The Science of Salt: Updating the evidence on global estimates of salt intake

Abstract

The Global Burden of Disease (GBD) 2010 study estimated national salt intake for 187 countries based on data available up to 2010. The purpose of this review was to identify studies that have measured salt intake in a nationally representative population using the 24‐hour urine collection method since 2010, with a view to updating evidence on population salt intake globally. Studies published from January 2011 to September 2018 were searched for from MEDLINE, Scopus, and Embase databases using relevant terms. Studies that provided nationally representative estimates of salt intake among the healthy adult population based on the 24‐hour urine collection were included. Measured salt intake was extracted and compared with the GBD estimates. Of the 115 identified studies assessed for eligibility, 13 studies were included: Four studies were from Europe, and one each from the United States, Canada, Benin, India, Samoa, Fiji, Barbados, Australia, and New Zealand. Mean daily salt intake ranged from 6.75 g/d in Barbados to 10.66 g/d in Portugal. Measured mean population salt intake in Italy, England, Canada, and Barbados was lower, and in Fiji, Samoa, and Benin was higher, in recent surveys compared to the GBD 2010 estimates. Despite global targets to reduce population salt intake, only 13 countries have published nationally representative salt intake data since the GBD 2010 study. In all countries, salt intake levels remain higher than the World Health Organization's recommendation, highlighting the need for additional global efforts to lower salt intake and monitor salt reduction strategies.

Sodium and Salt Consumption in Latin America and the Caribbean: A Systematic-Review and Meta-Analysis of Population-Based Studies and Surveys

“…We found that most recent estimates are slightly smaller than those of previous years. A similar finding was pinpointed by a recent global work [8], in which they reported that for countries with national sodium intake estimates post 2010, these were smaller than the estimates reported for 2010 [7,8]. Although largely speculative, this could suggest that policies and population-wide interventions to reduce salt consumption may be showing positive results.…”

“…We followed a strong methodology using five search engines, summarizing studies with reliable methods to ascertain 24 h sodium consumption. We have summarized more results for Latin America and the Caribbean than previous and most recent global reviews [7,8].…”

“…Consequently, current trends, i.e., in the last decade, are unknown. A recent systematic review tried to update these estimates, yet they focused on national surveys in which 24 h urine samples were collected [8]. In both cases [7,8], the inclusion of studies from Latin America and the Caribbean was scarce.…”

“…A recent systematic review tried to update these estimates, yet they focused on national surveys in which 24 h urine samples were collected [8]. In both cases [7,8], the inclusion of studies from Latin America and the Caribbean was scarce. This limits the information available for the region and hampers the regional capacity to monitor sodium intake and meet global targets to achieve sodium/salt intake reduction.…”

Sodium and health—concordance and controversy

“…However, there is some debate about how far salt intake should be reduced. Current mean population sodium intake is about 3600 mg/day in the US,1 and the estimated global average is 3660-4000 mg/day,23 with a wide range across countries 4. Recent guidelines in the US, Canada, and the UK call for lowering sodium consumption below 2300-2400 mg/day,567 but some organisations go even lower.…”