Individually caged male Cobb broilers (24), 44 d of age, were used to evaluate effects of heat stress (1 d of data collection) and dietary electrolyte balance (DEB; Na + K - Cl, mEq/kg from 1 d of age). During summer rearing, mortality was variable, but DEB 240 improved growth, feed conversion ratio, water intake, and water:feed ratio vs. DEB 0. The temperature sequence for heat stress was 24 to 32 degrees C in 30 min, 32 to 36 degrees C in 30 min, 36 to 37 degrees C in 15 min, and 37 to 41 degrees C in 45 min. Maximum temperature was held for 15, 60, 90, or 360 min for data collection (relative humidity averaged 42 +/- 7%). Results from the same room before and after heat stress were analyzed by DEB (1-factor ANOVA) and before vs. after heat stress compared across DEB (2-sample t-test). Heat stress decreased blood Na, K, and pCO2, and lymphocytes but increased heterophils. Blood HCO3 rose, Cl declined, and hematocrit gave a concave pattern (lowest at DEB 120) as DEB increased. After heat stress, DEB 0 decreased blood Na and K, and DEB 0 and 120 levels decreased blood HCO3. After heat stress blood pCO2 and hemoglobin decreased with DEB 240, but it had highest pCO2, a key factor. The DEB 120 gave longest times to panting and prostration with DEB 0 and 240 results lower but similar statistically. In heat stress, DEB 360 was excessive, DEB 120 and 240 were favorable, and DEB 0 was intermediate based on hematology, panting, and prostration responses.

Introduction Hypertension (HTN) is the leading cause of disease and death on a global scale. Diet’s sodium and potassium levels may synergistically affect blood pressure. Currently, the sodium-to-potassium (Na/K) ratio is becoming a more reliable indicator. There has not been a systematic investigation of the dose–response relationship between dietary sodium, potassium, the Na/K ratio and the incidence of HTN based on the same study criteria. This study will conduct a thorough dose–response meta-analysis of cohort studies to estimate the effects of dietary sodium, potassium, and the Na/K ratio on the incidence of HTN to provide the most accurate reference for sodium and potassium intake. Methods and analysis We will identify all relevant prospective and retrospective cohort studies by searching PubMed, Embase and Web of Science (from inception until December 2022). Exposures are 24 hours urinary excretions, and the outcome is the incidence of HTN. Two researchers will perform the literature selection and data extraction separately. The Newcastle-Ottawa Scale will be used to evaluate the quality of the included studies. We will use both linear and non-linear regression models to investigate the dose–response relationship among different levels (≥3) of sodium, potassium, Na/K ratio intake and the incidence of HTN (OR/RR/HR). Subgroup and sensitivity analyses will be applied to assess the potential heterogeneity sources and examine the stability of the results. We will also evaluate heterogeneity across studies and publication bias. Stata V.15.0 and RevMan V.5.0 will be used for statistical analyses. Ethics and dissemination According to the Institutional Review Board/Independent Ethics Committee of the Guang'anmen Hospital of the China Academy of Chinese Medical Science, this systematic meta-analysis protocol does not require ethical approval or informed consent. This meta-analysis will be published in a scientific journal with peer reviews. PROSPERO registration numb Abstract Introduction Hypertension (HTN) is the leading cause of disease and death on a global scale. Diet’s sodium and potassium levels may synergistically affect blood pressure. Currently, the sodium-to-potassium (Na/K) ratio is becoming a more reliable indicator. There has not been a systematic investigation of the dose–response relationship between dietary sodium, potassium, the Na/K ratio and the incidence of HTN based on the same study criteria. An investigation in The China Health and Nutrition Survey cohort showed strong independent dose–response relationships between dietary sodium, potassium, Na/K ratio and the incidence of HTN. 19 In contrast, Mirmiran et al reported no significant correlation between dietary sodium, potassium, Na/K ratio and the HTN risk in a cohort study in Iran over a 6.3-year follow-up period. 