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Theories of myopia etiology based on near work and lack of outdoor exposure have had inconsistent support and have not prevented the rising prevalence of global myopia. New scientific theories in the cause and prevention of myopia are needed. Myopia prevalence is low in native people consuming traditional diets lacking in sodium chloride, and nutritional epidemiological evidence supports the association of rising myopia prevalence with dietary sodium intake. East Asian populations have among the highest rates of myopia associated with high dietary sodium. Similar associations of sodium and rising myopia prevalence were observed in the United States in the late 20th century. The present perspective synthesizes nutritional epidemiology evidence with pathophysiological concepts and proposes that axial myopia occurs from increased fluid retention in the vitreous of the eye, induced by dietary sodium chloride intake. Salt disturbs ionic permeability of retinal membranes, increases the osmotic gradient flow of fluid into the vitreous, and stretches ocular tissue during axial elongation. Based on the present nutritional epidemiology evidence, experimental research should investigate the effect of sodium chloride as the cause of myopia, and clinical research should test a very low-salt diet in myopia correction and prevention. [ABSTRACT FROM AUTHOR]

Sea levels across the planet are rising, particularly along the eastern coast of the United States. Climate‐induced sea level rise can result in the inundation and intrusion of seawater into freshwater drainages. This would alter salinity regimes and lead to the salinization of coastal freshwater ecosystems. Increased salinity levels in freshwater can negatively affect freshwater‐dependent species, including native mussels belonging to the order Unionida, which are highly sensitive to changes in water quality. Sea salt is largely made up of sodium and chloride ions, forming sodium chloride, a known toxicant to freshwater mussels. However, sea salt is a mixture that also contains other major ions, including potassium, sulfate, calcium, strontium, and magnesium, among others. Freshwater mussels exposed to sea salt would be exposed to each of the sea salt ions at the same time, resulting in a mixture toxicity effect. The mixture toxicity of these ions on early life stages of freshwater mussels is largely unknown because most research to date has evaluated individual salt ions in relative isolation. Therefore, we conducted acute toxicity tests on early life stages (glochidia and juvenile) of three freshwater mussel species that inhabit Atlantic Slope drainages (nonsalinity‐adapted Atlanticoncha ochracea, salinity‐adapted A. ochracea, Sagittunio nasutus, and Utterbackiana implicata). Glochidia and juveniles of each species were exposed to a control and six concentrations of Instant Ocean® Sea Salt (IOSS), a synthetic sea salt that closely resembles the ionic composition of natural sea salt. Exposure concentrations were 1 part(s) per thousand (ppt), 2 ppt, 8.5 ppt, 12.5 ppt, 17 ppt, and 34 ppt. We calculated the median effect concentration (EC50) for each of the eight acute toxicity tests and found that glochidia were more sensitive than juveniles to IOSS. At hour 24 EC50s for the glochidia ranged from 0.38 to 3.6 ppt, with the most sensitive freshwater mussel being the nonsalinity‐adapted A. ochracea, exhibiting an EC50 of 0.38 ppt (95% confidence interval [CI] 0.33–0.44). Juvenile freshwater mussels exhibited EC50s at hour 96 ranging from 5.0 to 10.4 ppt, with the least sensitive freshwater mussel being the nonsalinity‐adapted A. ochracea, exhibiting an EC50 of 10.4 ppt (95% CI 9.1–12.0). Our results show that acute exposure to sea salt adversely affects freshwater mussel viability, particularly glochidia. This information can be used to enhance freshwater mussel conservation strategies in regions that are or will be impacted by climate‐induced sea level rise and associated freshwater salinization. Environ Toxicol Chem 2023;42:2478–2489. © 2023 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. [ABSTRACT FROM AUTHOR]

The article investigates the case of terminal lakes or shrinking inland seas that expose salty particulates, metals and other compounds. Topics discussed are potential effect of dust from Salton Sea in California on the respiratory health of children, presence of arsenic in the bed of Great Salt Lake Utah, global water diversion and climate change, and approaches to mitigate dust emissions from dry lakes.

Groundwater contamination of bedrock domestic wells by road salt is an ever‐increasing problem in the Northeast United States. Given the many factors that influence salt transport to wells, the timeframe of salt impacts cannot be readily determined. As such, one cannot optimize quarterly monitoring for assessing the extent of a problem, its source or the effectiveness of remedial measures. Although the use of high‐frequency monitoring by installing pressure/electrical conductance probes in wells can be conducted to help determining salt contamination changes with time, this can be costly given the application to multiple wells. In addition, there are logistical issues with regard to probe placement in a drinking water well. In this study a stakeholder participated in high‐resolution monitoring of salt contamination using a chloride field test kit. The daily stakeholder water quality monitoring was highly correlated to the specific conductance results obtained with a pressure/conductivity probe. Voluntary stakeholder participation in monitoring can offer a lower cost means of high‐frequency monitoring of salt contamination changes with time. [ABSTRACT FROM AUTHOR]

Creeping bentgrass (Agrostis stolonifera L.) is a turfgrass species that is widely used on golf courses throughout the United States. In field settings, plants are often subjected to more than one stress at a time, and studying stresses independently is likely insufficient. Stresses, such as heat stress and salt stress, can affect plant hormone levels and, in turn, plant hormone levels can affect how well the plant tolerates stress. The objectives of the experiments were to determine if the levels of heat stress and salt stress used would be detrimental to creeping bentgrass health, and if applying plant growth regulators could improve plant health during stress. During the first experiment, creeping bentgrass was transplanted to hydroponics systems in two different growth chambers. One chamber was set to have day and night temperatures of 35 °C and 30°C (heat stress), respectively, and the other had day and night temperatures of 25 °C and 20°C, respectively. Within each chamber, one block received a 50 mM NaCl treatment (salt stress) and the other did not (control). The stress treatments were applied for 14 days. Results of the first experiment indicated that the treatments were sufficient to negatively affect creeping bentgrass growth and health as indicated by fresh shoot and root weights, tillering, electrolyte leakage, and total chlorophyll content (TCC). There were significant interactions of temperature x salt level detected for shoot and root weights and electrolyte leakage. Plants that were exposed to both heat stress and salt stress were more negatively affected than plants exposed to either heat stress or salt stress alone for all metrics except for tillering. The presence of salt reduced tillering regardless of the temperature regimen. During the second experiment, plants were treated the same, but the plant growth regulator (PGR) treatments were also applied. The PGR treatments consisted of two different gibberellic acid (GA) synthesis inhibitor products, 2,4-dichlorophenoxyacetic acid, two different rates of aminoethoxyvinylglycine (AVG), an ethylene synthesis suppressor, and plants that were not treated with the PGR. In addition to the measurements of plant health and growth, dry shoot and root weights were measured. For the TCC, there was a two-way interaction between temperature x PGR treatment. For electrolyte leakage, there was a three-way interaction between temperature x salt level x PGR treatment. Combined heat stress and salt stress negatively affected all plants regardless of PGR treatment, but there were differences between PGR treatments. Plants treated with AVG exhibited improved health and growth compared with the other PGR treatments. These plants had the highest shoot and root masses. Plants treated with GA synthesis inhibitors had the lowest shoot and root masses as well as the lowest TCC when subjected to stress. [ABSTRACT FROM AUTHOR]

Gilbert Bay, the largest embayment of the expansive Great Salt Lake (GSL) in the United States, is a productive aquatic system providing a suite of ecosystem services, both locally and across hemispheric flyways and global aquaculture networks. Gilbert Bay is currently at a record low stand and elevated salinity attributable to the coupled effects of drought and human water use in the basin. However, a recent management berm at the breach in the mid‐lake causeway provides a unique adaptive management tool to mitigate harmful salinity changes. The present study measured the fluctuating Gilbert Bay salinities and salt loads across a multi‐year period of changing causeway breach management. Opening of the breach in 2016 and a high spring runoff in 2017 exported a substantial portion of Gilbert Bay salt load into adjacent Gunnison Bay, lowering the salinity–elevation relationship in Gilbert. The salt load in the bay has since returned to nearly pre‐breach levels with salinities at the current low stand now exceeding the ecologically optimal range. The chronicled salt movement and salinity relationships were used to recommend short‐ and long‐term adaptive management strategies for the causeway berm in order to sustain the crucial Gilbert Bay aquatic ecosystem in the face of drought and future variability, as well as highlighting the structural advantages GSL has over other saline lakes experiencing anthropogenic water loss. [ABSTRACT FROM AUTHOR]

