Abstract
Reduction of population sodium intake has been identified as a key initiative for reduction of Non-Communicable Disease. Monitoring of population sodium intake must accompany public health initiatives aimed at sodium reduction. A number of different methods for estimating dietary sodium intake are currently in use. Dietary assessment is time consuming and often under-estimates intake due to under-reporting and difficulties quantifying sodium concentration in recipes, and discretionary salt. Twenty-four hour urinary collection (widely considered to be the most accurate method) is also burdensome and is limited by under-collection and lack of suitable methodology to accurately identify incomplete samples. Spot urine sampling has recently been identified as a convenient and affordable alternative, but remains highly controversial as a means of monitoring population intake. Studies suggest that while spot urinary sodium is a poor predictor of 24-h excretion in individuals, it may provide population estimates adequate for monitoring. Further research is needed into the accuracy and suitability of spot urine collection in different populations as a means of monitoring sodium intake.
Highlights
The World Health Organization (WHO) Global Action Plan for the Prevention and Control ofNon-Communicable Diseases (NCDs) 2013–2020 identifies nine key targets for the reduction of chronic disease, including “a 30% relative reduction in mean population intake of salt/sodium” [1]
This study suggested that estimates using the INTERSALT formula may perform better than Tanaka or Kawasaki estimates across a range of values of 24 h excretion in a range of different population groups [46]
For example Pfeiffer et al have estimated 24 h excretion in US adults aged 20–59 years participating in NHANES surveys between 1988 and 2010 using estimates derived from a convenience sample of casual/random spot urine samples using the INTERSALT formula [41]
Summary
The World Health Organization (WHO) Global Action Plan for the Prevention and Control of. Non-Communicable Diseases (NCDs) 2013–2020 identifies nine key targets for the reduction of chronic disease, including “a 30% relative reduction in mean population intake of salt/sodium” [1]. This target differs from, but is consistent with previous WHO statements on dietary sodium intake. In 2006, WHO identified a population mean intake of sodium of
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