Abstract
The limited Australian measures to reduce population sodium intake through national initiatives targeting sodium in the food supply have not been evaluated. The aim was, thus, to assess if there has been a change in salt intake and discretionary salt use between 2011 and 2014 in the state of Victoria, Australia. Adults drawn from a population sample provided 24 h urine collections and reported discretionary salt use in 2011 and 2014. The final sample included 307 subjects who participated in both surveys, 291 who participated in 2011 only, and 135 subjects who participated in 2014 only. Analysis included adjustment for age, gender, metropolitan area, weekend collection and participation in both surveys, where appropriate. In 2011, 598 participants: 53% female, age 57.1(12.0)(SD) years and in 2014, 442 participants: 53% female, age 61.2(10.7) years provided valid urine collections, with no difference in the mean urinary salt excretion between 2011: 7.9 (7.6, 8.2) (95% CI) g/salt/day and 2014: 7.8 (7.5, 8.1) g/salt/day (p = 0.589), and no difference in discretionary salt use: 35% (2011) and 36% (2014) reported adding salt sometimes or often/always at the table (p = 0.76). Those that sometimes or often/always added salt at the table and when cooking had 0.7 (0.7, 0.8) g/salt/day (p = 0.0016) higher salt excretion. There is no indication over this 3-year period that national salt reduction initiatives targeting the food supply have resulted in a population reduction in salt intake. More concerted efforts are required to reduce the salt content of manufactured foods, together with a consumer education campaign targeting the use of discretionary salt.
Highlights
Reducing average salt intake from current high levels (8–9 g/salt/day) in Australia towards the World Health Organization’s (WHO) recommended upper daily limit of 5 g per person could significantly reduce cardiovascular events and mortality [1]
The final sample of valid urines included 307 subjects who participated in both surveys (2011 and 2014) (n = 614 urine collections), 291 from those who participated in 2011 only, and 135 subjects who participated for the first time in 2014
Seven individuals who participated in both years had invalid urine collections in one year (4 in 2011, 3 in 2014)
Summary
Reducing average salt intake from current high levels (8–9 g/salt/day) in Australia towards the World Health Organization’s (WHO) recommended upper daily limit of 5 g per person could significantly reduce cardiovascular events and mortality [1]. Studies published between 2003 and 2011 indicate average intakes of between 7.0 g/salt/day for women and 9.6 g/salt/day for men (expressed as grams of salt: mmol sodium 23 ˆ 2.54/1000) [3,4,5,6,7,8,9,10,11,12]. The 2011–2013 National Nutrition and Physical Activity Survey indicates a lower average intake of 6.9 g/salt/day for males and 5.2 g/salt/day for females [19] from previous surveys, these dietary assessments do not include an estimate of discretionary salt use and rely on generic food composition data making estimation of population change in total salt intake problematic
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