Summary: Baking powders contain leavening acids that activate gas‐releasing agents such as sodium bicarbonate. This is a review of the patent literature on phosphate‐based leavening acids developed between 1856 and 2019. Overall, 174 patented inventions were found on 28 phosphate‐based compounds, which corresponded to more than half of the inventions disclosed on leavening acids. Inventors had a strong interest in monocalcium phosphate, sodium acid pyrophosphate and, to a lesser extent, sodium aluminium phosphate and miscellaneous acid phosphates. As cheap alternatives to tartrates, most early phosphate‐based leavening acids were difficult to keep because they had a high affinity for moisture and tended to react prematurely with gas‐releasing agents in baking powders. The evolution of phosphates in chemical leavening reflected changes in the consumption of bakery foods, especially in the United States where chemical leavening has been very popular for food preparations like prepared flours, ready‐to‐use bakery mixes and refrigerated doughs. Sodium‐free phosphates are solutions to reduce salt intake in food. Alternatives to phosphates are searched due to potential health issues. [ABSTRACT FROM AUTHOR]

Background: High intake of added sugar is linked to weight gain and cardiometabolic risk. In 2018, the US National Salt and Sugar Reduction Initiative proposed government-supported voluntary national sugar reduction targets. This intervention's potential effects and cost-effectiveness are unclear.Methods: A validated microsimulation model, CVD-PREDICT (Cardiovascular Disease Policy Model for Risk, Events, Detection, Interventions, Costs, and Trends), coded in C++, was used to estimate incremental changes in type 2 diabetes, cardiovascular disease (CVD), quality-adjusted life-years (QALYs), costs, and cost-effectiveness of the US National Salt and Sugar Reduction Initiative policy. The model was run at the individual level, incorporating the annual probability of each person's transition between health statuses on the basis of risk factors. The model incorporated national demographic and dietary data from the National Health and Nutrition Examination Survey across 3 cycles (2011 through 2016), added sugar-related diseases from meta-analyses, and policy costs and health-related costs from established sources. A simulated nationally representative US population was created and followed until age 100 years or death, with 2019 as the year of intervention start. Findings were evaluated over 10 years and a lifetime from health care and societal perspectives. Uncertainty was evaluated in a 1-way analysis by assuming 50% industry compliance and probabilistic sensitivity analyses through a second-order Monte Carlo approach. Model outputs included averted diabetes cases, CVD events and CVD deaths, QALYs gained, and formal health care cost savings, stratified by age, race, income, and education.Results: Achieving the US National Salt and Sugar Reduction Initiative sugar reduction targets could prevent 2.48 million CVD events, 0.49 million CVD deaths, and 0.75 million diabetes cases; gain 6.67 million QALYs; and save $160.88 billion net costs from a societal perspective over a lifetime. The policy became cost-effective (<150 000/QALYs) at 6 years, highly cost-effective (<50 000/QALYs) at 7 years, and cost-saving at 9 years. Results were robust from a health care perspective, with lower (50%) industry compliance, and in probabilistic sensitivity analyses. The policy could also reduce disparities, with greatest estimated health gains per million adults among Black or Hispanic individuals, lower income, and less educated Americans.Conclusions: Implementing and achieving the US National Salt and Sugar Reduction Initiative sugar reformation targets could generate substantial health gains, equity gains, and cost savings. [ABSTRACT FROM AUTHOR]

Background: Although the subject of numerous studies, the associations between dietary sodium, potassium, and the ratio of dietary sodium to potassium with blood pressure are not clear-cut. In addition, there is a paucity of research on these relationships in prospective cohort studies with representation from diverse Hispanic/Latino adults., Objectives: To evaluate the associations between dietary intake of sodium, potassium, and the ratio of dietary sodium to potassium and blood pressure in a diverse sample of Hispanics living in the United States., Methods: This analysis included 11,429 Hispanic/Latino participants of the prospective cohort Hispanic Community Health Study/Study of Latinos recruited between 2008 and 2011 in visit 1 who participated in a follow-up visit in 2014-2017. Dietary sodium and potassium intakes were averaged from 2 interviewer-administered 24-h diet recalls collected at visit 1. At both visits, blood pressure was measured 3 times in a seated position and averaged. We assessed the relationship between dietary sodium, potassium, and the sodium-to-potassium ratio with changes in systolic and diastolic blood pressure using survey-weighted multivariable-adjusted regression models., Results: At visit 1, the mean age was 41 y, and the mean sodium intake was 3203 mg/d. Each 500 mg/d sodium increment in intake was associated with an increase in systolic blood pressure (β: 0.35 [mmHg]; 95% confidence interval: 0.06, 0.63) and diastolic blood pressure (β: 0.45 [mmHg]; 95% confidence interval: 0.08, 0.82). Dietary potassium and the molar ratio of dietary sodium to potassium were not associated with changes in systolic or diastolic blood pressure., Conclusions: Among a large sample of diverse United States Hispanic/Latino adults, higher sodium intake was associated with small increases in systolic blood pressure over 6 y. This research underscores the importance of dietary sodium reduction in maintaining lower blood pressure., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background Sodium intake in the USA exceeds recommendations. The replacement of added sodium chloride (NaCl) with potassium chloride (KCl) provides a potential strategy to reduce sodium intake. Objective The purpose of this study was to quantitatively estimate changes in intakes of sodium and potassium by the US population assuming use of potassium-based NaCl replacers in top dietary sodium sources. Methods Data collected in the What We Eat in America (WWEIA) component of the 2015–2016 and 2009–2010 NHANES were used to identify top-ranking sources of dietary sodium among the population aged 2 y and older based on contributions from food categories aligning with the FDA draft guidance for voluntary sodium reduction. Predicted nutrient intakes were estimated in models assuming total and feasible and practical (F&P) replacement of added NaCl with KCl in foods and ingredients within the top food sources of sodium. An expert elicitation was conducted to collect information on the F&P KCl replacement of added NaCl. Results Using 2015–2016 consumption data, the total replacement of added NaCl with KCl in the 18 top-ranking sources of dietary sodium results in a predicted sodium intake of 2004 mg/d from the replacement of 1406 mg/d sodium with 1870 mg/d potassium as KCl. Modeled F&P replacement predicted sodium intakes of 3117 mg/d (range of 2953 to 3255 mg/d) from the replacement of 294 mg/d sodium (155 to 457 mg/d) with 390 mg/d potassium (206 to 608 mg/d). Similar results are seen with 2009–2010 data. Conclusions The F&P replacement of NaCl with KCl in top-ranking sources of dietary sodium modeled in this study can result in decreased sodium to a level consistent with the short-term intake goal targeted by the FDA of 3000 mg/d, with the mean potassium intake remaining in the range recommended for the apparently healthy population. [ABSTRACT FROM AUTHOR]

Using deposition observations from precipitation samples collected by the National Atmospheric Deposition Program at 125 sites across the United States, we show that the mean wet deposition flux of non‐sea‐salt chloride (NSS Cl−) has decreased by 83% throughout the eastern United States between 1998 and 2018. We find that 30% of the sites switch from having excess Cl− to being depleted in Cl−. We attribute the observed decreases in NSS Cl− deposition to a 95% decrease in U.S. anthropogenic HCl emissions since 1998. We propose that industry emission controls that remove HCl as a cobenefit of NOx and SO2 have caused significant decreases in NSS Cl− deposition throughout the eastern United States, in addition to shifts from coal to natural gas and to coal with lower Cl− content. Our analysis implies that the lower tropospheric reactive inorganic chlorine burden was larger over the United States in the past than it is today. Plain Language Summary: Comparing the relative ratio of sodium and chloride that is deposited in rainwater, it is possible to separate out whether that chloride is from anthropogenic sources, like burning coal, or from natural sources, like seawater. Using rainwater samples collected at 125 sites by the National Atmospheric Deposition Program between 1998 and 2018, we show that the amount of chloride deposited in rainwater from anthropogenic sources has decreased by 83% across the eastern United States. Power plant scrubbers designed to reduce emissions of SO2 and NOx, which lead to acid rain and smog, also remove emissions of HCl from burning coal, as a cobenefit. The widespread installation of these emission control technologies, together with a switch from coal to natural gas and to coal with lower chloride content, has resulted in a decrease in emissions of anthropogenic HCl by 95% in the last 21 years. We show that these anthropogenic HCl emission decreases are closely correlated with decreases of non‐sea‐salt sources of chloride in rainwater. Our results suggest that the impacts of chlorine on air quality and climate were significantly larger in the past over the United States than they are today. Key Points: Wet deposition of non‐sea‐salt chloride has decreased 83% on average since 1998 across the eastern United States at sites with significant trendsDecreases in deposition of non‐sea‐salt chloride are well correlated with changes in sulfate deposition as well as decreasing HCl emissionsIn the southeastern United States, chlorine wet deposition patterns suggest weaker anthropogenically driven displacement of chloride from sea salt [ABSTRACT FROM AUTHOR]

