The Key to Life Nutrition Program: results from a community-based dietary sodium reduction trial

Objective: Evaluation of a dietary Na reduction trial in a community setting. Design: Community-based randomized trial. Ten-week nutrition intervention activities focused on lifestyle modification to decrease dietary Na intake, under the supervision of a registered dietitian. Twenty-four hour urine specimens were collected at baseline and follow-up visits to determine 24h urinary Na excretion. Setting: The University of Pittsburgh Center for Healthy Aging, Key to Life Nutrition Program. Subjects: Hypertensive adults at least 65 years of age. Results: Mean age of participants was 75 years. Twenty-four hour mean urinary Na excretion at baseline was 3174 mg/d. This reduced to 2944 mg/d (P = 0.30) and 2875 mg/d (P <= 0.03) at 6- and 12-month follow-ups, respectively. In a sub-sample (urine volume of >= 1000 ml, baseline to 12 months), mean urinary Na excretion decreased from 3220 mg/d to 2875 mg/d (P <= 0.02). Conclusions: Significant reductions in mean 24 h urinary Na were reported, but results fell short of the recommended guidelines of 1500 mg/d for at-risk individuals. Our results reiterate the difficulty in implementing these guidelines in community-based programmes. More aggressive public health efforts, food industry support and health policy changes are needed to decrease Na levels in older adults to the recommended guidelines.