title: Salt intake and mental distress among rural community-dwelling Japanese men.
abstract: BACKGROUND
  Activated mineralocorticoid receptors influence the association between daily salt intake and blood pressure. A relatively low mineralocorticoid receptor function is reported to be a risk for mental distress such as depression. Since mental distress is also a known risk for hypertension and cardiovascular disease, understanding of the association between estimated daily salt intake and mental distress contributing to hypertension is important for risk estimation for cardiovascular disease. However, no single study has reported this association.
  
  
  METHODS
  We conducted a cross-sectional study of 1014 Japanese men undergoing general health check-ups. Mental distress was diagnosed as a Kessler 6 scale score ≥5. We also classified mental distress by levels of hypertension. Estimated daily salt intake was calculated from a causal urine specimen.
  
  
  RESULTS
  Independent from classical cardiovascular risk factors and thyroid disease, we found a significant inverse association between estimated daily salt intake and mental distress. When we analyzed for mental distress and hypertension, we also found a significant association. With the reference group being the lowest tertiles of estimated daily salt intake, the multivariable odds ratios (ORs) of mental distress and mental distress with hypertension for the highest tertiles were 0.50 (0.29-0.88) and 0.46 (0.22-0.96).
  
  
  CONCLUSIONS
  Lower estimated daily salt intake is a significant risk of mental distress for rural community-dwelling Japanese men. Since depression is reported to be associated with cardiovascular disease, risk estimation for the lower intake of salt on mental distress, especially for mental distress with hypertension, may become an important tool to prevent cardiovascular disease.
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. simizicyuu@yahoo.co.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. ko-kado@remus.dti.ne.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kadota
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. jun_koyamatsu@yahoo.co.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Koyamatsu
authors.affiliation: Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. yhirotomo@yahoo.co.jp.
authors.forename: Hirotomo
authors.initials: H
authors.lastname: Yamanashi
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. nmako@hotmail.com.
authors.forename: Mako
authors.initials: M
authors.lastname: Nagayoshi
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. noda9033@nagasaki-u.ac.jp.
authors.forename: Miki
authors.initials: M
authors.lastname: Noda
authors.affiliation: Department of Public Health, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. takayukikid@gmail.com.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nishimura
authors.affiliation: Graduate School of Education, Nagasaki University, Nagasaki, Japan. jtayama@nagasaki-u.ac.jp.|Center for Health and Community Medicine, Nagasaki University, Nagasaki, Japan. jtayama@nagasaki-u.ac.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Tayama
authors.affiliation: Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. ynagata1961@nagasaki-u.ac.jp.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nagata
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. tmaeda@nagasaki-u.ac.jp.|Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. tmaeda@nagasaki-u.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Maeda
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012424:Rural Population / Q000706:statistics & numerical data*; D017673:Sodium Chloride, Dietary; D013315:Stress, Psychological / Q000453:epidemiology*
chemical_list: D017673:Sodium Chloride, Dietary