Monitoring salt pans is important for agricultural management in arid/semi-arid regions because salt pans can negatively affect human life, wildlife, ecology, and cause accelerated desertification, cropland loss, and economic downturn. Spectral salt pan indices based on remotely-sensed data from previous studies vary by location and may not be readily applicable to another location due to the spatial heterogeneity of salt components across the continental surface. Using Landsat-8 imagery and climate datasets, this study aims to develop a mapping scheme which effectively delineates the maximum salt pan/playa extents under various spectral conditions for different geographic locations. Calibrated by a spectral training pool sampled from eight major salt pan/playa sites in the world, this mapping scheme first implements a conservative spectral index to highlight potential salt-covered regions, from which salt pans/playas are further extracted by a support vector machine (SVM). Quality assurance/quality control (QA/QC) with assistance of auxiliary datasets and high-resolution images was performed to reduce commission errors and refine the results. The mapping scheme was applied to the endorheic regions of the western United States with a total area of approximately 700,000 km2, of which 1.6% was mapped as salt pans. Quality assessments show reasonable reliability of the mapping result for most regions, with the producer's accuracy, user's accuracy, and kappa coefficient exceeding 90%. The mapped spatial details reveal that salt pans are distributed fairly evenly across the arid western United States, with areas positively correlated to the sizes of the endorheic basins. Given these results, we foresee potential applicability of the developed scheme to map salt pans/playas across Earth's continental surface. Our spectral training pool and produced salt pan/playa extents are available through https://doi.pangaea.de/10.1594/PANGAEA.913152. [ABSTRACT FROM AUTHOR]

In 1924, the Morton Salt Company began nationwide distribution of iodine-fortified salt. Access to iodine, a key determinant of cognitive ability, rose sharply. We compare outcomes for cohorts exposed in utero with those of slightly older, unexposed cohorts, across states with high versus low baseline iodine deficiency. Income increased by 11%, labor force participation rose 0.68 percentage points, and full-time work went up 0.9 percentage points due to increased iodine availability. These impacts were largely driven by changes in the economic outcomes of young women. In later adulthood, both men and women had higher family incomes due to iodization. [ABSTRACT FROM AUTHOR]

Objective: The study examined which snack factors and nutritional ingredients influence college students' snack choices using a discrete choice experiment (DCE). Participants: In November 2016, a total of 1,624 undergraduate students participated in the study. Methods: Two DCEs were constructed using a unique approach of block fractional factorial designs. The first DCE examined four three-level snack factors: healthiness, taste, convenience, and price. The second DCE focused on six two-level nutritional ingredients: sugar, salt, calories, fat, all natural, and fiber. Results: Students preferred quick and cheap snacks, but higher prices on healthy snacks did not affect their decision significantly. Healthiness and sugar had the highest relative importance of snack factors and nutritional ingredients, respectively. High-sugar snacks were less favored if students considered themselves educated in nutrition. Conclusion: Thus, potential ways to improve the snack choices for college students are to offer healthier snacks on college campuses and to promote nutrition education. [ABSTRACT FROM AUTHOR]

Most Americans consume dietary sodium exceeding age-specific government-recommended targets of 1,500–2,300 mg/day per person. The majority (71%) of US dietary sodium comes from restaurant and packaged foods. Excess sodium intake contributes to hypertension and cardiovascular disease, which is the leading cause of death in the United States. This review summarizes evidence for policy progress to reduce sodium in the US food supply and the American diet. We provide a historical overview of US sodium-reduction policy (1969–2010), then examine progress toward implementing the 2010 National Academy of Medicine (NAM) sodium report's recommendations (2010–2019). Results suggest that the US Food and Drug Administration made no progress in setting mandatory sodium-reduction standards, industry made some progress in meeting voluntary targets, and other stakeholders made some progress on sodium-reduction actions. Insights from countries that have significantly reduced population sodium intake offer strategies to accelerate US progress toward implementing the NAM sodium-reduction recommendations in the future. [ABSTRACT FROM AUTHOR]

Processed foods have been part of the human diet from the very earliest times. Recently, processed foods have come under scrutiny, particularly the category ultraprocessed foods as defined in the NOVA classification of foods. The basic tenet behind this renewed concern about ultraprocessed foods is that it is processing per se, which matters in diet and health, not nutrients or foods. Notwithstanding this, the literature on ultraprocessed foods is almost entirely focused around nutrients and obesity. However, not all studies have found positive links between obesity and ultraprocessed food intake. The category, ultraprocessed foods, is large, accounting for approximately 60% of energy intake and 90% of added sugar intake. The advocates of the NOVA system advise that the intakes of these foods should be avoided, but the scientific basis for this advice is very weak. Thus, a reduction in ultraprocessed foods has been advocated covering 16 foods to reduce US intakes of added sugar. However, when US food consumption data are examined on a food-by-food basis, only 6 of these 16 foods are associated with high added sugar intakes. Data from the United States, United Kingdom, Canada, and Brazil fail to show a relationship between percent energy from ultraprocessed foods and the intakes of fats, saturated fatty acids, or sodium. There is a positive association between ultraprocessed food intake and the intake of added sugar. A negative correlation with dietary fiber is found. This is not surprising, because almost all added sugar is found in the category, ultraprocessed foods, while the majority of dietary fiber is excluded. When compared with the scientific literature, there is little scientific basis for limiting the use of infant foods, fat spreads, or commercially prepared breads in the present diet. [ABSTRACT FROM AUTHOR]

Excess sodium intake is a major risk factor for hypertension, and subsequently, heart disease and stroke, the first and fifth leading causes of death in the United States. For many people, blood pressure rises progressively as salt (sodium chloride) intake increases. Nearly one in three Americans or 67 million adults have hypertension, half of whom have uncontrolled hypertension. Furthermore, the estimated lifetime risk of developing hypertension in the United States is 90%. In 2009, high blood pressure was reported as a primary or contributing cause of approximately 348,000 US deaths. That's almost 1,000 deaths each day. The costs of prehypertension and hypertension are staggering. Estimates place the direct and indirect costs of hypertension at $73.4 billion in 2009. The purpose of this study was to determine if providing sodium information to restaurant guests would influence their menu choices. The sodium study was conducted in a hospitality management college's student-operated restaurant. The restaurant was open to the public for lunch and dinner. Once guests were seated, they were given a menu. Guests were given menus for 3 weeks during lunch and dinner without sodium information printed on the menus and for 3 weeks during lunch and dinner with sodium information printed on the menus. The number of orders for each item on both the lunch and dinner menus was recorded during the 3 weeks for lunch and dinner when no sodium information was printed on the menus and during the 3 weeks for lunch and dinner when sodium information was printed on the menus. Each item on the menu was rated as either high in sodium or low in sodium. Statistical analysis was performed on the data collected. The analysis was conducted between lunch and dinner menus with sodium listed and without sodium listed and between menu items high in sodium and low in sodium. A two-way chi squares test was applied on the data. The results showed that whether sodium was listed or not listed on the lunch menu, guests ordered high-sodium menu items. Likewise, results showed that whether sodium was listed or not listed on the dinner menu, guests ordered low-sodium menu items. [ABSTRACT FROM AUTHOR]

US–Russian nuclear arms control efforts should seek to limit not just numbers of weapons but nuclear missions as well, the most dangerous being “counterforce,” or an attack on enemy nuclear weapons before they can be launched. Giving up the counterforce mission means giving up the capability and all its dangerous requirements, including high alert rates. To eliminate counterforce, the United States and Russia will have to reduce both the capability and the vulnerability of their nuclear weapons. Once nuclear weapons are essentially invulnerable to attack, a small number will be enough to deter any potential attacker. [ABSTRACT FROM AUTHOR]

