The Feasibility of a Low Sodium Meal Plan for Residents of a Subsidized Senior Housing Facility: The SOTRUE Pilot Study. (29th May 2020) - Juraschek, Stephen
Abstract: Objectives: To determine the feasibility of a low sodium meal plan intervention aimed at reducing seated blood pressure (BP) in residents of a government-subsidized congregate, senior living facility. Methods: The Satter House Trial of Reduced Sodium Meals (SOTRUE) was an individual-level, masked, randomized, controlled pilot study, testing the feasibility of administering a low versus typical sodium meal plan to adult residents of Jack Satter House, a section 202 congregate living facility in Revere, MA, subsidized by the Federal Department of Housing and Urban Development (HUD). Adults over age 60 years received 3 isocaloric meals with two snacks daily over a 14-day period. Both meal plans were equivalent in potassium and macronutrients, but differed in sodium density (<0.95 mg/kcal vs > 2 mg/kcal). The primary outcome was seated systolic BP (SBP) averaged over 2 visits (days 10 and 14) using an Omron HEM-907XL automated cuff. Our objective measure of compliance was morning urine sodium-creatinine ratio. Results: We randomized 20 participants (95% women, 95% white, and mean age 78 +/− 8 years), beginning in October 7, 2019. Baseline characteristics were evenly distributed between groups. Dietary compliance was high (only 2 discontinued meals) and follow-up was 100% with the last participant ending November 4, 2019. Baseline SBP changed from 121 to 116 mm Hg on the typical sodium meal plan ( N = 9; mean difference of −5 mm Hg; 95% CI: −18, 8) and 123 to 112 mm Hg on the low sodium meal plan ( N = 11; mean difference of −11 mm Hg; 95% CI: −15.2, −7.7). Compared to the typical sodium meal plan, the low sodium meal plan non-significantly reduced SBP by 5 mm Hg (95% CI: −14, 4) and non-significantly reduced urine sodium-creatinine ratio (%-difference −36.0; 95% CI: −60.3, 3.4). Effects on SBP were greater in the subgroup using hypertension medications at baseline (−13 mm Hg; 95% CI: −26, −0) and changes in SBP from baseline were correlated with changes in urine sodium-creatinine ratio (Pearson's r = 0.31). Conclusions: This trial represents an innovative, feasible, and practical approach to healthier eating by altering federally-mandated meal plans. A definitive study with a larger sample size is needed to establish the efficacy and safety of this approach in older adults who reside in section 202 housing. Funding Sources: ISAC, Marcus Institute for Aging Research, Hebrew SeniorLife.