scholarly journals Estimating sodium intake from spot urine samples at population level: a validation and application study in French adults

2019 ◽  
Vol 122 (2) ◽  
pp. 186-194 ◽  
Author(s):  
Elise Emeville ◽  
Camille Lassale ◽  
Katia Castetbon ◽  
Valérie Deschamps ◽  
Benoît Salanave ◽  
...  
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Adult Population ◽  
Correlation Coefficients ◽  
Population Level ◽  
Urine Samples ◽  
Validation Sample ◽  
Application Study ◽  
Spot Urine ◽  
Calibration Coefficients

AbstractThe aim of this study was to assess the validity of the predictive INTERSALT equation using spot urine samples to estimate 24-h urinary Na (24-hUNa) excretion and daily Na intake among the French adult population. Among 193 French adults (‘validation sample’), we assessed the validity by comparing predicted 24-hUNa excretion from spot urine and measured 24-hUNa excretion from 24-h urine collections. Spearman correlation coefficients and Bland–Altman plots were used and we calculated calibration coefficients. In a nationally representative sample of 1720 French adults (‘application sample’), the calibrated predictive equation was then applied to the spot urine Na values to estimate 24-hUNa excretion and daily Na intake. In that sample, predicted Na intake was compared with that estimated from 24-h dietary recalls. Results were adjusted and corrected using calibration coefficients. In the validation sample, the measured 24-hUNa excretion was on average 14 % higher than the predicted 24-hUNa (+13 % for men and +16 % for women). Correlation between measured and predicted 24-hUNa excretion was moderate (Spearman r 0·42), and the Bland–Altman plots showed underestimation at lower excretion level and overestimation at higher level. In the application study, estimated daily salt intake was 8·0 g/d using dietary recalls, 8·1 g/d using predicted INTERSALT equation and 9·3 g/d after applying calibration coefficients calculated in the validation study. Despite overall underestimation of 24-hUNa excretion by spot urinary Na, the use of predictive INTERSALT equation remains an acceptable alternative in monitoring global Na intake/excreted in the French population but its use is not advised at the individual level.

scholarly journals Correlation Between Spot Urine Sodium, 24 Hour Urinary Sodium and Food Frequency Questionnairein Estimation of Salt Intake in Healthy Individuals

2020 ◽  
Vol 5 (1) ◽  
pp. 74
Author(s):  
Jaafar Maryam Kamiliah ◽  
Nordin Nani ◽  
Abdul Rahman Abdul Rashid
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Cost Effective ◽  
Urinary Sodium ◽  
Urine Samples ◽  
Urine Sodium ◽  
Gold Standard Method ◽  
Food Frequency ◽  
Spot Urine ◽  
Daily Sodium Intake

Background:Salt intake is a known contributor to increased blood pressure. However, it is rarely monitored in clinical practice. 24-hr urinary sodium (24-HrNa) is the gold standard method to estimate salt intake but this method is rather burdensome.Objective: The objective of this study is to correlate between spot urine sodium (SUNa), 24-HrNa and Na intake estimation by food frequency questionnaire (FFQ) (FFQNa).Methods : 430 healthy participants aged between 20-40 years old were recruited. Second morning voided urine samples were obtained from all participants to estimate SUNa. 24-HrNa samples were obtained from 77 out of 430 participants. All participants were required to answer a validated FFQ. Urine samples were analysed for Na using indirect ion-selective electrode (ISE) method. Daily sodium intake was calculated from the FFQ.Results:The mean daily sodium intake from 24-hrNa (n=77) was 155 mmol/day, SUNa (n=430) was 158 mmol/L and FFQNa (n=430) was 271 mmol/day. There was a moderate correlation between SUNa and 24-hrNa (ρ = 0.62, P < 0.000). No correlation was seen between both 24-hrNa and SUNa with FFQNa (ρ = 0.035, P = 0.768 and ρ = 0.026, P = 0.597 respectively).Conclusion: Spot urine Na is a simple cost-effective method to estimate daily Na intake and has the potential to replace 24-hour urinary Na.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 74-80

scholarly journals Development, validation and application of a machine learning model to estimate salt consumption in 54 countries

eLife ◽  
2022 ◽  
Vol 11 ◽  
Author(s):  
Wilmer Cristobal Guzman-Vilca ◽  
Manuel Castillo-Cara ◽  
Rodrigo M Carrillo-Larco
Keyword(s):  
Machine Learning ◽  
Salt Intake ◽  
Population Level ◽  
American Samoa ◽  
Population Based ◽  
Urine Samples ◽  
Spot Urine ◽  
Salt Consumption ◽  
Model Based ◽  
Machine Learning Model

