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Background and aim: Excess sodium intake is a recognised causal factor of hypertension and its cardiovascular complications, there is however a lack of practical instruments to assess and monitor the level of knowledge and behaviour about dietary salt intake and to relate these factors to the population general dietary habits. Methods and Results: A self-administered questionnaire was developed to assess the salt and health related knowledge and behaviour of the Italian population through an online survey. A sample of 11,618 Italian participants completed the questionnaire. The degree of knowledge and the reported behaviour about salt intake were both found to be related to age, gender, home region, level of education and occupation. There was a significant interrelation between salt knowledge and behaviour and both were significantly and directly related to the degree of adherence to a Mediterranean-like dietary pattern. A hierarchical evaluation was also made of the relevance of any single question to the overall assessment of knowledge and behaviour about salt intake. Conclusions: The study population overall appeared to have a decent level of knowledge about salt, but a less satisfactory behaviour. Our findings point to social inequalities and young age as the main factors having a negative impact on knowledge and behaviour about salt intake as part of generally inadequate dietary habits. The degrees of knowledge and behaviour were significantly and directly interrelated, confirming that improving knowledge is a key step for behavioural changes, and suggesting that educational campaigns are crucial for the implementation of good practices in nutrition.

Arterial stiffness is an independent cardiovascular risk factor and sodium intake could be a determinant of arterial stiffness. Nevertheless, the studies that investigated the effect of reducing dietary sodium intake on arterial stiffness in humans provided inconsistent results. Therefore, we performed a systematic review and a meta-analysis of the available randomized controlled trials of salt restriction and arterial stiffness to try and achieve more definitive conclusions. A systematic search of the online databases available (from 1996 through July 2017) was conducted including randomized controlled trials that reported arterial stiffness, expressed by carotid–femoral pulse wave velocity (PWV), as difference between the effects of two different sodium intake regimens. For each study, the mean difference and 95% confidence intervals were pooled using a random effect model. Sensitivity, heterogeneity, publication bias, subgroup and meta-regression analyses were performed. Eleven studies met the predefined inclusion criteria and provided 14 cohorts with 431 participants and 1–6 weeks intervention time. In the pooled analysis, an average reduction in sodium intake of 89.3 mmol/day was associated with a 2.84% (95% CI: 0.51–5.08) reduction in PWV. There was no significant heterogeneity among studies and no evidence of publication bias was detected. No single feature of the studies analyzed seemed to impact on the effect of salt restriction on PWV. The results of this meta-analysis indicate that restriction of dietary sodium intake reduces arterial stiffness. This effect seems be at least in part independent of the changes in blood pressure.

Background and aims Recently, some studies have indicated that a new anthropometric index, body adiposity index (BAI), could be more strongly correlated with the percentage of body fat than BMI. However, the results on its role in predicting cardiovascular risk were not univocal. Therefore, the aim of our study was to compare the predictive role of BMI and BAI on risk of hypertension (HP), blood pressure (BP) changes, and subclinical organ damage after an 8-year follow-up, in a sample of adult men participating in the Olivetti Heart Study. Methods and results Participants were 350 untreated normotensive men without diabetes, examined twice at baseline (1994–95) and after 8 years of follow-up [2002–04]. BMI was expressed as kg/m2. BAI was calculated according to the following formula: [(hip circumference (cm)/height1.5 (m)) − 18]. Subclinical organ damage was detected by urinary albumin excretion (UAE) and left ventricular mass, evaluated by the Cornell product (CP). At baseline, BAI and BMI were both associated with diastolic blood pressure (DBP) and mean arterial pressure (MAP). After 8 years, both baseline BAI and BMI were associated with changes (Δ) in systolic BP, MAP and pulse pressure, while only BMI was also positively related to ΔDBP. Analysis of HP incidence showed that both indices were significant predictors of HP. In addition, both BAI and BMI were significantly associated with ΔUAE, but not with ΔCP. Analysis of the changes in BAI and BMI confirmed these results, as the two indices were significantly associated with risk of HP and changes in BP and UAE, but not with changes in CP. Conclusions In this sample of healthy adult men, BAI and BMI were significant predictors of risk of HP and changes in BP, after an 8-years follow-up. In addition both indices predicted UAE changes, but neither was associated with the CP changes.