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

Dinesh Neupane, Anupa Rijal, Megan E. Henry, Per Kallestrup, Bhagawan Koirala, Craig S. Mclachlan, Kamal Ghimire, Di Zhao, Shailendra Sharma, Yashashwi Pokharel, Kristy Joseph, Michael Hecht Olsen, Aletta E. Schutte, Lawrence J. Appel

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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.

Original languageEnglish
JournalJournal of Clinical Hypertension
DOIs
Publication statusAccepted/In press - 1 Jan 2020

Keywords

  • 24-hour urinary sodium excretion
  • hypertension
  • nutrition
  • population studies
  • salt intake
  • sodium

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    Neupane, D., Rijal, A., Henry, M. E., Kallestrup, P., Koirala, B., Mclachlan, C. S., Ghimire, K., Zhao, D., Sharma, S., Pokharel, Y., Joseph, K., Olsen, M. H., Schutte, A. E., & Appel, L. J. (Accepted/In press). Mean dietary salt intake in Nepal: A population survey with 24-hour urine collections. Journal of Clinical Hypertension. https://doi.org/10.1111/jch.13813