Global targets to reduce salt intake have been proposed but their monitoring is challenged by the lack of population-based data on salt consumption. We developed a machine learning (ML) model to predict salt consumption at the population level based on simple predictors and applied this model to national surveys in 54 countries. We used 21 surveys with spot urine samples for the ML model derivation and validation; we developed a supervised ML regression model based on: sex, age, weight, height, systolic and diastolic blood pressure. We applied the ML model to 54 new surveys to quantify the mean salt consumption in the population. The pooled dataset in which we developed the ML model included 49,776 people. Overall, there were no substantial differences between the observed and ML-predicted mean salt intake (p<0.001). The pooled dataset where we applied the ML model included 166,677 people; the predicted mean salt consumption ranged from 6.8 g/day (95% CI: 6.8-6.8 g/day) in Eritrea to 10.0 g/day (95% CI: 9.9-10.0 g/day) in American Samoa. The countries with the highest predicted mean salt intake were in Western Pacific. The lowest predicted intake was found in Africa. The country-specific predicted mean salt intake was within reasonable difference from the best available evidence. A ML model based on readily available predictors estimated daily salt consumption with good accuracy. This model could be used to predict mean salt consumption in the general population where urine samples are not available.

scholarly journals Estimating Usual Sodium Intake and Sodium-to-Potassium Molar Ratios From Urine Excretion Among Canadian Adults: An Analysis of the Canadian Health Measures Survey

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1020-1020
Author(s):  
Anthea Christoforou ◽  
Alena (Praneet) Ng ◽  
Jodi Bernstein ◽  
Mary L'Abbe
Keyword(s):  
Sodium Excretion ◽  
Sodium Intake ◽  
Population Level ◽  
Urine Samples ◽  
Dietary Sodium ◽  
Dietary Salt ◽  
Salt Reduction ◽  
Men And Women ◽  
Spot Urine ◽  
Molar Ratios

Abstract Objectives High dietary sodium is now well established to be a major risk factor for hypertension, cardiovascular disease and mortality. Monitoring population sodium intakes is critical for evaluating progress towards Health Canada's dietary salt reduction targets. Given that approximately 90% of ingested sodium is excreted in the urine, accurate estimations of average daily urinary sodium is critical for determining population sodium intake. However, until recently, nationally representative surveys from Canada have only collected a single “spot” (casual) urine sample which are prone to bias due to large day-to-day variation amongst individuals. The aim of this study was to estimate average population sodium intake using the latest version of the Canadian Heath Measures Survey, Cycle 5 (2016–2017) which, for the first time includes 2 non-consecutive days of spot urine samples from a representative sample of the Canadian population. Methods The INTERSALT equations, validated for western populations, was used to estimate 24hr intakes of sodium amongst adults ≥19 years of age, excluding pregnant women (n = 3032). Individual sodium-to-potassium molar ratios (Na: K) were also calculated, given their importance in predicting hypertension risk. The second day of spot urines was used to control for within-person variation in both sodium excretion and NA: K molar ratios, using the National Cancer Institute method for estimating usual dietary intake, adjusting for respondents’ fasting status. Results Mean sodium excretion was 3142 ± 30 mg/day and 3154 ± 30 mg/dayin men and women, respectively. In both men and women only 14% of participants consumed less than the recommended 2300 mg of sodium/day. The Na: K was approximately 1.4 in both men and women with only 15–20%, at or below, an optimal Na: K of 1. Conclusions This is the first study from Canada to estimate sodium and NA: K at the population level, using two days of spot urine samples, providing robust baseline data for continued monitoring. Our findings reveal a need for ongoing efforts to reduce population sodium and improve potassium intakes in order to reduce cardiovascular risk. Funding Sources Canadian Institutes of Health Research.

