Dietary Approaches to Improving Cardiovascular Health

Abstract

Cardiovascular diseases are among the noncommunicable diseases that threaten public health in Turkey and worldwide. Poor dietary patterns are a major contributor to the evolution of cardiovascular illnesses, along with tobacco use and physical inactivity. An increased risk of cardiovascular disease is linked to a poor diet. Eight recommendations for improving cardiometabolic health have been provided in this review by considering evidence-based dietary patterns. These recommendations to promote cardiometabolic health include the following: adjust energy intake and maintain a healthy body weight, eat plenty and a variety of fruits and vegetables, choose whole grain foods, healthy sources of protein, and use healthy liquid plant oils, minimize the intake of processed foods, added sugars, and salt. It is believed that increased adherence to these suggestions can contribute to lowering the risk of cardiovascular disease.

Keywords

• Cardiovascular diseases
• feeding patterns
• suggestions
• public health

Kardiyovasküler Sağlığı İyileştirmeye Yönelik Diyet Yaklaşımları

Abstract

Kardiyovasküler hastalıklar; ülkemizde ve dünyada halk sağlığını tehdit eden bulaşıcı olmayan hastalıklar arasındadır. Kardiyovasküler hastalıkların gelişiminde tütün kullanımı ve fiziksel inaktivite yanında sağlıksız beslenme alışkanlıkları da önemli bir yer almaktadır. Kötü diyet kalitesi artmış kardiyovasküler hastalık riski ile ilişkilidir. Bu derlemede; diyet örüntüleri kanıta dayalı ele alınarak; kardiyometabolik sağlığı iyileştirmeye yönelik sekiz öneri geliştirilmiştir. Bu öneriler arasında; enerji alımının ayarlanması, sağlıklı vücut ağırlığının korunması, yeterli miktarda ve çeşitte sebze ve meyvelerin tüketilmesi, tam tahıllı besinlerin, sağlıklı protein kaynaklarının ve sağlıklı bitkisel yağların tercih edilmesi, işlenmiş besin, eklenmiş şeker ve tuz tüketiminin azaltılması yer almaktadır. Geliştirilen bu önerilere uyumun artırılmasının kardiyovasküler hastalık riskinin azaltılmasına katkı sağlayacağı düşünülmektedir.

Keywords

• Kardiyovasküler hastalıklar
• beslenme örüntüsü
• öneriler
• halk sağlığı.

References

1. Dünya Sağlık Örgütü. Kardiyovasküler Hastalıklar. [cited Kasım 2022]. Erişim: https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1
2. Türkiye İstatistik Kurumu. Ölüm ve Ölüm Nedeni İstatistikleri. [ cited Kasım 2022]. Erişim : https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve- Olum-Nedeni-Istatistikleri-2019-33710
3. Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A , et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017 Jul;377(1):13-27. DOI:10.1056/NEJMoa1614362.
4. Physicians Committee for Responsible Medicine. 2020-2025 Dietary Guidelines for Americans Recommendations. [cited Kasım 2022]. Erişim: https://www.pcrm.org/good-nutrition/nutrition-programs-policies/2020-2025-dietary-guidelines
5. Gao M, Lv J, Yu C, Guo Y, Bian Z, Yang R, et al. Metabolically healthy obesity, transition to unhealthy metabolic status, and vascular disease in Chinese adults: A cohort study. PLoS Med. 2020 Oct;17(10):1003351. DOI: 10.1371/journal.pmed.1003351.
6. Van Horn L, Carson JA, Appel LJ, Burke LE, Economos C, Karmally W, et al. Recommended dietary pattern to achieve adherence to the american heart association/american college of cardiology (AHA/ACC) guidelines: a scientific statement from the american heart association. Circulation. 2016 Nov;134(22):505-29. DOI: 10.1161/CIR.0000000000000462.
7. Riaz H, Khan MS, Siddiqi TJ, Usman MS, Shah N, Goyal A, et al. Association between obesity and cardiovascular outcomes: a systematic review and meta-analysis of mendelian randomization studies. JAMA Netw Open. 2018 Nov;1(7):183788. DOI: 10.1001/jamanetworkopen.2018.3788.
8. Fan H, Li X, Zheng L, Chen X, Lan Q, Wu H, et al. Abdominal obesity is strongly associated with cardiovascular disease and its risk factors in elderly and very elderly community-dwelling chinese. Sci Rep. 2016 Feb;6(1):21521. DOI: 10.1038/srep21521.