Most feed manufacturers in the United States use the same mixing time (and thus mix uniformity) throughout the growing period regardless of age and consumption patterns. However, research evaluating the optimum mixing time requirements and novel analysis methods, such as in-line near-infrared (NIR) spectroscopy, on the coefficient of variation (CV) and growth performance of broilers throughout the production phases is sparse. Two experiments were conducted to determine the effects of marker selection, in-line NIR, and varying mix times on mix uniformity, broiler growth performance, and body weight uniformity from 1 to 42 d of age. Feed was manufactured utilizing a 1,815-kg counterpoise ribbon mixer. In both experiments, feed was mixed for 4.5 min (3 min dry mix and 90 s of wet mix) and 30 s (0 s dry mix and 30 s wet mix) to obtain a standard mix (SM) and an abbreviated mix (AM), respectively. Experiment 1 constituted a 2 × 2 × 4 factorial arrangement of 2 mix times, (4.5 and 0.5 min), 2 batch sizes (908 and 1,815 kg), and 4 methodologies to evaluate mixer performance (sodium chloride, Microtracers (Red#40 and Blue#40), and in-line NIR). In experiment 2, broilers received different mix time combinations: 1) SM from 1 to 42 d, 2) SM from 1 to 28 d and AM from 28 to 42 d, 3) SM from 1 to 14 d and AM from 14 to 42 d, and 4) AM from 1 to 42 d. In both experiments, selecting a single source marker provided a more accurate estimation of mixer CV in SM and AM diets (P < 0.05). In experiment 2, mix time did not influence BW, feed intake (FI), FCR, or individual bird BW CV from 1 to 42 d of age (P > 0.05). These data indicated that mixer CV differed depending on total mix time and methodology used and diets with a reduced mix time may not necessarily influence growth performance and BW uniformity during the starter, grower, and finisher periods of broilers. [ABSTRACT FROM AUTHOR]

The article presents Bans, Taxes or Product Placement, and applying the Liberal Perfectionist Proviso to Public Health Food Policy. Topics discussed include the concept of a Liberal Proviso introduced in "Neutrality and Perfectionism in Public Health"; and provides some ideas on how to limit excessive or unjustified interventions from governments in public health; and attempts to make Perfectionist policies more agreeable by presenting criteria aimed at limiting potential State coercion.

This article deals with a neglected passage in J. Hector St. John de Crèvecœur's unpublished writings, in which a farmer in one of the Maritime Colonies punishes one of his slaves by tying him naked to a pole in a salt meadow. Very soon after, the slave dies from an inflammation caused by mosquito bites. The article discusses the parallels and differences between this passage and the more famous slave death scene in Charleston included in the published Letters from an American Farmer. Whereas critics have argued that James's ambivalent response to the caged slave's suffering in the Charleston episode should be attributed to Crèvecœur's commitment to the dualistic ontology of modern science, this article offers an ecomaterialist reading of the salt meadow scene, revealing the presence of a competing, relational epistemology at the heart of Crèvecœur's writings. Pointing to the significance of salt in eighteenth-century natural history, in particular that of Count Buffon, the article shows how the death of the slave in the salt meadow emblematizes a broader crisis in contemporary philosophies of mechanism. The salt letter moreover brings out the ethical dilemmas attendant on this epistemological crisis in late Enlightenment natural history. [ABSTRACT FROM AUTHOR]

• For regional-scale or greater deployment, pressure buildup in saline formations could significantly constrain dynamic CO 2 storage capacity. • Brine extraction could be necessary to increase the CO 2 storage capacity of saline formations. • A function is derived to estimate the brine extraction rate that could be necessary to achieve a target rate of CO 2 injection for a given scenario. • At least part of a "Beyond Two-degree Celsius Scenario" goal could be achieved with a volume ratio of brine extraction to CO 2 injection as low as 1:4. The carbon dioxide (CO 2) storage capacity of saline formations may be constrained by reservoir pressure limitations. Brine extraction could be necessary to increase the CO 2 storage capacity of a given formation, manage the extent of the underground CO 2 plume and induced pressure front, and control the migration direction. To estimate the additional CO 2 storage capacity of a saline formation that can be made accessible by extraction of in-situ brines, a three-dimensional (3D) generic cubic cell containing one CO 2 injector in the middle surrounded by four brine extractors at each corner of the cell was assumed. A series of Tough2-ECO2N reservoir simulations were constructed with varying reservoir properties and run. Based on a series of scenarios, a mechanism was developed and demonstrated that resulted in derivation of a function to provide estimates of the ratio of total CO 2 injection over the brine extraction rate for a given scenario. We selected multiple saline formations in U.S. basins and evaluated the potential to increase the combined dynamic CO 2 storage capacity of the selected saline formations to over 1000 million metric tonnes per year (Mt/yr) of CO 2 for 100 years by means of brine extraction. Such storage capacities may be adequate to accommodate the CO 2 injection rates suggested for the United States under a "beyond two-degree Celsius scenario" (B2DS) that has been proposed to maintain global temperature rise to less than 2°C above pre-industrial reported levels. The results suggest that B2DS goals could be achieved with a volume ratio of brine extraction to CO 2 injection as low as 1:4, which is far lower than the ratios that have been commonly assumed in the literature. [ABSTRACT FROM AUTHOR]

Synthetic cathinones, commonly referred to as "bath salts," are recreational designer drugs that recently emerged as a drug of abuse. However, little is known about bath salt users, particularly in the United States (US). This descriptive study aims to better characterize users and user behavior, including common motives for and consequences of use. Individuals with a lifetime history of bath salt use (BSU; n = 110) completed an Internet survey. Participants (50.9% male) were aged 18 to 58 (M = 31.21, SD = 10.25) years and were from 32 US states. Most participants reported past-year BSU, via intranasal use, obtained from a friend or acquaintance. Recreational motives (e.g., to get high, experimentation) were commonly reported, as was use due to drug availability. Participants reported experiencing an average of 5.50 consequences, with both physical (e.g., rapid heartbeat) and psychological (e.g., anxiety) negative outcomes commonly reported. This descriptive information on BSU from a small but diverse sample of users may inform efforts to reduce use and negative consequences, such as eliminating riskier routes of administration (e.g., injection) and targeting specific motives for use (e.g., providing alternative methods for mood expansion). [ABSTRACT FROM AUTHOR]

Background Several studies have reported that dietary salt intake may be an independent risk factor for overweight/obesity, but results from previous studies are controversial, reflecting study limitations such as use of a single spot urine or dietary recall to estimate daily salt intake rather than 24-h urine collections, and population samples from only a single country or center. Objective The aim of this study was to use data from the International Study of Macro-/Micro-nutrients and Blood Pressure (INTERMAP Study) to explore the relation between dietary salt intake estimated from 2 timed 24-h urine collections and body mass index (BMI; in kg/m2) as well as prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States. Methods Data were from a cross-sectional study of 4680 men and women aged 40–59 y in Japan (n  = 1145), China (n  = 839), the United Kingdom (n  = 501), and the United States (n  = 2195). General linear models were used to obtain the regression coefficients (β) of salt intake associated with BMI. Multivariable logistic regression models were used to determine the ORs and 95% CIs of overweight/obesity associated with a 1-g/d higher dietary salt intake. Results After adjustment for potential confounding factors including energy intake, salt intake 1 g/d higher was associated with BMI higher by 0.28 in Japan, 0.10 in China, 0.42 in the United Kingdom, and 0.52 in the United States, all P values < 0.001. Salt intake 1 g/d higher was associated with odds of overweight/obesity 21% higher in Japan, 4% higher in China, 29% higher in the United Kingdom, and 24% higher in the United States, all P values < 0.05. Conclusions Salt intake is positively associated with BMI and the prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States. This association needs to be further confirmed in well-designed prospective studies with repeated dietary and BMI measurements.This trial was registered at clinicaltrials.gov as NCT00005271. [ABSTRACT FROM AUTHOR]

