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Dietary sodium intake in urban and rural Malawi, and directions for future interventions

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Prynn, Josephine E, Banda, Louis, Amberbir, Alemayehu, Price, Alison J, Kayuni, Ndoliwe, Jaffar, Shabbar, Crampin, Amelia C, Smeeth, Liam and Nyirenda, Moffat (2018) 'Dietary sodium intake in urban and rural Malawi, and directions for future interventions'. The American Journal of Clinical Nutrition, Vol 108, Issue 3, pp. 587-593.

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Abstract

Background
High dietary sodium intake is a major risk factor for hypertension. Data on population sodium intake are scanty in sub-Saharan Africa, despite a high hypertension prevalence in most countries.

Objective
We aimed to determine daily sodium intake in urban and rural communities in Malawi.

Design
In an observational cross-sectional survey, data were collected on estimated household-level per capita sodium intake, based on how long participants reported that a defined quantity of plain salt lasts in a household. In a subset of 2078 participants, 24-h urinary sodium was estimated from a morning spot urine sample.
Results
Of 29,074 participants, 52.8% of rural and 50.1% of urban individuals lived in households with an estimated per capita plain salt consumption >5 g/d. Of participants with urinary sodium data, 90.8% of rural and 95.9% of urban participants had estimated 24-h urinary sodium >2 g/d; there was no correlation between household per capita salt intake and estimated 24-h urinary sodium excretion. Younger adults were more likely to have high urinary sodium and to eat food prepared outside the home than were those over the age of 60 y. Households with a member with previously diagnosed hypertension had reduced odds (OR: 0.59; 95% CI: 0.51, 0.68) of per capita household plain salt intake >5 g/d, compared with those where hypertension was undiagnosed.

Conclusions
Sodium consumption exceeds the recommended amounts for most of the population in rural and urban Malawi. Population-level interventions for sodium intake reduction with a wide focus are needed, targeting both sources outside the home as well as home cooking. This trial was registered at clinicaltrials.gov as NCT03422185.

Item Type: Article
Subjects: QU Biochemistry > Vitamins > QU 145 Nutrition. Nutritional requirements
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WB Practice of Medicine > Therapeutics > WB 300 General works
WG Cardiovascular System > WG 100 General works
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1093/ajcn/nqy125
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 11 Jul 2018 15:59
Last Modified: 28 Sep 2018 10:08
URI: http://archive.lstmed.ac.uk/id/eprint/8888

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