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      The Association between Salt Taste Perception, Mediterranean Diet and Metabolic Syndrome: A Cross-Sectional Study

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          Abstract

          Metabolic syndrome (MetS) is a widespread disorder and an important public health challenge. The purpose of this study was to identify the association between salt taste perception, Mediterranean diet and MetS. This cross-sectional study included 2798 subjects from the general population of Dalmatia, Croatia. MetS was determined using the Joint Interim Statement definition, and Mediterranean diet compliance was estimated using Mediterranean Diet Serving Score. Salt taste perception was assessed by threshold and suprathreshold testing (intensity and hedonic perception). Logistic regression was used in the analysis, adjusting for important confounding factors. As many as 44% of subjects had MetS, with elevated waist circumference as the most common component (77%). Higher salt taste sensitivity (lower threshold) was associated with several positive outcomes: lower odds of MetS (OR = 0.69; 95% CI 0.52–0.92), lower odds for elevated waist circumference (0.47; 0.27–0.82), elevated fasting glucose or diabetes (0.65; 0.45–0.94), and reduced HDL cholesterol (0.59; 0.42–0.84), compared to the higher threshold group. Subjects with lower salt taste threshold were more likely to consume more fruit, and less likely to adhere to olive oil and white meat guidelines, but without a difference in the overall Mediterranean diet compliance. Salt taste intensity perception was not associated with any of the investigated outcomes, while salty solution liking was associated with MetS (OR = 1.85, CI 95% 1.02–3.35). This study identified an association between salt taste perception and MetS and gave a new insight into taste perception, nutrition, and possible health outcomes.

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          Sodium Intake and Hypertension

          The close relationship between hypertension and dietary sodium intake is widely recognized and supported by several studies. A reduction in dietary sodium not only decreases the blood pressure and the incidence of hypertension, but is also associated with a reduction in morbidity and mortality from cardiovascular diseases. Prolonged modest reduction in salt intake induces a relevant fall in blood pressure in both hypertensive and normotensive individuals, irrespective of sex and ethnic group, with larger falls in systolic blood pressure for larger reductions in dietary salt. The high sodium intake and the increase in blood pressure levels are related to water retention, increase in systemic peripheral resistance, alterations in the endothelial function, changes in the structure and function of large elastic arteries, modification in sympathetic activity, and in the autonomic neuronal modulation of the cardiovascular system. In this review, we have focused on the effects of sodium intake on vascular hemodynamics and their implication in the pathogenesis of hypertension.
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            High salt intake causes leptin resistance and obesity in mice by stimulating endogenous fructose production and metabolism

            High salt intake is common in Western diets and likely contributes to hypertension and cardiovascular disease. Recently high salt intake has also been found to both be associated and predict the development of obesity, insulin resistance, and metabolic syndrome. Here we show that high-salt diet activates the aldose reductase (polyol) pathway in the liver, resulting in endogenous fructose production that then induces leptin resistance and the development of metabolic syndrome and fatty liver. Blocking fructose metabolism blocks the effects of high-salt diet. High salt intake also predicts diabetes and nonalcoholic fatty liver disease in Japanese adults. Thus, high-salt diet, an essential micronutrient with no intrinsic caloric value, may have a contributory role in driving obesity and diabetes. Dietary guidelines for obesity typically focus on three food groups (carbohydrates, fat, and protein) and caloric restriction. Intake of noncaloric nutrients, such as salt, are rarely discussed. However, recently high salt intake has been reported to predict the development of obesity and insulin resistance. The mechanism for this effect is unknown. Here we show that high intake of salt activates the aldose reductase–fructokinase pathway in the liver and hypothalamus, leading to endogenous fructose production with the development of leptin resistance and hyperphagia that cause obesity, insulin resistance, and fatty liver. A high-salt diet was also found to predict the development of diabetes and nonalcoholic fatty liver disease in a healthy population. These studies provide insights into the pathogenesis of obesity and diabetes and raise the potential for reduction in salt intake as an additional interventional approach for reducing the risk for developing obesity and metabolic syndrome.
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              Prevalence and Trends of Overweight and Obesity in European Children From 1999 to 2016

              Studies of trends in excess weight among European children throughout the last few decades have rendered mixed results. Additionally, some studies were outdated, were based on self-reported weight and height, or included only a few European countries.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                22 April 2020
                April 2020
                : 12
                : 4
                : 1164
                Affiliations
                [1 ]University of Split School of Medicine, Šoltanska 2, 21 000 Split, Croatia; veceknika@ 123456gmail.com (N.N.V.); ruzica.dragun@ 123456yahoo.com (R.D.); ajka.relja@ 123456mefst.hr (A.P.)
                [2 ]Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA; lmucalo@ 123456mcw.edu
                [3 ]Department of Endocrinology and Diabetology, University Hospital Center Split, Šoltanska 1, 21 000 Split, Croatia; tanja.milicevic2@ 123456gmail.com
                [4 ]Bioinformatics and Omics Data Science Platform, Berlin Institute for Medical Systems Biology, Max-Delbrück Center for Molecular Medicine, 13092 Berlin, Germany; inga.patarcic@ 123456mdc-berlin.de
                [5 ]MRC Human Genetics Unit, IGMM, University of Edinburgh, Edinburgh EH4 2XU, UK; caroline.hayward@ 123456igmm.ed.ac.uk
                [6 ]Department of Public Health, University of Split School of Medicine, Šoltanska 2, 21 000 Split, Croatia; opolasek@ 123456mefst.hr
                Author notes
                [* ]Correspondence: ikolcic@ 123456mefst.hr
                Author information
                https://orcid.org/0000-0003-3083-6880
                https://orcid.org/0000-0001-7918-6052
                Article
                nutrients-12-01164
                10.3390/nu12041164
                7230181
                32331287
                4007f016-9868-4441-a84a-12b85cff174b
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 27 March 2020
                : 20 April 2020
                Categories
                Article

                Nutrition & Dietetics
                salt taste perception,taste threshold,sodium chloride,metabolic syndrome,mediterranean diet

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