Boron element is widely distributed in different geologic bodies, and there are important geo-chemical applications in earth science. Halite is a common mineral found in sediment basin. However there is no good method to accurately measure the boron content in halite, which is mainly because Inductively Coupled Plasma Optical Emission Spectrometer (ICP-OES) and Inductively Coupled Plasma Mass Spectrometer (ICP-MS) are limited by the high salt matrix interference and the instrument detection limit. Thus enriching the boron element and removing the matrix interference are necessary before the measuring. In this paper, Amberlite IRA 743 boron-specific resin was applied to enrich the boron element and remove most of the high-salt matrix. The strong acid cation resin (Dowex 50 W×8, 200-400 mesh, USA) and weak-base anion resin (Ion Exchanger II, Germany) were mixed with equal volume, which could remove the foreign ions completely: meanwhile, the relative content of boron in the solution reached above 98%, and the recoveries ranged from 97.8% to 104%. 208.900 nm was chosen as the detection wavelength for ICP-OES, and the detection identification and quantification limits were 0.006 mg·L−1 and 0.02 mg·L−1, respectively. 11B was chosen as the measuring element for ICP-MS, and the detection identification and quantification limits were severally 0.036 mg·L−1 and 0.12 mg·L−1. The relative standard deviations ranged from 1.4% to 3.4% through six replicates under different salinities. Therefore, the process could be regarded as a feasible method to measure boron content in halite by ICP-OES and ICP-MS. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the duration of efficacy, safety, and tolerability of SHP465 mixed amphetamine salts (MAS) extended-release versus placebo and immediate-release MAS (MAS IR) in adolescents with attention-deficit/hyperactivity disorder (ADHD).Methods: This phase 2, randomized, 3-period, 3-treatment crossover study compared SHP465 MAS (25/50 mg) with placebo and MAS IR (12.5 mg) in 13-17-year-old adolescents with ADHD having ADHD Rating Scale, Version IV (ADHD-RS-IV) total scores ≥24. A laboratory classroom served as a controlled environment during 16-hour observations, with efficacy assessed on the last day of each 7-day treatment period. The primary efficacy analysis compared SHP465 MAS with placebo on Permanent Product Measure of Performance (PERMP) total score averaged over the 16-hour postdose period using a mixed linear model. Comparisons were also conducted between MAS IR and placebo (for assay sensitivity) and between SHP465 MAS and MAS IR. PERMP problems attempted and answered correctly and ADHD symptoms based on ADHD-RS-IV; participant self-report; Swanson, Kotkin, Agler, M-Flynn, and Pelham Scale; and Revised Conner's Parent Rating Scale scores were also evaluated. Safety and tolerability assessments included treatment-emergent adverse events and vital signs.Results: The intent-to-treat population included 84 participants. Least squares mean (95% CI) PERMP total score treatment differences significantly favored SHP465 MAS (combined 25/50 mg) over placebo for the average of all postdose assessment time points (41.26 [32.24, 50.29]; P < 0.0001) and each postdose assessment time point (all P < 0.0001). Similar results were observed for MAS IR versus placebo (all postdose assessment time points averaged: nominal P < 0.0001; each postdose assessment time point: all nominal P < 0.004). The safety and tolerability of SHP465 MAS were consistent with previous reports.Conclusions: SHP465 MAS significantly improved PERMP total scores versus placebo from 2 to 16 hours postdose in adolescents with ADHD. The safety and tolerability profile of SHP465 MAS was consistent with previous reports of SHP465 MAS in individuals with ADHD. [ABSTRACT FROM AUTHOR]

The potential contribution of sodium to chronic disease risk has been an area of exploration for many years. Currently, a National Academies of Sciences, Engineering, and Medicine committee is working to update the 2005 Dietary Reference Intakes for sodium and potassium, evaluating the latest evidence with a look to excesses, inadequacies, and chronic disease risk reduction. Two recent reports will support the National Academies of Sciences, Engineering, and Medicine review: a systematic review of the science related to sodium, potassium, and chronic disease and guidelines for considering chronic disease in setting dietary reference intakes. While sodium intake reduction initiatives have been underway for years, current intake estimates significantly exceed recommendations. Recently, the US Food and Drug Administration issued draft guidance on voluntary sodium reduction targets for 150 food categories. This review is based on a session at the American Society for Nutrition 2018 Annual Meeting, which brought together stakeholders to discuss these developments, progress, conundrums, and opportunities toward reducing sodium intakes. [ABSTRACT FROM AUTHOR]

Purpose. Trends in the shortages of sterile solutions in the United States were evaluated. Methods. A retrospective review of shortage data from the University of Utah Drug Information Service (UUDIS) was performed. Shortages of sterile solutions, including saline, dextrose, lactated Ringer's, and sterile water for injection, were identified. We extracted the product name, reason for the shortage, shortage duration, and primary use of the solution, examining trends in shortages over time. Results. There were 37 sterile solution shortages in the UUDIS data set, 22 of which had been resolved. The mean ± S.D. duration of a resolved shortage was 13.9 ± 9.6 months. The most common category of solution shortage was for saline products (n = 11). Manufacturing delay was the most common reason given for shortages (n = 19). In 2017, 12 new shortages were reported, and 15 solutions remained in shortage by year's end. This was the highest number of shortages at any time during the study period. The longest active shortage was for 5% dextrose/0.45% sodium chloride, which began in October 2007 and has yet to be resolved. Conclusion. There were 37 shortages of sterile solutions from 2001 through 2017. Shortages became more severe after Hurricane Maria damaged manufacturing facilities in Puerto Rico, with 12 new shortages reported in 2017. [ABSTRACT FROM AUTHOR]

Background Traditional diets are often credited for the robust cardiometabolic health of subsistence populations. Yet, rural subsistence populations are undergoing nutrition transitions that have been linked to the increase in chronic noncommunicable diseases. Few studies have presented detailed dietary estimates in transitioning populations. Objectives We aimed to 1) characterize and compare dietary profiles of 2 neighboring subsistence populations in Bolivia who vary in market integration and 2) identify dietary factors contributing to low cardiovascular disease risk. Design We used a mixed longitudinal design to estimate nutrient intake via 24-h recall and dietary questionnaires among 1299 Tsimane (aged 30--91 y) and 229 Moseten (aged 30--84 y) men and women. We constructed population-level estimates of energy intake, dietary diversity, and nutrient shortfalls and analyzed dietary changes over time and space using multilevel models. Last, we compared Tsimane and Moseten dietary profiles with those of Americans (NHANES). Results The Tsimane diet was characterized by high energy (2422--2736 kcal/d), carbohydrate (376--423 g/d), and protein (119--139 g/d) intakes; low fat intake (40--46 g/d); and low dietary diversity relative to the average US diet. Most calories (64%) were derived from complex carbohydrates. Total energy and carbohydrate intake increased significantly during the 5-y study, particularly in villages near market towns. Tsimane consumption of food additives (lard, oil, sugar, salt) increased significantly [sugar (15.8 g ⋅ person-1 ⋅ d-1) and oil (4.9 mL ⋅ person-1 ⋅ d-1)] between 2010 and 2015. The more-acculturated Moseten consumed substantially more sugar (by 343%) and oil (by 535%) than the Tsimane. Conclusions A high-energy diet rich in complex carbohydrates is associated with low cardiovascular disease risk when coupled with a physically active lifestyle. A transition away from a high-fiber and low-fat, low-salt, and low-processed-sugar diet is a salient health risk for transitioning populations. Evidence of a nutrition transition in Bolivia parallels trends of increasing body fat and body mass index, which suggests that a low prevalence of cardiovascular disease may not persist. [ABSTRACT FROM AUTHOR]

Abstract This study explores the association between social support and chronic disease self-management among older adults of Mexican heritage who live in the U.S. and Mexico. We hypothesize that social support increases the ability to manage hypertension and Type 2 (T2) diabetes, regardless of place of residence. We also investigate if differences in country of residence and health system factors influence the ability to manage chronic conditions. Older adults 65 years or older from Los Angeles (LA) and Mexico City (CDMX), with diagnosed hypertension or T2 diabetes (self-reported), attending government agencies, participated in the study. The statistical analyses investigate differences between older adults in LA and CDMX; identify the association between social support and chronic disease self-management; and examine the role of T2 diabetes treatment, testing and complications on self-management. Our study findings show that social support was a statistically significant predictor of improved T2 diabetes self-management (37%–51%, p < 0.05). The association between social support and hypertension self-management was only significant (90% confidence level) for adherence to weight management and increased alcohol consumption. Our study did not identify statistically significant differences in social support between LA and CDMX. However, almost 40% of sampled older adults were at risk of social isolation, signaling a vulnerable population that needs to be targeted by health and social systems in the U.S. and Mexico. Our study also shows that social support is a strong predictor of improved T2 diabetes management in the U.S. and Mexico. While older adults in the U.S. and Mexico reported similar access to care and health insurance coverage, higher adherence to low salt diets in LA and reduced coverage of glucose testing in CDMX could signal areas of opportunity for policymakers. Health care providers in both countries need to identify ways of improving adherence to physical activity and weight management. Highlights • Almost 40% of sampled older adults were at risk of social isolation in both cities. • Social support was a significant predictor of improved T2 diabetes self-management. • Gender and age differences in diagnosed hypertension and T2 diabetes in both cities. • Increased adherence to low salt diets in Los Angeles. • Glucose testing and foot care were key differences in T2 diabetes self-management. [ABSTRACT FROM AUTHOR]

