Dataset Information

Salt and potassium intake among adult Ghanaians: WHO-SAGE Ghana Wave 3.

ABSTRACT: Though Ghana has high hypertension prevalence, the country lacks current national salt consumption data required to build and enhance advocacy for salt reduction. We explored the characteristics of a randomly selected sub sample that had valid urine collection, along with matched survey, anthropometric and BP data (n = 839, mean age = 60y), from the World Health Organization's Study on global AGEing and adult health (WHO-SAGE), Ghana Wave 3, n = 3053). We also investigated the relationship between salt intake and blood pressure (BP) among the cohort. BP was measured in triplicate and 24 h urine was collected for the determination of urinary sodium (Na), potassium (K), creatinine (Cr) and iodine levels. Hypertension prevalence was 44.3%. Median salt intake was 8.3 g/day, higher in women compared to men (8.6, interquartile range (IQR) 7.5 g/day vs 7.5, IQR 7.4 g/day, p < 0.01), younger participants (18-49 y) compared to older ones (50+ y) (9.7, IQR 7.9 g/day vs 8.1, IQR 7.1 g/day, p < 0.01) and those with higher Body Mass Index (BMI) (> 30 kg/m²) compared to a healthy BMI (18.5-24.9 kg/m²) (10.04, IQR 5.1 g/day vs 6.2, IQR 5.6 g/day, p < 0.01). More than three quarters (77%, n = 647) of participants had salt intakes above the WHO maximum recommendation of 5 g/d, and nearly two thirds (65%, n = 548) had daily K intakes below the recommended level of 90 mmol. Dietary sodium to potassium (Na: K) ratios above 2 mmol/mmol were positively associated with increasing BP with age. Population-based interventions to reduce salt intake and increase K consumption are needed.

SUBMITTER: Menyanu EK

PROVIDER: S-EPMC7523323 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Salt and potassium intake among adult Ghanaians: WHO-SAGE Ghana Wave 3.

Menyanu Elias K EK Corso Barbara B Minicuci Nadia N Rocco Ilaria I Russell Joanna J Ware Lisa J LJ Biritwum Richard R Kowal Paul P Schutte Aletta E AE Charlton Karen E KE

BMC nutrition 20200929

Though Ghana has high hypertension prevalence, the country lacks current national salt consumption data required to build and enhance advocacy for salt reduction. We explored the characteristics of a randomly selected sub sample that had valid urine collection, along with matched survey, anthropometric and BP data (<i>n</i> = 839, mean age = 60y), from the World Health Organization's Study on global AGEing and adult health (WHO-SAGE), Ghana Wave 3, <i>n</i> = 3053). We also investigated the rela ...[more]

PMID: 33005430

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Project description:BackgroundIntegrated management of cardiometabolic diseases is crucial in improving the quality of life of older persons. The objective of the study was to identify clusters of cardiometabolic multimorbidity associated with moderate and severe disabilities in Ghana and South Africa.MethodsData were from the World Health Organization (WHO) study on global AGEing and adult health (SAGE) Wave-2 (2015) conducted in Ghana and South Africa. We analysed the clustering of cardiometabolic diseases including angina, stroke, diabetes, obesity, and hypertension with unrelated conditions such as asthma, chronic lung disease, arthritis, cataracts, and depression. The WHO Disability Assessment Instrument version 2.0 was used to assess functional disability. We used latent class analysis to calculate the multimorbidity classes and disability severity levels. Ordinal logistic regression was used to identify the clusters of multimorbidity associated with moderate and severe disabilities.ResultsData from 4,190 adults aged over 50 years were analysed. The prevalence of moderate and severe disabilities was 27.0% and 8.9% respectively. Four latent classes of multimorbidity were identified. These included a relatively healthy group with minimal cardiometabolic multimorbidity (63.5%), general and abdominal obesity (20.5%), hypertension, abdominal obesity, diabetes, cataracts, and arthritis (10.0%), and angina, chronic lung disease, asthma, and depression (6.0%). Compared to the participants with minimal cardiometabolic multimorbidity, the odds of moderate and severe disabilities were higher among participants with multimorbidity comprising hypertension, abdominal obesity, diabetes, cataract and arthritis [aOR = 3.0; 95% CI 1.6 to 5.6], and those with angina, chronic lung disease, asthma and depression [aOR = 2.7; 95% CI 1.6 to 4.5].ConclusionsCardiometabolic diseases among older persons in Ghana and South Africa cluster in distinct multimorbidity patterns that are significant predictors of functional disabilities. This evidence may be useful for defining disability prevention strategies and long-term care for older persons living with or at risk of cardiometabolic multimorbidity in sub-Saharan Africa.

