Relationship of household salt intake level with long-term all-cause and cardiovascular disease mortality in Japan: NIPPON DATA80

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Abstract

In Asian countries, a major source of salt intake is from seasoning or table salt added at home. However, little is known about the adverse effects of salt intake evaluated according to household unit. We investigated the relationship between household salt intake level and mortality from all-cause and cardiovascular diseases (CVDs). Participants included 8702 individuals (56% women) who were living with someone else and who were aged 30–79 years and enrolled in the National Nutritional Survey of Japan in 1980 with a 24-year follow-up. Household nutrient intake was evaluated using a 3-day weighing record method in which all foods and beverages consumed by any of the household members were recorded. The household salt intake level was defined as the amount of salt consumed (g) per 1000 kcal of total energy intake in each household, and its average was 6.25 (2.02) g/1000 kcal. During the follow-up, there were 2360 deaths (787 CVD, 168 coronary heart disease [CHD], and 361 stroke). Cox proportional hazard ratios (HRs) for an increment of 2 g/1000 kcal in household salt intake were calculated and adjusting for sex, age, body mass index, smoking status, alcohol consumption status, self-reported work exertion level, household potassium intake, household saturated fatty acid intake, and household long-chain n-3 polyunsaturated fatty acid intake. The HRs (95% confidence intervals) were 1.07 (1.02, 1.12) for all-cause mortality, 1.11 (1.03, 1.19) for CVD, 1.25 (1.08, 1.44) for CHD, and 1.12 (1.00, 1.25) for stroke. The household salt intake level was significantly associated with long-term risk of all-cause, CVD, CHD, and stroke mortality in a representative Japanese population.

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Acknowledgements

The authors are deeply indebted to public health centers that cooperated in this study and the staff members of the NIPPON DATA80 research group. We also thank Analisa Avila, ELS, of Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

For the NIPPON DATA80 Research Group

Hirotsugu Ueshima1,3, Akira Okayama9, Tomonori Okamura8, Shigeyuki Saitoh10, Kiyomi Sakata11, Atsushi Hozawa12, Takehito Hayakawa13, Yosikazu Nakamura14, Nobuo Nishi4, Nagako Okuda5, Takayoshi Ohkubo15, Fumiyoshi Kasagi16, Yoshitaka Murakami17, Toru Izumi18, Yasuhiro Matsumura19, Toshiyuki Ojima20, Koji Tamakoshi21, Hideaki Nakagawa22, Yoshikuni Kita23, Katsuyuki Miura1,3, Aya Kadota1, Akira Fujiyoshi7, Naomi Miyamatsu2, Yasuyuki Nakamura24, Katsushi Yoshita6, Yoshihiro Miyamoto25, Kazunori Kodama26 and Yutaka Kiyohara27

Funding

This study was supported by a grant-in-aid from the Ministry of Health, Labor and Welfare, under the auspices of the Japanese Association for Cerebro-cardiovascular Disease Control; a Research Grant for Cardiovascular Diseases (7A-2) from the Ministry of Health, Labor and Welfare; Health and Labor Sciences Research Grants, Japan (Comprehensive Research on Aging and Health) [H11-Chouju-046, H14-Chouju-003, H17-Chouju-012, H19-Chouju-Ippan-014]; and Comprehensive Research on Lifestyle Related Diseases, including Cardiovascular Diseases and Diabetes Mellitus [H22-Junkankitou-Seishuu-Sitei-017, H25-Junkankitou-Seishuu-Sitei-022, H30-Junkankitou-Seishuu-Sitei-002]).

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Correspondence to Katsuyuki Miura.

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Members of the NIPPON DATA80 Research Group are listed below Acknowledgement.

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Shima, A., Miyamatsu, N., Miura, K. et al. Relationship of household salt intake level with long-term all-cause and cardiovascular disease mortality in Japan: NIPPON DATA80. Hypertens Res 43, 132–139 (2020) doi:10.1038/s41440-019-0349-9

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Keywords

  • Household
  • Salt intake
  • Cardiovascular diseases
  • Cohort study