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

Abstract

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.

Estimated dietary sodium intake in Thailand: A nationwide population survey with 24‐hour urine collections

“…The estimated mean dietary sodium intake in Thailand is comparable with the global average (3720 mg/day) 22 and is within the range reported by western countries: United States (3608 mg/day), 23 Australia (3560 mg/day), and Canada (3325 mg/d) 23‐25 . Interestingly, estimated sodium intake in Thailand was lower than in its Asian neighbors: India (3720 mg/d in Delhi and 4098 mg/day in Andhra Pradesh); South Korea (3960 mg/day); China (4349 mg/day); Nepal (5280 mg/day); and Bangladesh (6800 mg/day) 26‐30 . Whether the comparatively lower estimates found in this study reflect a recent declining trend in Thailand cannot be stated with certainty due to the lack of previous studies using 24‐hour urine collections.…”

Dietary salt reduction for primary prevention of cardiovascular disease in Nepal

“…This will have implications for salt intake strategies into the future. In the present study, salt intake was negatively associated with age, with a decrease of around 1.4 g/d for each 10‐year increase in age . As this is a cross‐sectional survey, it is not clear whether this is an age‐related or cohort effect.…”

“…In the present study, salt intake was negatively associated with age, with a decrease of around 1.4 g/d for each 10-year increase in age. 8 As this is a cross-sectional survey, it is not clear whether this is an age-related or cohort effect. If young people are increasing intakes of high salt processed food more than older adults, this could impact substantially population salt intake in the future.…”

“…This issue of the Journal includes a study which confirms that high salt intake is also an important modifiable risk factor for hypertension in Nepal. Neupane et al describe results of a cross‐sectional survey of a random sample of adult participants from the Community‐based management of non‐communicable diseases (COBIN) study from Pokhara Municipality of Western Nepal in 2018. Participants provided a single 24‐hour urine which was analyzed for sodium content.…”

MicroRNA-210-5p&nbsp;Alleviates Cardiac Fibrosis via Targeting Transforming Growth Factor-beta Type I Receptor in Rats on High Salt Diet

“…Epidemiological studies have reported the association between high salt intake and the risk of cardiovascular diseases [1][2][3]. High sodium or salt intake can lead to chronic comorbidities such as hypertension, heart failure, stroke, chronic kidney disease, and increase mortality [4,5].…”