Geographic and socioeconomic variation of sodium and potassium intake in Italy: results from the MINISAL-GIRCSI programme

Abstract

ObjectivesTo assess geographic and socioeconomic gradients in sodium and potassium intake in Italy.SettingCross-sectional survey in Italy.Participants3857 men and women, aged 39–79 years, randomly sampled in 20 regions (as part of a National cardiovascular survey of 8714 men and women).Primary outcome measuresParticipants’ dietary sodium and potassium intakes were measured by 24 h urinary sodium and potassium excretions. 2 indicators measured socioeconomic status: education and occupation. Bayesian geoadditive models were used to assess spatial and socioeconomic patterns of sodium and potassium intakes accounting for sociodemographic, anthropometric and behavioural confounders.ResultsThere was a significant north-south pattern of sodium excretion in Italy. Participants living in southern Italy (eg, Calabria, Basilicata and Puglia >180 mmol/24 h) had a significantly higher sodium excretion than elsewhere (eg, Val d'Aosta and Trentino-Alto Adige <140 mmol/24 h; p<0.001). There was a linear association between occupation and sodium excretion (p<0.001). When compared with occupation I (top managerial), occupations III and IV had a 6.5% higher sodium excretion (coefficients: 0.054 (90% credible levels 0.014, 0.093) and 0.064 (0.024, 0.104), respectively). A similar relationship was found between educational attainment and sodium excretion (p<0.0001). When compared with those with a university degree, participants with primary and junior school education had a 5.9% higher urinary sodium (coefficients: 0.074 (0.031, 0.116) and 0.038 (0.001, 0.075), respectively). The socioeconomic gradient explained the spatial variation. Potassium excretion was higher in central regions and in some southern regions. Those in occupation V (low-skill workers) showed a 3% lower potassium excretion compared with those in occupation I. However, the socioeconomic gradient only partially explained the spatial variation.ConclusionsSalt intake in Italy is significantly higher in less advantaged social groups. This gradient is independent of confounders and explains the geographical variation.

Salt Consumption in Latvian Population: A Pilot Study

“…Collections were considered valid if the volume of the 24-h sample was at least 500 mL [12]. Samples were analyzed in three different laboratories using two different methods to compare the accuracy and reliability of different methods and to evaluate the most cost-effective method, which could be used in the future for larger studies.…”

“…To compare the amount of sodium and potassium in the urine with food consumption data, analytical values of excreted sodium and potassium mass were multiplied by coefficients of 1/0.9 and 1/0.7 respectively, assuming that 90% of ingested sodium and 70% of ingested potassium is excreted in the urine [12]. Urinary data was compared with the WHO recommendations of consuming no more than 2000 mg of sodium or 5 g of salt per day [2], and consuming at least 3510 mg of potassium per day [9].…”

Sodium and Potassium Intake in Healthy Adults in Thessaloniki Greater Metropolitan Area&mdash;The SING (Salt Intake in Northern Greece) Study

“…High salt intakes were anticipated in this sample, since salt consumption in neighbouring countries with similar dietary habits is also high. For example, in Turkey the average salt intake is about 15g per day [29] while in Italy it is approximately 9g per day [25].…”

“…In order to convert urinary output to dietary intake, the urinary excretion of sodium or potassium values (mEq/d) were first converted to mg/d. Then sodium values were multiplied by 1.05 (since urine output reflect approximately 95% of intake), while potassium values were multiplied by 1.3 (assuming that 70% of dietary potassium is found in urine) [25]. The conversion from dietary sodium (Na) intake to salt (NaCl) intake was made by multiplying the sodium value by 2.542 (NaCl(g) = Na(g) x 2.542).…”

Outcome of public consultations on the Scientific Opinions of the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) on Dietary Reference Values for sodium and chloride

“…References on sodium urinary excretion in the Italian (Cappuccio et al, 2015) and Dutch populations (van Rossum et al, 2012;Hendriksen et al, 2016) were provided for inclusion in Appendices D and E. Cappuccio et al (2015) and Donfrancesco et al (2013) have now been added to the tables. References on sodium urinary excretion in the Italian (Cappuccio et al, 2015) and Dutch populations (van Rossum et al, 2012;Hendriksen et al, 2016) were provided for inclusion in Appendices D and E. Cappuccio et al (2015) and Donfrancesco et al (2013) have now been added to the tables.…”