global dietary goals of salt intake in the Japanese population were also calculated.ResultsWithout compromising the taste, the universal incorporation of umami substances can reduce the salt intake of adult Japanese persons by 12.0-21.1% in the population level, which is equivalent to 1.27-2.22g of salt reduction. A mean daily salt intake before and after scenario in universal umami substance’s incorporation changes from 9.95g to 7.73g for the total population, from 10.83g to 8.40g for men and from 9.21g to 7.17g for women, respectively. Approximately 60% of Japanese adults could achieve the national dietary goal of 8g/day, while only 7.6% could meet the global target of 5.0g/day. ConclusionsOur study provides essential information on the potential salt reduction from sodium replacement with alternatives. The universal incorporation of umami substances into some foods could achieve the national dietary goals for the Japanese. However, the reduced salt intake level still falls short of the global dietary recommendation of 5g of salt daily.

Pontine and extra-pontine osmotic demyelination syndrome: Case report

Osmotic demyelination syndrome is a rare disease, clinically presented as a global reduction in strength, tetraparesis, variations in the level of consciousness, and its content, and comatose status, associated with rapid variances in serum sodium levels (whether hyponatremia or hypernatremia). The neuroimaging findings are mainly in the pontine region, but currently the number of reports of extrapontine involvement has increased, typically with lesions in the topography of the thalamus, cerebellum, midbrain (substantia nigra), corpus callosum and hypothalamus. We display a rare case of pontine and extra-pontine involvement, even after the sodium replacement protocols of the current guidelines.

Combination of Freezing, Low Sodium Brine, and Cold Smoking on the Quality and Shelf-Life of Sea Bass (Dicentrarchus labrax L.) Fillets as a Strategy to Innovate the Market of Aquaculture Products

Aquaculture is playing a leading role in both meeting the growing demand for seafood and increasing the sustainability of the fish production sector. Thus, innovative technologies that improve its sustainability, competitiveness, and safety are necessary for growth in the sector. This study aimed to develop cold smoked sea bass fillets from aquaculture. The aptitude of frozen and fresh fillets for cold smoking was investigated by processing both fresh and thawed fillets kept previously at −20 °C for 15, 30, 60, and 90 days. Moreover, to develop a low-salt product, fillets were immersed in low-sodium or standard brine. Sensory, biochemical, and physical-chemical analyses were performed on both the raw fillets and the smoked fillets during vacuum packaged storage for 35 days at 1 ± 0.5 °C. Young modulus values, representative of texture and sensory evaluation, showed that the quality of fresh fillets was better compared to the thawed ones, thus affecting the quality of the final product as the correlation between parameters showed (principal component analysis). Cold smoking was effective in both maintaining the total volatile basic nitrogen (TVB-N) below the threshold for spoilage and preventing lipid peroxidation. Moreover, partial sodium replacement by potassium did not alter the sensory attributes of smoked fillets, which maintained high scores up to 21 days.

Sodium reduction by hyposodic salt on quality and chemical composition of hamburgers

This work evaluated the effect of NaCl reduction on the quality and sensorial attributes of hamburgers. Three treatments were tested: control (CON), 100% NaCl; reduction of 25% NaCl (T25), and one with 50% NaCl (T50). The pH, color, lipid oxidation, cooking losses, and texture were analyzed during 120 days of freezing storage. Chemical composition and sensory analyses were performed. The chemical composition was similar for all treatments. The pH value remained within acceptable limits throughout storage. The color, lipid oxidation, cooking losses, and texture were not influenced by the sodium replacement and freezing storage. Sensorial acceptability was also not influenced by sodium reduction. Thus, the results indicated that up to 50% replacement of NaCl by KCl could be carried out in hamburger production without altering the quality and sensorial acceptability.

Continuous veno-venous hemofiltration in the treatment of severely burned patients with acute hypernatremia: A retrospective study of 13 cases

Objectives: This study aimed to evaluate the clinical effects of continuous veno-venous hemofiltration in the treatment of severely burned patients with acute hypernatremia. Methods: A total of 13 severely burned patients with acute hypernatremia admitted to Xijing Hospital were included in this study. All patients received continuous veno-venous hemofiltration treatment in addition to conventional treatment. The original sodium level in the replacement fluid was set to be lower than the serum sodium level by 8 mmol/L and subsequently undergoes a reduction rate of 2.16 ± 0.18 mmol/L every 4 h. Patients’ clinical features, serum laboratory tests, hemodynamic variables, changes in sodium levels in serum, and replacement fluid during continuous veno-venous hemofiltration treatment were monitored. Results: Patients had an average total burn surface area of 66.69% ± 20.28%. Two patients died of systematic Pseudomonas aeruginosa infections, and 11 patients survived. After continuous veno-venous hemofiltration treatment, patients showed a significant reduction in the serum sodium level (168.91 ± 4.88 mmol/L vs 144.62 ± 2.98 mmol/L, p < 0.01). Likewise, the serum levels of urea and creatinine decreased from 24.8 ± 6.5 mmol/L to 14.9 ± 8.3 mmol/L and from 278.6 ± 155.3 μmol/L to 152.6 ± 29.7 μmol/L, respectively (p < 0.05). The patients also displayed improvements in the Acute Physiology and Chronic Health Evaluation II and Glasgow scores (p < 0.05) and showed a significant reduction in hemoglobin and serum albumin levels (p < 0.05), but no obvious change in levels of platelets, alanine aminotransferase, and aspartate aminotransferase (p > 0.05). Conclusion: Our results indicate that continuous veno-venous hemofiltration with gradient sodium replacement fluid is effective in treating hypernatremia in severely burned patients with the controllable sodium reduction rate and satisfactory clinical outcomes.

Congenital chloride diarrhoea

Congenital chloride diarrhoea is one of the rare causes of diarrhoea during infancy and it is infrequently reported throughout the world. It is an autosomal recessive condition which is more prevalent in Poland, Finland, Saudi Arabia and Kuwait while rarely reported in Pakistan. Our patient was 7.5-month-old baby boy who presented with diarrhoea since neonatal period. He had consanguineous parents. On examination, baby had distended abdomen, hypotonia and hyporeflexia. Investigations revealed hypochloremic hypokalemic metabolic alkalosis. Urinary electrolytes were normal. Stool electrolytes revealed increased stool chloride excretion that confirmed our diagnosis of congenital chloride diarrhoea. Patient was treated with intravenous fluids and electrolyte replacement, followed by oral potassium and sodium replacement. He was also started on butyrate, cholestyramine and proton-pump inhibitors. He started gaining weight during his hospital admission and is being followed up in clinic.