9. Aune D, Sen A, Schlesinger S, Norat T, Janszky I, Romundstad P, et al. Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose-response meta-analysis of prospective studies. Eur J Epidemiol. 2017 Mar;32(3):181-92. DOI: 10.1007/s10654-017-0232-4.
10. Dünya Sağlık Örgütü. DSÖ Avrupa Bölgesi için Fiziksel Aktivite Stratejisi 2016-2025. [cited Mayıs 2023]. Erişim: https://hsgm.saglik. gov. tr/depo/birimler/saglikli-beslenme-hareketli-hayat-db/Yayinlar/ kitaplar/ diger-kitaplar/dunya-saglik-orgutu/DSO-Avrupa-Bolgesi-icin- Fiziksel- Aktivite-Stratejisi-2016-2025.
11. Minich DM. Review of the science of colorful, plant-based food and practical strategies for "eating the rainbow". J Nutr Metab. 2020 Nov;2020:5631762.DOI: 10.1155/2020/5631762.
12. Wang DD, Li Y, Bhupathiraju SN, Rosner BA, Sun Q, Giovannucci EL, et al.Fruit and vegetable intake and mortality: results from 2 prospective cohort studies of US men and women and a meta-analysis of 26 Cohort Studies. Circulation. 2021 Apr;143(17):1642-54. DOI: 10.1161/ SİRCULATIONAHA.120.048996.
13. Zurbau A, Au-Yeung F, Blanco Mejia S, Khan TA, Vuksan V, Jovanovski E, et al. Relation of different fruit and vegetable sources with incident cardiovascular outcomes: a systematic review and meta-analysis of prospective cohort studies. J Am Heart Assoc. 2020 Oct;9(19):e017728. DOI: 10.1161/JAHA.120.017728.
14. T.C. Sağlık Bakanlığı Türkiye Halk Kurumu Sağlığı. Türkiye Beslenme Rehberi 2015 (TÜBER). T.C. Sağlık Bakanlığı Yayın No: 1031. Ankara: 2016 [cited 2021 May 5]. Available from: https://dosyasb.saglik.gov.tr/ Eklenti/10915,tuber-turkiye-beslenme-rehberipdf.pdf
15. Ferruzzi MG, Jonnalagadda SS, Liu S, Marquart L, McKeown N, Reicks M, et al. Developing a standard definition of whole-grain foods for dietary recommendations: summary report of a multidisciplinary expert roundtable discussion. Adv Nutr. 2014 Mar;5 (2):164-76. DOI:15. 10.3945/an.113.005223.
16. Fu L, Zhang G, Qian S, Zhang Q, Tan M. Associations between dietary fiber intake and cardiovascular risk factors: an umbrella review of meta-analyses of randomized controlled trials. 2022 Sep;12(9):972399. DOI: 10.3389/fnut.2022.972399.
17. Nie Y, Luo F. Dietary Fiber: An opportunity for a global control of hyperlipidemia. Oxid Med Cell Longev. 2021 Apr;2021(1):5542342. DOI: 10.1155/2021/5542342.
18. Dai FJ, Chau CF. Classification and regulatory perspectives of dietary fiber. J Food Drug Anal.2017 Jan;25(1):37-42. DOI: 10.1016/j. jfda.2016.09.006.
19. Liu P, Wang Y, Yang G, Zhang Q, Meng L, Xin Y, et al. The role of short- chain fatty acids in intestinal barrier function, inflammation, oxidative stress, and colonic carcinogenesis. Pharmacol Res. 2021 Mar;165(1):105420. DOI: 10.1016/j.phrs.2021.105420.
20. Kim JA, Montagnani M, Chandrasekran S, Quon MJ. Role of lipotoxicity in endothelial dysfunction. Heart Fail Clin. 2012 Oct;8(4):589- 607. DOI: 10.1016/j.hfc.2012.06.012.
21. Kwak BR, Bäck M, Bochaton-Piallat ML, Caligiuri G, Daemen MJ, Davies PF, et al. Biomechanical factors in atherosclerosis: mechanisms and clinical implications. Eur Heart J. 2014 Nov;35(43):3013-20. DOI: 10.1093/eurheartj/ehu353.