Project description:Understanding the patterns of multimorbidity, defined as the co-occurrence of more than one chronic condition, is important for planning health system capacity and response. This study assessed the association of different cardiometabolic multimorbidity combinations with healthcare utilization and quality of life (QoL). Data were from the World Health Organization (WHO) study on global AGEing and adult health Wave 2 (2015) conducted in Ghana. We analysed the clustering of cardiometabolic diseases including angina, stroke, type 2 diabetes, and hypertension with unrelated conditions such as asthma, chronic lung disease, arthritis, cataract and depression. The clusters of adults with cardiometabolic multimorbidity were identified using latent class analysis and agglomerative hierarchical clustering algorithms. We used negative binomial regression to determine the association of multimorbidity combinations with outpatient visits. The association of multimorbidity clusters with hospitalization and QoL were assessed using multivariable logistic and linear regressions. Data from 3,128 adults aged over 50 years were analysed. We identified four distinct classes of multimorbidity: relatively "healthy class" with no multimorbidity (47.9%): abdominal obesity only (40.7%): cardiometabolic and arthritis class comprising participants with hypertension, type 2 diabetes, stroke, abdominal and general obesity, arthritis and cataract (5.7%); and cardiopulmonary and depression class including participants with angina, chronic lung disease, asthma, and depression (5.7%). Relative to the class with no multimorbidity, the cardiopulmonary and depression class was associated with a higher frequency of outpatient visits [β = 0.3; 95% CI 0.1 to 0.6] and higher odds of hospitalization [aOR = 1.9; 95% CI 1.0 to 3.7]. However, cardiometabolic and arthritis class was associated with a higher frequency of outpatient visits [β = 0.8; 95% CI 0.3 to 1.2] and not hospitalization [aOR = 1.1; 95% CI 0.5 to 2.9]. The mean QoL scores was lowest among participants in the cardiopulmonary and depression class [β = -4.8; 95% CI -7.3 to -2.3] followed by the cardiometabolic and arthritis class [β = -3.9; 95% CI -6.4 to -1.4]. Our findings show that cardiometabolic multimorbidity among older persons in Ghana cluster together in distinct patterns that differ in healthcare utilization. This evidence may be used in healthcare planning to optimize treatment and care.

Project description:ObjectiveThe WHO's global targets for non-communicable disease reduction recommend consumption of<5 g salt/day. In 2016, South Africa was the first country to legislate maximum salt levels in processed foods. South Africa's salt iodisation fortification programme has successfully addressed iodine deficiency but information is dated. Simultaneous monitoring of sodium reduction and iodine status is required to ensure compatibility of the two public health interventions.Design/setting/participantsA nested cohort design within WHO's 2015 Study on global AGEing and adult health (n=2887) including individuals from households across South Africa. Randomly selected adults (n=875) provided 24-hour and spot urine samples for sodium and iodine concentration analysis (the primary and secondary outcome measures, respectively). Median 24-hour urinary iodine excretion (UIE) and spot urinary iodine concentrations (UIC) were compared by salt intakes of <5g/day, 5-9g/dayand >9 g/day.ResultsMedian daily sodium excretion was equivalent to 6.3 g salt/day (range 1-43 g/day); 35% had urinary sodium excretion values within the desirable range (<5 g salt/day), 37% had high values (5-9 g salt/day) and 28% had very high values (>9 g salt/day). Median UIC was 130 µg/L (IQR=58-202), indicating population iodine sufficiency (≥100 µg/L). Both UIC and UIE differed across salt intake categories (p<0.001) and were positively correlated with estimated salt intake (r=0.166 and 0.552, respectively; both p<0.001). Participants with salt intakes of <5 g/day were not meeting the Estimated Average Requirement for iodine intake (95 µg/day).ConclusionsIn a nationally representative sample of South African adults, the association between indicators of population iodine status (UIC and UIE) and salt intake, estimated using 24-hour urinary sodium excretion, indicate that low salt intakes may compromise adequacy of iodine intakes in a country with mandatory iodisation of table salt. The iodine status of populations undergoing salt reduction strategies needs to be closely monitored to prevent re-emergence of iodine deficiency.