Abstract Background Long-term care workers are at high risk for cardiovascular disease, in part because of their poor health habits. Objective The purpose of this study is to test the impact of the Worksite Heart Health Improvement Project (WHHIP) on subjective behavioral cardiovascular risk factors over time among long-term care staff. Design The WHHIP was a 12-month cluster randomized control trial conducted in four long-term care facilities. The exercise, nutrition, and stress management intervention lasted 9-months and was implemented during paid work time. Setting and participants Ninety-eight long-term care workers consented to participate in the study. Methods Survey data included: mood, dietary salt intake, dietary fat intake, sleep quality, and sleep duration. Results A significant positive short-term intervention effect at 9-month (p =.037) and long-term effect at 12-month for mood (p =.039) was found, signifying reduction in mood symptoms in the treatment group over time. The intervention group also showed longer sleep time (p =.016) and better sleep quality (p =.046) at 12-months. The intervention group had less dietary sodium intake at 9-months (p =.036); yet, this was not maintained over time. Conclusion The WHHIP demonstrated the ability to improve participants' mood, sleep and sodium intake over time. Lessons learned particularly the challenges faced implementing the WHHIP and the solutions recommended provide critical insights to strengthen future programs with this population. [ABSTRACT FROM AUTHOR]

Summary: Background: Previous studies have indicated that snacking is contributing to increased calorie intake of American children and that the energy density of snacks in US diets has increased in recent decades. Objective: Examine short‐term and long‐term trends in the energy density and food sources of snacks for US children from 1977 to 2014, and examine whether trends differ between socio‐demographic groups. Methods: We used data collected from eight nationally representative surveys of food intake in 49,952 US children age 2–18 years, between 1977 and 2014. Overall patterns of snacking, trends in energy intake from snacking, trends in food and beverage sources and energy density of snacks across race‐ethnic, age, gender, education and income groups were examined. Results: In all socio‐demographic groups, there was a significant increase in per capita energy intake deriving from snacks from 1977 to 2014 (P < 0.01). Salty snack intake doubled over the study period, and sugar‐sweetened beverage intake decreased overall from 1977 to 2014 but increased in Non‐Hispanic Blacks. Non‐Hispanic Blacks had the largest increase in per capita intake from foods as a snack from 1977 to 2014. Children in the lowest poverty level and household education groups had more than 100% increase in calorie intake from snacks from 1977 to 2014. Conclusions: We found that snacking behaviour in the USA differs between race‐ethnic, household education, gender and income groups, yet snacking remains a significant component of children's diets and the foods consumed at these snacks are not the types of foods recommended by the US dietary guidelines. [ABSTRACT FROM AUTHOR]

Objective: Americans consume Na in excess of daily recommendations. Most dietary Na comes from packaged foods, and bread is a major contributor. In the UK, national Na reduction strategies contributed to lower Na levels in packaged foods and lower population Na intake. Similar initiatives are emerging in the USA and require surveillance to assess effectiveness. We aimed to examine Na levels in bread products in the USA and compare levels with similar UK products.Design: Na data for bread products were obtained from the US Label Insight Open Data Initiative (n 4466) and the FoodSwitch UK database (n 1651). Mean, median and range of Na content, and proportion of products meeting Na targets established by the National Salt Reduction Initiative (NSRI) and the UK Department of Health (DH) were calculated overall, by bread type and by country.Results: Mean (sd) Na content in bread was 455 (170) mg/100 g in the USA and 406 (179) mg/100 g in the UK. In both countries, savoury bread had the highest mean Na (USA=584 mg/100 g, UK=543 mg/100 g) and fruit bread the lowest mean Na (USA=345 mg/100 g, UK=277 mg/100 g). Na content of US bread products was 12 % higher than in the UK, with 21 % of US bread products and 31 % of UK bread products meeting the NSRI and DH targets, respectively.Conclusions: US bread products have, on average, 12 % more Na than similar products in the UK. Variation in Na content within product categories, and between countries, suggests the feasibility of manufacturing products with lower Na to lower dietary Na intake. [ABSTRACT FROM AUTHOR]

Purpose. The results of a study to determine the physical compatibility of ZTI-01 (fosfomycin for injection) in 0.9% sodium chloride or 5% dextrose during simulated Y-site administration with 37 i.v. antimicrobials and 58 nonantimicrobials are reported. Methods. Fosfomycin, an epoxide antibiotic with broad-spectrum activity against multidrug-resistant bacteria, is marketed in the United States only in an oral formulation with limited bioavailability, but an i.v. formulation is in development. Fosfomycin for injection and other evaluated drugs were reconstituted according to manufacturer recommendations and further diluted with 0.9% sodium chloride or 5% dextrose to the final desired concentrations. Y-site administration was simulated in glass culture tubes. Incompatibility was defined as changes in visual characteristics or a change in turbidity of >0.5 nephelometric turbidity units over the 120-minute observation period. Results. Of the 95 drugs tested, 16 were incompatible with fosfomycin in 0.9% sodium chloride, and 18 were incompatible with fosfomycin in 5% dextrose; incompatibility was observed with 10 of 37 antimicrobials, including the 3 commercially available amphotericin B products, anidulafungin, caspofungin, ceftaroline, ciprofloxacin, daptomycin, doxycycline, and isavuconazonium sulfate. Conclusion. Fosfomycin for injection at a concentration of 30 mg/mL was physically compatible with 73 of 95 (77%) of the i.v. drugs tested at concentrations used clinically in both 0.9% sodium chloride injection and 5% dextrose injection. Twenty-two drugs were deemed incompatible in at least 1 of the 2 diluents. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the role of extended time in the United States (as defined as a continuous period greater than two years; referred to hereafter as "US Acclimated"), as well as other demographic factors, on the level of net positive response of consumers to different salt levels in food samples. One hundred panelists were recruited, including 50 meeting our US acclimation criterion. Panelists assessed samples of potatoes with five different levels of salt concentrations, and the levels of their net positive responses were evaluated with FaceReader technology (Noldus). The data of our study showed a significant positive association between US Acclimated participants and the level of net positive response to samples with higher salt contents. This interaction remained statistically significant even when modeling the effects with consideration of race/ethnicity and gender. Another notable outcome was the unexpected significant interaction between gender and US acclimation in regards to evaluated positive response across all salt concentrations (US Acclimated females demonstrating substantially and significant higher levels of positive response than US Acclimated males). The association between living in the United States and showing more positive response to higher salt contents is consistent with many persistent characterizations of the eating habits in the United States, but it is not in fact well explained by the most recent data regarding the observed levels of average sodium consumption across worldwide geographical regions. The results of this study may be demonstrating evidence of underlying as-yet-unknown factors contributing to the responses of consumers to salt levels in foods. Further examination of these possible factors may well be warranted. [ABSTRACT FROM AUTHOR]

Background: Approximately 2 in 3 US adults have prehypertension or hypertension that increases their risk of cardiovascular disease. Reducing sodium intake can decrease blood pressure and prevent hypertension. Approximately 9 in 10 Americans consume excess sodium (≥2300 mg/d). Voluntary sodium standards for commercially processed and prepared foods were established in North America, but their impact on sodium intake is unclear. Objective: We modelled the potential impact on US sodium intake of applying voluntary sodium standards for foods. Design: We used NHANES 2007-2010 data for 17,933 participants aged ≥1 y to model predicted US daily mean sodium intake and the prevalence of excess sodium intake with the use of the standards of the New York City's National Salt Reduction Initiative (NSRI) and Health Canada for commercially processed and prepared foods. The Food and Nutrient Database for Dietary Studies food codes corresponding to foods reported by NHANES participants were matched to NSRI and Health Canada food categories, and the published sales-weighted mean percent reductions were applied. Results: The US population aged ≥1 y could have reduced their usual daily mean sodium intake of 3417 mg by 698 mg (95% CI: 683, 714 mg) by applying NSRI 2014 targets and by 615 mg (95% CI: 597, 634 mg) by applying Health Canada's 2016 benchmarks. Significant reductions could have occurred, regardless of age, sex, race/ethnicity, income, education, or hypertension status, up to a mean reduction in sodium intake of 850 mg/d in men aged ≥19 y by applying NSRI targets. The proportion of adults aged ≥19 y who consume ≥2300 mg/d would decline from 88% (95% CI: 86%, 91%) to 71% (95% CI: 68%, 73%) by applying NSRI targets and to 74% (95% CI: 71%, 76%) by applying Health Canada benchmarks. Conclusion: If established sodium standards are applied to commercially processed and prepared foods, a significant reduction of US sodium intake could occur. [ABSTRACT FROM AUTHOR]

