The relationship of diuretics and dietary sodium in patients with heart failure: an analysis of the SODIUM-HF trial.

Background: SODIUM-HF was a large clinical trial testing dietary sodium restriction compared to usual care in patients with heart failure that showed no reduction in clinical events. It has been suggested that diuretic doses in response to dietary sodium modification may have influenced the trial results.

Objective: We assessed the effects of baseline diuretic dose and diuretic dose changes on clinical outcomes in the SODIUM-HF trial.

Examining changes in the sodium content of Canadian prepackaged foods: 2013 to 2017.

Canadians consume excessive amounts of sodium, a leading risk factor for cardiovascular disease. In 2012, Health Canada released guidance outlining voluntary sodium reduction benchmarks for pre-packaged foods to be met by manufacturers by 2016. Using the University of Toronto's Food Label Information Program(FLIP), the aim of this study was to evaluate changes in average sodium content of Canadian pre-packaged foods from 2013 to 2017 and manufacturers' progress in meeting final phase III sodium reduction benchmark targets.

Co-Design and Refinement of Curriculum-Based Foodbot Factory Intervention to Support Elementary School Nutrition Education.

Background/objectives: School-based nutrition education interventions can support the development of children's food literacy and healthy eating habits. The Foodbot Factory serious game was developed to support school nutrition education based on Canada's Food Guide and Ontario curriculum. The objective of this research was to refine the Foodbot Factory intervention to include curriculum-based lesson plans that had a high-level of acceptability by stakeholders to support implementation by teachers in classrooms.

The implementation of non-weight focused approaches in clinical practice: A Canadian cross-sectional study among registered dietitians.

Background: An increasing number of dietitians use non-diet approaches, referred to as non-weight focused practice approaches (NWFAs), in clinical practice when working with higher weight adult clients. However, the factors that impact dietitians' ability to successfully implement these approaches in practice are unknown.

Methods: Aiming to examine how implementing NWFAs in clinical practice differs based on the extent to which a dietitian uses NWFAs with their clients, we conducted a cross-sectional online survey among Canadian registered dietitians who work with higher weight adults (May to July 2021), developed and validated following the Consolidated Framework for Implementation Research.

The current state of evidence for sodium and fluid restriction in heart failure.

The field of heart failure has evolved in terms of the therapies that are available including pharmaceutical and device therapies. There is now substantial randomized trial data to indicate that dietary sodium restriction does not provide the reduction in clinical events with accepted heterogeneity in the clinical trial results. Dietary sodium restriction should be considered for some but not all patients and with different objectives than clinical outcomes but instead for potential quality of life benefit.

Updating the Foodbot Factory serious game with new interactive engaging features and enhanced educational content.

Serious games (i.e., digital games designed for educational purposes) can foster positive learning attitudes and are increasingly used as educational tools.

Factors Impacting the Uptake of Research into Dietary Sodium Reduction Policies in Five Latin American Countries: A Qualitative Study.

Background: Diets high in sodium are a risk factor for cardiovascular disease (CVD). Latin American countries (LAC) consume more than double the recommended sodium levels. Research uptake in dietary sodium reduction policies has been inconsistent in LAC, and the factors impacting research uptake are largely unknown.

Patient perspectives on the use of mobile apps to support heart failure management: A qualitative descriptive study.

Background: Adherence to diet and medical therapies are key to improving heart failure (HF) outcomes; however, nonadherence is common. While mobile apps may be a promising way to support patients with adherence via education and monitoring, HF patient perspectives regarding the use of apps for HF management in unknown. This data is critical for these tools to be successfully developed, implemented, and adopted to optimize adherence and improve HF outcomes.

Impact of mHealth Interventions on Supporting Dietary Adherence in Cardiovascular Disease: A Systematic Review.

Introduction: A systematic review was conducted to determine if mobile health (mHealth) interventions, and which intervention characteristics, effectively support dietary adherence and reduce risk factors in patients with cardiovascular disease (CVD).

Method: Using 7 databases, studies involving adult participants with specific CVD diagnoses, mHealth intervention testing, and dietary adherence assessment were identified. Systematic reviews, qualitative studies, or studies testing interventions involving open dialogue between participants and health care providers or researchers were excluded.

An Examination of the Practice Approaches of Canadian Dietitians Who Counsel Higher-Weight Adults Using a Novel Framework: Emerging Data on Non-Weight-Focused Approaches.

Non-weight-focused approaches (NWFAs) may be used by some clinicians when working with higher-weight clients. In contrast to weight-focused approaches (WFAs), NWFAs de-emphasize or negate weight loss and emphasize overall diet quality and physical activity. The extent to which WFAs, NWFAs, or a combination of both WFAs and NWFAs are used by dietitians is unknown in Canada and globally.

Automated digital counselling with social network support as a novel intervention for patients with heart failure: protocol for randomised controlled trial.

Introduction: Heart failure (HF) symptoms improve through self-care, for which adherence remains low among patients despite the provision of education for these behaviours by clinical teams. Open Access Digital Community Promoting Self-Care, Peer Support and Health Literacy (ODYSSEE-vCHAT) combines automated digital counselling with social network support to improve mortality and morbidity, engagement with self-care materials, and health-related quality of life.

Methods And Analysis: Use of ODYSSEE-vCHAT via Internet-connected personal computer by 162 HF patients will be compared with a control condition over 22 months.

