Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke

A randomized, multicenter, double-blind controlled trial

Wen Harn Pan, Ying Ho Lai, Wen Ting Yeh, Jiunn Rong Chen, Jiann Shing Jeng, Chyi Huey Bai, Ruey Tay Lin, Tsong Hai Lee, Ku Chou Chang, Huey Juan Lin, Chin Fu Hsiao, Chang Ming Chern, Li Ming Lien, Chung Hsiang Liu, Wei Hung Chen, Anna Chang

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Stroke is one of the leading causes of mortality and neurologic deficits. Management measures to improve neurologic outcomes are in great need. Our previous intervention trial in elderly subjects successfully used salt as a carrier for potassium, demonstrating a 41% reduction in cardiovascular mortality by switching to potassium-enriched salt. Dietary magnesium has been associated with lowered diabetes and/or stroke risk in humans and with neuroprotection in animals. Objective: Because a large proportion of Taiwanese individuals are in marginal deficiency states for potassium and for magnesium and salt is a good carrier for minerals, it is justifiable to study whether further enriching salt with magnesium at an amount near the Dietary Reference Intake (DRI) amount may provide additional benefit for stroke recovery. Design: This was a double-blind, randomized controlled trial comprising 291 discharged stroke patients with modified Rankin scale (mRS) ≤4. There were 3 arms: 1) regular salt (Na salt) (n = 99), 2) potassium-enriched salt (K salt) (n = 97), and 3) potassium- and magnesium-enriched salt (K/Mg salt) (n = 95). The NIH Stroke Scale (NIHSS), Barthel Index (BI), and mRS were evaluated at discharge, at 3 mo, and at 6 mo. A good neurologic performance was defined by NIHSS = 0, BI = 100, and mRS ≤1. Results: After the 6-mo intervention, the proportion of patients with good neurologic performance increased in a greater magnitude in the K/Mg salt group than in the K salt group and the Na salt group, in that order. The K/Mg salt group had a significantly increased OR (2.25; 95% CI: 1.09, 4.67) of achieving good neurologic performance compared with the Na salt group. But the effect of K salt alone (OR: 1.58; 95% CI: 0.77, 3.22) was not significant. Conclusions: This study suggests that providing the DRI amount of magnesium and potassium together long term is beneficial for stroke patient recovery from neurologic deficits. This trial was registered at clinicaltrials.gov as NCT02910427.

Original languageEnglish
Pages (from-to)1267-1273
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Volume106
Issue number5
DOIs
Publication statusPublished - Nov 1 2017

Fingerprint

Magnesium
Potassium
Salts
Stroke
Nervous System
Recommended Dietary Allowances
Neurologic Manifestations
Potassium Deficiency
Mortality
Minerals
Randomized Controlled Trials

Keywords

  • Enriched salt
  • Magnesium
  • Neurologic performance
  • Potassium
  • Stroke

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke : A randomized, multicenter, double-blind controlled trial. / Pan, Wen Harn; Lai, Ying Ho; Yeh, Wen Ting; Chen, Jiunn Rong; Jeng, Jiann Shing; Bai, Chyi Huey; Lin, Ruey Tay; Lee, Tsong Hai; Chang, Ku Chou; Lin, Huey Juan; Hsiao, Chin Fu; Chern, Chang Ming; Lien, Li Ming; Liu, Chung Hsiang; Chen, Wei Hung; Chang, Anna.

In: American Journal of Clinical Nutrition, Vol. 106, No. 5, 01.11.2017, p. 1267-1273.

Research output: Contribution to journalArticle

Pan, WH, Lai, YH, Yeh, WT, Chen, JR, Jeng, JS, Bai, CH, Lin, RT, Lee, TH, Chang, KC, Lin, HJ, Hsiao, CF, Chern, CM, Lien, LM, Liu, CH, Chen, WH & Chang, A 2017, 'Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke: A randomized, multicenter, double-blind controlled trial', American Journal of Clinical Nutrition, vol. 106, no. 5, pp. 1267-1273. https://doi.org/10.3945/ajcn.116.148536
Pan, Wen Harn ; Lai, Ying Ho ; Yeh, Wen Ting ; Chen, Jiunn Rong ; Jeng, Jiann Shing ; Bai, Chyi Huey ; Lin, Ruey Tay ; Lee, Tsong Hai ; Chang, Ku Chou ; Lin, Huey Juan ; Hsiao, Chin Fu ; Chern, Chang Ming ; Lien, Li Ming ; Liu, Chung Hsiang ; Chen, Wei Hung ; Chang, Anna. / Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke : A randomized, multicenter, double-blind controlled trial. In: American Journal of Clinical Nutrition. 2017 ; Vol. 106, No. 5. pp. 1267-1273.
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AU - Pan, Wen Harn

