scholarly journals Dietary sodium intake in urban and rural Malawi, and directions for future interventions

2018 ◽  
Vol 108 (3) ◽  
pp. 587-593 ◽  
Author(s):  
Josephine E Prynn ◽  
Louis Banda ◽  
Alemayehu Amberbir ◽  
Alison J Price ◽  
Ndoliwe Kayuni ◽  
...  
Keyword(s):  
Rural Communities ◽  
Salt Intake ◽  
Sodium Intake ◽  
Urinary Sodium ◽  
Sub Saharan Africa ◽  
Dietary Sodium ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Spot Urine ◽  
Per Capita

ABSTRACT Background High dietary sodium intake is a major risk factor for hypertension. Data on population sodium intake are scanty in sub-Saharan Africa, despite a high hypertension prevalence in most countries. Objective We aimed to determine daily sodium intake in urban and rural communities in Malawi. Design In an observational cross-sectional survey, data were collected on estimated household-level per capita sodium intake, based on how long participants reported that a defined quantity of plain salt lasts in a household. In a subset of 2078 participants, 24-h urinary sodium was estimated from a morning spot urine sample. Results Of 29,074 participants, 52.8% of rural and 50.1% of urban individuals lived in households with an estimated per capita plain salt consumption >5 g/d. Of participants with urinary sodium data, 90.8% of rural and 95.9% of urban participants had estimated 24-h urinary sodium >2 g/d; there was no correlation between household per capita salt intake and estimated 24-h urinary sodium excretion. Younger adults were more likely to have high urinary sodium and to eat food prepared outside the home than were those over the age of 60 y. Households with a member with previously diagnosed hypertension had reduced odds (OR: 0.59; 95% CI: 0.51, 0.68) of per capita household plain salt intake >5 g/d, compared with those where hypertension was undiagnosed. Conclusions Sodium consumption exceeds the recommended amounts for most of the population in rural and urban Malawi. Population-level interventions for sodium intake reduction with a wide focus are needed, targeting both sources outside the home as well as home cooking. This trial was registered at clinicaltrials.gov as NCT03422185.

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 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.

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 Contribution of major food companies and their products to household dietary sodium purchases in Australia

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Daisy H. Coyle ◽  
Maria Shahid ◽  
Elizabeth K. Dunford ◽  
Cliona Ni Mhurchu ◽  
Sarah Mckee ◽  
...  
Keyword(s):  
Low Income ◽  
Sodium Intake ◽  
Food Product ◽  
Sodium Content ◽  
Dietary Sodium ◽  
Processed Meat ◽  
Cross Sectional ◽  
Major Food ◽  
Packaged Foods ◽  
Per Capita

Abstract Background The Australian federal government will soon release voluntary sodium reduction targets for 30 packaged food categories through the Healthy Food Partnership. Previous assessments of voluntary targets show variable industry engagement, and little is known about the extent that major food companies and their products contribute to dietary sodium purchases among Australian households. Methods The aim of this cross-sectional study was to identify the relative contribution that food companies and their products made to Australian household sodium purchases in 2018, and to examine differences in sodium purchases by household income level. We used 1 year of grocery purchase data from a nationally representative consumer panel of Australian households who reported their grocery purchases (the Nielsen Homescan panel), combined with database that contains product-specific sodium content for packaged foods and beverages (FoodSwitch). The top food companies and food categories were ranked according to their contribution to household sodium purchases. Differences in per capita sodium purchases by income levels were assessed by 1-factor ANOVA. All analyses were modelled to the Australian population in 2018 using sample weights. Results Sodium data were available from 7188 households who purchased 26,728 unique products and purchased just under 7.5 million food product units. Out of 1329 food companies, the top 10 accounted for 35% of unique products and contributed to 58% of all sodium purchased from packaged foods and beverages. The top three companies were grocery food retailers each contributing 12–15% of sodium purchases from sales of their private label products, particularly processed meat, cheese and bread. Out of the 67 food categories, the top 10 accounted for 73% of sodium purchased, particularly driven by purchases of processed meat (14%), bread (12%) and sauces (11%). Low-income Australian households purchased significantly more sodium from packaged products than high-income households per capita (452 mg/d, 95%CI: 363-540 mg/d, P < 0.001). Conclusions A small number of food companies and food categories account for most of the dietary sodium purchased by Australian households. Prioritizing government engagement with these groups could deliver a large reduction in population sodium intake.

scholarly journals Contribution of major food companies and their products to household dietary sodium purchases in Australia