A Program Evaluation of a Dietary Sodium Reduction Research Consortium of Five Low- and Middle-Income Countries in Latin America.

Excess dietary sodium is a global public health priority, particularly in low- and middle-income countries where rates of hypertension and cardiovascular disease are high. The International Development Research Centre funded a research consortium of five Latin American countries (LAC) to inform public health policy for dietary sodium reduction (2016-2020). The objective of this study was to determine the outcomes of this funding on short-term (e.

Evaluating Health Care Provider Perspectives on the Use of Mobile Apps to Support Patients With Heart Failure Management: Qualitative Descriptive Study.

Background: Nonadherence to diet and medical therapies in heart failure (HF) contributes to poor HF outcomes. Mobile apps may be a promising way to improve adherence because they increase knowledge and behavior change via education and monitoring. Well-designed apps with input from health care providers (HCPs) can lead to successful adoption of such apps in practice.

A feasibility study of a randomized controlled trial protocol to assess the impact of an eHealth intervention on the provision of dietary advice in primary care.

Background: Canadian sodium intakes remain high despite population-wide sodium reduction initiatives, highlighting the need for personal action in reducing dietary sodium. eHealth interventions support patients in dietary change and assist clinicians in decision-making and delivering care, including provision of advice. To date, impact of diet-focused eHealth tools, like the Sodium Calculator (SC) dietary screening tool, on clinical outcomes has received minimal examination.

Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial.

Background: Dietary restriction of sodium has been suggested to prevent fluid overload and adverse outcomes for patients with heart failure. We designed the Study of Dietary Intervention under 100 mmol in Heart Failure (SODIUM-HF) to test whether or not a reduction in dietary sodium reduces the incidence of future clinical events.

Methods: SODIUM-HF is an international, open-label, randomised, controlled trial that enrolled patients at 26 sites in six countries (Australia, Canada, Chile, Colombia, Mexico, and New Zealand).

The Content, Quality, and Behavior Change Techniques in Nutrition-Themed Mobile Apps for Children in Canada: App Review and Evaluation Study.

Background: Children increasingly use mobile apps. Strategies to increase child engagement with apps include the use of gamification and images that incite fun and interaction, such as food. However, the foods and beverages that children are exposed to while using apps are unknown and may vary by app type.

Sodium and Health: Old Myths and a Controversy Based on Denial.

Purpose Of Review: The scientific consensus on which global health organizations base public health policies is that high sodium intake increases blood pressure (BP) in a linear fashion contributing to cardiovascular disease (CVD). A moderate reduction in sodium intake to 2000 mg per day helps ensure that BP remains at a healthy level to reduce the burden of CVD.

Recent Findings: Yet, since as long ago as 1988, and more recently in eight articles published in the European Heart Journal in 2020 and 2021, some researchers have propagated a myth that reducing sodium does not consistently reduce CVD but rather that lower sodium might increase the risk of CVD.

Socioeconomic position and consumption of sugary drinks, sugar-sweetened beverages and 100% juice among Canadians: a cross-sectional analysis of the 2015 Canadian Community Health Survey-Nutrition.

Objective: The aim of this study was to describe sugary drink (beverages with free sugars), sugar-sweetened beverage (beverages with added sugars, SSB) and 100% juice (beverages with natural sugars) consumption across socioeconomic position (SEP) among Canadians.

Methods: We conducted a cross-sectional analysis of 19,742 respondents of single-day 24-h dietary recalls in the nationally representative 2015 Canadian Community Health Survey-Nutrition. Poisson regressions were used to estimate the prevalence of consuming each beverage type on a given day.

Changes in the Sodium Content of Foods Sold in Four Latin American Countries: 2015 to 2018.

In 2015, the Pan American Health Organization (PAHO) published sodium targets for packaged foods, which included two distinct levels: one "regional" and one "lower" target. Changes to the sodium content of the food supply in Latin American Countries (LAC) has not been evaluated. A repeated cross-sectional study used food label data from 2015 ( = 3859) and 2018 ( = 5312) to determine changes in the proportion of packaged foods meeting the PAHO sodium targets and the distribution in the sodium content of foods in four LAC (Argentina, Costa Rica, Paraguay, Peru).

Development and pilot testing of the Nutrition Attitudes and Knowledge Questionnaire to measure changes of child nutrition knowledge related to the Canada's Food Guide.

Foodbot Factory is a serious game developed to teach children about the 2019 Canada's Food Guide (CFG) healthy eating principles. Because no measurement tools existed to assess changes in children's knowledge of the CFG, the Nutrition Attitudes and Knowledge (NAK) questionnaire was developed for this purpose. The NAK is based on the 2019 CFG nutrition content and aligned with the Foodbot Factory modules (Drinks, Whole Grain foods, Vegetables and Fruit, Protein foods).

The Equity and Effectiveness of Achieving Canada's Voluntary Sodium Reduction Guidance Targets: A Modelling Study Using the 2015 Canadian Community Health Survey-Nutrition.

: High sodium intake is a leading modifiable risk factor for cardiovascular diseases. This study estimated full compliance to Canada's voluntary sodium reduction guidance (SRG) targets on social inequities and population sodium intake. : We conducted a modeling study using = 19,645, 24 h dietary recalls (Canadians ≥ 2 years) from the 2015 Canadian Community Health Survey-Nutrition (2015 CCHS-N).