Sodium intake and dietary sources of sodium in a sample of undergraduate students from Novi Sad, Serbia
Abstract
Background/Aim. Data on sodium intake and sources of sodium in the diet in Serbia are limited. The aim of this study was to estimate the sodium intake and identify the sources of sodium in the diet of undergraduate students attending the University of Novi Sad. Methods. Students completed a questionnaire to gather data on their gender, age and university faculty attended, and then a 24 h dietary recall. The sodium intake of the students was calculated using the dietary recall data and data on the sodium content of foods. The contribution of different food groups as well as of specific foodstuffs to the total sodium intake was calculated. Results. The mean estimated sodium intake of the students was 3,938.5 ± 1,708.1 mg/day. The sodium intake of 89.1% of the surveyed students exceeded the guideline for sodium intake, the majority of the sodium coming from processed foods (78.9% of the total sodium intake). The food groups that contributed the most to the total sodium intake of the students were meat and meat products (21.7%) and cereals and cereal-based products (18.6%). Bread and other bakery products were responsible for 13.1% of the total sodium intake. Conclusion. High sodium intake in students of the University of Novi Sad puts them at high risk of developing high blood pressure. The food industry should work towards reformulating products with high sodium content, especially bread and other bakery products. Efforts should be taken to reduce sodium intake among undergraduate students in Novi Sad.
References
World Health Organization. Global health risks: Mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization; 2009.
World Health Organization. Global status report on noncommu-nicable diseases 2010. Geneva: World Health Organization; 2011.
World Health Organization. Global Atlas on cardiovascular diseases prevention and control Geneva: World Health Organization; 2011.
World Health Organization. Guideline: Sodium intake for adults and children. Geneva: World Health Organization; 2012.
Brinsden HC, Farrand CE. Reducing salt; preventing stroke. Nutr Bull 2012; 37(1): 57−63.
Brown IJ, Tzoulaki I, Candeias V, Elliott P. Salt intakes around the world: implications for public health. Int J Epidemiol 2009; 38(3): 791−813.
Mattes RD, Donnelly D. Relative contributions of dietary sodium sources. J Am Coll Nutr 1991; 10(4): 383−93.
Sanchez-Castillo CP, Warrender S, Whitehead TP, James WP. An assessment of the sources of dietary salt in a British population. Clin Sci 1987; 72(1): 95−102.
Ministry of Health, Republic of Serbia. Health examination study of the population of Serbia, 2006. Basic results. Belgrade: Ministry of Health, Republic of Serbia; 2007. (Serbian)
Novaković B, Božić D. Diabetes, obesity and hypertension in Vojvodina. Novi Sad: School of Medicine of the University of Novi. Sad; 2004. (Serbian)
National Center for Health Statistics. NHANES 2002 MEC in-person dietary interviewers procedure manual. Available from: http://www.cdc.gov/nchs/data/nhanes/nhanes_01_02/dietary_year_3.pdf. [accessed 2007 November 12].
Szponar L, Wolnicka K, Rychlik E. Album of photographs of food products and dishes. Warszawa , Poland: National Food and Nutrition Institute; 2000. (Polish)
Institute for Medical Research. Serbian food and nutrition database [Internet]. 2007. Available from: http://www.serbianfood.info/.
Food Research Institute. Slovak Food Composition Data Bank (SFCDB): Online food composition database. 2010. [Internet]. [last update 2013 November]. Available from: http://www.pbd-online.sk/en.
Centre for Food Composition Database. On-line Czech Food Composition Database, Version 2. 11 [Internet]. 2012. 2011. Available from: http://www.czfcdb.cz/en/.
Institute of Medicine. Strategies to reduce sodium intake in the United States. Washington, DC: The National Academies Press; 2010.
Moshfegh AJ, Holden JM, Cogswell ME, Kuklina EV, Patel SM, Gunn JP, et al. Vital signs: food categories contributing the most to sodium consumption - United States, 2007-2008. MMWR Morb Mortal Wkly Rep 2012; 61(5): 92−8.
