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Salt intake monitoring at a population level

Journal of Human Hypertension volume 34, pages 604–605 (2020)Cite this article

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I have read with great interest the scientific statement of the British and Irish Hypertension Society on the importance of a valid assessment of salt intake [1]. While I agree that 24-h urine collections, if complete, are the best method to assess salt intake, one should not underestimate the value of urine spot samples—with an adequate equation—to monitor salt intake at a population level [2,3,4].

To avoid confusion and oversimplification on how to measure salt intake, we have to be explicit on why we want to measure salt intake. It is indeed key to distinguish three goals: (1) to estimate salt intake at the individual level, e.g., to identify patients with a high intake and to follow-up their intake throughout time; (2) to estimate salt intake at the group or population level, e.g., for the monitoring of salt intake in a given population; and (3) to estimate the health risk associated with salt intake. On the one hand, at an individual level, urinary spots are not a convincing method. However, at that level, nothing is really convincing. If we want to estimate salt intake at an individual level, multiple 24-h urine collections would be needed what is not feasible out of a research setting. Urinary spot samples are surely also not adequate for estimating the health risk associated with salt intake, as measurement errors lead to serious biases [1, 5].

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Funding

This work was funded in part by the Swiss Federal Food Safety and Veterinary Office (funding reference number 5.15.03).

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Authors and Affiliations

  1. Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland

    Arnaud Chiolero

  2. Population Health Laborator, University of Fribourg, Fribourg, Switzerland

    Arnaud Chiolero

  3. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada

    Arnaud Chiolero

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Correspondence to Arnaud Chiolero.

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Chiolero, A. Salt intake monitoring at a population level. J Hum Hypertens 34, 604–605 (2020). https://doi.org/10.1038/s41371-019-0249-0

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