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Estimation of Salt Intake Using 24-Hour Urine Collection: Switzerland

Author(s): Aline Chappuis1, Fred Paccaud1, Murielle Bochud1, Michel Burnier2
Affiliation(s): 1Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland, 2 Division of Nephrology and Hypertension, Lausanne University Hospital, Lausanne, Switzerland
1st country of focus: Switzerland
Relevant to the conference theme: Non-communicable chronic diseases
Summary (max 100 words): We submit this abstract on behalf of the Swiss Survey on Salt Group. Within the framework of a nationwide strategy on dietary salt reduction launched by the Swiss Federal Office of Public Health, we conducted a national population-based survey aiming at estimating dietary salt intake in the population aged 15 years and over, using 24-hour urine collection. Mean urinary salt excretion was 10.6 g/24h in men and 7.8 g/24h in women; a large proportion of participants had a urinary salt excretion above the recommended thresholds, which is similar to what is found in other Western countries.
Background (max 200 words): The Swiss Federal Office of Public Health has launched a nationwide strategy on dietary salt reduction for 2008-2012. The aim of this strategy is to reduce salt intake to less than 8g/day in the population. The long term goal is to stabilize salt intake to the WHO-recommendation of less than 5g/day. Data on dietary salt intake are lacking at a national level in Switzerland.
Objectives (max 100 words): We conducted a national survey in 2010-2011 to estimate dietary salt intake in the population living in Switzerland aged 15 years and over.
Methodology (max 400 words): The population-based survey included eleven study centers, covering nine cantons and the three main linguistic regions of Switzerland (German, French and Italian). Participants aged 15 years and over were recruited within eight predefined sex- and age-strata, using a 2-level sampling strategy similar to the one used in the Swiss Health Interview Surveys. Participants collected 24-hour urine; collections <300ml were excluded from the following analysis (n=3). Urinary sodium was measured centrally in the Laboratoire de Chimie Clinique, CHUV, Lausanne, Switzerland using indirect potentiometry.
Results (max 400 words): Data from 704 men and 740 women were available for the analysis. The mean (SD) urinary salt excretion was 10.6 (4.2) g NaCl/24h in men and 7.8 (3.3) g NaCl/24h in women (p<0.001). In the 15-29, 30-44, 45-59 and ≥60 year-old groups, salt excretion was 9.8, 11.1, 11.3 and 10.2 g NaCl/24h in men and 7.8, 8.2, 8.2 and 7.0 g NaCl/24h in women. The age-, sex- and body mass index-adjusted mean urinary salt excretion in the German-speaking region (9.3 g/24h) was higher than in the French- (8.7 g/24h) but similar to the Italian- (9.2 g/24h) speaking region. Cantons of Luzern and St.Gallen had significantly higher salt excretion (9.8 g/24h) than Zürich and Basel (mean 9.0 g/24h), which highlights heterogeneity within the German-speaking region. A large proportion of men and women had a urinary salt excretion above the WHO recommendation of 5 g/day (94.2% and 78.7% respectively, p<0.001); furthermore, 71.2% of men and 41.5% of women (p<0.001) were also above the national short-term objective of 8 g/day.
Conclusion (max 400 words): Similar to what is found in other Western countries, 24-hour urinary salt excretion, which reflects dietary salt intake, is above the recommended thresholds in a large part of the population of Switzerland, especially in men and middle-aged people. The observed small regional differences do not justify different strategies to reduce salt intake in the Swiss population.

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