12 Given the limited availability of high-quality cohort studies, there are fewer meta-analyses on the preventive effects of low sodium, high potassium intake and low Na/K ratio on HTN. Only Filippini et al conducted a systematic review and dose–response meta-analysis on the relationship between dietary sodium and the incidence of HTN, confirming a linear correlation between sodium intake and the risk of HTN. 20 The relationship between dietary Na/K ratio and incident HTN remains a critical research gap. No systematic dose–response meta-analyses of dietary sodium, potassium intake and more representative and reliable Na/K ratio with the incidence of HTN has not been conducted under the same study criteria. Therefore, we will perform a comprehensive dose–response meta-analysis on all prospective and retrospective cohort studies with the aim of quantitatively assessing whether there are potential linear and non-linear dose–response relationships between dietary sodium, potassium intake and sodium-to-potassium ratio and the incidence of HTN. In order to offer the optimum reference for dietary sodium, potassium intake, and Na/K ratio to prevent HTN. Objectives This study aimed to examine the potential dose–response relationship between dietary sodium, potassium intake, Na/K ratio and HTN risk in the adult population by a comprehensive systematic review and dose–response meta-analysis. This Patient and public involvement Patients and/or the public will not be directly involved in the research’s conception, execution, reporting or dissemination. This study utilised only previously existing data from the above sources and scholarly literature. Type of studies Prospective or retrospective cohort studies assessing the relationship between dietary sodium, potassium intake, Na/K ratio and the incidence of HTN. We will exclude case–control studies, cross-sectional studies or abstract-only publications. There will be no language limits on qualified studies. This meta-analysis will be published in a scientific journal with peer reviews. Discussion Despite substantial breakthroughs in pharmaceutical treatment, HTN continues to be a leading cause of premature morbidity and mortality worldwide. 46 Current guidelines promote dietary modification to prevent and manage HTN. 47 48 Dietary patterns that reduce dietary sodium and increase intake of fruits and vegetables, that is, potassium, have been tested in early studies to reduce blood pressure and prevent CVD, 49 such as the Dietary Approaches to Stop Hypertension diet, with positive results. 50 More and more studies have been conducted on the relationship between dietary sodium, potassium intake, Na/K ratio and the risk of HTN, but the results are still controversial. The Na/K ratio as an observational indicator is gradually showing greater representativeness. We will combine all the data from current cohort studies to investigate the possible linear and non-linear dose–response meta-analysis between dietary sodium, potassium intake, Na/K ratio and the risk of HTN. To offer the optimum reference for dietary sodium, potassium intake and Na/K ratio to prevent HTN.

Background: Widespread adoption of a westernized diet represents a major lifestyle change characterized by substantially higher sodium consumption and lower potassium intake, which is related to cardiovascular morbidity. Methods: We performed a systematic review and meta-analysis over published studies in accordance with quantifying the dietary intake of sodium and potassium of the universal population across the world. The PubMed, EMBASE, Cochrane Library, and Google Scholar databases were used to find research that pronounced 24-hour urinary sodium or potassium excretion (reference period: 2014–2021). The effect size was estimated using the fixed-effect model; sub-group analysis become accomplished to determine urinary sodium and potassium excretion disaggregated by geographical location. Publication bias became evaluated the usage of graphical funnel plot. Data analysis was performed using STATA 16. Results: Forty-three studies (n= 62,940) qualified the selection criteria. The mean urinary excretion of sodium and potassium was 156.73 mmol/24h [95% confidence interval (CI), 148.98–164.47] and 48.89 mmol/24 h (95% CI, 43.61–54.17), respectively; the mean urinary sodium/potassium ratio was 3.68 (95% CI, 2.96–4.40). Conclusions: This updated systematic review highlights excessively high dietary intake of sodium and low intake of potassium at the community level in most parts of the world. The urinary Na/K ratio exceeded the level recommended by the WHO guidelines. Community-level dietary intake of sodium,... | F1000Research --> --> --> Home Browse Community-level dietary intake of sodium, potassium, and sodium-to-potassium... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Farapti F, Maulia PH, Fadilla C et al. Community-level dietary intake of sodium, potassium, and sodium-to-potassium ratio as a global public health problem: a systematic review and meta-analysis [version 1; peer review: 2 approved with reservations] . This article is included in the The Role of Nutrition in Healing and Improving Health collection. Abstract Background: Widespread adoption of a westernized diet represents a major lifestyle change characterized by substantially higher sodium consumption and lower potassium intake, which is related to cardiovascular morbidity. Methods: We performed a systematic review and meta-analysis over published studies in accordance with quantifying the dietary intake of sodium and potassium of the universal population across the world. The mean urinary excretion of sodium and potassium was 156.73 mmol/24h [95% confidence interval (CI), 148.98–164.47] and 48.89 mmol/24 h (95% CI, 43.61–54.17), respectively; the mean urinary sodium/potassium ratio was 3.68 (95% CI, 2.96–4.40). Conclusions: This updated systematic review highlights excessively high dietary intake of sodium and low intake of potassium at the community level in most parts of the world. The urinary Na/K ratio exceeded the level recommended by the WHO guidelines. