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Background and Aims: Low potassium intake, in addition to high sodium, has been associated with higher risk of hypertension and CVD. The Study assessed habitual potassium intake and sodium/potassium ratio of the Italian adult population from 2008 to 2012 to 2018-2019 based on 24-h urine collection, in the framework of the CUORE Project/MINISAL-GIRCSI/MENO SALE PIU' SALUTE national surveys.Methods and Results: Data were from cross-sectional surveys of randomly selected age-and-sex stratified samples of resident persons aged 35-74 years in 10 (out of 20) Italian regions. Urinary electrolyte and creatinine measurements were performed in a central laboratory. Analyses considered 942 men and 916 women, examined in 2008-2012, and 967 men and 1010 women, examined in 2018-2019. In 2008-2012, the age-standardized mean of potassium intake (urinary potassium accounts for 70% of potassium intake) was 3147 mg (95% CI 3086-3208) in men and 2784 mg (2727-2841) in women, whereas in 2018-2019, it was 3043 mg (2968-3118) and 2561 mg (2508-2614) respectively. In 2008-2012, age-adjusted prevalence of persons with an adequate potassium intake (i.e. ≥ 3510 mg/day) was 31% (95% CI 28-34%) for men and 18% (16-21%) for women; in 2018-2019, it was 26% (23-29%) and 12% (10-14%) respectively. The sodium/potassium ratio significantly decreased both in men and women.Conclusions: The average daily potassium intake of the Italian general adult population remains lower than the WHO and EFSA recommended level. These results suggest the need of a revision to strengthen initiatives for the promotion of an adequate potassium intake at the population level. [ABSTRACT FROM AUTHOR]

Background and Aims: The WHO Global Action Plan for the Prevention of non-communicable diseases (NCDs) recommends a 30% relative reduction in mean population salt/sodium intake. The study assessed the trend in the habitual salt intake of the Italian adult population from 2008 to 2012 to 2018-2019 based on 24-h urinary sodium excretion, in the framework of the CUORE Project/MINISAL-GIRCSI/MENO SALE PIU' SALUTE national surveys.Methods and Results: Data were from cross-sectional surveys of randomly selected age and sex-stratified samples of resident persons aged 35-74 years in 10 (out of 20) Italian Regions distributed in North, Centre and South of the Country. Urinary sodium and creatinine measurements were carried out in a central laboratory. The analyses included 942 men and 916 women examined in 2008-2012, and 967 men and 1010 women examined in 2018-2019. The age-standardized mean daily population salt (sodium chloride) intake was 10.8 g (95% CI 10.5-11.1) in men and 8.3 g (8.1-8.5) in women in 2008-2012 and respectively 9.5 g (9.3-9.8) and 7.2 g (7.0-7.4) in 2018-2019. A statistically significant (p<0.0001) salt intake reduction was thus observed over 10 years for both genders, and all age, body mass index (BMI) and educational classes.Conclusions: The average daily salt intake of the Italian general adult population remains higher than the WHO recommended level, but a significant reduction of 12% in men and 13% in women has occurred in the past ten years. These results encourage the initiatives undertaken by the Italian Ministry of Health aimed at the reduction of salt intake at the population level. [ABSTRACT FROM AUTHOR]

Objectives To describe longitudinal relationships of metabolic syndrome (MetS) to cognitive decline and functional disability in a sample of older non-institutionalized men. Methods data from 1991 to 2000 of the Italian cohorts of the Finland, Italy, the Netherlands, Elderly (FINE) study, were used. Global cognitive function and functional disability, defined as limitations in mobility, basic (ADLs) and instrumental activities of daily living (IADLs) were screened in 1991 and 2000. MetS was defined according to the NCEP ATP-III criteria. Results The study sample consisted of 195 men, baseline age 76.1 ± 3.1 years. Baseline MetS was prospectively associated with greater 10-year cognitive and functional decline in ADLs and IADLs. After multiple adjustment including age, education, marital status, ApoE ε4 allele, cerebrovascular disease and initial cognitive and depressive status, MetS predicted cognitive decline (B = −1.684, 95%CI = −2.202 to −1.167, p < 0.001) and risk of IADLs (OR = 1.09, 95% CI = 1.01–1.20, p = 0.048) and ADLs disability (OR = 1.35, 95%CI = 1.12–1.62, p < 0.001). Interestingly, such associations were not attributable to individual altered components of MetS nor to their sum. Incident disability in ADLs and IADLs were not explained by parallel decline in cognitive function. Conclusions MetS as an entity was associated with accelerated cognitive and functional decline in a population-based sample of very old men. [ABSTRACT FROM AUTHOR]

