A systematic review of the sources of dietary salt around the world
File(s)
Author(s)
Type
Journal Article
Abstract
Excess salt intake contributes to hypertension and increased cardiovascular disease risk. Efforts to implement effective salt-reduction strategies require accurate data on the sources of salt consumption. We therefore performed a systematic review to identify the sources of dietary salt around the world. We systematically searched peer-reviewed and gray literature databases for studies that quantified discretionary (salt added during cooking or at the table) and nondiscretionary sources of salt and those that provided information about the food groups contributing to dietary salt intake. Exploratory linear regression analysis was also conducted to assess whether the proportion of discretionary salt intake is related to the gross domestic product (GDP) per capita of a country. We identified 80 studies conducted in 34 countries between 1975 and 2018. The majority (n = 44, 55%) collected data on dietary salt sources within the past 10 y and were deemed to have a low or moderate risk of bias (n = 75, 94%). Thirty-two (40%) studies were judged to be nationally representative. Populations in Brazil, China, Costa Rica, Guatemala, India, Japan, Mozambique, and Romania received more than half of their daily salt intake from discretionary sources. A significant inverse correlation between discretionary salt intake and a country's per capita GDP was observed (P < 0.0001), such that for every $10,000 increase in per capita GDP, the amount of salt obtained from discretionary sources was lower by 8.7% (95% CI: 5.1%, 12%). Bread products, cereal and grains, meat products, and dairy products were the major contributors to dietary salt intake in most populations. There is marked variation in discretionary salt use around the world that is highly correlated with the level of economic development. Our findings have important implications for the type of salt-reduction strategy likely to be effective in a country.
Date Issued
2020-05-01
Date Acceptance
2019-12-17
Citation
Advances in Nutrition, 2020, 11 (3), pp.677-686
ISSN
2156-5376
Publisher
Oxford University Press (OUP)
Start Page
677
End Page
686
Journal / Book Title
Advances in Nutrition
Volume
11
Issue
3
Copyright Statement
© The Author(s) on behalf of the American Society for Nutrition 2020. This is a pre-copy-editing, author-produced version of an article accepted for publication in Advances in Nutrition following peer review. The definitive publisher-authenticated version is available online at: https://academic.oup.com/advances/article/11/3/677/5697078
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/31904809
PII: 5697078
Subjects
blood pressure
food policy
hypertension
nutrition
salt
salt-reduction
sodium
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2020-01-06