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Prospective relevance of fruit and vegetable consumption and salt intake during adolescence for blood pressure in young adulthood

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Abstract

Purpose

Fruit and vegetable (FV) consumption and salt intake are known dietary influences on blood pressure (BP) in adults, but data on their long-term relevance during growth for later BP are rare. We aimed to examine the independent and concomitant influences of adolescent FV and salt intakes on BP in young adulthood.

Methods

In total, 206 participants (108 males) provided a plausible BP measurement in young adulthood (18–25 years) as well as three repeated 3-day weighed dietary records, 24-h urine samples and BP measurements during adolescence (11–16 years). FV intake was assessed based on dietary records and its urinary biomarkers such as potassium, oxalate and hippuric acid. Urinary sodium chloride (NaCl) was used to estimate salt intake. Prospective associations of adolescent FV and salt intake with adult BP were examined in sex-stratified linear regression models.

Results

In multivariable models, a 100 g higher FV intake during adolescence was prospectively related to 0.9 mmHg lower systolic BP in young adult females (P = 0.02), but not in males (P = 0.8). Biomarkers supported the findings for FV regarding systolic BP. Concurrently, a 1 g higher salt intake was related to 1.7 mmHg higher systolic BP in young men only (P = 0.01). For diastolic BP, results were inconsistent.

Conclusions

Our findings suggest that in adolescent healthy girls, a higher FV intake may be more relevant for BP than a reduced salt intake and the opposite appears to apply for boys. The physiological implications of the observed sex-specific diet–BP relationships need deeper examination.

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References

  1. WHO (2009) Global health risks: mortality and burden of disease attributable to selected major risks. World Health Organization (WHO), Geneva, pp 1–62

    Google Scholar 

  2. Gray L, Lee IM, Sesso HD, Batty GD (2011) Blood pressure in early adulthood, hypertension in middle age, and future cardiovascular disease mortality: HAHS (Harvard Alumni Health Study). J Am Coll Cardiol 58:2396–2403

    Article  Google Scholar 

  3. Myers VH, Champagne CM (2007) Nutritional effects on blood pressure. Curr Opin Lipidol 18:20–24

    Article  CAS  Google Scholar 

  4. He FJ, Li J, Macgregor GA (2013) Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ 346:f1325

    Article  Google Scholar 

  5. Boeing H, Bechthold A, Bub A, Ellinger S, Haller D, Kroke A et al (2012) Critical review: vegetables and fruit in the prevention of chronic diseases. Eur J Nutr 51:637–663

    Article  CAS  Google Scholar 

  6. Moore LL, Singer MR, Bradlee ML, Djousse L, Proctor MH, Cupples LA et al (2005) Intake of fruits, vegetables, and dairy products in early childhood and subsequent blood pressure change. Epidemiology 16:4–11

    Article  Google Scholar 

  7. Moore LL, Bradlee ML, Singer MR, Qureshi MM, Buendia JR, Daniels SR (2012) Dietary approaches to stop hypertension (DASH) eating pattern and risk of elevated blood pressure in adolescent girls. Br J Nutr 108:1678–1685

    Article  CAS  Google Scholar 

  8. van de Laar RJ, Stehouwer CD, van Bussel BC, te Velde SJ, Prins MH, Twisk JW et al (2012) Lower lifetime dietary fiber intake is associated with carotid artery stiffness: the Amsterdam Growth and Health Longitudinal Study. Am J Clin Nutr 96:14–23

    Article  Google Scholar 

  9. Jaaskelainen P, Magnussen CG, Pahkala K, Mikkila V, Kahonen M, Sabin MA et al (2012) Childhood nutrition in predicting metabolic syndrome in adults: the cardiovascular risk in Young Finns Study. Diabetes Care 35:1937–1943

    Article  CAS  Google Scholar 

  10. Steffen LM, Kroenke CH, Yu X, Pereira MA, Slattery ML, Van Horn L et al (2005) Associations of plant food, dairy product, and meat intakes with 15-years incidence of elevated blood pressure in young black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr 82:1169–1177; quiz 1363–1164