Consumption of red meat in the United States has progressively declined over the past 35 years. This occurred in conjunction with public recommendations to reduce red meat intake, based mainly on associations between higher red meat intake and increased chronic disease risk. This narrative review presents and discusses results from both observational cohort studies that focus on cardiometabolic disease development and mortality and randomized controlled trials that focus on cardiometabolic disease risk factors. This review will also address the potential effect of categorizations of red meat and processed meats on our understanding of cardiometabolic health implications of consuming red meat. [ABSTRACT FROM AUTHOR]

Background: Food reformulation has been identified as a strategy to improve nutritional intakes; however, little is known about the potential impact of industry-wide reformulations. Objective: The aim of the study was to model the dietary impact of food and beverage reformulation following the Nestl'e Nutritional Profiling System (NNPS) standards for children, adolescents, and adults in the United States and France. Design: Dietary intakes of individuals aged ≥4 y were retrieved from nationally representative surveys: the US NHANES 2011-2012 (n = 7456) and the French Individual and National Survey on Food Consumption (n = 3330). The composition of all foods and beverages consumed were compared with the NNPS standards for energy, total and saturated fats, sodium, added sugars, protein, fiber, and calcium. Two scenarios were modeled. In the first, the nutrient content of foods and beverages was adjusted to the NNPS standards if they were not met. In the second, products not meeting the standards were replaced by the most nutritionally similar alternative meeting the standards from the same category. Dietary intakes were assessed against local nutrient recommendations, and analyses were stratified by body mass index and socioeconomic status. Results: Scenarios 1 and 2 showed reductions in US adults' mean daily energy (-88 and -225 kcal, respectively), saturated fats (-4.2, -6.9 g), sodium (-406, -324 mg), and added sugars (-29.4, -35.8 g). Similar trends were observed for US youth and in France. The effects on fiber and calcium were limited. In the United States, the social gradient of added sugars intake was attenuated in both scenarios compared with the baseline values. Conclusions: Potential industry-wide reformulation of the food supply could lead to higher compliance with recommendations in both the United States and France, and across all socioeconomic groups. NNPS standards seemed to be especially effective for nutrients consumed in excess. [ABSTRACT FROM AUTHOR]

Background: High loss-to-follow-up rates are a risk in even the most rigorously designed randomized controlled trials (RCTs). Consequently, predicting and preventing loss to follow-up are important methodological considerations. We hypothesized that certain baseline characteristics are associated with a greater likelihood of patients being lost to follow-up. Our primary objective was to determine which baseline characteristics are associated with loss to follow-up within 12 months after an open fracture in adult patients participating in the Fluid Lavage of Open Wounds (FLOW) trial. We also present strategies to reduce loss to follow-up in trauma trials.Methods: Data for this study were derived from the FLOW trial, a funded trial in which payments to clinical sites were tied to participant retention. We conducted a binary logistic regression analysis with loss to follow-up as the dependent variable to determine participant characteristics associated with a higher risk of loss to follow-up.Results: Complete data were available for 2,381 of 2,447 participants. One hundred and sixty-three participants (6.7%) were lost to follow-up. Participants who received treatment in the U.S. were more likely to be lost to follow-up than those who received treatment in other countries (odds ratio [OR] = 3.56, 95% confidence interval [CI]: 2.46 to 5.17, p < 0.001). Male sex (OR = 1.75, 95% CI: 1.15 to 2.67, p = 0.009), current smoking (OR = 1.82, 95% CI: 1.28 to 2.58, p = 0.001), high-risk alcohol consumption (OR = 1.88, 95% CI: 1.16 to 3.05, p = 0.010), and an age of <30 years (OR = 2.16, 95% CI: 1.19 to 3.95, p = 0.012) all significantly increased the odds of a patient being lost to follow-up. Conversely, participants who had sustained polytrauma (OR = 0.52, 95% CI: 0.37 to 0.73, p < 0.001) or had a Gustilo-Anderson type-IIIA, B, or C fracture (OR = 0.60, 95% CI: 0.38 to 0.94, p = 0.024) had lower odds of being lost to follow-up.Conclusions: Using a number of strategies, we were able to reduce the loss-to-follow-up rate to <7%. Males, current smokers, young participants, participants who consumed a high-risk amount of alcohol, and participants in the U.S. were more likely to be lost to follow-up even after these strategies had been employed; therefore, additional strategies should be developed to target these high-risk participants.Clinical Relevance: This study highlights an important need to develop additional strategies to minimize loss to follow-up, including targeted participant-retention strategies. Male sex, an age of <30 years, current smoking, high-risk alcohol consumption, and treatment in a developed country with a predominantly privately funded health-care system increased the likelihood of participants being lost to follow-up. Therefore, strategies should be targeted to these participants. Use of the planning and prevention strategies outlined in the current study can minimize loss to follow-up in orthopaedic trials. [ABSTRACT FROM AUTHOR]

Background: As part of a healthy diet, limiting intakes of excess sodium, added sugars, saturated fat, and trans fat has been recommended. The American Heart Association recommends that children aged <2 y should avoid added sugars. Objective: We sought to determine commercial complementary infant-toddler food categories that were of potential concern because of the sodium, added sugar, saturated fat, or trans fat content. Design: Nutrition label information (e.g., serving size, sodium, saturated fat, trans fat) for 1032 infant and toddler foods was collected from manufacturers' websites and stores from May to July 2015 for 24 brands, which accounted for >95% of infant-toddler food sales. The presence of added sugars was determined from the ingredient list. Reference amount customarily consumed (RACC) categories were used to group foods and standardize serving sizes. A high sodium content was evaluated on the basis of the Upper Intake Level for children aged 1--3 y and the number of potential servings per day ([i.e., 1500 mg/7 servings (>210 mg/RACC)], a sodium amount >200 mg/100 g, or a mean sodium density >1000 mg/1000 kcal. Results: In 2015, most commercial infant-only vegetables, fruit, dinners, and cereals were low in sodium, contained no saturated fat, and did not contain added sugars. On average, toddler meals contained 2233 mg Na/1000 kcal, and 84% of the meals had >210 mg Na/RACC (170 g), whereas 69% of infant-toddler savory snacks had >200 mg Na/100 g. More than 70% of toddler meals, cereal bars and breakfast pastries, and infant-toddler grain- or dairy-based desserts contained ≥1 sources of added sugar. Approximately 70% of toddler meals contained saturated fat (mean: 1.9 g/RACC), and no commercial infant-toddler foods contained trans fats. Conclusion: Most commercial toddler meals, cereal bars and breakfast pastries, and infant-toddler snacks and desserts have high sodium contents or contain added sugars, suggesting a need for continued public health efforts to support parents in choosing complementary foods for their infants and toddlers. [ABSTRACT FROM AUTHOR]

