Recipient Organization
FLORIDA STATE UNIVERSITY
118 N. WOODWARD AVE
TALLAHASSEE,FL 32306
Performing Department
(N/A)
Non Technical Summary
Consuming too much sodium is a major contributor to cardiovascular disease, which is the number one cause of death for Americans. One way that excess dietary sodium leads to cardiovascular disease is by damaging the health of our blood vessels, which leads to a condition called endothelial dysfunction. Endothelial dysfunction is the key precursor to atherosclerosis, which can ultimately lead to a heart attack or stroke. Endothelial function is not typically measured in clinical settings, and impairments in endothelial function may develop long before we experience any symptoms. Previous work has shown that a high sodium diet impairs endothelial function even in healthy young adults with no cardiovascular disease risk factors. This suggests that early intervention is critical for cardiovascular disease prevention. Unfortunately, most Americans consume sodium in excess of current recommendations. Significant research and public health efforts have been devoted to helping individuals reduce their sodium intake, with mixed success. It is difficult for individuals to reduce their sodium intake as it is widely distributed in our food supply, making it difficult to avoid. Thus, rather than focusing on reducing sodium intake at the individual level, identifying strategies to offset the effects of sodium are warranted. Potassium has shown promise as a potential dietary component that can mitigate sodium-induced endothelial dysfunction, even in young adults. Most importantly, increasing potassium intake has been shown to improve endothelial function even if sodium intake remains high. This suggests potassium may be a key dietary component to target for reducing cardiovascular disease risk.To date, the beneficial effects of potassium for mitigating sodium-induced endothelial dysfunction have only been demonstrated in controlled feeding studies. In these studies, researchers provide participants with carefully designed and prepared meals that contain the exact amount of potassium and other nutrients that they want participants to consume; study participants do not need to make any conscious changes to their diet, other than eating the food they are provided. What remains unknown is whether individuals, with guidance, can successfully increase their potassium intake to a sufficient level to experience improvements in endothelial function outside of these highly controlled studies in real-life settings. This is a major gap in our knowledge, which our study aims to fill. The overall purpose of our study is to compare the effectiveness of an intervention focused on helping healthy young adults increase their potassium intake (>4,700 mg/day) against an intervention focused on reducing sodium intake (<1,500 mg/day) for achieving the stated dietary goals as well as improving endothelial function. The proposed project is innovative because it shifts public health focus to promoting potassium intake rather than reducing sodium intake, which challenges established dogmas. Participants in our study will be randomly assigned to receive individualized nutrition education focused on either increasing potassium intake or lowering sodium intake. Education will be delivered through weekly, one-on-one sessions for four weeks. After the four weeks, we will follow up with participants every two months for six months to assess their dietary changes (i.e. changes in potassium and sodium intake) as well as changes in their endothelial function. We hypothesize that participants will have an easier time achieving a self-selected high potassium diet compared to a self-selected low sodium diet, which will result in greater improvements in endothelial function. Our study will be the first to examine the effects of increasing potassium intake via education and counseling on endothelial function. The long-term goal of our work is to implement effective, self-sustaining dietary intervention strategies to mitigate the effects of excess sodium intake on cardiovascular disease risk factors. Our work will set the foundation for developing more effective clinical and dietary guidelines and public health programs to reduce cardiovascular disease burden. Identifying novel strategies to offset the effects of sodium in adults will ensure USDA and other federal resources are used effectively to improve the health of Americans.
Animal Health Component
100%
Research Effort Categories
Basic
0%
Applied
100%
Developmental
0%
Goals / Objectives
We know that most people exceed sodium intake guidelines, and consuming excess sodium can increase cardiovascular disease risk; unfortunately, it can be challenging for individuals to lower their sodium intake. Previous work from controlled feeding studies has shown that increasing potassium intake is equally as effective at improving cardiovascular health as reducing sodium intake in young adults. The major goal of this project is to explore whether providing resources and education to help individuals adopt a high potassium diet on their own results in more sustainable dietary changes, and ultimately better improvements in cardiovascular health, compared to education centered on reducing sodium intake.The specific objectives are:To determine whether providing four one-one-one educational sessions focused on adopting a high-potassium diet (>4,700 mg/d)leads to greater compliance with the dietary goals over the subsequent six months compared to similar educational sessions focused on adopting a low-sodium diet (<1,500 mg/d)in healthy young adults.To examine whether providing four one-one-one educational sessions focused on adopting a high-potassium diet (>4,700 mg/d) leads to greater improvements in endothelial function compared to similar educational sessions focused on adopting a low-sodium diet (<1,500 mg/d)in healthy young adults.
Project Methods
Eligible adults ages 18-45 who enroll in the study will be randomly assigned to receive comprehensive dietary education on adopting either a low sodium diet (<1,500 mg/day) or a high potassium diet (>4,700 mg/day) in once weekly individual sessions over the course of four weeks. Participants assigned to the high-potassium intervention will not receive any education related to sodium intake; participants assigned to the low-sodium intervention will not receive any education related to potassium intake. The educational sessions will be delivered by graduate students in nutrition science who are trained and mentored by a registered dietitian faculty member. After the four-week intervention, we will follow up with participants to assess changes in dietary intake and endothelial functionevery two months for six months total. Dietary compliance will be assessed using 3-day diet records, which will be analyzed using specialized software with the most comprehensive database available for analyzing dietary data. Dietary compliance will also be measured using 24-hour urinary sodium and potassium excretion, which provides an accurate biomarker of sodium and potassium intake. A significant increase in self-reported potassium intake and a significant increase in urinary potassium excretion in the group assigned to receive education related to potassium intake over the 6-month follow-up period is indicative of a successful intervention. Similarly, a significant decrease in self-reported sodium intake and urinary sodium excretion is indicative of a successful intervention.Endothelial function will be measured using brachial artery flow-mediated dilation (FMD), a non-invasive method that uses ultrasonography to obtain images of the brachial artery before and after reactive hyperemia induced by a small blood pressure cuff. FMD videos are analyzed using edge-detection software to calculate changes in the diameter of the artery during the 8-minute procedure, and results are reported as the percent change in arterial diameter (%FMD). A larger %FMD is indicative of a healthier artery; thus, a significant increase in %FMD over the 6-month follow-up period is indicative of a successful intervention.