scholarly journals Estimating mean population salt intake in Fiji and Samoa using spot urine samples

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Joseph Alvin Santos ◽  
Emalie Rosewarne ◽  
Martyna Hogendorf ◽  
Kathy Trieu ◽  
Arti Pillay ◽  
...  
Keyword(s):  
Developing Countries ◽  
Salt Intake ◽  
Intraclass Correlation ◽  
Population Level ◽  
Urine Samples ◽  
Urine Collection ◽  
Cross Sectional ◽  
Spot Urine ◽  
Paired Samples ◽  
Secondary Analyses

Abstract Background There is an increasing interest in finding less costly and burdensome alternatives to measuring population-level salt intake than 24-h urine collection, such as spot urine samples. However, little is known about their usefulness in developing countries like Fiji and Samoa. The purpose of this study was to evaluate the capacity of spot urine samples to estimate mean population salt intake in Fiji and Samoa. Methods The study involved secondary analyses of urine data from cross-sectional surveys conducted in Fiji and Samoa between 2012 and 2016. Mean salt intake was estimated from spot urine samples using six equations, and compared with the measured salt intake from 24-h urine samples. Differences and agreement between the two methods were examined through paired samples t-test, intraclass correlation coefficient analysis, and Bland-Altman plots and analyses. Results A total of 414 participants from Fiji and 725 participants from Samoa were included. Unweighted mean salt intake based on 24-h urine collection was 10.58 g/day (95% CI 9.95 to 11.22) in Fiji and 7.09 g/day (95% CI 6.83 to 7.36) in Samoa. In both samples, the INTERSALT equation with potassium produced the closest salt intake estimate to the 24-h urine (difference of − 0.92 g/day, 95% CI − 1.67 to − 0.18 in the Fiji sample and + 1.53 g/day, 95% CI 1.28 to 1.77 in the Samoa sample). The presence of proportional bias was evident for all equations except for the Kawasaki equation. Conclusion These data suggest that additional studies where both 24-h urine and spot urine samples are collected are needed to further assess whether methods based on spot urine samples can be confidently used to estimate mean population salt intake in Fiji and Samoa.

scholarly journals Urine Spot Samples Can Be Used to Estimate 24-Hour Urinary Sodium Excretion in Children

2018 ◽  
Vol 148 (12) ◽  
pp. 1946-1953 ◽  
Author(s):  
Magali Rios-Leyvraz ◽  
Pascal Bovet ◽  
René Tabin ◽  
Bernard Genin ◽  
Michel Russo ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Salt Intake ◽  
Sodium Intake ◽  
Population Level ◽  
Urinary Sodium Excretion ◽  
Cross Sectional Study ◽  
Urinary Sodium ◽  
Cross Sectional ◽  
High Sodium ◽  
Individual Level

ABSTRACT Background The gold standard to assess salt intake is 24-h urine collections. Use of a urine spot sample can be a simpler alternative, especially when the goal is to assess sodium intake at the population level. Several equations to estimate 24-h urinary sodium excretion from urine spot samples have been tested in adults, but not in children. Objective The objective of this study was to assess the ability of several equations and urine spot samples to estimate 24-h urinary sodium excretion in children. Methods A cross-sectional study of children between 6 and 16 y of age was conducted. Each child collected one 24-h urine sample and 3 timed urine spot samples, i.e., evening (last void before going to bed), overnight (first void in the morning), and morning (second void in the morning). Eight equations (i.e., Kawasaki, Tanaka, Remer, Mage, Brown with and without potassium, Toft, and Meng) were used to estimate 24-h urinary sodium excretion. The estimates from the different spot samples and equations were compared with the measured excretion through the use of several statistics. Results Among the 101 children recruited, 86 had a complete 24-h urine collection and were included in the analysis (mean age: 10.5 y). The mean measured 24-h urinary sodium excretion was 2.5 g (range: 0.8–6.4 g). The different spot samples and equations provided highly heterogeneous estimates of the 24-h urinary sodium excretion. The overnight spot samples with the Tanaka and Brown equations provided the most accurate estimates (mean bias: −0.20 to −0.12 g; correlation: 0.48–0.53; precision: 69.7–76.5%; sensitivity: 76.9–81.6%; specificity: 66.7%; and misclassification: 23.0–27.7%). The other equations, irrespective of the timing of the spot, provided less accurate estimates. Conclusions Urine spot samples, with selected equations, might provide accurate estimates of the 24-h sodium excretion in children at a population level. At an individual level, they could be used to identify children with high sodium excretion. This study was registered at clinicaltrials.gov as NCT02900261.

