Hand Grip Force-Time Curve Indicators Evaluated by Dynamometer: A Systematic Review.

BACKGROUND: Handgrip strength (HGS) is an indicator of muscular strength, used in the diagnosis of sarcopenia, undernutrition, and physical frailty as well as recovery. Typically, the maximum HGS value is used; however, recent evidence suggests the exploration of new indicators provided based on the force-time curve to achieve a more comprehensive assessment of muscle function. Therefore, the objective was to identify indicators of the HGS profile beyond maximum HGS, based on force-time curves, and to systematize knowledge about their applications to various types of samples, health issues, and physical performance. METHODS: A systematic review was performed including studies whose participants' HGS was assessed with a digital or adapted dynamometer. The outcome measures were HGS profile indicators calculated from the force-time curve. RESULTS: a total of 15 studies were included, and the following indicators were identified: grip fatigue, fatigability index, fatigue rate, fatigue resistance, time to 80% maximal voluntary contraction, plateau coefficient of variability, time to maximum value, T-90%, release rate, power factor, grip work, average integrated area, endurance, cycle duration, time between cycles, maximum and minimum force-velocity, rate of grip force, final force, inflection point, integrated area, submaximal control, and response time. CONCLUSIONS: Various indicators based on the force-time curve can be assessed through digital or adapted dynamometers. Future research should analyze these indicators to understand their implications for muscle function assessment, to standardize evaluation procedures, to identify clinically relevant measures, and to clarify their implications in clinical practice.

Iodine intake assessment in the staff of a Porto region university (Portugal): the iMC Salt trial.

PURPOSE: Iodine deficiency disorder (IDD) is an ongoing worldwide recognized problem with over two billion individuals having insufficient iodine intake. School-aged children and pregnant women are often target groups for epidemiological studies, but there is a lack of knowledge on the general adult population. The aim of this study was to assess the iodine status among a Portuguese public university staff as a proxy for the adult working population. METHODS: The population study covered 103 adults within the iMC Salt randomized clinical trial, aged 24-69 years. Urinary iodine concentration was measured spectrophotometrically using the Sandell-Kolthoff reaction. Iodine food intake was assessed using a 24-h dietary recall. The contribution of discretionary salt to the iodine daily intake was assessed through 24-h urinary sodium excretion (UIE) and potentiometric iodine determination of household salt. RESULTS: The mean urine volume in 24 h was 1.5 L. The median daily iodine intake estimated from 24-h UIE was 113 µg/day, being lower among women (p < 0.05). Only 22% of participants showed iodine intake above the WHO-recommended cutoff (150 µg/day). The median daily iodine intake estimated from the 24-h dietary recall was 58 µg/day (51 and 68 µg/day in women and men, respectively). Dairy, including yoghurt and milk products, were the primary dietary iodine source (55%). Iodine intake estimated from 24-h UIE and 24-h dietary recall was moderately correlated (Spearman rank correlation coefficient r = 0.34, p < 0.05). The average iodine concentration in household salt was 14 mg I/kg, with 45% of the samples below the minimum threshold preconized by WHO (15 mg I/kg). The contribution of discretionary salt to the daily iodine intake was around 38%. CONCLUSION: This study contributes new knowledge about iodine status in Portuguese working adults. The results revealed moderate iodine deficiency, particularly in women. Public health strategies and monitoring programs are needed to ensure iodine adequacy in all population groups.

Salt-Related Knowledge, Attitudes and Behavior in an Intervention to Reduce Added Salt When Cooking in a Sample of Adults in Portugal.

(1) Background: Excessive salt intake is associated with an increased risk of hypertension and cardiovascular disease, so reducing it is critical. The main objective of this study was to verify whether one intervention to reduce added salt during cooking changed knowledge, attitudes and behavior (KAB) towards salt, and to analyze changes in the main sources of salt. (2) Methods: The intervention study was an 8-week randomized controlled trial with 97 workers from a public university. KAB in relation to salt were obtained through the WHO STEPwise questionnaire, and the main sources of salt were obtained by 24-h food recall and 24 h urinary sodium excretion over two days. (3) Results: After the intervention, participants in the intervention group reported a decrease in the addition of salt when cooking (p = 0.037), an increase in the percentage of subjects who avoided the consumption of processed foods (from 54.2% to 83.3%, p = 0.001), who looked for salt on food labels (from 18.8% to 39.6%, p = 0.013), and who bought low-salt food alternatives (from 43.8% to 60.4%, p = 0.039). However, there were no significant differences between the intervention group and the control group at baseline and post-intervention assessments. In the intervention group, after the intervention, the added salt decreased by 5%; food sources of salt such as the snacks and pizza group decreased by 7%, and the meat, fish and eggs group increased by 4%, but without statistical significance. (4) Conclusions: With innovative equipment for dosing salt when cooking, it is possible to change some dimensions of consumer behavior in relation to salt.

Pilot Study to Reduce Added Salt on a University Canteen through the Use of an Innovative Dosage Equipment.

BACKGROUND: This study aims to demonstrate the practical application of an innovative easy-to-use equipment to dosage cooking salt, and evaluate the effectiveness in reducing 30% of the added salt in meals and the impact on consumer's satisfaction and food waste. METHODS: Two canteens from one public university where randomized in one control arm and one intervention arm. The first step was to evaluate the salt added to food through atomic emission spectrophotometry in both canteens, and the second step was to perform gradual reductions of up to 30% of cooking salt in the intervention canteen using the Salt Control-C (SC-C) equipment. Consumer acceptability was assessed through satisfaction questionnaires and food waste was evaluated by weighing. RESULTS: The intervention canteen achieved to a reduction of more than 30% of added salt in soup (-34.3% per 100 g), fish dish (-41.1% per 100 g) and meat dish (-48.0% per 100 g), except for the vegetarian dish (6.1% per 100 g). There was no decrease in consumer satisfaction, with a significant satisfaction increase of 15.7% (p = 0.044) regarding the flavor of the main dish. Also, no significant differences were found in food waste. CONCLUSIONS: SC-C seems to be effective in reducing 30% of added salt levels in canteen meals, and may be a good strategy to control and reach adequate levels of added salt in meals served outside-the-home, promoting benefits to the individual's health.

