title: Reporting accuracy of population dietary sodium intake using duplicate 24 h dietary recalls and a salt questionnaire.
abstract: High dietary Na intake is associated with multiple health risks, making accurate assessment of population dietary Na intake critical. In the present study, reporting accuracy of dietary Na intake was evaluated by 24 h urinary Na excretion using the EPIC-Soft 24 h dietary recall (24-HDR). Participants from a subsample of the European Food Consumption Validation study (n 365; countries: Belgium, Norway and Czech Republic), aged 45-65 years, completed two 24 h urine collections and two 24-HDR. Reporting accuracy was calculated as the ratio of reported Na intake to that estimated from the urinary biomarker. A questionnaire on salt use was completed in order to assess the discretionary use of table and cooking salt. The reporting accuracy of dietary Na intake was assessed using two scenarios: (1) a salt adjustment procedure using data from the salt questionnaire; (2) without salt adjustment. Overall, reporting accuracy improved when data from the salt questionnaire were included. The mean reporting accuracy was 0·67 (95 % CI 0·62, 0·72), 0·73 (95 % CI 0·68, 0·79) and 0·79 (95 % CI 0·74, 0·85) for Belgium, Norway and Czech Republic, respectively. Reporting accuracy decreased with increasing BMI among male subjects in all the three countries. For women from Belgium and Norway, reporting accuracy was highest among those classified as obese (BMI ≥ 30 kg/m2: 0·73, 95 % CI 0·67, 0·81 and 0·81, 95 % CI 0·77, 0·86, respectively). The findings from the present study showed considerable underestimation of dietary Na intake assessed using two 24-HDR. The questionnaire-based salt adjustment procedure improved reporting accuracy by 7-13 %. Further development of both the questionnaire and EPIC-Soft databases (e.g. inclusion of a facet to describe salt content) is necessary to estimate population dietary Na intakes accurately.
authors.affiliation: Department of Bio- and Food Sciences,University College Ghent,Ghent,Belgium.
authors.forename: Willem
authors.initials: W
authors.lastname: De Keyzer
authors.affiliation: Center for Health, Nutrition and Food, National Institute of Public Health in Prague,Brno,Czech Republic.
authors.forename: Marcela
authors.initials: M
authors.lastname: Dofková
authors.affiliation: Norwegian Scientific Committee for Food Safety,Oslo,Norway.
authors.forename: Inger Therese L
authors.initials: IT
authors.lastname: Lillegaard
authors.affiliation: Department of Public Health,Ghent University,Ghent,Belgium.
authors.forename: Mieke
authors.initials: M
authors.lastname: De Maeyer
authors.affiliation: Institute of Basic Medical Sciences, University of Oslo,Oslo,Norway.
authors.forename: Lene Frost
authors.initials: LF
authors.lastname: Andersen
authors.affiliation: Center for Health, Nutrition and Food, National Institute of Public Health in Prague,Brno,Czech Republic.
authors.forename: Jirí
authors.initials: J
authors.lastname: Ruprich
authors.affiliation: Center for Health, Nutrition and Food, National Institute of Public Health in Prague,Brno,Czech Republic.
authors.forename: Irena
authors.initials: I
authors.lastname: Řehůřková
authors.affiliation: Division of Human Nutrition, Wageningen University,Wageningen,The Netherlands.
authors.forename: Anouk
authors.initials: A
authors.lastname: Geelen
authors.affiliation: Division of Human Nutrition, Wageningen University,Wageningen,The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: van 't Veer
authors.affiliation: Department of Bio- and Food Sciences,University College Ghent,Ghent,Belgium.
authors.forename: Stefaan
authors.initials: S
authors.lastname: De Henauw
authors.affiliation: Dietary Exposure Assessment group, International Agency for Research on Cancer (IARC),Lyon,France.
authors.forename: Sandra Patricia
authors.initials: SP
authors.lastname: Crispim
authors.affiliation: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM),Bilthoven,The Netherlands.
authors.forename: Evelien
authors.initials: E
authors.lastname: de Boer
authors.affiliation: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM),Bilthoven,The Netherlands.
authors.forename: Marga
authors.initials: M
authors.lastname: Ocké
authors.affiliation: Dietary Exposure Assessment group, International Agency for Research on Cancer (IARC),Lyon,France.
authors.forename: Nadia
authors.initials: N
authors.lastname: Slimani
authors.affiliation: Department of Public Health,Ghent University,Ghent,Belgium.
authors.forename: Inge
authors.initials: I
authors.lastname: Huybrechts
mesh_terms: D000368:Aged; D001530:Belgium; D015415:Biomarkers / Q000652:urine; D015992:Body Mass Index; D018153:Czech Republic; D015930:Diet Records; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009664:Norway; D015203:Reproducibility of Results; D012737:Sex Factors; D012964:Sodium / Q000652:urine; D012982:Sodium, Dietary / Q000008:administration & dosage*; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D012982:Sodium, Dietary; D012964:Sodium
keywords: European Food Consumption Validation