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. 1994 Sep;49(9):875–880. doi: 10.1136/thx.49.9.875

Dietary sodium intake and the risk of airway hyperreactivity in a random adult population.

J Britton 1, I Pavord 1, K Richards 1, A Knox 1, A Wisniewski 1, S Weiss 1, A Tattersfield 1
PMCID: PMC475179  PMID: 7940426

Abstract

BACKGROUND--High dietary sodium intake has been identified as a potential cause of asthma and airway hyperreactivity. This study was designed to test the hypothesis that dietary sodium intake is an independent determinant of the risk of hyperreactivity in the general population, and to assess the role of atopy in the association between these factors. METHODS--Airway reactivity to methacholine, atopy, 24 hour urinary sodium excretion, and self-reported smoking and symptom history were measured in a random sample of 1702 adults aged 18-70 from an administrative district of Nottingham. Hyperreactivity was defined as a PD20FEV1 of 12.25 mumol or less, and atopy was defined quantitatively as the mean allergen skin weal response to Dermatophagoides pteronyssinus, cat fur, and grass pollen, and categorically as the occurrence of any allergen response 1 mm or greater than the saline control. Multiple logistic regression analysis was used to estimate the independent relative odds of hyperreactivity, atopy, or symptoms in relation to sodium excretion in all 1702 subjects, and multiple linear regression to assess the independent relation between sodium excretion and mean allergen skin weal diameter, and the PD20 value amongst hyperreactive subjects. RESULTS--There was no relation between the relative odds of hyperreactivity to methacholine and 24 hour urinary sodium excretion, either before or after adjustment for age, smoking, allergen skin weal diameter, and sex, and similarly no relation if the analysis was restricted to men or women only. The relative odds of having at least one allergen skin test response 1 mm greater than the saline control were increased in relation to sodium excretion after adjustment for age, sex, and smoking by a ratio of 2.08 (95% CI 1.04 to 4.15) per log10 unit increase in sodium excretion, but there was no evidence of an association between sodium excretion and the occurrence of self-reported wheeze, hay fever, eczema, or asthma. There was no relation between 24 hour sodium excretion and the magnitude of the mean allergen skin weal response or the PD20 value. CONCLUSIONS--These findings do not support the hypothesis that a high dietary sodium intake is a risk factor for airway hyperreactivity or atopic disease in the general adult population.

