Estimation of salt intake and excretion in children in one region of Switzerland: a cross-sectional study

Abstract

Salt intake among children in Switzerland is unknown. The objectives of this study were to determine salt excretion and to identify the main dietary sources of salt intake among children in one region of Switzerland. Methods: We conducted a cross-sectional study using a convenient sample of children 6-16 years of age in Valais, Switzerland, between 2016 and 2018. All children visiting several regional health care providers and without any clinical condition that could affect sodium intake or excretion were eligible. Each child completed a 24-hour urine collection to assess salt excretion and two dietary questionnaires to assess dietary sources of salt intake. Weight and height were measured. Results: Data was available on 94 children (55 boys and 39 girls; mean age: 10.5 years; age range: 6-16 years). The mean 24-hour salt urinary excretion was 5.9 g (SD: 2.8; range: 0.8-16.0; 95% confidence interval (CI): 5.3-6.5). Two thirds (62%) of the children had salt excretions above recommendations of maximum intake (i.e., ≥2 g per day for children up to 6 years of age and ≥5 g per day for children 7-16 years of age). The salt excretion tended to be higher during the weekend (6.0 g, 95% CI: 5.4-6.6) than during the week (5.4 g, 95% CI: 4.3-6.7). The main sources of salt intake were pastas, potatoes, and rice (23% of total salt intake), pastries (16%), bread (16%), and cured meats (10%). One child out of three (34%) added salt to their plate at the table. Conclusions: Salt intake in children in one region of Switzerland was high. Our findings suggest that salt intake in children could be reduced by lowering salt content in commonly eaten foods.

Salt/Sodium Intake Estimation in Children and Adolescents of Costa Rica

“…For Swiss children, the main sources of salt/sodium intake were pasta, potatoes and rice (23% of the total intake), cakes (16%), bread (16%) and cured meats or sausages (10%) [30], similar to what was found in this Costa Rican study regarding the group of fried prepared pastries and sandwiches. Also similar to what has also been found in some European countries, despite regional and cultural differences, the foods that provide the greatest amounts of salt are grain-based products (including bread), meat products and dairy products [35], but differing from their Costa Rican counterparts in the present study regarding the consumption of sauces.…”

“…Other studies carried out in Portugal [29] that used dietary registration and 24-hour urinary excretion, reported salt consumption of <7; 6.6 g and 5.9 g/day, respectively. Swiss children, 62% had salt excretions above the maximum intake recommendations (≥2 g for up to 6 years and ≥5 g per day from 7 to 16 years) [30]. On average, children and adolescents consumed 1.6 to 1.8 mg/kcal, a much higher amount than 1 mg sodium/ kcal, proposed by Guenther et al (2013) [31].…”

“…In addition, 34% of Swiss children reported adding salt to their served plate (at the table) [30]; this proportion was higher in the participants from Costa Rica (49.4%). Near 38.8% reported that they usually add from 1 to 2 days a week, at least one "pinch" of salt to their served plate or some foods such as fruits (mango, pineapple), sour cream, avocado, among others.…”

“…Likewise, companies in the food industry must be incentivized to market the components of healthy diets; this could be primarily through selective taxes and subsidies, marketing controls, food quality regulations, consumer education and in the medium term, consumers' desires to combine healthier foods with their continued pursuit of convenience in the face of their busy work schedules. At the end, the food industry in general, and specifically in Latin America and the Caribbean, is expected to move towards profitable solutions, that is, those demanded by a large volume of smart (educated) consumers[30] [65] [66] [67] [68].…”

The Use of Added Salt and Sugar in the Diet of Polish and Austrian Toddlers. Associated Factors and Dietary Patterns, Feeding and Maternal Practices

“…Those results are consistent with previous studies that linked salt intake with consumption of sugar-sweetened beverages [ 67 ] or consumption of savory snacks with sugar-sweetened beverages and sweets [ 56 ]. Toddlers who a followed Western-like dietary pattern may be a risk group of higher sodium/salt [ 24 , 26 , 39 , 68 , 69 ] or sugars [ 37 , 39 , 40 , 45 ] intake from processed foods which are characteristic of this pattern. Moreover, higher consumption of salty and sweet foods may blunt the appetite and decrease the intake of nutrient-dense food [ 35 ].…”