22. Mooradian AD. Dyslipidemia in type 2 diabetes mellitus. Nat. Rev. Endocrinol. 2009 Mar; 5(3):150-9. DOI: 10.1038/ncpendmet1066.
23. Félétou M, Huang Y, Vanhoutte PM. Endothelium-mediated control of vascular tone: COX-1 and COX-2 products. Br J Pharmacol. 2011 Oct;164(3): 894-12. DOI: 10.1111/j.1476-5381.2011.01276.x.
24. Rebello CJ, Greenway FL, Finley JW. Whole grains and pulses: a comparison of the nutritional and health benefits. J Agric Food Chem. 2014 Jul;62(29):7029-49.DOI: 10.1021/jf500932z.
25. Bazzano LA, He J, Ogden LG, Loria C, Vupputuri S, Myers L, et al. Legume consumption and risk of coronary heart disease in US Men and Women. Arch Intern 2001 Nov;161(1):2573-78.DOI: 10.1001/ archinte.161.21.2573.
26. Yokoyama Y, Nishimura K, Barnard ND, Takegami M, Watanabe M, Sekikawa A, et al. Vegetarian diets and blood pressure: a meta-analysis. JAMA Int Med. 2014 Apr;174(4):577-87. DOI: 10.1001/ jamainternmed.2013.14547.
27. Yokoyama Y, Levin SM, Barnard ND. Association between plant-based diets and plasma lipids: a systematic review and meta-analysis. Nutr. Rev. 2019 Sep;179(10):1335-44. DOI: 10.1093/nutrit/nux030.
28. Qian F, Liu G, Hu FB, Bhupathiraju SN, Sun Q. Association between plant-based dietary patterns and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA Int Med. 2019 Oct;179(10):1335-44. DOI: 10.1001/jamainternmed.2019.2195.
29. Jenkins DJ, Kendall CW, Augustin LS, Mitchell S, Sahye-Pudaruth S, Blanco Mejia S, et al. Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 Diabetes mellitus.Arch Intern Med. 2012 Nov;172(21):1653-60. DOI: 10.1001/2013. jamainternmed.70.
30. Hermsdorff HH, Zulet MÁ, Abete I, Martínez JA. A legume-based hypocaloric diet reduces proinflammatory status and improves metabolic features in overweight/obese subjects. Eur J Nutr. 2010 Feb;50(1):61-9. DOI: 10.1007/s00394-010-0115-x.
31. Denissen KFM, Heil SG, Eussen SJPM, Heeskens JPJ, Thijs C, Mommers M , et al . Intakes of vitamin B-12 from dairy food, meat, and fish and shellfish are independently and positively associated with vitamin B-12 niomarker status in pregnant dutch women. J Nutr. 2019 Jan;149(1):131- 38.DOI: 10.1093/jn/nxy233.
32. Bergqvist C, Ezzedine K. Vitamin D and the skin: what should a dermatologist know? G Ital Dermatol Venereol. 2019 Jan;154(6):669-80. DOI: 10.23736/S0392-0488.19.06433-2.
33. Zhang J, Wang C, Li L, Man Q, Meng L, Song P, et al. Dietary inclusion of salmon, herring and pompano as oily fish reduces CVD risk markers in dyslipidaemic middle-aged and elderly Chinese women. Br J Nutr. 2012 Oct;108(8):1455-65. DOI: 10.1017/S0007114511006866.
34. Torris C, Smastuen MC, Molin M. Nutrients in fish and possible associations with cardiovascular disease risk factors in metabolic syndrome. Nutrients. 2018 Jul;10(7):952. DOI: 10.3390/nu10070952.
35. Jayedi A, Shab-Bidar S. Fish consumption and the risk of chronic disease: an umbrella review of meta-analyses of prospective cohort Studies. Adv Nutr. 2020 Sep;11(5):1123-33. DOI: 10.1093/advances/nmaa029.
