title: Mean population salt intake estimated from 24-h urine samples and spot urine samples: a systematic review and meta-analysis.
abstract: BACKGROUND
  Estimating equations based on spot urine samples have been identified as a possible alternative approach to 24-h urine collections for determining mean population salt intake. This review compares estimates of mean population salt intake based upon spot and 24-h urine samples.
  
  
  METHODS
  We systematically searched for all studies that reported estimates of daily salt intake based upon both spot and 24-h urine samples for the same population. The associations between the two were quantified and compared overall and in subsets of studies.
  
  
  RESULTS
  A total of 538 records were identified, 108 were assessed as full text and 29 were included. The included studies involved 10,414 participants from 34 countries and made 71 comparisons available for the primary analysis. Overall average population salt intake estimated from 24-h urine samples was 9.3 g/day compared with 9.0 g/day estimated from the spot urine samples. Estimates based upon spot urine samples had excellent sensitivity (97%) and specificity (100%) at classifying mean population salt intake as above or below the World Health Organization maximum target of 5 g/day. Compared with the 24-h samples, estimates based upon spot urine overestimated intake at lower levels of consumption and underestimated intake at higher levels of consumption.
  
  
  CONCLUSIONS
  Estimates of mean population salt intake based upon spot urine samples can provide countries with a good indication of mean population salt intake and whether action on salt consumption is required.
authors.forename: Liping
authors.initials: L
authors.lastname: Huang
authors.forename: Michelle
authors.initials: M
authors.lastname: Crino
authors.forename: Jason H Y
authors.initials: JH
authors.lastname: Wu
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.forename: Federica
authors.initials: F
authors.lastname: Barzi
authors.forename: Mary-Anne
authors.initials: MA
authors.lastname: Land
authors.forename: Rachael
authors.initials: R
authors.lastname: McLean
authors.forename: Jacqui
authors.initials: J
authors.lastname: Webster
authors.forename: Batsaikhan
authors.initials: B
authors.lastname: Enkhtungalag
authors.forename: Bruce
authors.initials: B
authors.lastname: Neal
mesh_terms: D006801:Humans; D064167:Recommended Dietary Allowances; D017673:Sodium Chloride, Dietary / Q000652:urine*; D014944:World Health Organization
chemical_list: D017673:Sodium Chloride, Dietary