Socioeconomic Determinants of Sodium Intake in Adult Populations of High-Income Countries: A Systematic Review and Meta-Analysis

Mestral, Carlos de; Mayén, Ana‐Lucia; Petrović, Dušan; Marques‐Vidal, Pedro; Bochud, Murielle; Stringhini, Silvia

doi:10.2105/ajph.2016.303629

Cited by 44 publications

(40 citation statements)

References 90 publications

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“…An inverse relationship was found between sodium availability in households (energy-adjusted) and income, which is similar to that reported in studies conducted in developing [12,13] and developed countries [31]. Although a poorer diet quality among low-income families may be one of the reasons for high sodium intake [31], this result might also relate to the main source of sodium consumption in Costa Rica, namely common salt (table or kitchen).…”

Section: Discussionsupporting

confidence: 86%

Baseline and Estimated Trends of Sodium Availability and Food Sources in the Costa Rican Population during 2004–2005 and 2012–2013

et al. 2017

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In 2012, Costa Rica launched a program to reduce salt and sodium consumption to prevent cardiovascular disease and associated risk factors, but little was known about the level of sodium consumption or its sources. Our aim was to estimate the magnitude and time trends of sodium consumption (based on food and beverage acquisitions) in Costa Rica. Data from the National Household Income and Expenditure Surveys carried out in 2004–2005 (n = 4231) and 2012–2013 (n = 5705) were used. Records of food purchases for household consumption were converted into sodium and energy using food composition tables. Mean sodium availability (per person/per day and adjusted for a 2000-kcal energy intake) and the contribution of food groups to this availability were estimated for each year. Sodium availability increased in the period from 3.9 to 4.6 g/person/day (p < 0.001). The income level was inversely related to sodium availability. The main sources of sodium in the diet were domestic salt (60%) in addition to processed foods and condiments (with added sodium) (27.4%). Dietary sources of sodium varied within surveys (p < 0.05). Sodium available for consumption in Costa Rican households largely exceeds the World Health Organization-recommended intake levels (<2 g sodium/person/day). These results are essential for the design and implementation of effective policies and interventions.

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Section: Discussionsupporting

confidence: 86%

Baseline and Estimated Trends of Sodium Availability and Food Sources in the Costa Rican Population during 2004–2005 and 2012–2013

et al. 2017

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“…While these findings are not directly comparable due to different classification systems used for categorizing products, they still highlight a number of key food categories globally that consistently contribute to a large share of sodium purchases. Prior research in Australia and globally has also demonstrated higher sodium intakes in individuals with a lower socio-economic status (SES) [29][30][31][32]. By using contemporary and objectively collected sodium purchase data, representative of Australian households, our findings suggest that differences in sodium consumption according to SES is likely at least partly driven by larger volumes of packaged foods and beverages purchased by lower-income households, rather than due to purchases of higher-sodium content products.…”

Section: Discussionmentioning

confidence: 60%

Contribution of major food companies and their products to household dietary sodium purchases in Australia

Coyle

Shahid

Dunford

et al. 2020

Int J Behav Nutr Phys Act

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Background: The Australian federal government will soon release voluntary sodium reduction targets for 30 packaged food categories through the Healthy Food Partnership. Previous assessments of voluntary targets show variable industry engagement, and little is known about the extent that major food companies and their products contribute to dietary sodium purchases among Australian households. Methods: The aim of this cross-sectional study was to identify the relative contribution that food companies and their products made to Australian household sodium purchases in 2018, and to examine differences in sodium purchases by household income level. We used 1 year of grocery purchase data from a nationally representative consumer panel of Australian households who reported their grocery purchases (the Nielsen Homescan panel), combined with database that contains product-specific sodium content for packaged foods and beverages (FoodSwitch). The top food companies and food categories were ranked according to their contribution to household sodium purchases. Differences in per capita sodium purchases by income levels were assessed by 1factor ANOVA. All analyses were modelled to the Australian population in 2018 using sample weights. Results: Sodium data were available from 7188 households who purchased 26,728 unique products and purchased just under 7.5 million food product units. Out of 1329 food companies, the top 10 accounted for 35% of unique products and contributed to 58% of all sodium purchased from packaged foods and beverages. The top three companies were grocery food retailers each contributing 12-15% of sodium purchases from sales of their private label products, particularly processed meat, cheese and bread. Out of the 67 food categories, the top 10 accounted for 73% of sodium purchased, particularly driven by purchases of processed meat (14%), bread (12%) and sauces (11%). Low-income Australian households purchased significantly more sodium from packaged products than highincome households per capita (452 mg/d, 95%CI: 363-540 mg/d, P < 0.001). Conclusions: A small number of food companies and food categories account for most of the dietary sodium purchased by Australian households. Prioritizing government engagement with these groups could deliver a large reduction in population sodium intake.

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“…Higher-income persons are more likely to consume a healthy diet than lower income people, and the diet of high-income groups is reported to be higher in potassium ( 44 ), in line with our findings. Regarding sodium, income has been described as a variable that does not affect 24 h urinary sodium excretion ( 45 ), although in a recent systematic review and meta-analysis to assess socioeconomic determinants of sodium intake in adult populations of high-income countries ( 46 ), about two-thirds showed higher sodium intake in subjects with low socioeconomic conditions.…”

Section: Discussionmentioning

confidence: 99%

Sodium and potassium urinary excretion and their ratio in the elderly: results from the Nutrition UP 65 study

Moreira¹,

Sousa²,

Guerra³

et al. 2018

Food & Nutrition Research

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BackgroundWe aimed to describe urinary sodium and potassium excretion and their ratio in a representative sample of Portuguese elderly population, according to sociodemographic characteristics and weight status.MethodsA cluster sampling approach was used, representing older Portuguese adults (≥65 years) according to age, sex, education level, and regional area within the Nutrition UP 65 study. This cross-sectional evaluation was conducted in 2015 and 2016. From a sample size of 1,500 participants, 1,318 were eligible for the present analysis, 57.3% were women, and 23.5% were aged ≥80 years. Sodium and potassium consumption was evaluated through one 24 h urinary excretion. Inadequate sodium intake was defined as ≥2,000 mg/day, inadequate potassium intake was considered as <3,510 mg/day, and inadequate sodium-to-potassium ratio was defined as >1, according to the World Health Organization cutoffs.ResultsThe proportion of the participants with an inadequate intake was 80.0% in women and 91.5% in men (sodium), 96.2% of women and 79.4% of men (potassium), and 98.4% of women and 99.1% of men (sodium-to-potassium ratio). Higher sodium adequacy was observed among the older elderly, unmarried, with lower household income, and underweight/normal weight. Higher potassium adequacy was observed in the younger elderly, married, and with higher income.ConclusionThe majority of the Portuguese elderly population was classified as having inadequate sodium, potassium, and sodium-to-potassium ratio urinary excretion. Therefore, strategies for reducing sodium and increasing potassium intake are priorities in the Portuguese elderly population.

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Socioeconomic Determinants of Sodium Intake in Adult Populations of High-Income Countries: A Systematic Review and Meta-Analysis

Cited by 44 publications

References 90 publications

Baseline and Estimated Trends of Sodium Availability and Food Sources in the Costa Rican Population during 2004–2005 and 2012–2013

Baseline and Estimated Trends of Sodium Availability and Food Sources in the Costa Rican Population during 2004–2005 and 2012–2013

Contribution of major food companies and their products to household dietary sodium purchases in Australia

Sodium and potassium urinary excretion and their ratio in the elderly: results from the Nutrition UP 65 study

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