Project description:Agronomic biofortification is the deliberate use of mineral fertilizers to increase the concentration of a target mineral in edible portions of crops to increase dietary intake of the target mineral. Globally, increased dietary intake of potassium (K) is becoming a part of the strategy to address hidden hunger and related non-communicable diseases such as hypertension and cardiac disorders. This study aimed at demonstrating the efficacy of increasing the concentration of K in the edible portions of three commonly consumed but underutilized solanacea vegetables (Solanum aethiopicum, S. macrocarpon and S. torvum) in Ghana. The effects of different types and rates of K fertilizer application on the leaf- and fruit-K contents of the vegetables, as well as the K loss between the raw and cooked fruits were investigated. Five levels of each of three types of K fertilizer (liquid drench of potassium chloride, granular Muriate of potash and Sulphate of potash) were applied to each of the three field-grown vegetables. Yield data were collected and the fruits and leaves were analysed for the content of K, N, P, Ca, Fe, Zn and Cu. The results showed the rate of fertilizer application had significant effect on the yields of S. aethiopicum and macrocarpon but the yield of S. torvum was significantly affected by type, rate and interactive effect of type and rate of fertilizer application. Fruit K concentrations were greatest for S. aethiopicum (2130 mg K kg-1 DW) and S. torvum (1883 mg K kg-1 DW) with liquid KCl but with Sulphate of Potash for S. macrocarpon (1801 mg K kg-1 DW). There were higher K concentrations in leaves than in fruits of all the vegetables. Household cooking of the fruits resulted in the retention of over 70% of the K content in the raw fruits. Potassium fertilization increased the Ca, Fe, and Zn contents of S. aethiopicum and S. torvum. It is concluded that agronomic biofortification may be a useful strategy to increase K intakes and other important elements (e.g. Fe and Zn) in the vegetables studied.

Project description:BackgroundLongitudinal data on blood pressure changes in sub-Saharan African populations are limited despite a high hypertension burden. This study analysed systolic blood pressure (SBP) change and hypertension incidence among people from Ghana living in rural Ghana, urban Ghana, people from Ghana living in The Netherlands and a Dutch European population living in Amsterdam, The Netherlands.MethodsThe population-based Research on Obesity and Diabetes among African Migrants Prospective (RODAM-Pros) cohort study included adults aged ≥18 years at baseline (2012-2015) and follow-up (2019-2021) to study cardiovascular risk factors. At both timepoints, blood pressure (BP) was measured using a semiautomated device. Hypertension was defined as having a SBP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg or the use of antihypertensive medication. We compared age-standardised SBP change and hypertension incidence between the geographical locations via linear and Poisson regression analyses, with adjustment for age, follow-up time, education, baseline BP, body mass index, renal function, and diabetes mellitus. The study protocol was approved by the respective ethics committees in Ghana and The Netherlands.FindingsData from 632 people living in rural Ghana, 602 in urban Ghana, 861 Ghanaian, and 2038 Dutch people living in Amsterdam, were analysed (58.3% women, mean age at baseline 46.5 years, follow-up time 6·5 years). SBP increased most in women in rural Ghana (+9.5 mmHg, 95% confidence interval 7·3-11·7 mmHg), compared to +5·7 mmHg (3·6-7·7 mmHg) in urban Ghana, +2·2 mmHg (0·7-3·7 mmHg) in Ghanaian women in Amsterdam and -0·4 mmHg (-1·2 to 0·4 mmHg) in Dutch women. In men, SBP increased +5·5 mmHg (2·6-8·4 mmHg) in rural Ghana, +6·1 mmHg (2·8-9·5 mmHg) in urban Ghana, +2·1 mmHg (0·4-3·8 mmHg) in Ghanaian men in Amsterdam, and +0·3 mmHg (-0·5 to 1·1 mmHg) in Dutch men. Hypertension incidence ranged from 20·7% (95% confidence interval 14·3-29·2%) in men in rural Ghana to 34·2% (23·3-49·1%) in urban Ghana, vs. 27·9% (19·8-38·5%) in Ghanaian men in Amsterdam and 14·5% (11·8-17·6%) in Dutch men. Among women, incidence was 29·0% (23·1-35·9%) in rural Ghana, 27·6% (21·4-35·3%) in urban Ghana, 34·4% (26·0-45·4%) in Ghanaian women in Amsterdam, and 7·2% (5·6-9·2%) in Dutch women. Hypertension incidence rate ratios did not differ across populations, regardless of adjustment for covariates.InterpretationSBP and hypertension increases were more pronounced in rural and urban Ghana than among migrants from Ghana in The Netherlands, suggesting that urbanisation of cardiovascular risk profile now extends to rural sub-Saharan Africa.FundingEuropean Research Council (grant number 772244).

Dataset Information

Salt and potassium intake among adult Ghanaians: WHO-SAGE Ghana Wave 3.

Publications

Salt and potassium intake among adult Ghanaians: WHO-SAGE Ghana Wave 3.

Similar Datasets

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