***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To examine whether a worksite nutrition programme using a low-fat vegan diet could significantly improve nutritional intake . DESIGN At two corporate sites of the Government Employees Insurance Company , employees who were either overweight ( BMI > or = 25 kg/m2 ) and /or had type 2 diabetes participated in a 22-week worksite-based dietary intervention study . SETTING At the intervention site , participants were asked to follow a low-fat vegan diet and participate in weekly group meetings that included instruction and group support ( intervention group ) . At the control site , participants received no instruction ( control group ) . At weeks 0 and 22 , participants completed 3 d dietary records to assess energy and nutrient intake . SUBJECTS A total of 109 participants ( sixty-five intervention and forty-four control ) . RESULTS In the intervention group , reported intake of total fat , trans fat , saturated fat and cholesterol decreased significantly ( P < or = 0.001 ) , as did energy and protein ( P = 0.01 ) , and vitamin B12 ( P = 0.002 ) , compared with the control group . Intake ( exclusive of any use of nutritional supplements ) of carbohydrate , fibre , vitamin C , magnesium and potassium increased significantly ( P < or = 0.0001 ) , as did that for beta-carotene ( P = 0.0004 ) , total vitamin A activity ( P = 0.004 ) , vitamin K ( P = 0.01 ) and sodium ( P = 0.04 ) in the intervention group , compared with the control group . CONCLUSIONS The present study suggests that a worksite vegan nutrition programme increases intakes of protective nutrients , such as fibre , folate and vitamin C , and decreases intakes of total fat , saturated fat and cholesterol BACKGROUND The beneficial effects of potassium-enriched salt on blood pressure have been reported in a few short-term trials . The long-term effects of potassium-enriched salt on cardiovascular mortality have not been carefully studied . OBJECTIVE The objective was to examine the effects of potassium-enriched salt on cardiovascular disease ( CVD ) mortality and medical expenditures in elderly veterans . DESIGN Five kitchens of a veteran retirement home were r and omized into 2 groups ( experimental or control ) and veterans assigned to those kitchens were given either potassium-enriched salt ( experimental group ) or regular salt ( control group ) for approximately 31 mo . Information on death , health insurance cl aims , and date s that veterans moved in or out of the home was gathered . RESULTS Altogether , 1981 veterans , 768 in the experimental [ x ( + /-SD ) age : 74.8 + /- 7.1 y ] and 1213 in the control ( age : 74.9 + /- 6.7 y ) groups , were included in the analysis . The experimental group had better CVD survivorship than did the control group . The incidence of CVD-related deaths was 13.1 per 1000 persons ( 27 deaths in 2057 person-years ) and 20.5 per 1000 ( 66 deaths in 3218 person-years ) for the experimental and control groups , respectively . A significant reduction in CVD mortality ( age-adjusted hazard ratio : 0.59 ; 95 % CI : 0.37 , 0.95 ) was observed in the experimental group . Persons in the experimental group lived 0.3 - 0.90 y longer and spent significantly less ( approximately US Dollars 426/y ) in inpatient care for CVD than did the control group , after control for age and previous hospitalization expenditures . CONCLUSIONS This study showed a long-term beneficial effect on CVD mortality and medical expenditure associated with a switch from regular salt to potassium-enriched salt in a group of elderly veterans . The effect was likely due to a major increase in potassium and a moderate reduction in sodium intakes BACKGROUND Sodium intake is high in people with type 2 diabetes ( T2DM ) . The aim of this study was to investigate whether urinary sodium excretion can be reduced by educating people with T2DM to read food labels and choose low sodium products . METHOD In a 3 month r and omised controlled trial , 78 men ( n=49 ) and women ( n=29 ) with T2DM were recruited from a Diabetes Centre at a University teaching hospital . The intervention