Evaluation of a Brief Sodium Screener in Two Samples.

Christy Tangney,Bradley Appelhans,Candace Richards,Michelle Li,Heather Rasmussen

doi:10.3390/nu11010166

Christy Tangney, Bradley Appelhans + Show 3 more

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https://doi.org/10.3390/nu11010166

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Abstract

The Sodium Screener© (SS©), as developed by NutritionQuest (Berkeley, CA, USA), was designed to reduce the burden of repeated dietary or urinary sodium measurements, but the accuracy of daily sodium intake estimates has not been reported. Associations were examined between sodium intakes derived from the SS© scores and repeated 24-h recalls (24DR) in two studies with different administration modes. In one study, 102 registered dietitians (RD) completed three Automated Self-Administered 24DRs (ASA24©), version 2014, followed by the SS©; both were self-administered and web-based. In the second sample, (the Study of Household Purchasing Patterns, Eating, and Recreation or SHoPPER), trained dietitians conducted 24DR interviews with 69 community-dwelling adults in their homes; all the community adults then completed a paper-based SS© at the final visit. In the RD study, SS© -predicted sodium intakes were 2604 ± 990 (mean ± Standard deviation (SD)), and ASA24© sodium intakes were 3193 ± 907 mg/day. In the SHoPPER sample, corresponding values were 3338 ± 1310 mg/day and 2939 ± 1231 mg/day, respectively. SS©-predicted and recall sodium estimates were correlated in the RD study (r = 0.381, p = 0.0001) and in the SHoPPER (r = 0.430, p = 0.0002). Agreement between the SS© and 24-h recalls was poor when classifying individuals as meeting the dietary sodium guidelines of 2300 mg/day or not (RD study: kappa = 0.080, p = 0.32; SHoPPER: kappa = 0.207, p = 0.08). Based on repeated 24DR either in person or self-reported online as the criterion for estimating daily sodium intakes, the SS© may require additional modifications.

Highlights

Considerable efforts are being made to reduce sodium consumption at both the individual and the population level, and practical brief tools to monitor sodium intakes are needed
There is a need for dietary sodium assessment tools that provide rapid feedback to clients in order to foster changes in specific dietary behaviors
A sodium screener that can be scored by the health professional and, possibly, by the respondent would be useful in clinical settings; considerable bias in sodium intake estimates may arise from the need to include a limited number of food items on the screener and use “generic” item descriptions

Summary

Introduction

Considerable efforts are being made to reduce sodium consumption at both the individual and the population level, and practical brief tools to monitor sodium intakes are needed. A sodium screener that can be scored by the health professional and, possibly, by the respondent would be useful in clinical settings; considerable bias in sodium intake estimates may arise from the need to include a limited number of food items on the screener and use “generic” item descriptions (i.e., with specific brands excluded). SS© scores may be used in one of two sex-specific prediction equations to obtain an estimate of daily sodium intake, as described by NutritionQuest. Block Food Frequency Questionnaire data and adjusted to approximate the median levels of adults in NHANES 2007–2008 [4]. In the SHoPPER, a paper copy of the identically-worded SS© was given to the participant to complete during the home visit

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