Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1995 Sep;50(9):941–947. doi: 10.1136/thx.50.9.941

Effect of dietary sodium on airways responsiveness and its importance in the epidemiology of asthma: an evaluation in three areas of northern England.

G Devereux 1, J R Beach 1, C Bromly 1, A J Avery 1, S M Ayatollahi 1, S M Williams 1, S C Stenton 1, S J Bourke 1, D J Hendrick 1
PMCID: PMC1021306  PMID: 8539673

Abstract

BACKGROUND--Although several investigations have shown a relationship between asthma (or its surrogate, airways responsiveness) and dietary or urinary sodium, others have not, and the matter remains controversial. This "salt effect" has been investigated during two recent epidemiological surveys of men in northern England. The first assessed the possible effect on airways responsiveness of occupational exposure to welding fumes, and the second characterised airways responsiveness in two geographically distinct residential areas. Thus, three separate study areas/populations were involved. METHODS--Investigation 1 involved 1059 shipyard workers aged 16-27 years who were exposed variously to welding fumes, and Investigation 2 involved 587 men aged 20-44 years who lived in rural West Cumbria or in urban Newcastle upon Tyne. In Investigation 1, a 24 hour urine specimen was requested from each subject with quantifiable airways responsiveness (PD20 < or = 6400 micrograms methacholine) and from an equal number of subjects without measurable airways responsiveness from the same occupational subgroup. In Investigation 2, every subject was asked to provide a 24 hour urine specimen. RESULTS--Of the men undergoing methacholine tests, satisfactory 24 hour urine specimens were obtained from 234 (22.1%) in Investigation 1 and 232 (39.5%) in Investigation 2. Analysis using multiple linear regression, multiple linear logistic regression, and multiple regression for censored data produced consistent results within each study population but conflicting results between them, such that there was no hint of a relationship between airways responsiveness and 24 hour urinary sodium excretion in the shipyard workers of Investigation 1 nor in the rural West Cumbrian population of Investigation 2, but an association was found in the urban Newcastle population of Investigation 2. All study populations were sufficiently large to demonstrate anticipated relationships between airways responsiveness and atopy, baseline FEV1, and (Newcastle only) age. CONCLUSIONS--If airways responsiveness is related to dietary sodium the relationship is not likely to be strong.

