Short-term effect of modest salt reduction combined with the CM-DASH diet on salt eating habits in hypertensive patients with type II diabetes: A randomized, control, single-blind trial

Abstract Background Excessive salt intake is currently the foremost universal risk factor for controllable chronic disease. Reducing salt intake has been identified as one of the most cost-effective measures countries can adopt to improve the health outcomes of their populations. This study evaluated the short-term effects of a modest salt intake reduction combined with the Chinese Modified Dietary Approaches to Stop Hypertension (CM-DASH) diet on salt intake, certain biochemical parameters, mean arterial pressure (MAP), and pulse pressure (PP) in hypertensive patients with type II diabetes. Methods Sixty-one participants were randomized to the intervention group (52% low-sodium salt and DASH intervention [n = 30, 11 men]) and control group (normal salt and DASH intervention [n = 31, 14 men]). An 8-week dietary intervention was applied. Daily salt intake, blood pressure, and drug use were recorded every week. Twenty-four-hour urine samples, casual urine samples, and blood samples were measured at baseline, the fourth week, and the end of the intervention.Results Of the 61 participants, 59 patients (25 men and 34 women) completed the entire study. The daily salt intake of all patients significantly decreased compared with at baseline (P < 0.001). The Na+/K+ ratio and urine creatinine decreased after the intervention, and the 24-hour urine potassium of the intervention and control groups increased after the intervention and the fourth week, respectively. Additionally, 24-hour UNa, (MAU), and urinary microalbumin-to-creatinine ratio(UACR) decreased significantly after the intervention but increased after the fourth week. Finally, MAP and PP both decreased after the intervention, but the difference between the two groups was not statistically significant.Conclusion A modest salt reduction and the CM-DASH diet for hypertensive patients with type II diabetes can achieve the effect of salt reduction in a short period. Before and after individual comparisons, sodium and potassium intake, MAU, MAP, and PP were improved, but no statistically significant difference was observed between the two groups regardless of the use of 52% sodium limited formula salt or traditional table salt. The salt reduction effect needs to be investigated with an extended follow-up.Trail registration ChiCTR2000029017.Registered on 11/01/2020-Prospective registration, http:// www.chictr.org.cn/