Directorate-General Health and Consumers. Implementation of the EU Salt Reduction Framework. Results of member states survey. Luxembourg: Publications Office of the European Union; 2012.
Ribič CH, Zakotnik JM, Vertnik L, Vegnuti M, Cappuccio FP. Salt intake of the Slovene population assessed by 24 h urinary sodium excretion. Public Health Nutr 2010; 13(11): 1803−9.
Jelaković B, Premužić V, Čvorišćec D, Erceg I, Fuček M, Jelaković A, et al. Salt mapping in Croatia. Croatian Action on Salt and Health (CRASH). Kidney Blood Press Res 2009; 32(5): 323.
Xu J, Wang M, Chen Y, Zhen B, Li J, Luan W, et al. Estimation of salt intake by 24-hour urinary sodium excretion: a cross-sectional study in Yantai, China. BMC Public Health 2014; 14(1): 136.
Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, En-gell RE, et al. Global Sodium Consumption and Death from Cardiovascular Causes. New Engl J Med 2014; 371(7): 624−34.
Hendriksen MA, van Raaij JM, Geleijnse JM, Wilson-van dC, Ocké MC, van der Daphne L. Monitoring salt and iodine intakes in Dutch adults between 2006 and 2010 using 24 h urinary so-dium and iodine excretions. Public Health Nutr 2014; 17(7): 1431−8.
Zhang J, Yan L, Tang J, Ma J, Guo L, Zhao W, et al. Estimating daily salt intake based on 24 h urinary sodium excretion in adults aged 18-69 years in Shandong, China. BMJ Open. 2014; 4(7): e005089.
Intersalt Cooperative Research Group. Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. BMJ 1988; 297(6644): 319−28.
Anderson CA, Appel LJ, Okuda N, Brown IJ, Chan Q, Zhao L, et al. Dietary sources of sodium in China, Japan, the United Kingdom, and the United States, women and men aged 40 to 59 years: the INTERMAP study. J Am Diet Assoc 2010; 110(5): 736−45.
Zhou BF, Stamler J, Dennis B, Moag-Stahlberg A, Okuda N, Robertson C, et al. Nutrient intakes of middle-aged men and women in China, Japan, United Kingdom, and United States in the late 1990s: the INTERMAP study. J Hum Hypertens 2003; 17(9): 623−30.
Trajković-Pavlović LJ, Novaković B, Dragnić NR, Torović LJ. Salt content in meals of boarding schools and students' restaurants in Novi Sad. HealthMed 2010; 4(1): 45−51.
Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev 2012; 70(1): 3−21.
European Commission. Collated information on salt re-duction in the EU (draft). 2008. Available from: ec.europa.eu/health/.../compilation_salt_en.pdf
Keogh JB, Lange K, Hogarth R, Clifton PM. Foods contributing to sodium intake and urinary sodium excretion in a group of Australian women. Public Health Nutr 2013; 16(10): 1837−42.
Mugavero K, Losby JL, Gunn JP, Levings JL, Lane RI. Reducing Sodium Intake at the Community Level: The Sodium Reduc-tion in Communities Program. Prev Chronic Dis 2012; 9: 120081.
European Commission. EU framework for national salt initia-tives. 2012. Available from: http://ec.europa.eu/health/archive/ph_determinants/life_style/nutrition/documents/salt_initiiniti.pdf.
Jelaković B, Kaić-Rak A, Milicić D, Premuzić V, Skupnjak B, Reiner Z. Less salt-more health. Croatian action on salt and health (CRASH). Lijec Vjesn 2009; 131(3−4): 87−92. (Croatian)
National programme for prevention, medical treatment and control of cardiovascular diseases in Serbia until 2020. Official Gazette of the Republic of Serbia 2010; 5(110): 1266.