Abstract
Background: Strategies aiming at reducing dietary sodium are being implemented in many countries based on evidence-based knowledge supporting their cost-effectiveness for reduction of cardiovascular and other chronic diseases. From 2009 to 2011 a Preventive Program of the Italian Ministry of Health has been implemented in Italy including the agreement with bread makers’ associations for the gradual reduction of the salt content in bread, public information campaigns, and the evaluation of population current dietary sodium intakes. This analyses aim to monitor dietary intake of sodium and potassium in representative samples of the Italian adult population before and after the Preventive Program. Methods: Data from random samples of persons aged 35-79 years and resident in Italian central regions were collected from October 2009 to September 2010 (299 men and 280 women) and from April to July 2012 (205 men and 210 women). Determinations of sodium and potassium were assessed in a centralized laboratory. Information on the consumption of high salt content food were collected through a questionnaire. Comparisons between mean levels and prevalences were performed using t-test and chi-squared test respectively. Results: In men, mean level of sodium chloride per day resulted 185 mmol (95% confidence interval: 177-193 mmol) in 2009-2010 samples and 161 mmol (152-169 mmol) in 2012 samples (p<0.0001). In women, mean level of sodium chloride per day resulted 144 mmol (138-151 mmol) and 125 mmol (117-132 mmol) respectively (p=0.0001). Among men, sodium chloride excretion was higher than 85 mmol (the WHO recommended upper level for sodium intake) in 97% in 2009-2010 samples and 91% in 2012 samples (p=0.0026); among women in 86% and 73% respectively (p=0.0002). Among men, 23% have declared in 2009- 2010 to eat bread without salt often, while 40% in 2012 (p<0.0001); in women 22% and 39% respectively (p=0.0001). No statistically significant differences were found between mean levels of potassium between samples collected in 2009- 2010 and samples of 2012. Conclusions: Presented data show that average daily sodium intake in central Italy is still largely higher than that recommended but a significant improvement of mean level of sodium intake and consumption of bread without salt resulted. This results fully justify and encourage the preventive initiatives for reduction of sodium intake and its monitoring in the general population.
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