scholarly journals Estimating salt intake in a Caucasian population: can spot urine substitute 24-hour urine samples?

2013 ◽  
Vol 21 (10) ◽  
pp. 1300-1307 ◽  
Author(s):  
Ulla Toft ◽  
Charlotte Cerqueira ◽  
Anne Helms Andreasen ◽  
Betina Heinsbæk Thuesen ◽  
Peter Laurberg ◽  
...  
Keyword(s):  
Salt Intake ◽  
Caucasian Population ◽  
Urine Samples ◽  
Spot Urine

scholarly journals Estimating 24-Hour Sodium Excretion from Spot Urine Samples in Chinese Adults: Can Spot Urine Substitute 24-Hour Urine Samples?

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 798
Author(s):  
Jianwei Xu ◽  
Jiyu Zhang ◽  
Min Liu ◽  
Yamin Bai ◽  
Xiaolei Guo ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Population Level ◽  
Relative Difference ◽  
Urine Samples ◽  
Misclassification Rate ◽  
Absolute Difference ◽  
Sample Collection ◽  
Spot Urine ◽  
Individual Level ◽  
Chinese Populations

Several estimating equations for predicting 24-h urinary sodium (24-hUNa) excretion using spot urine (SU) samples have been developed, but have not been readily available to Chinese populations. We aimed to compare and validate the six existing methods at population level and individual level. We extracted 1671 adults eligible for both 24-h urine and SU sample collection. Mean biases (95% CI) of predicting 24-hUNa excretion using six formulas were 58.6 (54.7, 62.5) mmol for Kawasaki, −2.7 (−6.2, 0.9) mmol for Tanaka, −24.5 (−28.0, −21.0) mmol for the International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT) with potassium, –26.8 (−30.1, −23.3) mmol for INTERSALT without potassium, 5.9 (2.3, 9.6) mmol for Toft, and −24.2 (−27.7, −20.6) mmol for Whitton. The proportions of relative difference >40% with the six methods were nearly a third, and the proportions of absolute difference >51.3 mmol/24-h (3 g/day salt) were more than 40%. The misclassification rate were all >55% for the six methods at the individual level. Although the Tanaka method could offer a plausible estimation for surveillance of the population sodium excretion in Shandong province, caution remains when using the Tanaka formula for other provincial populations in China. However, these predictive methods were inadequate to evaluate individual sodium excretion.

scholarly journals Correcting for Intra-Individual Variability in Sodium Excretion in Spot Urine Samples Does Not Improve the Ability to Predict 24 h Urinary Sodium Excretion

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2026
Author(s):  
Karen Elizabeth Charlton ◽  
Aletta Elisabeth Schutte ◽  
Leanda Wepener ◽  
Barbara Corso ◽  
Paul Kowal ◽  
...  
Keyword(s):  
Analysis Of Variance ◽  
Individual Variation ◽  
Sodium Excretion ◽  
Distribution Curve ◽  
Salt Intake ◽  
Individual Variability ◽  
Urinary Sodium ◽  
Urine Samples ◽  
Prediction Equations ◽  
Spot Urine

