Dataset Information

National approaches to monitoring population salt intake: a trade-off between accuracy and practicality?

ABSTRACT:

Aims

There is strong evidence that diets high in salt are bad for health and that salt reduction strategies are cost effective. However, whilst it is clear that most people are eating too much salt, obtaining an accurate assessment of population salt intake is not straightforward, particularly in resource poor settings. The objective of this study is to identify what approaches governments are taking to monitoring salt intake, with the ultimate goal of identifying what actions are needed to address challenges to monitoring salt intake, especially in low and middle-income countries.

Methods and results

A written survey was issued to governments to establish the details of their monitoring methods. Of the 30 countries that reported conducting formal government salt monitoring activities, 73% were high income countries. Less than half of the 30 countries, used the most accurate assessment of salt through 24 hour urine, and only two of these were developing countries. The remainder mainly relied on estimates through dietary surveys.

Conclusions

The study identified a strong need to establish more practical ways of assessing salt intake as well as technical support and advice to ensure that low and middle income countries can implement salt monitoring activities effectively.

SUBMITTER: Hawkes C

PROVIDER: S-EPMC3474782 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Publications

National approaches to monitoring population salt intake: a trade-off between accuracy and practicality?

Hawkes Corinna C Webster Jacqui J

PloS one 20121017 10

<h4>Aims</h4>There is strong evidence that diets high in salt are bad for health and that salt reduction strategies are cost effective. However, whilst it is clear that most people are eating too much salt, obtaining an accurate assessment of population salt intake is not straightforward, particularly in resource poor settings. The objective of this study is to identify what approaches governments are taking to monitoring salt intake, with the ultimate goal of identifying what actions are needed ...[more]

PMID: 23082128

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Project description:Abstract Objectives Monitoring population salt intake is a critical component of implementing salt fortification programs. In Cambodia, salt is being considered as a vehicle for thiamine fortification to prevent infantile beriberi among breastfed infants. However, salt intake among lactating mothers is not known. The gold standard for assessing sodium intake is repeat 24-hr urinary sodium concentrations. This method has logistical barriers, especially in low-resource settings, and other methods have not been trialed in this population. Here we compare three methods of assessing salt intake in lactating Cambodian women: repeat 24-hr urinary sodium concentrations (USC), repeat 12-hr observed weighed intake records (OWIR), and household salt disappearance (HSD). Methods Data from trial: NCT03616288. Salt intake was assessed using the three methods in a subsample of lactating women (n = 104) between 8 and 22 weeks postpartum. Women were asked to collect two 24-hour urine samples within 7 days. Repeat 12-hr OWIR were collected from women. Household salt disappearance was recorded fortnightly, and was divided by the number of household members to estimate individual intakes. Descriptive household salt use was also recorded. Differences in estimated salt intake from each method were compared using a Kruskal-Wallis test. Results Mean (95%CI) estimated salt intakes from repeat 24-hr USC, repeat 12-hr OWIR, and HSD were: 9.0 (8.3, 9.8) g/day, 9.1 (7.9, 10.3) g/day, and 10.9 (9.8, 11.9) g/day, respectively. Estimated intakes from HSD were significantly higher than both 24-hr USC (p = 0.009) and 12-hr OWIR (p = 0.002). Estimated intakes from 24-hr USC and 12-hr OWIR were not statistically different (p = 0.6). Salt was being used for purposes other than consumption, such as cleaning fish and vegetables, in 26% of fortnightly visits. Conclusions Repeat 24-hr USC and 12-hr OWIR are both acceptable and logistically feasible methods of salt intake assessment among lactating women in rural Cambodia. While HSD is a less resource-intensive approach, this method over-estimated salt intake. Salt being used for purposes other than consumption may contribute to over-estimation using this method. Funding Sources Bill & Melinda Gates Foundation, New York Academy of Sciences, Canadian Institutes of Health Research, Research Nova Scotia.

Project description:BACKGROUND AND PURPOSE:Data for a relationship between salt intake and stroke have been inconsistent. This inconstancy could be because of the majority of studies evaluated salt intake at a single time point, which may be insufficient to accurately characterize salt intake throughout the observation period. METHODS:Included were 77?605 participants from the Kailuan study. We assessed perceived salt intake via questionnaire in 2006, 2008, and 2010. Salt intake trajectories from 2006 to 2010 were identified using latent mixture models. Incident stroke cases were identified from 2010 to 2015 and confirmed by review of medical records. Cox proportional hazards model was used to examine the association between salt intake trajectories and stroke risk after adjusting for possible confounders, including age, sex, lifestyle, social economic status, body mass index, use of medicines, blood pressure, and lipoprotein profiles. RESULTS:Identified were 5 distinct salt intake trajectories: moderate-stable (n=59?241), moderate-decreasing (n=9268), moderate-increasing (n=2975), low-increasing (n=2879), and high-decreasing (n=3242). During the 5-year follow-up period, there were 1564 incident strokes cases. Compared with individuals with the moderate-stable salt intake trajectory, individuals with moderate-decreasing salt intake trajectory had significantly lower cerebral infarction stroke risk (adjusted hazard ratio, 0.76; 95% confidence interval, 0.63-0.92) but not intracerebral hemorrhage risk (adjusted hazard ratio, 0.84; 95% confidence interval, 0.55-1.29). Further adjustment for 2006 or 2010 perceived salt intakes generated similar results. When baseline perceived salt intake only was used as the exposure, a significant dose-response relationship between higher perceived salt intake and higher stroke risk was observed (P trend=0.006). CONCLUSIONS:Change in salt intake was associated with the stroke risk. These data support the dietary recommendation to the reduction of salt intake.

Dataset Information

National approaches to monitoring population salt intake: a trade-off between accuracy and practicality?

Aims

Methods and results

Conclusions

Publications

National approaches to monitoring population salt intake: a trade-off between accuracy and practicality?

Similar Datasets

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