group was educated in a single session to use the nutrition information panel on food labels to choose products which complied with the Food St and ards Australia New Zeal and ( FSANZ ) guideline of < 120 mg sodium/100 g food . The control group continued on their usual diet . The primary outcome measure was 24h urinary sodium excretion which was performed at baseline and 3 months . Data was analysed using repeated measures analysis of variance , independent sample s t-test and Pearson 's correlations . RESULTS At 3 months mean urinary sodium excretion was unchanged in the intervention ( 174±13 mmol/24 h and 175±13 mmol/24 h ) and control group ( 167±15mmol/24h and 161±13 mmol/24 h ) , and there was no between group difference ( p>0.05 ) . CONCLUSION Sodium excretion was not reduced following the label reading education provided to this group of people with T2DM The aim of this study is to examine  sodium intake and dietary sodium sources of 1‐5‐y‐old children in a prospect i ve , r and omized long‐term coronary heart disease prevention trial , focused on dietary fat modification . Counselling included no advice about reducing salt in the children 's diets . Food consumption of 100 intervention children and 100 control children was recorded for 3 consecutive days at the age of 13 mo and for 4 consecutive days at the ages of 3 and 5 y.  Sodium intakes  were calculated using the Micro Nutrica program . Children 's mean daily sodium ( NaCl ) consumption ( intervention and control children combined ) was 1600 ± 527 mg ( 4.0 ± 1.3 g ) , 1900 ± 504 mg ( 4.8 ± 1.3 g ) and 2200 ± 531 mg ( 5.5 ± 1.3 g ) at the ages of 13 mo and 3 and 5 y , respectively . The intervention children consumed as much or slightly more sodium than the control children at all ages studied . Half the sodium consumption was derived from added salt in commercially prepared or homemade foods . Milk , meat products , bread and cereals were other important sodium sources Objectives To assess geographic and socioeconomic gradients in sodium and potassium intake in Italy . Setting Cross-sectional survey in Italy . Participants 3857 men and women , aged 39–79 years , r and omly sample d in 20 regions ( as part of a National cardiovascular survey of 8714 men and women ) . Primary outcome measures Participants  ’ dietary sodium and potassium intakes  were measured by 24 h urinary sodium and potassium excretions . 2 indicators measured socioeconomic status : education and occupation . Bayesian geoadditive models were used to assess spatial and socioeconomic patterns of  sodium and potassium intakes accounting for sociodemographic , anthropometric and behavioural confounders . Results There was a significant north-south pattern of sodium excretion in Italy . Participants living in southern Italy ( eg , Calabria , Basilicata and Puglia > 180 mmol/24 h ) had a significantly higher sodium excretion than elsewhere ( eg , Val d'Aosta and Trentino-Alto Adige < 140 mmol/24 h ; p<0.001 ) . There was a linear association between occupation and sodium excretion ( p<0.001 ) . When compared with occupation I ( top managerial ) , occupations III and IV had a 6.5 % higher sodium excretion ( coefficients : 0.054 ( 90 % credible levels 0.014 , 0.093 ) and 0.064 ( 0.024 , 0.104 ) , respectively ) . A similar relationship was found between educational attainment and sodium excretion ( p<0.0001 ) . When compared with those with a university degree , participants with primary and junior school education had a 5.9 % higher urinary sodium ( coefficients : 0.074 ( 0.031 , 0.116 ) and 0.038 ( 0.001 , 0.075 ) , respectively ) . The socioeconomic gradient explained the spatial variation . Potassium excretion was higher in central regions and in some southern regions . Those in occupation V ( low-skill workers ) showed a 3 % lower potassium excretion compared with those in occupation I. However , the socioeconomic gradient only partially explained the spatial variation . Conclusions Salt intake in Italy is significantly higher in less advantaged social groups . This gradient is independent of confounders and explains the geographical variation Background In Africa hypertension is common and stroke is increasing . Detection , treatment and control of high blood pressure ( BP ) is limited . BP can be lowered by reducing salt intake . In Africa salt is added to the food by the consumer , as processed food is rare . A population -wide approach with programmes based on health education and promotion is thus possible . Methods We carried out a community-based cluster r and omised trial of health promotion in 1,013 participants from 12 villages ( 628 women , 481 rural dwellers ) ; mean age 55 years to reduce salt intake and BP .  