  11. He FJ, MacGregor GA (2006) Importance of salt in determining blood pressure in children: meta-analysis of controlled trials. Hypertension 48:861–869

    Article  CAS  Google Scholar 

  12. Brion MJ, Ness AR, Davey Smith G, Emmett P, Rogers I, Whincup P et al (2008) Sodium intake in infancy and blood pressure at 7 years: findings from the Avon Longitudinal Study of Parents and Children. Eur J Clin Nutr 62:1162–1169

    Article  CAS  Google Scholar 

  13. Geleijnse JM, Grobbee DE, Hofman A (1990) Sodium and potassium intake and blood pressure change in childhood. BMJ 300:899–902

    Article  CAS  Google Scholar 

  14. Wills AK, Lawlor DA, Matthews FE, Sayer AA, Bakra E, Ben-Shlomo Y et al (2011) Life course trajectories of systolic blood pressure using longitudinal data from eight UK cohorts. PLoS Med 8:e1000440

    Article  Google Scholar 

  15. Mensink GB, Kleiser C, Richter A (2007) Lebensmittelverzehr bei Kindern und Jugendlichen in Deutschland. Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50:609–623

    Article  CAS  Google Scholar 

  16. Remer T, Neubert A, Maser-Gluth C (2002) Anthropometry-based reference values for 24-h urinary creatinine excretion during growth and their use in endocrine and nutritional research. Am J Clin Nutr 75:561–569

    CAS  Google Scholar 

  17. Sichert-Hellert W, Kersting M, Chada C, Schäfer K, Kroke A (2007) German food composition database for dietary evaluations in children and adolescents. J Food Compos Anal 20:63–70

    Article  Google Scholar 

  18. Smith-Warner SA, Elmer PJ, Tharp TM, Fosdick L, Randall B, Gross M et al (2000) Increasing vegetable and fruit intake: randomized intervention and monitoring in an at-risk population. Cancer Epidemiol Biomark Prev 9:307–317

    CAS  Google Scholar 

  19. Meschi T, Maggiore U, Fiaccadori E, Schianchi T, Bosi S, Adorni G et al (2004) The effect of fruits and vegetables on urinary stone risk factors. Kidney Int 66:2402–2410

    Article  CAS  Google Scholar 

  20. Krupp D, Doberstein N, Shi L, Remer T (2012) Hippuric acid in 24-hour urine collections is a potential biomarker for fruit and vegetable consumption in healthy children and adolescents. J Nutr 142:1314–1320

    Article  CAS  Google Scholar 

  21. Frank T, Netzel G, Kammerer DR, Carle R, Kler A, Kriesl E et al (2012) Consumption of Hibiscus sabdariffa L. aqueous extract and its impact on systemic antioxidant potential in healthy subjects. J Sci Food Agric 92:2207–2218

    Article  CAS  Google Scholar 

  22. Toromanovic J, Kovac-Besovic E, Sapcanin A, Tahirovic I, Rimpapa Z, Kroyer G et al (2008) Urinary hippuric acid after ingestion of edible fruits. Bosn J Basic Med Sci 8:38–43

    Google Scholar 

  23. Tomokuni K, Ogata M (1972) Direct colorimetric determination of hippuric acid in urine. Clin Chem 18:349–351

    CAS  Google Scholar 

  24. Yang W, Gu D, Chen J, Jaquish CE, Rao DC, Wu X et al (2008) Agreement of blood pressure measurements between random-zero and standard mercury sphygmomanometers. Am J Med Sci 336:373–378

    Article  Google Scholar 

  25. Neuhauser H, Schienkiewitz A, Schaffrath Rosario A, Dortschy R, Kurth B-M (2011) Referenzperzentile für anthropometrische Maßzahlen und Blutdruck aus der Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland (KiGGS) 2003–2006. Robert Koch-Institut, Berlin, pp 100–113