36. Rhee JJ, Kim E, Buring JE, Kurth T. Fish consumption, omega-3 fatty acids, and risk of cardiovascular disease. Am J Prev Med. 2017 Jan;52(1):10- 19. DOI: 10.1016/j.amepre.2016.07.020.
37. Jayedi A, Shab-Bidar S, Eimeri S, Djafarian K. Fish consumption and risk of all-cause and cardiovascular mortality: a dose-response meta-analysis of prospective observational studies. Public Health Nutr.2018 May;21(7):1297-06. DOI: 10.1017/S1368980017003834.
38. Sun Y, Liu B, Snetselaar LG, Robinson JG, Wallace RB, Peterson LL , et al. Association of fried food consumption with all cause, cardiovascular, and cancer mortality: prospective cohort study. BMJ. 2019 Jan;363(1):5420. DOI: 10.1136/bmj.k5420.
39. Valenzuela CA, Baker EJ, Miles EA, Calder PC. Eighteen carbon trans fatty acids and inflammation in the context of atherosclerosis. Prog Lipid Res. 2019 Oct;76(1):101009. DOI: 10.1016/j.plipres.2019.101009.
40. He FJ , MacGregor GA. Role of salt intake in prevention of cardiovascular disease: Controversies and challenges. Nat Rev Cardiol. 2018 Jun;15(6):371-77. DOI: 10.1038/s41569-018-0004-1
41. Lastra G, Dhuper S, Johnson MS, Sowers JR. Salt, aldosterone, and insulin resistance: impact on the cardiovascular system. Nat Rev Cardiol. 2010 Oct;7(10):577-84. DOI: 10.1038/nrcardio.2010.123.
42. Sikand G, Severson T. Top 10 dietary strategies for atherosclerotic cardiovascular risk reduction. Am J Prev Cardiol. 2020 Nov;4(1):100106. DOI: 10.1016/j.ajpc.2020.100106.
43. Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010 Jun;121(21):2271-83. DOI: 10.1161/ CIRCULATIONAHA.109.924977.
44. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr. 2010 Mar; 91(3):535-46. DOI: 10.3945/ajcn.2009.27725.
45. AB, Hill. The environment and disease: association or causation? Proc R Soc Med. 1965 May;58(5):295-300.
46. Micha R, Mozaffarian D. Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence. Lipids. 2010 Oct;45(10):893-605. DOI: 10.1007/s11745-010-3393-4.
47. Clayton ZS, Fusco E, Kern M. Egg consumption and heart health: a review. Nutrition. 2017 May;37:79-85. DOI: 10.1016/j.nut.2016.12.014.
48. Berger S, Raman G, Vishwanathan R, Jacques PF, Johnson EJ. Dietary cholesterol and cardiovascular disease:a systematic review and meta- analysis. Am J Clin Nutr. 2015 Aug; 102(2):276-94. DOI: 10.3945/ ajcn.114.100305.
49. Roberts SL, McMurry MP, Connor WE . Does egg feeding (i.e., dietary cholesterol) affect plasma cholesterol levels in humans? the results of a double-blind study. Am J Clin Nutr.1981 Oct;34(10):2092-9. DOI: 10.1093/ ajcn/34.10.2092
50. Arne Astrup Goodbye to the egg-white omelet—welcome back to the whole-egg omelet. Am. J. Clin. Nutr. 2018 Jun;107(1):853-854. DOI: 10.1093/ ajcn/nqy106.
51. Guo J, Astrup A, Lovegrove JA, Gijsbers L, Givens DI, Soedamah- Muthu SS. Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies. Eur J Epidemiol. 2017 Apr;32(4):269-287. DOI: 10.1007/ s10654-017-0243-1.
52. Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi AM, Knüppel S, Iqbal K, et al. Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2017 Jun;(6):1462- 1473. DOI: 10.3945/ajcn.117.153148