AU - Lai, Ying Ho

AU - Yeh, Wen Ting

AU - Chen, Jiunn Rong

AU - Jeng, Jiann Shing

AU - Bai, Chyi Huey

AU - Lin, Ruey Tay

AU - Lee, Tsong Hai

AU - Chang, Ku Chou

AU - Lin, Huey Juan

AU - Hsiao, Chin Fu

AU - Chern, Chang Ming

AU - Lien, Li Ming

AU - Liu, Chung Hsiang

AU - Chen, Wei Hung

AU - Chang, Anna

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background: Stroke is one of the leading causes of mortality and neurologic deficits. Management measures to improve neurologic outcomes are in great need. Our previous intervention trial in elderly subjects successfully used salt as a carrier for potassium, demonstrating a 41% reduction in cardiovascular mortality by switching to potassium-enriched salt. Dietary magnesium has been associated with lowered diabetes and/or stroke risk in humans and with neuroprotection in animals. Objective: Because a large proportion of Taiwanese individuals are in marginal deficiency states for potassium and for magnesium and salt is a good carrier for minerals, it is justifiable to study whether further enriching salt with magnesium at an amount near the Dietary Reference Intake (DRI) amount may provide additional benefit for stroke recovery. Design: This was a double-blind, randomized controlled trial comprising 291 discharged stroke patients with modified Rankin scale (mRS) ≤4. There were 3 arms: 1) regular salt (Na salt) (n = 99), 2) potassium-enriched salt (K salt) (n = 97), and 3) potassium- and magnesium-enriched salt (K/Mg salt) (n = 95). The NIH Stroke Scale (NIHSS), Barthel Index (BI), and mRS were evaluated at discharge, at 3 mo, and at 6 mo. A good neurologic performance was defined by NIHSS = 0, BI = 100, and mRS ≤1. Results: After the 6-mo intervention, the proportion of patients with good neurologic performance increased in a greater magnitude in the K/Mg salt group than in the K salt group and the Na salt group, in that order. The K/Mg salt group had a significantly increased OR (2.25; 95% CI: 1.09, 4.67) of achieving good neurologic performance compared with the Na salt group. But the effect of K salt alone (OR: 1.58; 95% CI: 0.77, 3.22) was not significant. Conclusions: This study suggests that providing the DRI amount of magnesium and potassium together long term is beneficial for stroke patient recovery from neurologic deficits. This trial was registered at clinicaltrials.gov as NCT02910427.

AB - Background: Stroke is one of the leading causes of mortality and neurologic deficits. Management measures to improve neurologic outcomes are in great need. Our previous intervention trial in elderly subjects successfully used salt as a carrier for potassium, demonstrating a 41% reduction in cardiovascular mortality by switching to potassium-enriched salt. Dietary magnesium has been associated with lowered diabetes and/or stroke risk in humans and with neuroprotection in animals. Objective: Because a large proportion of Taiwanese individuals are in marginal deficiency states for potassium and for magnesium and salt is a good carrier for minerals, it is justifiable to study whether further enriching salt with magnesium at an amount near the Dietary Reference Intake (DRI) amount may provide additional benefit for stroke recovery. Design: This was a double-blind, randomized controlled trial comprising 291 discharged stroke patients with modified Rankin scale (mRS) ≤4. There were 3 arms: 1) regular salt (Na salt) (n = 99), 2) potassium-enriched salt (K salt) (n = 97), and 3) potassium- and magnesium-enriched salt (K/Mg salt) (n = 95). The NIH Stroke Scale (NIHSS), Barthel Index (BI), and mRS were evaluated at discharge, at 3 mo, and at 6 mo. A good neurologic performance was defined by NIHSS = 0, BI = 100, and mRS ≤1. Results: After the 6-mo intervention, the proportion of patients with good neurologic performance increased in a greater magnitude in the K/Mg salt group than in the K salt group and the Na salt group, in that order. The K/Mg salt group had a significantly increased OR (2.25; 95% CI: 1.09, 4.67) of achieving good neurologic performance compared with the Na salt group. But the effect of K salt alone (OR: 1.58; 95% CI: 0.77, 3.22) was not significant. Conclusions: This study suggests that providing the DRI amount of magnesium and potassium together long term is beneficial for stroke patient recovery from neurologic deficits. This trial was registered at clinicaltrials.gov as NCT02910427.

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