Monitoring population salt intake using casual urinary sodium: Tehran Lipid and Glucose Study (original) (raw)
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Nutrition, Metabolism and Cardiovascular Diseases, 2019
Background and aim: Few population-based studies conducted in the Eastern Mediterranean region assessed salt intake by the measurement of 24-h sodium urine excretion (24-hUNa). The current study aimed to assess the trend of mean salt intake in Iranian adults between 1998 and 2013. Methods and results: These cross-sectional studies were performed on 564, 157, 509 and 837 randomly selected healthy adults aged >18 years from Isfahan city, Iran, in 1998, 2001, 2007 and 2013, respectively. BP was measured using a mercury sphygmomanometer according to a standard protocol. Single 24-h urine was collected to assess 24-hUNa as a surrogate of salt intake, and 24-h urinary K (24-hUK). The estimated trend of salt intake was 9.5, 9.7, 9.6 and 10.2 g/day in total population (P < 0.001). The increase in salt intake between 1998 and 2013 was significant only in men, (P < 0.001). The risk of pre-hypertension was 21% and 18% significantly greater in the highest quartiles of UNa/UK after adjustment for potential confounders in 2001 and 2013, respectively, [OR (95% CI): 1.21 (1.03e1.64) and 1.18 (1.02e1.38), respectively]. Conclusions: This population-based study indicated that mean salt intake was about two times of recommendation in Isfahan city, Iran, and suggest that it would be essential to implement a salt reduction strategy program in Iranian population. Longitudinal national studies with larger samples examining the trend of salt intake are warranted.
2020
BackgroundThe study was designed to estimate daily salt intake, its discretionary use in healthy individuals and to validate three common methods for salt estimation in Pakistani population.MethodsInformation on demography and discretionary salt use was collected healthy adults (>18 years) along with a blood sample, spot urine sample and 24 hours urine samples. Sodium, chloride, potassium levels and serum creatinine were measured using standard methods. For daily salt estimation, three common methods i.e. INTERSALT, Tanaka and Kawasaki were validated for their applicability in local settings.ResultsOverall 24 h sodium excretion was 158 mmol/l indicating intake of 8.64 (±4.43) grams salt per day which was significantly associated with male gender (p. <0.004) and adding salt during cooking (p. <0.0001). Most (73%) of the participants know about hazardous effects of high salt intake, however, only 25% consider important to lower salt intake. Although, there is insignificant di...
Salt Intake Estimation from Urine Samples in South Asian Population: Scoping Review
According to WHO, reducing salt intake to less than 5 g/day means less death, disability, and suffering from heart disease and stroke, with around 1.89 million lives saved every year. In this scoping review, we have reviewed the salt consumption pattern of South Asia. For this purpose, we searched online databases and websites and consulted key informants to address relevant unpublished reports. The inclusion criteria are English-language publications between January 2011 and October 2021, as well as research that evaluated salt intake in the South Asian region and reported salt/sodium 24-hr urine or spot urine samples involving at least 100 participants. A total of 2043 studies were screened, out of which 12 studies fulfilled all the criteria. Our review revealed that reported salt intake in the South Asian region ranges from 6.7-13.3 g/day, which was higher than the WHO-recommended maximum level of 5 g/day in all countries. Men consumed more salt than women. This review demonstrat...
Estimation of the Daily Salt Intake by 24-Hour Urinary Sodium Excretion in Morocco: A Pilot Study
2016
Introduction: Hypertension is a serious public health problem in Morocco. The objective of this pilot study was to estimate the salt intake of Moroccan adults by measuring 24-hour urinary sodium excretion. Methods: 132 participants were recruited from the central region of Morocco. Sodium, potassium and creatinine levels were measured using the 24-hour urine samples. Additional data included anthropometric measurements and socio-demographic questionnaire. Results: The daily sodium, potassium and creatinine excretions were…
National and sub-national trends of salt intake in Iranians from 2000 to 2016: a systematic analysis
Archives of Public Health
Background One fifth of the global burden of cardiovascular diseases (CVDs) in 2017 was attributable to excessive salt intake. As a member of the World Health Organization (WHO), Iran has committed itself to a 30% reduction in salt intake by 2025. Evidence on the amount and trend of salt intake among the Iranian population at national and sub-national levels is scarce. This study aimed to estimate the Iranian population’s salt intake during 2000–2016 at the national and sub-national levels, by sex and age groups. Methods Data on national and sub-national mean salt intake was obtained through systematically searching the literature and contacting the research studies’ principal investigators. Data collected through various methods were harmonized using the cross-walk method. Bayesian hierarchical and spatio-temporal-age regression models and simulation analysis were used to estimate the mean salt intake and its uncertainty interval across sex, age, year, and province. Results Nationa...