2020 ◽  
Author(s):  
Daisy Hannah Coyle ◽  
Maria Shahid ◽  
Elizabeth K Dunford ◽  
Cliona Ni Mhurchu ◽  
Sarah Mckee ◽  
...  
Keyword(s):  
Low Income ◽  
Sodium Intake ◽  
Food Product ◽  
Sodium Content ◽  
Dietary Sodium ◽  
Processed Meat ◽  
Cross Sectional ◽  
Major Food ◽  
Packaged Foods ◽  
Per Capita

Abstract Background: The Australian federal government will soon release voluntary sodium reduction targets for 30 packaged food categories through the Healthy Food Partnership. Previous assessments of voluntary targets show variable industry engagement, and little is known about the extent that major food companies and their products contribute to dietary sodium purchases among Australian households. Methods: The aim of this cross-sectional study was to identify the relative contribution that food companies and their products made to Australian household sodium purchases in 2018, and to examine differences in sodium purchases by household income level. We used one year of grocery purchase data from a nationally representative consumer panel of Australian households who reported their grocery purchases (the Nielsen Homescan panel), combined with database that contains product-specific sodium content for packaged foods and beverages (FoodSwitch). The top food companies and food categories were ranked according to their contribution to household sodium purchases. Differences in per capita sodium purchases by income levels were assessed by 1-factor ANOVA. All analyses were modelled to the Australian population in 2018 using sample weights. Results: Sodium data were available from 7,188 households who purchased 26,728 unique products and purchased just under 7.5 million food product units. Out of 1,329 food companies, the top 10 accounted for 35% of unique products and contributed to 58% of all sodium purchased from packaged foods and beverages. The top three companies were grocery food retailers each contributing 12-15% of sodium purchases from sales of their private label products, particularly processed meat, cheese and bread. Out of the 67 food categories, the top 10 accounted for 73% of sodium purchased, particularly driven by purchases of processed meat (14%), bread (12%) and sauces (11%). Low-income Australian households purchased significantly more sodium from packaged products than high-income households per capita (452mg/d, 95%CI: 363-540mg/d, P<0.001). Conclusions: A small number of food companies and food categories account for most of the dietary sodium purchased by Australian households. Prioritizing government engagement with these groups could deliver a large reduction in population sodium intake.

scholarly journals Estimation of sodium consumption by novel formulas derived from random spot and 12-hour urine collection

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260408
Author(s):  
Pitchaporn Sonuch ◽  
Surasak Kantachuvesiri ◽  
Prin Vathesatogkit ◽  
Raweewan Lappichetpaiboon ◽  
Worawan Chailimpamontri ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Sodium Intake ◽  
Urine Collection ◽  
Cross Sectional Survey ◽  
Urine Sodium ◽  
Thai Population ◽  
Cross Sectional ◽  
Spot Urine ◽  
Urine Sodium Excretion ◽  
Predicted Values

The gold standard for estimating sodium intake is 24h urine sodium excretion. Several equations have been used to estimate 24h urine sodium excretion, however, a validated formula for calculating 24h urine sodium excretion from 12h urine collection has not yet been established. This study aims to develop novel equations for estimating 24h urine sodium excretion from 12h and random spot urine collection and also to validate existing spot urine equations in the Thai population. A cross-sectional survey was carried out among 209 adult hospital personnel. Participants were asked to perform a 12h daytime, 12h nighttime, and a random spot urine collection over a period of 24 hours. The mean 24h urine sodium excretion was 4,055±1,712 mg/day. Estimated urine sodium excretion from 3 different equations using random spot urine collection showed moderate correlation and agreement with actual 24h urine sodium excretion (r = 0.54, P<0.001, ICC = 0.53 for Kawasaki; r = 0.57, P<0.001, ICC = 0.44 for Tanaka; r = 0.60, P<0.001, ICC = 0.45 for INTERSALT). Novel equations for predicting 24h urine sodium excretion were then developed using variables derived from 12h daytime urine collection, 12h nighttime urine collection, random spot urine collection, 12h daytime with random spot urine collection, and 12h nighttime with random spot urine collection which showed strong correlation and agreement with actual measured values (r = 0.88, P<0.001, ICC = 0.87; r = 0.83, P<0.001, ICC = 0.81; r = 0.67, P<0.001, ICC = 0.62; r = 0.90, P<0.001, ICC = 0.90; and r = 0.83, p<0.001, ICC = 0.82 respectively). Bland-Altman plots indicated good agreement between predicted values and actual 24h urine sodium excretion using the new equations. Newly derived equations from 12h daytime and 12h nighttime urine collection with or without casual spot urine collection were able to accurately predict 24h urine sodium excretion.

