Abstract 017: National, Regional, and Global Sodium Intake in 1990 and 2010: A Systematic Analysis of 247 24-hour Urinary Sodium Excretion Studies and Dietary Surveys Worldwide
Background: Despite adverse effects of excess sodium (Na) on population health, reliable Na intake data have not been available globally, with limitations of coverage, time era, representativeness, comparability and potential heterogeneity by age and sex.
Methods: We systematically reviewed and accessed published and unpublished estimates of adult Na intakes from around the world, as part of the 2010 Global Burden of Diseases (GBD) study. 247 surveys were identified, including 143 using 24-h urinary Na and 104 diet-based surveys, representing 66 countries and 74.1% of the world population. We systematically assessed and addressed measurement comparability (including for urine vs. diet estimates) and developed a Bayesian hierarchical model to address missing data, national vs. subnational representativeness, and study year to estimate comprehensive global, regional, and national Na intakes, by age and sex, in 1990 and 2010.
Findings: Mean global Na intake in 2010 was 3.95 g/d, twice the WHO recommendation of 2 g/d. Substantial heterogeneity was seen by country and sex (Fig). Mean intakes of adult men and women in 97% and 95% of countries were >2g/d. Highest intakes were seen in Kazakhstan (6.0 g/d), Mauritius (5.6) and Uzbekistan (5.5); and lowest in Kenya (1.5), Malawi (1.5) and Rwanda (1.6). Little variation was seen by age. 0 and 5 countries had mean Na intakes <1.5 g/d in men and women, respectively; only 5 and 46 countries had intakes <2.3 g/d in men and women. From 1990 to 2010, global Na intake increased by 124 mg/d; Na intake increased by >100 mg/d in 83 countries, and decreased by >100 mg/d in only 15 countries.
Conclusions: Na intakes in nearly all countries globally are far higher than optimal, and have increased in most countries over the past 2 decades. These findings make it possible, for the first time, to estimate corresponding preventable disease burdens in specific countries and by specific age and sex subgroups, identify the correlates of excess Na intake in populations, and inform health polices and interventions.
- © 2013 by American Heart Association, Inc.