Conventional low-density lipoprotein cholesterol (LDL-C) quantification includes cholesterol attributable to lipoprotein(a) (Lp(a)-C) due to their overlapping densities. The purposes of this study were to compare the association between LDL-C and LDL-C corrected for Lp(a)-C (LDL Lp(a)corr) with incident coronary heart disease (CHD) in the general population and to investigate whether concomitant Lp(a) values influence the association of LDL-C or apolipoprotein B (apoB) with coronary events. Among 68,748 CHD-free subjects at baseline LDL Lp(a)corr was calculated as "LDL-C—Lp(a)-C," where Lp(a)-C was 30% or 17.3% of total Lp(a) mass. Fine and Gray competing risk-adjusted models were applied for the association between the outcome incident CHD and: 1) LDL-C and LDL Lp(a)corr in the total sample; and 2) LDL-C and apoB after stratification by Lp(a) mass (≥/<90th percentile). Similar risk estimates for incident CHD were found for LDL-C and LDL-C Lp(a) corr30 or LDL-C Lp(a) corr17.3 (subdistribution HR with 95% CI) were 2.73 (95% CI: 2.34-3.20) vs 2.51 (95% CI: 2.15-2.93) vs 2.64 (95% CI: 2.26-3.10), respectively (top vs bottom fifth; fully adjusted models). Categorization by Lp(a) mass resulted in higher subdistribution HRs for uncorrected LDL-C and incident CHD at Lp(a) ≥90th percentile (4.38 [95% CI: 2.08-9.22]) vs 2.60 [95% CI: 2.21-3.07]) at Lp(a) <90th percentile (top vs bottom fifth; P interaction 0.39). In contrast, apoB risk estimates were lower in subjects with higher Lp(a) mass (2.43 [95% CI: 1.34-4.40]) than in Lp(a) <90th percentile (3.34 [95% CI: 2.78-4.01]) (P interaction 0.49). Correction of LDL-C for its Lp(a)-C content provided no meaningful information on CHD-risk estimation at the population level. Simple categorization of Lp(a) mass (≥/<90th percentile) influenced the association between LDL-C or apoB with future CHD mostly at higher Lp(a) levels. [ABSTRACT FROM AUTHOR]

Highlights • Chronic kidney disease (CKD) might predict adverse health outcomes in old age. • Epidemiological data on the association of CKD with functional disability are limited. • We evaluated such a relationship using data from the population-based CARHES study. • CKD independently associated with greater disability in mobility, ADLs and IADLs. • Disability should be considered as a main outcome in the treatment of CKD patients. Abstract Objectives Chronic kidney disease (CKD) negatively impacts aging success. This study evaluates the association between CKD and functional disability, defined as limitations in performing mobility tasks, basic (ADLs) and instrumental activities of daily living (IADLs), in a population-based sample of older adults. In particular, we examined whether such a relationship extended to mild-moderate CKD stages (G1-G3ab). Methods Data from the Cardiovascular risk profile in Renal patients of the Italian Health Examination Survey (CARHES) study were used.Prevalence of CKD was estimated by means of urinary albumin to creatinine ratio (ACR) and eGFR (CKD-EPI equation-enzymatic assay of serum creatinine). A validated questionnaire was used to assess functional limitations. Potentially confounding variables, e.g. socio-demographic features, lifestyles, cardiovascular (CV) risk factors and prevalent CV diseases, were considered. Results 1309 participants, age 71.4 ± 4.3 years, 53.8% men, were studied. 15.2% of participants were identified as having CKD. Of these, 11.5% were aware of the condition. Prevalence of CKD increased with age, and was similar between men and women. Mild-moderate CKD was found to be significantly associated with disability in mobility (OR = 1.05, 95%CI =1.01–1.09, p =.014) and ADLs/IADLs (OR = 1.06, 95%CI = 1.02–1.12, p =.011) after multiple simultaneous adjustment including socio-demographic variables, CV risk profile, ACR, cognitive impairment and self-rated health. Conclusions Mild-moderate CKD independently associated with functional disability in a population-based sample of older adults. Evidence-based recommendations for disability prevention in CKD are needed. [ABSTRACT FROM AUTHOR]