TY - JOUR
T1 - Estimating mean population salt intake in Fiji and Samoa using spot urine samples
AU - Santos, Joseph Alvin
AU - Rosewarne, Emalie
AU - Hogendorf, Martyna
AU - Trieu, Kathy
AU - Pillay, Arti
AU - Ieremia, Merina
AU - Naseri, Leausa Toleafoa Take
AU - Tukana, Isimeli
AU - Snowdon, Wendy
AU - Petersen, Kristina
AU - Webster, Jacqui
N1 - Funding Information:
The salt study was supported by an NHMRC of Australia project grant through the GACD hypertension program (1040178). JW was supported by an NHMRC/National Heart Foundation Career Development Fellowship (1082924). JW is supported through an NHMRC Centre of Research Excellence on food policy interventions to reduce salt (1117300). KT is supported by an NHMRC/National Heart Foundation Early Career Fellowship grant (1161597). JS is supported by an NHMRC Postgraduate Scholarship (1168948). The funders had no role in the design, analysis, interpretation or writing of this manuscript.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/9/10
Y1 - 2019/9/10
N2 - Background: There is an increasing interest in finding less costly and burdensome alternatives to measuring population-level salt intake than 24-h urine collection, such as spot urine samples. However, little is known about their usefulness in developing countries like Fiji and Samoa. The purpose of this study was to evaluate the capacity of spot urine samples to estimate mean population salt intake in Fiji and Samoa. Methods: The study involved secondary analyses of urine data from cross-sectional surveys conducted in Fiji and Samoa between 2012 and 2016. Mean salt intake was estimated from spot urine samples using six equations, and compared with the measured salt intake from 24-h urine samples. Differences and agreement between the two methods were examined through paired samples t-test, intraclass correlation coefficient analysis, and Bland-Altman plots and analyses. Results: A total of 414 participants from Fiji and 725 participants from Samoa were included. Unweighted mean salt intake based on 24-h urine collection was 10.58 g/day (95% CI 9.95 to 11.22) in Fiji and 7.09 g/day (95% CI 6.83 to 7.36) in Samoa. In both samples, the INTERSALT equation with potassium produced the closest salt intake estimate to the 24-h urine (difference of-0.92 g/day, 95% CI-1.67 to-0.18 in the Fiji sample and + 1.53 g/day, 95% CI 1.28 to 1.77 in the Samoa sample). The presence of proportional bias was evident for all equations except for the Kawasaki equation. Conclusion: These data suggest that additional studies where both 24-h urine and spot urine samples are collected are needed to further assess whether methods based on spot urine samples can be confidently used to estimate mean population salt intake in Fiji and Samoa.
AB - Background: There is an increasing interest in finding less costly and burdensome alternatives to measuring population-level salt intake than 24-h urine collection, such as spot urine samples. However, little is known about their usefulness in developing countries like Fiji and Samoa. The purpose of this study was to evaluate the capacity of spot urine samples to estimate mean population salt intake in Fiji and Samoa. Methods: The study involved secondary analyses of urine data from cross-sectional surveys conducted in Fiji and Samoa between 2012 and 2016. Mean salt intake was estimated from spot urine samples using six equations, and compared with the measured salt intake from 24-h urine samples. Differences and agreement between the two methods were examined through paired samples t-test, intraclass correlation coefficient analysis, and Bland-Altman plots and analyses. Results: A total of 414 participants from Fiji and 725 participants from Samoa were included. Unweighted mean salt intake based on 24-h urine collection was 10.58 g/day (95% CI 9.95 to 11.22) in Fiji and 7.09 g/day (95% CI 6.83 to 7.36) in Samoa. In both samples, the INTERSALT equation with potassium produced the closest salt intake estimate to the 24-h urine (difference of-0.92 g/day, 95% CI-1.67 to-0.18 in the Fiji sample and + 1.53 g/day, 95% CI 1.28 to 1.77 in the Samoa sample). The presence of proportional bias was evident for all equations except for the Kawasaki equation. Conclusion: These data suggest that additional studies where both 24-h urine and spot urine samples are collected are needed to further assess whether methods based on spot urine samples can be confidently used to estimate mean population salt intake in Fiji and Samoa.
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U2 - 10.1186/s12937-019-0484-9
DO - 10.1186/s12937-019-0484-9
M3 - Article
C2 - 31506072
AN - SCOPUS:85072025713
SN - 1475-2891
VL - 18
JO - Nutrition Journal
JF - Nutrition Journal
IS - 1
M1 - 55
ER -