High Adherence to Mediterranean Diet Is Not Associated with an Improved Sodium and Potassium Intake.

Prevention and control of hypertension and cerebro-cardiovascular diseases are associated with adequate sodium and potassium intake and adherence to a Mediterranean dietary pattern. The aim of this study was to assess the association between adherence to a Mediterranean diet (MD) and the excretion of sodium and potassium as surrogate measures of intake. This is a cross-sectional analysis as part of a larger study (the iMC SALT randomized controlled trial) among workers of a public university. A food frequency questionnaire was used to assess the adherence to MD, using the alternative Mediterranean diet (aMED) score; sodium and potassium excretions were estimated by 24-h urine collections. Sociodemographic and other lifestyle characteristics were also obtained. The associations between the adherence to MD and Na and K excretion were calculated by logistic regression, adjusting for confounding variables. From the 109 selected participants, seven were excluded considering urine screening and completeness criteria, leaving a final sample of 102 subjects (48% male, average age 47 years). Mean sodium and potassium excretion were 3216 mg/day and 2646 mg/day, respectively. Sodium and potassium excretion were significantly higher in men, but no differences were found according to different levels of MD adherence. In logistic regression analysis, sodium, potassium, and sodium-to-potassium ratio urinary excretion tertiles were not associated with MD adherence (low/moderate versus high), even after adjustment for confounding variables. A high adherence to MD was thus not associated with a different level of sodium and potassium intake.

Impact of an Innovative Equipment to Monitor and Control Salt Usage during Cooking at Home on Salt Intake and Blood Pressure-Randomized Controlled Trial iMC SALT.

(1) Background: Excessive salt consumption is associated with an increased risk of hypertension and cardiovascular disease, and it is essential to reduce it to the level recommended by the World Health Organization (<5 g/day). The main objective of this study is to verify the impact of an intervention, which used the Salt Control H equipment to reducing salt consumption; (2) Methods: The study was an 8-week randomized control trial with 114 workers from a public university. The intervention group (n = 57) used the equipment to monitor and control the use of salt during cooking (Salt Control H) at home for 8 weeks. The primary outcome was 24 h urinary sodium excretion as a proxy of salt intake. Secondary outcomes included changes in 24 h urinary potassium excretion, sodium to potassium ratio (Na:K), and blood pressure. (3) Results: There was a decrease in sodium intake after the intervention but with no statistical significance. When analyzing the results by sex and hypertension status, there was a reduction in sodium (-1009 (-1876 to -142), p = 0.025) and in Na:K ratio (-0.9 (-1.5 to -0.3), p = 0.007) in hypertensive men in the intervention group. (4) Conclusions: Interventions with dosage equipment can be valid approaches in individual salt reduction strategies, especially in hypertensive men.

Interventions That Successfully Reduced Adults Salt Intake-A Systematic Review.

BACKGROUND: Adequate sodium intake is important for lowering blood pressure and thus reducing cardiovascular disease risk and other complications. The aim of this review is to identify recent interventions around the world that have been successful in reducing salt intake. METHODS: A search in the PubMed, Web of Science and Scopus databases was performed. We include studies published in the last 10 years; randomized trials, pilot intervention without a control arm or experimental study; adult participants; and interventions that successfully reduced salt intake. Study quality was assessed. RESULTS: We included 21 studies, 16 randomized intervention trials and five nonrandomized intervention studies. Eleven interventions described health and nutritional education, seven interventions described nutritional education plus other interventions, and three studies used salt meters to reduce sodium intake. CONCLUSION: Health and nutritional education, nutritional education plus other interventions and estimates of salt intake showed success in the reduction of salt consumption. There is no evidence that one type of intervention analyzed is more effective than other in reducing salt consumption, so we must analyze each in which individuals or subpopulations will have the intervention performed and use the most suitable approaches to lead to better results.

Innovative equipment to monitor and control salt usage when cooking at home: iMC SALT research protocol for a randomised controlled trial.

INTRODUCTION: Excessive salt intake is a public health concern due to its deleterious impact on health. Most of the salt consumed come from those that are added when cooking. This study will improve knowledge on the effectiveness of interventions to reduce salt consumption among consumers. METHODS AND ANALYSIS: In this randomised clinical trial, we will be evaluating the efficacy of an intervention-the Salt Control H, an innovative prototype equipment to monitor and control use of salt when cooking-among workers from a public university, with the aim of reducing their dietary salt intake. We will randomly select 260 workers who meet the eligibility criteria and who are enrolled to an occupational health appointment and randomise them into one of the two arms of the study (either control or intervention), with matched baseline characteristics (sex and hypertension). The intervention will last for 8 weeks, during which the participants will use the equipment at home to monitor and control their use of salt when cooking. The main outcome will be 24-hour urinary sodium excretion at baseline, at fourth and eighth weeks of intervention, and at 6 months after intervention. ETHICS AND DISSEMINATION: Ethical approval for the study has been obtained from the Ethics Committee of the Centro Hospitalar Universitário São João. The results of the investigation will be published in peer-reviewed scientific papers and presented at international conferences. TRIAL REGISTRATION NUMBER: NCT03974477 EQUIPMENT PROVISIONAL PATENT NUMBER: Registered at INPI: 20191000033265.