    Google Scholar 

  26. He FJ, Marrero NM, Macgregor GA (2008) Salt and blood pressure in children and adolescents. J Hum Hypertens 22:4–11

    Article  CAS  Google Scholar 

  27. He J, Gu D, Chen J, Jaquish CE, Rao DC, Hixson JE et al (2009) Gender difference in blood pressure responses to dietary sodium intervention in the GenSalt study. J Hypertens 27:48–54

    Article  CAS  Google Scholar 

  28. Miura K, Okuda N, Turin TC, Takashima N, Nakagawa H, Nakamura K et al (2010) Dietary salt intake and blood pressure in a representative Japanese population: baseline analyses of NIPPON DATA80. J Epidemiol 20(Suppl 3):S524–530

    Article  Google Scholar 

  29. Pechere-Bertschi A, Burnier M (2004) Female sex hormones, salt, and blood pressure regulation. Am J Hypertens 17:994–1001

    Article  CAS  Google Scholar 

  30. Nakamura K, Nagata C, Oba S, Takatsuka N, Shimizu H (2008) Fruit and vegetable intake and mortality from cardiovascular disease are inversely associated in Japanese women but not in men. J Nutr 138:1129–1134

    CAS  Google Scholar 

  31. Cassidy A, O’Reilly EJ, Kay C, Sampson L, Franz M, Forman JP et al (2011) Habitual intake of flavonoid subclasses and incident hypertension in adults. Am J Clin Nutr 93:338–347

    Article  CAS  Google Scholar 

  32. Haddy FJ, Vanhoutte PM, Feletou M (2006) Role of potassium in regulating blood flow and blood pressure. Am J Physiol Regul Integr Comp Physiol 290:R546–552

    Article  CAS  Google Scholar 

  33. Murakami K, Sasaki S, Takahashi Y, Uenishi K (2008) Association between dietary acid–base load and cardiometabolic risk factors in young Japanese women. Br J Nutr 100:642–651

    Article  CAS  Google Scholar 

  34. Zhang L, Curhan GC, Forman JP (2009) Diet-dependent net acid load and risk of incident hypertension in United States women. Hypertension 54:751–755

    Article  CAS  Google Scholar 

  35. Krupp D, Shi L, Maser-Gluth C, Pietzarka M, Remer T (2013) 11beta Hydroxysteroid dehydrogenase type 2 and dietary acid load are independently associated with blood pressure in healthy children and adolescents. Am J Clin Nutr 97:612–620

    Article  CAS  Google Scholar 

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Acknowledgments

The DONALD study is funded by the Ministry of Science and Research of North Rhine Westphalia, Germany. This work was partially supported by the Federal Ministry of Food, Agriculture and Consumer Protection (BMELV) through the Federal Agency for Agriculture and Food (BLE), Grant No. 2811HS007.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Nutritional Epidemiology, DONALD Study Centre Dortmund, Branch Laboratory of the Faculty of Agriculture, University of Bonn, Bonn, Germany

    Danika Krupp, Lijie Shi & Thomas Remer

  2. IEL-Nutritional Physiology, University of Bonn, Bonn, Germany

    Sarah Egert

  3. Laboratory of Translational Hormone Analytics in Pediatric Endocrinology, Center of Child and Adolescent Medicine, Justus-Liebig-University, Giessen, Germany

    Stefan A. Wudy

Authors
  1. Danika Krupp
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  2. Lijie Shi
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  3. Sarah Egert
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  4. Stefan A. Wudy
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  5. Thomas Remer
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Correspondence to Thomas Remer.

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Krupp, D., Shi, L., Egert, S. et al. Prospective relevance of fruit and vegetable consumption and salt intake during adolescence for blood pressure in young adulthood. Eur J Nutr 54, 1269–1279 (2015). https://doi.org/10.1007/s00394-014-0804-y

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  • DOI: https://doi.org/10.1007/s00394-014-0804-y

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