Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge, UK.
BMJ Open. 2013 Dec 23;3(12):e003733. doi: 10.1136/bmjopen-2013-003733.
To estimate global, regional (21 regions) and national (187 countries) sodium intakes in adults in 1990 and 2010.
Bayesian hierarchical modelling using all identifiable primary sources.
We searched and obtained published and unpublished data from 142 surveys of 24 h urinary sodium and 103 of dietary sodium conducted between 1980 and 2010 across 66 countries. Dietary estimates were converted to urine equivalents based on 79 pairs of dual measurements.
Bayesian hierarchical modelling used survey data and their characteristics to estimate mean sodium intake, by sex, 5 years age group and associated uncertainty for persons aged 20+ in 187 countries in 1990 and 2010. Country-level covariates were national income/person and composition of food supplies.
Mean sodium intake (g/day) as estimable by 24 h urine collections, without adjustment for non-urinary losses.
In 2010, global mean sodium intake was 3.95 g/day (95% uncertainty interval: 3.89 to 4.01). This was nearly twice the WHO recommended limit of 2 g/day and equivalent to 10.06 (9.88-10.21) g/day of salt. Intake in men was ∼10% higher than in women; differences by age were small. Intakes were highest in East Asia, Central Asia and Eastern Europe (mean >4.2 g/day) and in Central Europe and Middle East/North Africa (3.9-4.2 g/day). Regional mean intakes in North America, Western Europe and Australia/New Zealand ranged from 3.4 to 3.8 g/day. Intakes were lower (<3.3 g/day), but more uncertain, in sub-Saharan Africa and Latin America. Between 1990 and 2010, modest, but uncertain, increases in sodium intakes were identified.
Sodium intakes exceed the recommended levels in almost all countries with small differences by age and sex. Virtually all populations would benefit from sodium reduction, supported by enhanced surveillance.
估计 1990 年和 2010 年全球、区域(21 个区域)和国家(187 个国家)成年人的钠摄入量。
使用所有可识别的主要来源进行贝叶斯分层建模。
我们搜索并获得了 1980 年至 2010 年期间来自 66 个国家的 142 项 24 小时尿液钠和 103 项饮食钠调查的已发表和未发表数据。根据 79 对双测量值,将饮食估计值转换为尿液当量。
使用调查数据及其特征,通过性别、5 岁年龄组和 20 岁以上人群的不确定性,对 187 个国家 1990 年和 2010 年的钠摄入量进行贝叶斯分层建模。国家层面的协变量为国家收入/人以及食物供应的构成。
未经非尿损失调整的 24 小时尿液收集可估计的平均钠摄入量(g/天)。
2010 年,全球平均钠摄入量为 3.95g/天(95%置信区间:3.89-4.01)。这几乎是世界卫生组织建议的 2g/天摄入量的两倍,相当于 10.06(9.88-10.21)g/天的盐。男性的摄入量比女性高 10%左右;年龄差异较小。东亚、中亚和东欧的摄入量最高(平均>4.2g/天),中欧和中东/北非的摄入量为 3.9-4.2g/天。北美、西欧和澳大拉西亚/新西兰的区域平均摄入量在 3.4 至 3.8g/天之间。撒哈拉以南非洲和拉丁美洲的摄入量较低(<3.3g/天),但不确定性更大。1990 年至 2010 年间,钠摄入量略有增加,但不确定性较大。
几乎所有国家的钠摄入量都超过了建议水平,年龄和性别差异很小。几乎所有人群都将受益于减少钠的摄入,这需要加强监测。