title: Salt Intakes, Knowledge, and Behavior in Samoa: Monitoring Salt-Consumption Patterns Through the World Health Organization's Surveillance of Noncommunicable Disease Risk Factors (STEPS).
abstract: This project measured population salt intake in Samoa by integrating urinary sodium analysis into the World Health Organization's (WHO's) STEPwise approach to surveillance of noncommunicable disease risk factors (STEPS). A subsample of the Samoan Ministry of Health's 2013 STEPS Survey collected 24-hour and spot urine samples and completed questions on salt-related behaviors. Complete urine samples were available for 293 participants. Overall, weighted mean population 24-hour urine excretion of salt was 7.09 g (standard error 0.19) to 7.63 g (standard error 0.27) for men and 6.39 g (standard error 0.14) for women (P=.0014). Salt intake increased with body mass index (P=.0004), and people who added salt at the table had 1.5 g higher salt intakes than those who did not add salt (P=.0422). A total of 70% of the population had urinary excretion values above the 5 g/d cutoff recommended by the WHO. A reduction of 30% (2 g) would reduce average population salt intake to 5 g/d, in line with WHO recommendations. While challenging, integration of salt monitoring into STEPS provides clear logistical and cost benefits and the lessons communicated here can help inform future programs.
authors: The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia. jwebster@georgeinstitute.org.au.
authors: Jacqui
authors: J
authors: Webster
authors: Ministry of Health, Apia, Samoa.
authors: Sarah Asi Faletoese
authors: SA
authors: Su'a
authors: Ministry of Health, Apia, Samoa.
authors: Merina
authors: M
authors: Ieremia
authors: The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia.
authors: Severine
authors: S
authors: Bompoint
authors: The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia.
authors: Claire
authors: C
authors: Johnson
authors: Pacifika Futures, Auckland, New Zealand.
authors: Gavin
authors: G
authors: Faeamani
authors: Ministry of Health, Apia, Samoa.
authors: Miraneta
authors: M
authors: Vaiaso
authors: WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, VIC, Australia.
authors: Wendy
authors: W
authors: Snowdon
authors: The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia.
authors: Mary-Anne
authors: MA
authors: Land
authors: The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia.
authors: Kathy
authors: K
authors: Trieu
authors: Medical Specialist Clinic and Ministry of Health, Apia, Samoa.
authors: Satu
authors: S
authors: Viali
authors: Deakin Health Economics, Faculty of Health, Deakin University, VIC, Australia.
authors: Marj
authors: M
authors: Moodie
authors: School of Medicine, Deakin University, Melbourne, VIC, Australia.
authors: Colin
authors: C
authors: Bell
authors: The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia.
authors: Bruce
authors: B
authors: Neal
authors: The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia.|The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK.|Department of Epidemiology, Johns Hopkins University, Baltimore, MD.
authors: Mark
authors: M
authors: Woodward
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D064167:Recommended Dietary Allowances; D012307:Risk Factors; D018947:Samoa; D012964:Sodium / Q000652:urine*; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000652:urine; D014944:World Health Organization
chemical_list: D017673:Sodium Chloride, Dietary; D012964:Sodium