scholarly journals Contribution of major food companies and their products to household dietary sodium purchases in Australia

2019 ◽  
Author(s):  
Daisy Hannah Coyle ◽  
Maria Shahid ◽  
Elizabeth K Dunford ◽  
Cliona Ni Mhurchu ◽  
Sarah Mckee ◽  
...  
Keyword(s):  
Low Income ◽  
Sodium Intake ◽  
Food Product ◽  
Sodium Content ◽  
Dietary Sodium ◽  
Processed Meat ◽  
Cross Sectional ◽  
Major Food ◽  
Packaged Foods ◽  
Per Capita

Abstract Background: The Australian federal government will soon release voluntary sodium reduction targets for 30 packaged food categories through the Healthy Food Partnership. Previous assessments of voluntary targets show variable industry engagement and little is known about the extent that major food companies and their products contribute to dietary sodium purchases among Australian households. Methods: The aim of this cross-sectional study was to identify the relative contribution that food companies and their products made to Australian household sodium purchases in 2018, and to examine differences in sodium purchases by household income level. We used one year of grocery purchase data from a nationally representative consumer panel of Australian households who reported their grocery purchases (the Nielsen Homescan panel), combined with database that contains product-specific sodium content for packaged foods and beverages (FoodSwitch). The top food companies and food categories were ranked according to their contribution to household sodium purchases. Differences in per capita sodium purchases by income levels were assessed by 1-factor ANOVA. All analyses were modelled to the Australian population in 2018 using sample weights. Results: Sodium data were available from 7,188 households who purchased 26,728 unique products and purchased just under 7.5 million food product units. Out of 1,329 food companies, the top 10 accounted for 58% of all sodium purchased from packaged foods and beverages. The top three companies were grocery food retailers each contributing 12-15% of sodium purchases from sales of their private label products, particularly processed meat, cheese and bread. Out of the 67 food categories, the top 10 accounted for 73% of sodium purchased, particularly driven by purchases of processed meat (14%), bread (12%) and sauces (11%). Low-income Australian households purchased significantly more sodium from packaged products than high-income households per capita (452mg/d, 95%CI: 363-540mg/d, P<0.001). Conclusions: A small number of food companies and food categories account for most of the dietary sodium purchased by Australian households. Prioritizing government engagement with these groups could deliver a large reduction in population sodium intake.

Abstract P421: Estimation Of Adult Dietary Sodium Intake And Source In Shandong China 2011: Finding From SMASH Project Baseline Survey

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Liuxia YAN ◽  
Zilong LU ◽  
Jixiang MA ◽  
Xiaolei GUO ◽  
Jiyu ZHANG ◽  
...  
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Monosodium Glutamate ◽  
Soy Sauce ◽  
Dietary Sodium ◽  
Baseline Survey ◽  
Dietary Salt ◽  
Ministry Of Health ◽  
Cross Sectional ◽  
Dietary Recall

Zilong LU, Liuxia YAN, Jixiang MA, Xiaolei GUO, Jiyu ZHANG, Junli TANG, Huicheng WANG, Xiaoning CAI Background: Moderate population salt reduction could reduce blood pressure and the cardiovascular and stroke mortality in the long-term. In 2002, China’s national average dietary salt intake is twice of the recommendation sodium intake limit by Chinese Nutrition Association. To tackle the health burden of excessive salt intake, the former Ministry of Health has chosen Shandong province as national pilot and launched the Shandong & Ministry of Health Action on Salt and Hypertension (SMASH, 2011[[Unable to Display Character: &#8211;]]2015) project. Objective: To develop and target intervention priority, a cross-sectional population survey was conducted to collect baseline data on sodium intake and sources in Shandong adults in 2011. Methods: We used multi-stage clustering sampling method to select the provincial representative sample for Shandong adults aged 18~69 years old. The selected adults were invited to participate the questionnaire survey and consecutive three-round 24-hour dietary recall. The Chinese 24-hour dietary recall includes two parts, cooking condiment weighting and the food (exclude the condiment) intake diary. The sodium contents in the condiments and food were calculated by using reference values from China Food Composition 2004. Results: Overall, 2140 community adult residents were included in the data analysis. The total average dietary sodium intake estimated by 24-hour dietary recall was 5745mg (95%CI: 5428-6063). Men (6147mg/d, 5824-6471) consumed higher sodium than women (5339 mg/d, 5006-5673) (P<0.05). The majority of dietary sodium (81%) was from cooking condiments including salt, soy sauce, sauce and monosodium glutamate (MSG), with a mean sodium intake of 4640mg (4360-4920). Out of the cooking condiments, salt added during food preparation was the leading source (63%) of sodium intake, up to 3638mg/d (3397-3879) sodium intake. Sodium intake from processed food was account for 10% of the total sodium intake, averaged at 582 mg (498-666) sodium intake for Shandong adults. Conclusion: The Shandong adults consume excessive sodium than the recommendation intake and most is from the condiments added at cooking.