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Farapti F, Maulia PH, Fadilla C et al. Community-level dietary intake of sodium, potassium, and sodium-to-potassium ratio as a global public health problem: a systematic review and meta-analysis [version 1; peer review: 2 approved with reservations] . Both these nutrients circulate a crucial role in normal biological functioning such as regulation of body fluids, active transport of molecules across the cell membrane, maintenance of osmotic equilibrium, and acid-base balance. 1 Sodium and potassium are naturally occurring nutrients in a variety of foods. Processed food and condiments typically have a high sodium content, while fresh fruits, vegetables, and nuts are rich in potassium. 2 , 3 Industrialization and adoption of the westernized dietary patterns have contributed to the increased prevalence of obesity, metabolic diseases, and cardiovascular diseases. : Extended data for: “Community-level dietary intake of sodium, potassium, and sodium-to-potassium ratio as a global public health problem: A systematic review and meta-analysis.”.2022, June 14. However, we did not calculate details of quantity by meta-analysis table or figure, we only explain clearly some studies related it. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Wang NX. Reviewer Report For: Community-level dietary intake of sodium, potassium, and sodium-to-potassium ratio as a global public health problem: a systematic review and meta-analysis [version 1; peer review: 2 approved with reservations] . Author Response: Thank you for the suggestion We arranged and organized two paragraphs become one paragraph discussing about sodium and potassium intake and the correlation with obesity CONCLUSION Reviewer: Conclusion: " This dietary pattern is correlated with an elevated risk of hypertension and obesity." This is not part of the study's results and therefore, cannot be concluded as such. Author Response: Thank you for the correction. We deleted the sentence Competing Interests: No competing interests were disclosed. Author Response: Thank you for the suggestion We arranged and organized two paragraphs become one paragraph discussing about sodium and potassium intake and the correlation with obesity CONCLUSION Reviewer: Conclusion: " This dietary pattern is correlated with an elevated risk of hypertension and obesity." This is not part of the study's results and therefore, cannot be concluded as such. Author Response: Thank you for the correction. We deleted the sentence Competing Interests: No competing interests were disclosed.

Background: Widespread adoption of a westernized diet represents a major lifestyle change characterized by substantially higher sodium consumption and lower potassium intake, which is related to cardiovascular morbidity. Methods: We performed a systematic review and meta-analysis over published studies in accordance with quantifying the dietary intake of sodium and potassium of the universal population across the world. The PubMed, EMBASE, Cochrane Library, and Google Scholar databases were used to find research that pronounced 24-hour urinary sodium or potassium excretion (reference period: 2014–2021). The effect size was estimated using the fixed-effect model; sub-group analysis become accomplished to determine urinary sodium and potassium excretion disaggregated by geographical location. Publication bias became evaluated the usage of graphical funnel plot. Data analysis was performed using STATA 16. Results: Forty-three studies (n= 62,940) qualified the selection criteria. The mean urinary excretion of sodium and potassium was 156.73 mmol/24h [95% confidence interval (CI), 148.98–164.47] and 48.89 mmol/24 h (95% CI, 43.61–54.17), respectively; the mean urinary sodium/potassium ratio was 3.68 (95% CI, 2.96–4.40). Conclusions: This updated systematic review highlights excessively high dietary intake of sodium and low intake of potassium at the community level in most parts of the world. The urinary Na/K ratio exceeded the level recommended by the WHO guidelines. Community-level dietary intake of sodium,... | F1000Research --> --> --> Home Browse Community-level dietary intake of sodium, potassium, and sodium-to-potassium... