Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi.
Medical and Research Department, Dignitas International, Zomba, Malawi.
Am J Clin Nutr. 2018 Sep 1;108(3):587-593. doi: 10.1093/ajcn/nqy125.
High dietary sodium intake is a major risk factor for hypertension. Data on population sodium intake are scanty in sub-Saharan Africa, despite a high hypertension prevalence in most countries.
We aimed to determine daily sodium intake in urban and rural communities in Malawi.
In an observational cross-sectional survey, data were collected on estimated household-level per capita sodium intake, based on how long participants reported that a defined quantity of plain salt lasts in a household. In a subset of 2078 participants, 24-h urinary sodium was estimated from a morning spot urine sample.
Of 29,074 participants, 52.8% of rural and 50.1% of urban individuals lived in households with an estimated per capita plain salt consumption >5 g/d. Of participants with urinary sodium data, 90.8% of rural and 95.9% of urban participants had estimated 24-h urinary sodium >2 g/d; there was no correlation between household per capita salt intake and estimated 24-h urinary sodium excretion. Younger adults were more likely to have high urinary sodium and to eat food prepared outside the home than were those over the age of 60 y. Households with a member with previously diagnosed hypertension had reduced odds (OR: 0.59; 95% CI: 0.51, 0.68) of per capita household plain salt intake >5 g/d, compared with those where hypertension was undiagnosed.
Sodium consumption exceeds the recommended amounts for most of the population in rural and urban Malawi. Population-level interventions for sodium intake reduction with a wide focus are needed, targeting both sources outside the home as well as home cooking. This trial was registered at clinicaltrials.gov as NCT03422185.
高钠饮食是高血压的一个主要危险因素。尽管大多数国家的高血压患病率都很高，但撒哈拉以南非洲地区的人群钠摄入量数据却很少。
我们旨在确定马拉维城乡社区的每日钠摄入量。
在一项观察性横断面调查中，根据参与者报告的家中一定数量的普通盐可以使用多长时间，收集了估计家庭人均钠摄入量的数据。在 2078 名参与者的亚组中，通过早晨的一次随机尿样估算 24 小时尿钠。
在 29074 名参与者中，52.8%的农村和 50.1%的城市个体生活在人均普通盐摄入量估计>5 g/d 的家庭中。在有尿钠数据的参与者中，90.8%的农村和 95.9%的城市参与者估计 24 小时尿钠>2 g/d；家庭人均盐摄入量与估计的 24 小时尿钠排泄量之间没有相关性。年轻成年人比 60 岁以上的成年人更有可能摄入高尿钠和在家庭以外的地方准备的食物。与高血压未确诊的家庭相比，家中有确诊高血压患者的家庭人均家庭普通盐摄入量>5 g/d 的可能性降低（OR：0.59；95%CI：0.51，0.68）。
马拉维城乡地区的大多数人口的钠摄入量超过了推荐量。需要广泛关注人群的钠摄入量减少的干预措施，既要针对家庭以外的来源，也要针对家庭烹饪。本试验在 clinicaltrials.gov 上注册为 NCT03422185。