Average BP was 125/74 mmHg and urinary sodium ( UNa ) 101 mmol/day . A health promotion intervention was provided over 6 months to all villages . Assessment s were made at 3 and 6 months . Primary end-points were urinary sodium excretion and BP levels . Results There was a significant positive relationship between salt intake and both systolic ( 2.17 mmHg [ 95 % CI 0.44 to 3.91 ] per 50 mmol of UNa per day , p < 0.001 ) and diastolic BP ( 1.10 mmHg [ 0.08 to 1.94 ] , p < 0.001 ) at baseline . At six months the intervention group showed a reduction in systolic ( 2.54 mmHg [ -1.45 to 6.54 ] ) and diastolic ( 3.95 mmHg [ 0.78 to 7.11 ] , p = 0.015 ) BP when compared to control . There was no significant change in UNa . Smaller villages showed greater reductions in UNa than larger villages ( p = 0.042 ) . Irrespective of r and omisation , there was a consistent and significant relationship between change in UNa and change in systolic BP , when adjusted for confounders . A difference in 24-hour UNa of 50 mmol was associated with a lower systolic BP of 2.12 mmHg ( 1.03 to 3.21 ) at 3 months and 1.34 mmHg ( 0.08 to 2.60 ) at 6 months ( both p < 0.001 ) . Conclusion In West Africa the lower the salt intake , the lower the BP . It would appear that a reduction in the average salt intake in the whole community may lead to a small but significant reduction in population systolic BP Objectives To determine the relationship between the reduction in salt intake that occurred in Engl and , and blood pressure ( BP ) , as well as mortality from stroke and ischaemic heart disease ( IHD )  . Design Analysis of the data from the Health Survey for Engl and . Setting and participants Engl and , 2003 N=9183 , 2006 N=8762 , 2008 N=8974 and 2011 N=4753 , aged ≥16 years .  Outcomes BP , stroke and IHD mortality . Results From 2003 to 2011 , there was a decrease in mortality from stroke by 42 % ( p<0.001 ) and IHD by 40 % ( p<0.001 ) . In parallel , there was a fall in BP of 3.0±0.33/1.4±0.20 mm Hg ( p<0.001/p<0.001 ) , a decrease of 0.4±0.02 mmol/L ( p<0.001 ) in cholesterol , a reduction in smoking prevalence from 19 % to 14 % ( p<0.001 ) , an increase in fruit and vegetable consumption ( 0.2±0.05 portion/day , p<0.001 ) and an increase in body mass index ( BMI ; 0.5±0.09 kg/m2 , p<0.001 ) . Salt intake , as measured by 24 h urinary sodium , decreased by 1.4 g/day ( p<0.01 ) . It is likely that all of these factors ( with the exception of BMI ) , along with improvements in the treatments of BP , cholesterol and cardiovascular disease , contributed to the falls in stroke and IHD mortality . In individuals who were not on antihypertensive medication , there was a fall in BP of 2.7±0.34/1.1±0.23 mm Hg ( p<0.001/p<0.001 ) after adjusting for age , sex , ethnic group , education , household income , alcohol consumption , fruit 
    Output:
    
Multi-component strategies involving both upstream and downstream interventions , generally achieved the biggest reductions in salt consumption across an entire population , most notably 4g/day in Finl and and Japan , 3g/day in Turkey and 1.3g/day recently in the UK .
Worksite interventions achieved an increase in intake ( + 0.5g/day ) , however , with a very wide range .
Comprehensive strategies involving multiple components ( reformulation , food labelling and media campaigns ) and " upstream " population -wide policies such as m and atory reformulation generally appear to achieve larger reductions in population -wide salt consumption than " downstream " , individually focussed interventions .