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Article Dans Une Revue British Journal of Nutrition Année : 2019

Estimating sodium intake from spot urine samples at population level: a validation and application study in French adults

Résumé

The aim of this study was to assess the validity of the predictive INTERSALT equation using spot urine samples to estimate 24-h urinary Na (24-hUNa) excretion and daily Na intake among the French adult population. Among 193 French adults ('validation sample'), we assessed the validity by comparing predicted 24-hUNa excretion from spot urine and measured 24-hUNa excretion from 24-h urine collections. Spearman correlation coefficients and Bland-Altman plots were used and we calculated calibration coefficients. In a nationally representative sample of 1720 French adults ('application sample'), the calibrated predictive equation was then applied to the spot urine Na values to estimate 24-hUNa excretion and daily Na intake. In that sample, predicted Na intake was compared with that estimated from 24-h dietary recalls. Results were adjusted and corrected using calibration coefficients. In the validation sample, the measured 24-hUNa excretion was on average 14 % higher than the predicted 24-hUNa (+13 % for men and +16 % for women). Correlation between measured and predicted 24-hUNa excretion was moderate (Spearman r 0·42), and the Bland-Altman plots showed underestimation at lower excretion level and overestimation at higher level. In the application study, estimated daily salt intake was 8·0 g/d using dietary recalls, 8·1 g/d using predicted INTERSALT equation and 9·3 g/d after applying calibration coefficients calculated in the validation study. Despite overall underestimation of 24-hUNa excretion by spot urinary Na, the use of predictive INTERSALT equation remains an acceptable alternative in monitoring global Na intake/excreted in the French population but its use is not advised at the individual level. Na is an essential nutrient, mainly provided by the salt contained in foods and table salt used as condiment. Nevertheless, excessive Na consumption has adverse health outcomes, including high blood pressure and an increased risk of CVD and stroke (1-6). The average level of Na consumption has been estimated to be 3·95 g/d (equivalent to 10 g of salt) in sixty-six countries worldwide (7) , which is almost twice as much the amount recommended by the WHO (<2 g/d of Na) (8). Therefore, the reduction of population salt intake is a public health priority. However, quantification of discretionary salt (added by individuals) is particularly difficult in diet surveys (9) and accurate monitoring of salt intake can be challenging. As approximately 90 % of daily Na intake is excreted in the urine throughout the day (10) , 24-h urine collection is considered Abbreviations: 24-hUNa, 24-h urinary Na; ENNS, Etude Nationale Nutrition Santé.
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Dates et versions

hal-02558609 , version 1 (04-05-2020)

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Paternité - Pas d'utilisation commerciale - Pas de modification

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Elise Emeville, Camille Lassale, Katia Castetbon, Valérie Deschamps, Benoit Salanave, et al.. Estimating sodium intake from spot urine samples at population level: a validation and application study in French adults. British Journal of Nutrition, 2019, 122 (2), pp.186-194. ⟨10.1017/S0007114519000886⟩. ⟨hal-02558609⟩
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