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The Presence of Dietary Sodium Deficiency in Europe

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Dietary sodium deficiency in the healthy European population is rare, with Ireland having a trend of high intakes. In 2011, the average daily sodium intake for 18-64 year olds in Ireland was 2.96g (7.4g salt)3. According to the FSAI, this figure had increased to nearly 4.0g (10g salt) in adults by 20162. There is a severe gender difference with regarding intakes, 86% of men and 67% of women are consuming levels greater than the recommended amount4. Mean sodium intakes in men are significantly higher at 3.4g/day than women at 2.48g/day3. Adults in the 65+ population have a lower intake than those in younger categories, however, males still consume amounts greater than recommended (2.9g/day)3. Salt intake in children is also a concern, however extensive data is lacking in this area. A study of 1075 school children in Cork found that over half participants were consuming amounts above 2.0g/day5.

The food group meat, fish and in particular processed meats, provide nearly 30% of total sodium intake in Ireland, while bread and rolls contribute another 26%. Foods such as soups, sauces and confectionery are estimated to provide the remaining sodium intake. Discretionary salt added while cooking or serving is estimated to provide 15-20% of the total dietary sodium intake6.

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Despite the knowledge that sodium intakes in Ireland are greater than recommended, there are limitations associated with intake-measuring methods and biomarker detection7. Sodium intake is poorly measured in population-based epidemiological studies, resulting in inaccurate estimates8. 24 hour urine collections are currently considered the gold standard method of monitoring population sodium intake9. However, 24 hour urine collections are associated with a high participant burden, which highlights the issues with sodium intake monitoring, often reflected in the poor response rate for studies7. The issue with participation can then affect sample size and population bias. The European Food Safety Authority (EFSA) report that multiple collections and quality control procedures are often required to reliably estimate individual sodium intake1. Consequently, they encountered challenges when deriving a dietary reference intake (DRV) for sodium due to the lack of an appropriate biomarker1. This is an issue as incomplete collections due to cohort burden are common and can also contribute to bias in determining intake. Food frequency questionnaires and 24 hour dietary recalls can measure dietary sodium intake but are subject to under reporting and bias, limiting true nutritional assessment10. Sodium excretion tends to be greater in males than in females, and lower in the elderly, which may also affect accuracy of concentrations11. Inaccurate dietary assessment can prove to be a serious obstacle of understanding the impact of dietary factors on health and disease. Given these difficulties in assessing the sodium status of the Irish population.

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