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Selected References

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  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. 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]
  3. 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]
  4. 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]
  5. Burney P. G., Laitinen L. A., Perdrizet S., Huckauf H., Tattersfield A. E., Chinn S., Poisson N., Heeren A., Britton J. R., Jones T. Validity and repeatability of the IUATLD (1984) Bronchial Symptoms Questionnaire: an international comparison. Eur Respir J. 1989 Nov;2(10):940–945. [PubMed] [Google Scholar]
  6. 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]
  7. 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]
  8. 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]
  9. Cerveri I., Bruschi C., Zoia M. C., Maccarini L., Grassi M., Lebowitz M. D., Rampulla C., Grassi C. Smoking habit and bronchial reactivity in normal subjects. A population-based study. Am Rev Respir Dis. 1989 Jul;140(1):191–196. doi: 10.1164/ajrccm/140.1.191. [DOI] [PubMed] [Google Scholar]
  10. Froment A., Milon H., Gravier C. Relation entre consommation sodée et hypertension artérielle. Contribution de l'épidémiologie géographique. Rev Epidemiol Sante Publique. 1979;27(5-6):437–454. [PubMed] [Google Scholar]
  11. Fulton M., Thomson M., Elton R. A., Brown S., Wood D. A., Oliver M. F. Cigarette smoking, social class and nutrient intake: relevance to coronary heart disease. Eur J Clin Nutr. 1988 Sep;42(9):797–803. [PubMed] [Google Scholar]
  12. 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]
  13. Holland W. W., Kasap H. S., Colley J. R., Cormack W. Respiratory symptoms and ventilatory function: a family study. Br J Prev Soc Med. 1969 May;23(2):77–84. doi: 10.1136/jech.23.2.77. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. 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]
  15. Keeley D. J., Neill P., Gallivan S. Comparison of the prevalence of reversible airways obstruction in rural and urban Zimbabwean children. Thorax. 1991 Aug;46(8):549–553. doi: 10.1136/thx.46.8.549. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Krzyzanowski M., Robbins D. R., Lebowitz M. D. Smoking cessation and changes in respiratory symptoms in two populations followed for 13 years. Int J Epidemiol. 1993 Aug;22(4):666–673. doi: 10.1093/ije/22.4.666. [DOI] [PubMed] [Google Scholar]
  17. Lebowitz M. D., Burrows B. Respiratory symptoms related to smoking habits of family adults. Chest. 1976 Jan;69(1):48–50. doi: 10.1378/chest.69.1.48. [DOI] [PubMed] [Google Scholar]
  18. 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]
  19. Medici T. C., Vetter W. Bronchialasthma und Kochsalz. Schweiz Med Wochenschr. 1991 Apr 6;121(14):501–508. [PubMed] [Google Scholar]
  20. Merrett T. G., Merrett J., Cookson J. B. Allergy and parasites: the measurement of total and specific IgE levels in urban and rural communities in Rhodesia. Clin Allergy. 1976 Mar;6(2):131–134. doi: 10.1111/j.1365-2222.1976.tb01890.x. [DOI] [PubMed] [Google Scholar]
  21. 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]
  22. Pattemore P. K., Asher M. I., Harrison A. C., Mitchell E. A., Rea H. H., Stewart A. W. Ethnic differences in prevalence of asthma symptoms and bronchial hyperresponsiveness in New Zealand schoolchildren. Thorax. 1989 Mar;44(3):168–176. doi: 10.1136/thx.44.3.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Pistelli R., Forastiere F., Corbo G. M., Dell'Orco V., Brancato G., Agabiti N., Pizzabiocca A., Perucci C. A. Respiratory symptoms and bronchial responsiveness are related to dietary salt intake and urinary potassium excretion in male children. Eur Respir J. 1993 Apr;6(4):517–522. [PubMed] [Google Scholar]
  24. Rijcken B., Schouten J. P., Weiss S. T., Speizer F. E., van der Lende R. The relationship of nonspecific bronchial responsiveness to respiratory symptoms in a random population sample. Am Rev Respir Dis. 1987 Jul;136(1):62–68. doi: 10.1164/ajrccm/136.1.62. [DOI] [PubMed] [Google Scholar]
  25. Schwartz J., Weiss S. T. Dietary factors and their relation to respiratory symptoms. The Second National Health and Nutrition Examination Survey. Am J Epidemiol. 1990 Jul;132(1):67–76. doi: 10.1093/oxfordjournals.aje.a115644. [DOI] [PubMed] [Google Scholar]
  26. 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]
  27. 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]
  28. Waite D. A., Eyles E. F., Tonkin S. L., O'Donnell T. V. Asthma prevalence in Tokelauan children in two environments. Clin Allergy. 1980 Jan;10(1):71–75. doi: 10.1111/j.1365-2222.1980.tb02082.x. [DOI] [PubMed] [Google Scholar]
  29. Ware J. H., Dockery D. W., Spiro A., 3rd, Speizer F. E., Ferris B. G., Jr Passive smoking, gas cooking, and respiratory health of children living in six cities. Am Rev Respir Dis. 1984 Mar;129(3):366–374. doi: 10.1164/arrd.1984.129.3.366. [DOI] [PubMed] [Google Scholar]
  30. Welty C., Weiss S. T., Tager I. B., Muñoz A., Becker C., Speizer F. E., Ingram R. H., Jr The relationship of airways responsiveness to cold air, cigarette smoking, and atopy to respiratory symptoms and pulmonary function in adults. Am Rev Respir Dis. 1984 Aug;130(2):198–203. doi: 10.1164/arrd.1984.130.2.198. [DOI] [PubMed] [Google Scholar]
  31. Williams D. R., Bingham S. A. Sodium and potassium intakes in a representative population sample: estimation from 24 h urine collections known to be complete in a Cambridgeshire village. Br J Nutr. 1986 Jan;55(1):13–22. doi: 10.1079/bjn19860005. [DOI] [PubMed] [Google Scholar]
  32. Woolcock A. J., Peat J. K., Salome C. M., Yan K., Anderson S. D., Schoeffel R. E., McCowage G., Killalea T. Prevalence of bronchial hyperresponsiveness and asthma in a rural adult population. Thorax. 1987 May;42(5):361–368. doi: 10.1136/thx.42.5.361. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Yan K., Salome C., Woolcock A. J. Rapid method for measurement of bronchial responsiveness. Thorax. 1983 Oct;38(10):760–765. doi: 10.1136/thx.38.10.760. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. van Niekerk C. H., Weinberg E. G., Shore S. C., Heese H. D. Prevalence of childhood asthma in Africa. Lancet. 1977 Jan 8;1(8002):96–97. doi: 10.1016/s0140-6736(77)91112-6. [DOI] [PubMed] [Google Scholar]

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