53. Qin LQ, Xu JY, Han SF, Zhang ZL, Zhao YY, Szeto IM. Dairy consumption and risk of cardiovascular disease: an updated meta- analysis of prospective cohort studies. Asia Pac J Clin Nutr. Asia Pac J Clin Nutr. 2015;24(1):90-100. DOI: 10.6133/apjcn.2015.24.1.09.
54. Gröber U, Schmidt J, Kisters K. Magnesium in prevention and therapy. Nutrients. 2015 Sep;7(9):8199-226. DOI: 10.3390/nu7095388.
55. Lichtenstein AH, Appel LJ, Vadiveloo M, Hu FB, Kris-Etherton PM, Rebholz CM, et al. 2021 Dietary guidance to improve cardiovascular health: a scientific statement from the american heart association. Circulation. 2021 Dec;144(23):472-87. DOI: 10.1161/CIR.0000000000001031.
56. Mazidi M, Mikhailidis DP, Sattar N, Howard G, Graham I, Banach M, et al. Consumption of dairy product and its association with total and cause specific mortality a-population-based cohort study and meta- analysis. Clin Nutr. 2019 Dec;38(6):2833-45. DOI: 10.1016/j.clnu.2018.12.015.
57. Giosuè A, Calabrese I, Vitale M, Riccardi G, Vaccaro O. Consumption of dairy foods and cardiovascular disease: a systematic review. Nutrients. 2022 Feb;14(1):831. DOI: 10.3390/nu14040831.
58. Singh A, Duche RT, Wandhare AG, Sian JK, Singh BP, Sihag MK et al. Milk-Derived Antimicrobial Peptides: Overview, Applications, and Future Perspectives. Probiotics Antimicrob Proteins. 2023 Feb;15(1):44-62. DOI: 10.1007/s12602-022-10004-y.
59. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. European guidelines on cardiovascular disease prevention in clinical practice (version 2012). The fifth joint task force of the european society of cardiology and other societies on cardiovascular disease prevention in clinical practice. Eur Heart. 2012 Jul;33(13):1635- 01. DOI: 10.1093/ eurheartj/ehs092.
60. Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the american eart association's strategic Impact Goal through 2020 and beyond. Circulation. 2010 Feb;121(4):586-613. DOI: 10.1161/CIRCULATIONAHA.109.192703.
61. Sala-Vila A, Estruch R, Ros E. New insights into the role of nutrition in CVD prevention. Curr Cardiol Rep. 2015 May;17(5):26. DOI: 10.1007/ s11886-015-0583-y.
62. Monteiro CA,Cannon G, Levy R, Moubarac JC, Jaime P, Martins AP, et al. NOVA. The star shines bright. World Nutrition. 2016 Jan;7(1):28-38.
63. Mendonça RD, Lopes AC, Pimenta AM, Gea A, Martinez-Gonzalez MA, Bes-Rastrollo M. Ultra-processed food consumption and the incidence of hypertension in a Mediterranean Cohort: The Seguimiento Universidad de Navarra Project. Am J Hypertens. 2017 Apr;30(1):358-366. DOI: 10.1093/ajh/hpw137.
64. Suksatan W, Moradi S, Naeini F, Bagheri R, Mohammadi H, Talebi S, et al. Ultra-processed food consumption and adult mortality risk: a systematic review and dose-response meta-analysis of 207,291 Participants. Nutrients. 2021 Dec;14(1):174. DOI: 10.3390/nu14010174.
65. Zhong GC, Gu HT, Peng Y, Wang K, Wu YQ, Hu TY, et al. Association of ultra-processed food consumption with cardiovascular mortality in the US population: long-term results from a large prospective multicenter study. Int J Behav Nutr Phys Act. 2021 Feb;18(1):21. DOI: 10.1186/s12966- 021-01081-3.