scholarly journals Urinary sodium-to-potassium ratio associates with hypertension and current disease activity in patients with rheumatoid arthritis: a cross-sectional study

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Hiroto Minamino ◽  
Masao Katsushima ◽  
Motomu Hashimoto ◽  
Yoshihito Fujita ◽  
Tamami Yoshida ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Salt Intake ◽  
Cross Sectional Study ◽  
Urinary Sodium ◽  
Potential Candidate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Salt Loading ◽  
Spot Urine

Abstract Background Excessive salt intake is thought to exacerbate both development of hypertension and autoimmune diseases in animal models, but the clinical impact of excessive salt in rheumatoid arthritis (RA) patients is still unknown. We performed a cross-sectional study to clarify the associations between salt load index (urinary sodium-to-potassium ratio (Na/K ratio)), current disease activity, and hypertension in an RA population. Methods Three hundred thirty-six participants from our cohort database (KURAMA) were enrolled. We used the spot urine Na/K ratio as a simplified index of salt loading and used the 28-Joint RA Disease Activity Score (DAS28-ESR) as an indicator of current RA disease activity. Using these indicators, we evaluated statistical associations between urinary Na/K ratio, DAS28-ESR, and prevalence of hypertension. Results Urinary Na/K ratio was positively associated with measured systolic and diastolic blood pressure and also with prevalence of hypertension even after covariate adjustment (OR 1.34, p <  0.001). In addition, increased urinary Na/K ratio was significantly and positively correlated with DAS28-ESR in multiple regression analysis (estimate 0.12, p <  0.001), as was also the case in gender-separated and prednisolone-separated sub-analyses. Conclusion Urinary Na/K ratio was independently associated with current disease activity as well as with prevalence of hypertension in RA patients. Thus, dietary modifications such as salt restriction and potassium supplementation should be investigated as a potential candidate for attenuating both disease activity and hypertension in RA patients.

scholarly journals Dietary Sodium and Potassium Intake in Hungarian Elderly: Results from the Cross-Sectional Biomarker2019 Survey

2021 ◽  
Vol 18 (16) ◽  
pp. 8806
Author(s):  
Eszter Sarkadi-Nagy ◽  
Andrea Horváth ◽  
Anita Varga ◽  
Leonóra Zámbó ◽  
Andrea Török ◽  
...  
Keyword(s):  
Sodium Intake ◽  
Urinary Sodium ◽  
Dietary Sodium ◽  
World Health ◽  
Reliable Estimate ◽  
Cross Sectional ◽  
Potassium Intake ◽  
Urinary Potassium ◽  
The Mean ◽  
Sodium And Potassium

High sodium intake and inadequate potassium intake are associated with high blood pressure. The elderly are more salt sensitive than other age groups, yet a reliable estimate of the dietary sodium and potassium intake of this age group in Hungary is unavailable. The study aimed to estimate the sodium and potassium intakes in the Hungarian elderly from 24 h urine sodium and potassium excretion. In this cross-sectional study, participants were selected from patients of general practitioners practicing in western Hungary. The participants comprised 99 men and 90 women (mean age 67.1 (SD 5.4] years) who participated in the Biomarker2019 survey and returned a complete 24 h urine collection. We assessed dietary sodium and potassium by determining 24 h urinary sodium and potassium excretions and 3-day dietary records. The mean urinary sodium was 188.8 (73.5) mmoL/day, which is equivalent to 11.0 g of salt/day; and the mean urinary potassium was 65.8 (24.3) mmoL/day, which is equivalent to 3.03 g of potassium/day, after adjusting for non-urinary potassium losses. Only 7% of the subjects met the World Health Organization’s recommended target of less than 5 g of salt/day, and 33% consumed at least the recommended potassium amount of 3.5 g/day, based on the estimates from 24 h urine excretion. For most elderly, sodium intake exceeds, and potassium does not reach, dietary recommendations. The results underline the need to intensify salt reduction efforts in Hungary.

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