Sodium and potassium intake in South Africa: an evaluation of 24-hour urine collections in a white, black, and Indian population

Swanepoel, Bianca; Schutte, Aletta E.; Cockeran, Marike; Steyn, Krisela; Wentzel-Viljoen, Edelweiss

doi:10.1016/j.jash.2016.08.007

Cited by 42 publications

(45 citation statements)

References 38 publications

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“…It is also higher than global estimate 9.3 (9.0‐9.7) g/d as reported by meta‐analysis for estimation of salt intake using 24‐hour urine analysis . Likewise, the current estimate is much higher than mean salt intake reported in some states of India, that is, 8.59 g/d (95% CI 7.73, 9.45) in Delhi and Haryana, and 9.46 g/d (95% CI 8.95, 9.96) in Andhra Pradesh and other cross‐sectional studies from China (11.8 ± 4.5 g/d), Korea (9.9 ± 4.6 g/d), Brazil (10.3 ± 4.1 g/d) and median salt intake from South Africa 7.1 g/d (IQR: 5.0‐10.4) using 24‐hour urine analysis method. However, it was lower than a study from Bangladesh 17.0 g/d (95% CI 13.8, 20.2) and studies from Tibet, China …”

Section: Discussioncontrasting

confidence: 65%

Mean dietary salt intake in Nepal: A population survey with 24‐hour urine collections

Neupane

Rijal

Henry

et al. 2020

J of Clinical Hypertension

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High salt (sodium chloride) intake raises blood pressure and increases the risk of developing hypertension, a major risk factor for cardiovascular disease. Little is known about salt intake in Nepal, and no study has estimated salt consumption from 24‐hour urinary sodium excretion. Participants (n = 451) were recruited from the Community‐Based Management of Non‐Communicable Diseases in Nepal (COBIN) cohort in 2018. Salt intake was estimated by analyzing 24‐hour urinary sodium excretion. Multivariate linear regression was used to estimate differences in salt intake. The mean (±SD) age and salt intake were 49.6 (±9.8) years and 13.3 (±4.7) g/person/d, respectively. Higher salt intake was significantly associated with male gender (β for female = −2.4; 95% CI: −3.3, −1.4) and younger age (β10 years = −1.4; 95% CI: −1.4, −0.5) and higher BMI (β = 0.1; 95% CI: 0.0, 0.2). A significant association was also found between increase in systolic blood pressure and higher salt intake (β = 0.3; 95% CI: 0.0, 0.7). While 55% reported that they consumed just the right amount of salt, 98% were consuming more than the WHO recommended salt amount (<5 g/person/d). Daily salt intake in this population was over twice the limit recommended by the WHO, suggesting a substantial need to reduce salt intake in this population. It also supports the need of global initiatives such as WHO's Global Hearts Initiative SHAKE technical package and Resolves to Save Lives for sodium reduction in low‐ and middle‐income countries like Nepal.

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Section: Discussioncontrasting

confidence: 65%

Mean dietary salt intake in Nepal: A population survey with 24‐hour urine collections

Neupane

Rijal

Henry

et al. 2020

J of Clinical Hypertension

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“…More women (n 476) than men (n 205) were included in the present study. Further details of the characteristics of this population and the differences between subgroups are described elsewhere (19) . In Table 2 The β values of the linear regression were above zero and significant in the INTERSALT formula, but not in the Kawasaki and Tanaka formulas.…”

Section: Resultsmentioning

confidence: 99%

“…After careful aliquoting of the 24 h and spot urine samples, the samples were stored at −20°C until analysis. For 24 h and spot urine samples, Na, K and Cr were measured as described in Swanepoel et al (19) .…”

Section: Biochemical Analysis Blood Pressure and Anthropometric Measmentioning

confidence: 99%

Monitoring the South African population’s salt intake: spot urine v. 24 h urine

Swanepoel

Schutte

Cockeran

et al. 2017

Public Health Nutr.

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“…The impact of the sodium legislation on the burden of cardiovascular disease in South Africa will only become apparent some years after it is implemented. To attribute change in the burden of cardiovascular disease to the sodium legislation, assessment of each step between policy implementation and the anticipated health outcomes is needed, including evaluation of its impact on changes in the sodium levels of foods, population salt intake, and blood pressure levels [25,26,27]. The HealthyFood Switch technologies used in this study provide an objective, practical, transferable, and scalable approach to assess the nutritional composition of packaged foods, to assess whether targeted food products comply with the legislation, and to facilitate global benchmarking.…”

Section: Discussionmentioning

confidence: 99%

The Sodium Content of Processed Foods in South Africa during the Introduction of Mandatory Sodium Limits

et al. 2017

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Background: In June 2016, the Republic of South Africa introduced legislation for mandatory limits for the upper sodium content permitted in a wide range of processed foods. We assessed the sodium levels of packaged foods in South Africa during the one-year period leading up to the mandatory implementation date of the legislation. Methods: Data on the nutritional composition of packaged foods was obtained from nutrition information panels on food labels through both in-store surveys and crowdsourcing by users of the HealthyFood Switch mobile phone app between June 2015 and August 2016. Summary sodium levels were calculated for 15 food categories, including the 13 categories covered by the sodium legislation. The percentage of foods that met the government’s 2016 sodium limits was also calculated. Results: 11,065 processed food items were included in the analyses; 1851 of these were subject to the sodium legislation. Overall, 67% of targeted foods had a sodium level at or below the legislated limit. Categories with the lowest percentage of foods that met legislated limits were bread (27%), potato crisps (41%), salt and vinegar flavoured snacks (42%), and raw processed sausages (45%). About half (49%) of targeted foods not meeting the legislated limits were less than 25% above the maximum sodium level. Conclusion: Sodium levels in two-thirds of foods covered by the South African sodium legislation were at or below the permitted upper levels at the mandatory implementation date of the legislation and many more were close to the limit. The South African food industry has an excellent opportunity to rapidly meet the legislated requirements.

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Sodium and potassium intake in South Africa: an evaluation of 24-hour urine collections in a white, black, and Indian population

Cited by 42 publications

References 38 publications

Mean dietary salt intake in Nepal: A population survey with 24‐hour urine collections

Mean dietary salt intake in Nepal: A population survey with 24‐hour urine collections

Monitoring the South African population’s salt intake: spot urine v. 24 h urine

The Sodium Content of Processed Foods in South Africa during the Introduction of Mandatory Sodium Limits

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