Sodium and potassium excretion in an adult Caribbean population of African descent with a high burden of cardiovascular disease.
Hennis, Anselm JM
Samuels, T Alafia
BMC public health
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Harris, R. M., Rose, A. M., Hambleton, I. R., Howitt, C., Forouhi, N., Hennis, A. J., Samuels, T. A., & et al. (2018). Sodium and potassium excretion in an adult Caribbean population of African descent with a high burden of cardiovascular disease.. BMC public health, 18 (1), 998. https://doi.org/10.1186/s12889-018-5694-0
ABSTRACT Background: High sodium (Na) diets with inadequate potassium (K) and high Na:K ratios are a known determinant of hypertension and cardiovascular disease (CVD). The Caribbean island of Barbados has a high prevalence of hypertension and mortality from CVD. There has not been a representative population-based study of sodium excretion in Barbados, nor from countries in the Caribbean, for over 20 years. Objective: To estimate sodium and potassium excretion, to compare estimated levels with recommended intakes and to identify the main food sources of sodium in Barbadian adults. Design: A sub-sample (n=364; 25-64 years) was randomly selected from the representative population-based Health of the Nation cross-sectional study (n=1234), in 2012-13. A single 24-hour urine sample was collected from each participant, following a strictly applied protocol designed to reject incomplete samples, for the measurement of sodium and potassium excretion (in mg), which were used as proxy estimates of dietary intake. In addition, sensitivity analyses based on estimated completeness of urine collection from urine creatinine values were undertaken. Multiple linear regression was used to examine differences in sodium and potassium excretion, and the Na:K ratio, by age, sex and educational level. Two 24-hour recalls were used to identify the main dietary sources of sodium. All analyses were weighted for the survey design. Results: Mean sodium excretion was 2656 (95% CI 2488-2824) mg/day, with 67% (62-73%) exceeding the World Health Organization (WHO)recommended limit of 2000 mg/d. Mean potassium excretion was 1469 (1395-1542) mg/d; <0.5% met recommended minimum intake levels. Mean Na:K ratio was 2.0 (1.9-2.1); not one participant had a ratio that met WHO recommendations. Higher potassium intake, and lower Na:K ratio, were independently associated with age and tertiary education. Sensitivity analyses based on urine creatinine values did not notably alter these findings. Conclusions: In this first nationally representative study with objective assessment of sodium and potassium excretion in a Caribbean population in over 20 years, levels of sodium intake were high, and potassium intake was low. Younger age and lower educational level were associated with the highest Na:K ratios. These findings provide baseline values for planning future policy interventions for non-communicable disease prevention.
Humans, Cardiovascular Diseases, Potassium, Sodium, Sodium, Dietary, Diet, Diet Surveys, Prevalence, Cross-Sectional Studies, Adult, Middle Aged, African Continental Ancestry Group, Barbados, Female, Male
The Ministry of Health of the Government of Barbados funded this study.
External DOI: https://doi.org/10.1186/s12889-018-5694-0
This record's URL: https://www.repository.cam.ac.uk/handle/1810/283535
Attribution 4.0 International
Licence URL: https://creativecommons.org/licenses/by/4.0/