International Journal of Epidemiology, 2016
Background: Estimating equations based on spot urine samples have been identified as a possible alternative approach to 24-h urine collections for determining mean population salt intake. This review compares estimates of mean population salt intake based upon spot and 24-h urine samples. Methods: We systematically searched for all studies that reported estimates of daily salt intake based upon both spot and 24-h urine samples for the same population. The associations between the two were quantified and compared overall and in subsets of studies. Results: A total of 538 records were identified, 108 were assessed as full text and 29 were included. The included studies involved 10 414 participants from 34 countries and made 71 comparisons available for the primary analysis. Overall average population salt intake estimated from 24-h urine samples was 9.3 g/day compared with 9.0 g/day estimated from the spot urine samples. Estimates based upon spot urine samples had excellent sensitivity (97%) and specificity (100%) at classifying mean population salt intake as above or below the World Health Organization maximum target of 5 g/day. Compared with the 24-h samples, estimates based upon spot urine overestimated intake at lower levels of consumption and underestimated intake at higher levels of consumption.
Background Few semi-quantitative food frequency questionnaire (SFFQ) has yet been developed to assess sodium intake s in Middle East region. This study was performed to validate SFFQ for sodium consumption assessment and evaluation of food groups΄ contribution in sodium intake.Methods This was a validation study. This study was performed on 198 healthy participants aged ≥ 6 years in Isfahan city, central part of Iran in 2014–2015. They provided two SFFQ at the beginning and after one year to evaluate the reproducibility. The validity of SFFQ for assessment of sodium intake compared with 24-hour urine sodium and twelve 24-hour dietary recalls which were completed monthly during a year as two standard methods.Results Correlation coefficient between the contribution of food groups to sodium intake based on SFFQ and 24-hour dietary recalls varied from 0.04 for legumes (P = 0.667) to 0.47 for added salt (P
PLOS ONE
Background High dietary salt intake is recognized as a risk factor for several non-communicable diseases (NCDs), in particular cardiovascular diseases (CVDs), including heart attack and stroke. Accurate measurement of population level salt intake is essential for setting targeted goals and plans for salt reduction strategies. We used a spot urine sample to estimate the mean population salt intake in Nepal and evaluated the association of salt intake with excess weight, hypertension, raised blood sugar and hypercholesterolemia, and a number of socio-demographic characteristics. Methods A population-based cross-sectional study was carried out from February to May 2019 using a WHO STEPwise approach to surveillance. Spot urine was collected from 4361 participants aged 15–69 years for the analysis of salt intake. We then used the INTERSALT equation to calculate population salt intake. Student’s ‘t’ test, one-way ANOVA and multivariable linear regression were used to assess the associatio...
Public Health Nutrition
Objective:To assess agreement between established methods of estimating salt intake from spot urine collections and 24 h urinary Na (24hUNa) and then to develop a valid formula that can be used in the Iranian population to estimate salt intake from spot urine samples.Design:A validation study. Three spot urine samples were collected (fasting second-void morning; afternoon; evening) on the same day as a 24 h urine collection. We estimated 24hUNa from spot specimens using the Kawasaki, Tanaka and INTERSALT equations. Two new formulas were developed, the Iran formula 1 (Iran 1) and Iran formula 2 (Iran 2), based on our population characteristics.Setting:Iranian adults recruited in 2014–2015.Participants:Healthy volunteer adults aged ≥18 years.Results:With all three spot urine specimens, predicted population 24hUNa was underestimated based on the INTERSALT equation (−469 to −708 mg/d; all P < 0·05) and conversely overestimation occurred with the Kawasaki equation (926 to 1080 mg/d; a...