Background: The Supplemental Nutrition Assistance Program (SNAP), which is the largest federal nutrition assistance program in the United States, serves nearly 1 of 7 Americans. To date, few studies have examined food and beverage purchase behaviors in SNAP participants with the use of electronic purchase data. Objective: In this cross-sectional study, we examined household store purchases of key food, beverage, and nutrient groups in SNAP participants and nonparticipants. Design: Using a data set of US households' (n = 98,256 household-by-quarter observations) packaged food and beverage purchases and SNAP status [current participant, income-eligible nonparticipant (income ≤130% of the Federal Poverty Level [FPL]), and higher-income nonparticipants (income >130% of the FPL)] from 3 quarters during 2012-2013, we estimated pooled ordinary least-squares models, clustered at the household level, to examine the association between SNAP status and purchases while controlling for sociodemographic characteristics. We examined purchases of health- and policy-relevant food and beverage groups [e.g., fruit and sugar-sweetened beverages (SSBs)] and nutrients (e.g., total calories and sodium). Results: Regardless of SNAP status, households had low mean purchases of fruit, vegetables, and fiber and high mean purchases of junk foods, saturated fat, and sodium. After adjustment for multiple comparisons and demographic characteristics, we found significant differences by SNAP status of purchases of fruit, processed meat, salty snacks, sweeteners and toppings, SSBs, and total calories, fiber, sugar, and sodium. Several of these differences were clinically important. For example, compared with income-eligible and higher-income nonparticipants, SNAP participants purchased an additional ~15-20 kcal ⋅ person-1 ⋅ d-1 from SSBs (P < 0.0001) and ~174-195 mg total Na ⋅ person-1 ⋅ d-1 (P <0.0001). Results were robust to corrections for sample-selection bias and to the exclusion of observations with potentially misreported SNAP status. Conclusions: American households, including SNAP households, show room for improvement in the nutritional quality of store purchases. New interventions and policies may be needed to improve food and beverage purchases in both SNAP and non-SNAP households. [ABSTRACT FROM AUTHOR]

Background: Most US adults consume excess sodium. Knowledge about the dietary sources of sodium intake is critical to the development of effective reduction strategies.Methods: A total of 450 adults were recruited from 3 geographic locations: Birmingham, AL (n=150); Palo Alto, CA (n=150); and the Minneapolis-St. Paul, MN (n=150), metropolitan areas. Equal numbers of women and men from each of 4 race/ethnic groups (blacks, Asians, Hispanics, and non-Hispanic whites) were targeted for recruitment. Four record-assisted 24-hour dietary recalls were collected from each participant with special procedures, which included the collection of duplicate samples of salt added to food at the table and in home food preparation.Results: Sodium added to food outside the home was the leading source of sodium, accounting for more than two thirds (70.9%) of total sodium intake in the sample. Although the proportion of sodium from this source was smaller in some subgroups, it was the leading contributor for all subgroups. Contribution ranged from 66.3% for those with a high school level of education or less to 75.0% for those 18 to 29 years of age. Sodium inherent to food was the next highest contributor (14.2%), followed by salt added in home food preparation (5.6%) and salt added to food at the table (4.9%). Home tap water consumed as a beverage and dietary supplement and nonprescription antacids contributed minimally to sodium intake (<0.5% each).Conclusions: Sodium added to food outside the home accounted for ≈70% of dietary sodium intake. This finding is consistent with the 2010 Institute of Medicine recommendation for reduction of sodium in commercially processed foods as the primary strategy to reduce sodium intake in the United States.Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02474693. [ABSTRACT FROM AUTHOR]

Background: Dietary sodium has a dose-response relationship with cardiovascular disease, and sodium intake in Sweden exceeds national and international recommendations. Two thirds of dietary sodium intake comes from processed foods, and adults in Sweden eat more processed foods than any other European country. We hypothesized that sodium content in processed foods is higher in Sweden than in other countries. The aim of this study was to investigate sodium content in processed food items in Sweden, and how it differs from Australia, France, Hong Kong, South Africa, the United Kingdom and the United States., Methods: Data were collected from retailers by trained research staff using standardized methods. Data were categorized into 10 food categories and compared using Kruskal-Wallis test of ranks. Sodium content in the food items was compared in mg sodium per 100 g of product, based on the nutritional content labels on the packages., Results: Compared to other countries, Sweden had among the highest sodium content in the "dairy" and "convenience foods" categories, but among the lowest in "cereal and grain products," "seafood and seafood products" and "snack foods" categories. Australia had the overall lowest sodium content, and the US the overall highest. The highest sodium content in most analyzed countries was found in the "meat and meat products" category. The highest median sodium content in any category was found among "sauces, dips, spreads and dressings" in Hong Kong., Conclusion: The sodium content differed substantially between countries in all food categories, although contrary to our hypothesis, processed foods overall had lower sodium content in Sweden than in most other included countries. Sodium content in processed food was nonetheless high also in Sweden, and especially so in increasingly consumed food categories, such as "convenience foods"., Competing Interests: JS reports stock ownership in Anagram kommunikation AB and Symptoms Europe AB, outside of the present study. The collection and categorization of Swedish data was conducted by the Department of Medical Sciences at Uppsala University in collaboration with the George Institute. The FS databases and mobile application was funded by the George Institute. FS has no commercial relationship with food manufacturers that affect the information in the databases or recommendation of products in the application. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Karlsson, Rådholm, Dunford, Wu, Neal and Sundström.)

The article discusses the environmental and human health impacts of oil and gas wastewater spills in the U.S. Topics include an increase in the volume of wastewater produced by conventional and unconventional oil wells due to an increase of fracking in the U.S. since 2008, the lack of a complete list of chemicals to focus on despite the U.S. Environmental Protection Agency's research on potential impacts of hydraulic fracturing on drinking water sources, and a decline in microorganisms downstream.

Desalination provides a partial solution to water scarcity. While the desalination process provides much needed water to coastal areas, it also has various environmental impacts. Older operations entrain and impinge large and small organisms during the collection process, use significant amounts of energy, and produce substantial volumes of waste brine. These short- and long-term impacts warrant the involvement of environmental health practitioners. Sustainable water supplies depend on more than just the weather. Accordingly, we start by analyzing the rising global demand for drinking water and the ongoing deterioration of the oceans. Next, we detail known impacts of desalination, and discuss alternatives for addressing water scarcity. We challenge environmental health practitioners to help meet current and future drinking water needs with respect to environmental sustainability. The ocean is finite. We should ask the right questions so as not to consume it at an untenable pace. [ABSTRACT FROM AUTHOR]

Objective The present study examined plain water consumption in relation to energy intake and diet quality among US adults. Methods A nationally representative sample of 18 311 adults aged ≥18 years, from the National Health and Nutrition Examination Survey 2005-2012, was analysed. The first-difference estimator approach addressed confounding bias from time-invariant unobservables (e.g. eating habits, taste preferences) by using within-individual variations in diet and plain water consumption between two nonconsecutive 24-h dietary recalls. Results One percentage point increase in the proportion of daily plain water in total dietary water consumption was associated with a reduction in mean (95% confidence interval) daily total energy intake of 8.58 (7.87-9.29) kcal, energy intake from sugar-sweetened beverages of 1.43 (1.27-1.59) kcal, energy intake from discretionary foods of 0.88 (0.44-1.32) kcal, total fat intake of 0.21 (0.17-0.25) g, saturated fat intake of 0.07 (0.06-0.09) g, sugar intake of 0.74 (0.67-0.82) g, sodium intake of 9.80 (8.20-11.39) mg and cholesterol intake of 0.88 (0.64-1.13) g. The effects of plain water intake on diet were similar across race/ethnicity, education attainment, income level and body weight status, whereas they were larger among males and young/middle-aged adults than among females and older adults, respectively. Daily overall diet quality measured by the Healthy Eating Index-2010 was not found to be associated with the proportion of daily plain water in total dietary water consumption. Conclusions Promoting plain water intake could be a useful public health strategy for reducing energy and targeted nutrient consumption in US adults, which warrants confirmation in future controlled interventions. [ABSTRACT FROM AUTHOR]

Objectives. To assess the US packaged food industry's progress from 2009 to 2014, when the National Salt Reduction Initiative had voluntary, category-specific sodium targets with the goal of reducing sodium in packaged and restaurant foods by 25% over 5 years. Methods. Using the National Salt Reduction Initiative Packaged Food Database, we assessed target achievement and change in sales-weighted mean sodium density in top-selling products in 61 food categories in 2009 (n = 6336), 2012 (n = 6898), and 2014 (n = 7396). Results. In 2009, when the targets were established, no categories met National Salt Reduction Initiative 2012 or 2014 targets. By 2014, 26% of categories met 2012 targets and 3% met 2014 targets. From 2009 to 2014, the sales-weighted mean sodium density declined significantly in almost half of all food categories (43%; 26/61 categories). Overall, sales-weighted mean sodium density declined significantly (by 6.8%; P < .001). Conclusions. National target setting with monitoring through a partnership of local, state, and national health organizations proved feasible, but industry progress was modest. Public Health Implications. The US Food and Drug Administration's proposed voluntary targets will be an important step in achieving more substantial sodium reductions. [ABSTRACT FROM AUTHOR]