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Research Update 科 研 动 态Recent ResearchFindings on Dietand NutritionalTherapyCompiled by Kevin Chen, Ph.D.Effect of lower sodium intake on health: systematicreview and meta-analyses. BMJ. 2013 Apr 3;346:f1326. By Aburto NJ, Ziolkovska A, HooperL, et al. from Dept of Nutrition for Health and Development,World Health Organization, Switzerland.nancy.aburto@wfp.orgOBJECTIVE: To assess the effect of decreasedsodium intake on blood pressure, related cardiovasculardiseases, and potential adverse effectssuch as changes in blood lipids, catecholaminelevels, and renal function.DATA SOURCES: Cochrane Central Registerof Controlled Trials, Medline, Embase, WHO InternationalClinical Trials Registry Platform, theLatin American and Caribbean health science literaturedatabase, and the reference lists of previousreviews.STUDY SELECTION: Randomised controlledtrials (RCT) and prospective cohort studies innon-acutely ill adults and children assessing therelations between sodium intake and blood pressure,renal function, blood lipids, and catecholaminelevels, and in non-acutely ill adults all causemortality, cardiovascular disease, stroke, andcoronary heart disease. Potential studies werescreened independently and in duplicate andstudy characteristics and outcomes extracted.When possible we conducted a meta-analysis toestimate the effect of lower sodium intake usingthe inverse variance method and a random effectsmodel. We present results as mean differencesor risk ratios, with 95% confidence intervals.RESULTS: We included 14 cohort studies andfive RCTs reporting all cause mortality, cardiovasculardisease, stroke, or coronary heart disease;and 37 RCTs measuring blood pressure, renalfunction, blood lipids, and catecholamine levels inadults. Nine controlled trials and one cohortstudy in children reporting on blood pressurewere also included. In adults a reduction in sodiumintake significantly reduced resting systolicblood pressure by 3.39 mm Hg (95% confidenceinterval 2.46 to 4.31) and resting diastolic bloodpressure by 1.54 mm Hg (0.98 to 2.11). When sodiumintake was 0.05). There were insufficient RCTs toassess the effects of reduced sodium intake onmortality and morbidity. The associations in cohortstudies between sodium intake and all causemortality, incident fatal and non-fatal cardiovasculardisease, and coronary heart disease werenon-significant (P>0.05). Increased sodium intakewas associated with an increased risk ofstroke (risk ratio 1.24, 95% confidence interval1.08 to 1.43), stroke mortality (1.63, 1.27 to2.10), and coronary heart disease mortality (1.32,1.13 to 1.53). In children, a reduction in sodiumintake significantly reduced systolic blood pressureby 0.84 mm Hg (0.25 to 1.43) and diastolicblood pressure by 0.87 mm Hg (0.14 to 1.60). CONCLUSIONS: High quality evidence in nonacutelyill adults shows that reduced sodium intakereduces blood pressure and has no adverseeffect on blood lipids, catecholamine levels, orrenal function, and moderate quality evidence inchildren shows that a reduction in sodium intakereduces blood pressure. Lower sodium intake isalso associated with a reduced risk of stroke andfatal coronary heart disease in adults. The totalityof evidence suggests that most people will likelybenefit from reducing sodium intake.Dietary fiber intake and risk of first stroke: a systematicreview and meta-analysis. Stroke. 2013June-July 2013 Yang-Sheng (Nurturing Life) 11