Full text

PDF
943

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bakke P. S., Baste V., Gulsvik A. Bronchial responsiveness in a Norwegian community. Am Rev Respir Dis. 1991 Feb;143(2):317–322. doi: 10.1164/ajrccm/143.2.317. [DOI] [PubMed] [Google Scholar]
  2. Beach J. R., Young C. L., Avery A. J., Stenton S. C., Dennis J. H., Walters E. H., Hendrick D. J. Measurement of airway responsiveness to methacholine: relative importance of the precision of drug delivery and the method of assessing response. Thorax. 1993 Mar;48(3):239–243. doi: 10.1136/thx.48.3.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Berrill W. T. Is the death rate from asthma exaggerated? Evidence from west Cumbria. BMJ. 1993 Jan 16;306(6871):193–194. doi: 10.1136/bmj.306.6871.193. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Britton J., Pavord I., Richards K., Knox A., Wisniewski A., Wahedna I., Kinnear W., Tattersfield A., Weiss S. Factors influencing the occurrence of airway hyperreactivity in the general population: the importance of atopy and airway calibre. Eur Respir J. 1994 May;7(5):881–887. [PubMed] [Google Scholar]
  5. Britton J., Pavord I., Richards K., Knox A., Wisniewski A., Weiss S., Tattersfield A. Dietary sodium intake and the risk of airway hyperreactivity in a random adult population. Thorax. 1994 Sep;49(9):875–880. doi: 10.1136/thx.49.9.875. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Burney P. G., Britton J. R., Chinn S., Tattersfield A. E., Papacosta A. O., Kelson M. C., Anderson F., Corfield D. R. Descriptive epidemiology of bronchial reactivity in an adult population: results from a community study. Thorax. 1987 Jan;42(1):38–44. doi: 10.1136/thx.42.1.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Burney P. G., Britton J. R., Chinn S., Tattersfield A. E., Platt H. S., Papacosta A. O., Kelson M. C. Response to inhaled histamine and 24 hour sodium excretion. Br Med J (Clin Res Ed) 1986 Jun 7;292(6534):1483–1486. doi: 10.1136/bmj.292.6534.1483. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Burney P. G., Neild J. E., Twort C. H., Chinn S., Jones T. D., Mitchell W. D., Bateman C., Cameron I. R. Effect of changing dietary sodium on the airway response to histamine. Thorax. 1989 Jan;44(1):36–41. doi: 10.1136/thx.44.1.36. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Burney P. G. The causes of asthma--does salt potentiate bronchial activity? Discussion paper. J R Soc Med. 1987 Jun;80(6):364–367. doi: 10.1177/014107688708000612. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Carey O. J., Locke C., Cookson J. B. Effect of alterations of dietary sodium on the severity of asthma in men. Thorax. 1993 Jul;48(7):714–718. doi: 10.1136/thx.48.7.714. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Cockcroft D. W., Hurst T. S., Gore B. P. Importance of evaporative water losses during standardized nebulized inhalation provocation tests. Chest. 1989 Sep;96(3):505–508. doi: 10.1378/chest.96.3.505. [DOI] [PubMed] [Google Scholar]
  12. Gerrard J. W., Cockcroft D. W., Mink J. T., Cotton D. J., Poonawala R., Dosman J. A. Increased nonspecific bronchial reactivity in cigarette smokers with normal lung function. Am Rev Respir Dis. 1980 Oct;122(4):577–581. doi: 10.1164/arrd.1980.122.4.577. [DOI] [PubMed] [Google Scholar]
  13. Godfrey R. C. Asthma and IgE levels in rural and urban communities of The Gambia. Clin Allergy. 1975 Jun;5(2):201–207. doi: 10.1111/j.1365-2222.1975.tb01853.x. [DOI] [PubMed] [Google Scholar]
  14. Hendrick D. J., Fabbri L. M., Hughes J. M., Banks D. E., Barkman H. W., Jr, Connolly M. J., Jones R. N., Weill H. Modification of the methacholine inhalation test and its epidemiologic use in polyurethane workers. Am Rev Respir Dis. 1986 Apr;133(4):600–604. doi: 10.1164/arrd.1986.133.4.600. [DOI] [PubMed] [Google Scholar]
  15. Javaid A., Cushley M. J., Bone M. F. Effect of dietary salt on bronchial reactivity to histamine in asthma. BMJ. 1988 Aug 13;297(6646):454–454. doi: 10.1136/bmj.297.6646.454. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Lieberman D., Heimer D. Effect of dietary sodium on the severity of bronchial asthma. Thorax. 1992 May;47(5):360–362. doi: 10.1136/thx.47.5.360. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. O'Connor G. T., Sparrow D., Segal M. R., Weiss S. T. Smoking, atopy, and methacholine airway responsiveness among middle-aged and elderly men. The Normative Aging Study. Am Rev Respir Dis. 1989 Dec;140(6):1520–1526. doi: 10.1164/ajrccm/140.6.1520. [DOI] [PubMed] [Google Scholar]
  18. O'Connor G., Sparrow D., Taylor D., Segal M., Weiss S. Analysis of dose-response curves to methacholine. An approach suitable for population studies. Am Rev Respir Dis. 1987 Dec;136(6):1412–1417. doi: 10.1164/ajrccm/136.6.1412. [DOI] [PubMed] [Google Scholar]
  19. Rijcken B., Schouten J. P. Measuring bronchial responsiveness in epidemiology. Eur Respir J. 1993 May;6(5):617–618. [PubMed] [Google Scholar]
  20. Sparrow D., O'Connor G. T., Rosner B., Weiss S. T. Methacholine airway responsiveness and 24-hour urine excretion of sodium and potassium. The Normative Aging Study. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):722–725. doi: 10.1164/ajrccm/144.3_Pt_1.722. [DOI] [PubMed] [Google Scholar]
  21. Stenton S. C., Beach J. R., Avery A. J., Hendrick D. J. The value of questionnaires and spirometry in asthma surveillance programmes in the workplace. Occup Med (Lond) 1993 Nov;43(4):203–206. doi: 10.1093/occmed/43.4.203. [DOI] [PubMed] [Google Scholar]
  22. Van Niekerk C. H., Weinberg E. G., Shore S. C., Heese H. V., Van Schalkwyk J. Prevalence of asthma: a comparative study of urban and rural Xhosa children. Clin Allergy. 1979 Jul;9(4):319–314. doi: 10.1111/j.1365-2222.1979.tb02489.x. [DOI] [PubMed] [Google Scholar]
  23. Van Niekerk C. H., Weinberg E. G., Shore S. C., Heese H. V., Van Schalkwyk J. Prevalence of asthma: a comparative study of urban and rural Xhosa children. Clin Allergy. 1979 Jul;9(4):319–314. doi: 10.1111/j.1365-2222.1979.tb02489.x. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES