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The association between dietary sodium intake, adiposity and sugar-sweetened beverages in children and adults: a systematic review and meta-analysis

Published online by Cambridge University Press:  15 October 2020

Carley A. Grimes*
Affiliation:
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3216, Australia
Kristy A. Bolton
Affiliation:
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3216, Australia
Alison B. Booth
Affiliation:
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3216, Australia
Durreajam Khokhar
Affiliation:
School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia
Carrie Service
Affiliation:
School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia
Feng H. He
Affiliation:
Wolfson Institute of Preventative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
Caryl A. Nowson
Affiliation:
Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3216, Australia
*
*Corresponding author: Dr Carley A. Grimes, email carley.grimes@deakin.edu.au

Abstract

Higher intakes of Na may contribute to weight gain. The primary aim of this systematic review and meta-analysis was to examine the relationship between dietary Na intake and measures of adiposity in children and adults. Given the previous link between Na intake and the consumption of sugar-sweetened beverages (SSB), which are a known risk factor for obesity, a secondary aim examining the relationship between Na intake and SSB consumption was assessed. A systematic literature search identified cross-sectional and longitudinal studies and randomised controlled trials (RCT) which reduced dietary Na (≥3 months). Meta-analysis was performed for outcomes with ≥3 studies. Cross-sectionally higher Na intakes were associated with overweight/obesity in adults (five studies; n 11 067; OR 1·74; 95 % CI 1·43, 2·13) and in children (three studies; n 3625, OR 3·29; 95 % CI 2·25, 4·80), and abdominal obesity (five studies; n 19 744; OR 2·04; 95 % CI 1·72, 2·42) in adults. Overall, associations remained in sensitivity analyses which adjusted for energy. Findings from longitudinal studies were inconsistent. RCT in adults indicated a trend for lower body weight on reduced-Na compared with control diets (fifteen studies; n 5274; −0·29 kg; 95 % CI −0·59, 0·01; P = 0·06); however, it is unclear if energy intakes were also altered on reduced-Na diets. Among children higher Na intakes were associated with higher intake of SSB (four studies, n 10 329, b = 22, 16 and 26 g/d); no studies were retrieved for adults. Overall, there was a lack of high-quality studies retrieved. While cross-sectional evidence indicates Na intake was positively associated with adiposity, these findings have not been clearly confirmed by longitudinal studies or RCT.

Type
Full Papers
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Nutrition Society

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