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Farapti F, Maulia PH, Fadilla C et al. Community-level dietary intake of sodium, potassium, and sodium-to-potassium ratio as a global public health problem: a systematic review and meta-analysis [version 2; peer review: 1 approved, 2 approved with reservations] . The mean urinary excretion of sodium and potassium was 156.73 mmol/24h [95% confidence interval (CI), 148.98–164.47] and 48.89 mmol/24 h (95% CI, 43.61–54.17), respectively; the mean urinary sodium/potassium ratio was 3.68 (95% CI, 2.96–4.40). Conclusions: This updated systematic review highlights excessively high dietary intake of sodium and low intake of potassium at the community level in most parts of the world. The urinary Na/K ratio exceeded the level recommended by the WHO guidelines. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Farapti F, Maulia PH, Fadilla C et al. Community-level dietary intake of sodium, potassium, and sodium-to-potassium ratio as a global public health problem: a systematic review and meta-analysis [version 2; peer review: 1 approved, 2 approved with reservations] . (2018), 81 lowering sodium intake, increasing potassium intake, and the use of potassium-containing salt substitutes within the meals may significantly lower the BP, in particular among those with high blood pressure. Furthermore, a systematic review of studies published during 1995-2001 examined the influence of lowering sodium intake or potassium supplementation on BP. In all meta-analyses, the decrease in BP was found to be larger in hypertensive than normotensive subjects. : Extended data for: “Community-level dietary intake of sodium, potassium, and sodium-to-potassium ratio as a global public health problem: A systematic review and meta-analysis.”.2022, June 14. 76 Competing Interests: None Close Report a concern COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 18 Aug 2022 Views 0 Cite How to cite this report: Drenjančević I. Reviewer Report For: Community-level dietary intake of sodium, potassium, and sodium-to-potassium ratio as a global public health problem: a systematic review and meta-analysis [version 2; peer review: 1 approved, 2 approved with reservations] . Author response : Thank you for the suggestion We noted it as the limitation of this study and added the information in the last paragraph of discussion section. In this study, we attempt to systematically investigate the dietary consumption of sodium and potassium among adults at the community level across the world.The objective was to quantify the dietary intake of sodium and potassium as a public health problem at the community level. Author response : Thank you for the suggestion We noted it as the limitation of this study and added the information in the last paragraph of discussion section. In this study, we attempt to systematically investigate the dietary consumption of sodium and potassium among adults at the community level across the world.The objective was to quantify the dietary intake of sodium and potassium as a public health problem at the community level. In the discussion section of dietary intake of sodium and potassium as a community health problem, the Author response : Thank you for the suggestion We noted it as the limitation of this study and added the information in the last paragraph of discussion section. In this study, we attempt to systematically investigate the dietary consumption of sodium and potassium among adults at the community level across the world.The objective was to quantify the dietary intake of sodium and potassium as a public health problem at the community level. Author response : Thank you for the suggestion We noted it as the limitation of this study and added the information in the last paragraph of discussion section. In this study, we attempt to systematically investigate the dietary consumption of sodium and potassium among adults at the community level across the world.The objective was to quantify the dietary intake of sodium and potassium as a public health problem at the community level.

The mutual interaction that exists between the transport of albumin and sodium is probably responsible for the increased potassium transport seen at low external concentrations of potassium. Higher concentrations of potassium appear directly to inhibit the interaction between the transport of sodium and albumin. Published in The Journal of physiology (1971)

Raising the extracellular sodium and potassium concentrations had no effect. The results are consistent with the hypothesis that interactions between cAMP and calcium are involved in slow-wave generation in colon muscle. Published in The American journal of physiology (1982)

gills (sodium, chloride, and potassium) and kidney (magnesium, sulfate, and calcium). sodium and chloride) … permeable to sodium ions than before. Sodium rushes in. Actually only an extremely small amount of sodium traverses … molecules. The sodium pump requires en- ergy, since it is moving sodium “uphill” against the sodium electrical