Given a global focus on salt reduction efforts to reduce cardiovascular risk, it is important to obtain accurate measures of salt intake on a population level. This study determined firstly whether adjustment for intra-individual variation in urinary sodium (Na) excretion using three repeated 24 h collections affects daily estimates and whether the use of repeated spot urine samples results in better prediction of 24 h Na compared to a single collection. Twenty three community-dwelling men and women from South Africa (mean age 59.7 years (SD = 15.6)) participating in the World Health Organization Study on global AGEing and adult health (WHO-SAGE) Wave 3 study collected 24 h and spot early morning urine samples over three consecutive days to assess urinary Na excretion. INTERSALT, Tanaka, and Kawasaki prediction equations, with either average or adjusted spot Na values, were used to estimate 24 h Na and compared these against measured 24 h urinary Na. Adjustment was performed by using the ratio of between-person (sb) and total (sobs) variability obtained from repeated measures analysis of variance. Sensitivity of the equations to predict daily urinary Na values below 5 g salt equivalent was calculated. The sb/sobs for urinary Na using three repeated samples for spot and 24 h samples were 0.706 and 0.798, respectively. Correction using analysis of variance for 3 × 24 h collections resulted in contraction of the upper end of the distribution curve (90th centile: 157 to 136 mmoL/day; 95th centile: 220 to 178 mmoL/day). All three prediction equations grossly over-estimated 24 h urinary Na excretion, regardless of whether a single spot urine or repeated collections corrected for intra-individual variation were used. Sensitivity of equations to detect salt intake equivalent values of ≤5 g/day was 13% for INTERSALT, while the other two equations had zero sensitivity. Correcting for intra-individual variability in Na excretion using three 24 h urine collections contracted the distribution curve for high intakes. Repeated collection of spot samples for urinary Na analysis does not improve the accuracy of predicting 24 h Na excretion. Spot urine samples are not appropriate to detect participants with salt intakes below the recommended 5 g/day.

A13673 Estimating mean population salt intake in Fiji and Samoa using spot urine samples

2018 ◽  
Vol 36 ◽  
pp. e322
Author(s):  
Joseph Alvin Santos ◽  
Kathy Trieu ◽  
Merina Ieremia ◽  
Arti Pillay ◽  
Leausa Toleafoa Take Naseri ◽  
...  
Keyword(s):  
Salt Intake ◽  
Urine Samples ◽  
Spot Urine

scholarly journals Mean Dietary Salt Intake in Vanuatu: A Population Survey of 755 Participants on Efate Island

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 916
Author(s):  
Katherine Paterson ◽  
Nerida Hinge ◽  
Emalie Sparks ◽  
Kathy Trieu ◽  
Joseph Alvin Santos ◽  
...  
Keyword(s):  
Salt Intake ◽  
Urine Samples ◽  
World Health ◽  
Dietary Salt ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Dietary Salt Intake ◽  
Spot Urine ◽  
Salt Consumption

Non-communicable diseases are responsible for 63% of global deaths, with a higher burden in low- and middle-income countries. Hypertension is the leading cause of cardiovascular-disease-related deaths worldwide, and approximately 1.7 million deaths are directly attributable to excess salt intake annually. There has been little research conducted on the level of salt consumption amongst the population of Vanuatu. Based on data from other Pacific Island countries and knowledge of changing regional diets, it was predicted that salt intake would exceed the World Health Organization’s (WHO) recommended maximum of 5 g per day. The current study aimed to provide Vanuatu with a preliminary baseline assessment of population salt intake on Efate Island. A cross-sectional survey collected demographic, clinical, and urine data from participants aged 18 to 69 years in rural and urban communities on Efate Island in October 2016 and February 2017. Mean salt intake was determined to be 7.2 (SD 2.3) g/day from spot urine samples, and 5.9 (SD 3.6) g/day from 24-h urine samples, both of which exceed the WHO recommended maximum. Based on the spot urine samples, males had significantly higher salt intake than females (7.8 g compared to 6.5 g; p < 0.001) and almost 85% of the population consumed more than the WHO recommended maximum daily amount. A coordinated government strategy is recommended to reduce salt consumption, including fiscal policies, engagement with the food industry, and education and awareness-raising to promote behavior change.

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