66. Paglia L. The sweet danger of added sugars. Eur J Paediatr Dent. 2019 Jun;20(2):89. DOI: 10.23804/ejpd.2019.20.02.01.
67. Lichtenstein AH. Last nail in the coffin for sugar-sweetened beverages. Circulation. 2019 Apr;139(18):2126-28. DOI: 10.1161/ CIRCULATIONAHA.119.040245.
68. Hoare E, Varsamis P, Owen N, Dunstan DW, Jennings GL, Kingwell BA. Sugar- and intense-sweetened drinks in australia: a systematic review on cardiometabolic risk. Nutrients. 2017 Sep;10(1):1075. DOI: 10.3390/ nu9101075.
69. Song S, Shim JE, Song Y. Association of added sugar intake with all-cause and cardiovascular disease mortality: a systematic review of cohort studies. Nutr Res Pract. 2022 May;16(1):21-36. DOI: 10.4162/ nrp.2022.16.S1.S21.
70. Hawkins KR, Burton JH, Apolzan JW, Thomson JL, Williamson DA, Martin CK. Efficacy of a school-based obesity prevention intervention at reducing added sugar and sodium in children's school lunches: the LA Health randomized controlled trial. Int J Obes (Lond). 2018 Nov;42(11):1845- 52. DOI: 10.1038/s41366-018-0214-y.
71. Laviada-Molina H, Molina-Segui F, Pérez-Gaxiola G, Cuello-García C, Arjona-Villicaña R, Espinosa-Marrón A. Effects of nonnutritive sweeteners on body weight and bmi in diverse clinical contexts: systematic review and meta-analysis. Obes Rev. 2020 Jul; 21(1):e13020. DOI: 10.1111/obr.13020.
72. Malik VS, Hu FB. Sugar-sweetened beverages and cardiometabolic health: an update of the evidence. Nutrients. 2019 Aug;11(8):1840. DOI: 10.3390/nu11081840.
73. Ebrahimpour-Koujan S, Saneei P, Larijani B, Esmaillzadeh A. Consumption of sugar sweetened beverages and dietary fructose in relation to risk of gout and hyperuricemia: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2020;60(1):1-10. DOI: 10.1080/10408398.2018.1503155.
74. American Heart Association Nutrition Committee, Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006 Jul;114(1):82-96. DOI: 10.1161/CIRCULATIONAHA.106.176158.
75. National Academies of Sciences, Engineering, and Medicine. Dietary Reference Intakes for Sodium and Potassium. [cited Kasım 2022].Erişim: https://www.ncbi.nlm.nih.gov/books/NBK538102/
76. McMahon EJ, Campbell KL, Bauer JD, Mudge DW, Kelly JT. Altered dietary salt intake for people with chronic kidney disease. Cochrane Database Syst Rev. 2021 Feb;6(6):010070. DOI: 10.1002/14651858. CD010070.pub2.
77. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D et al. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. DASH-Sodium collaborative research group. N Engl J Med. 2001 Jan;344(1):3-10. DOI: 10.1056/NEJM200101043440101.
78. Juraschek SP, Miller ER 3rd, Weaver CM, Appel LJ. Effects of Sodium Reduction and the DASH Diet in Relation to Baseline Blood Pressure. J Am Coll Cardiol. 2017 Dec; 70(23):2841-48. DOI: 10.1016/j.jacc.2017.10.011.
79. Erdem Y, Arıcı M, Altun B, Turgan Ç, Sindel Ş, Erbay B et al. The relationship between hypertension and salt intake in Turkish population: SALTURK study. Blood Pressure. 2010 Oct;19(5):313-8. DOI: 10.3109/08037051003802541.