Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Assessing Sodium Intake in Middle-Aged and Older Adults with Elevated Blood Pressure: Validation of Spot Urine Excretion and Dietary Surveys Derived Estimates

Yee Chang Soh
ORCID logo ,
Andrea Fairley
,
Mawada Alawad
,
Siew Siew Lee
,
Tin Tin Su
ORCID logo ,
Blossom Christa Maree Stephan
,
Daniel Reidpath
,
Louise Robinson
,
Shajahan Yasin
,
Mario Siervo
,
Devi Mohan
* ORCID logo
Version 1 : Received: 16 February 2024 / Approved: 16 February 2024 / Online: 16 February 2024 (11:00:52 CET)

How to cite: Soh, Y.C.; Fairley, A.; Alawad, M.; Lee, S.S.; Su, T.T.; Stephan, B.C.M.; Reidpath, D.; Robinson, L.; Yasin, S.; Siervo, M.; Mohan, D. Assessing Sodium Intake in Middle-Aged and Older Adults with Elevated Blood Pressure: Validation of Spot Urine Excretion and Dietary Surveys Derived Estimates. Preprints 2024, 2024020895. https://doi.org/10.20944/preprints202402.0895.v1 Soh, Y.C.; Fairley, A.; Alawad, M.; Lee, S.S.; Su, T.T.; Stephan, B.C.M.; Reidpath, D.; Robinson, L.; Yasin, S.; Siervo, M.; Mohan, D. Assessing Sodium Intake in Middle-Aged and Older Adults with Elevated Blood Pressure: Validation of Spot Urine Excretion and Dietary Surveys Derived Estimates. Preprints 2024, 2024020895. https://doi.org/10.20944/preprints202402.0895.v1

Abstract

This cross-sectional study evaluated the validity of three alternative methods compared to the gold standard 24-h urine collection for estimating dietary sodium intake, a modifiable risk factor for hypertension, among middle-aged and older adults with elevated blood pressure. These included spot urine collection (using Kawasaki, Tanaka, and INTERSALT equations), 24-h dietary recall, and food frequency questionnaire responses, compared against 24-h urine collection in a subset of 65 participants (aged 50–75 years, 58.5 % women, 61.6 % hypertensive) from the DePEC-Nutrition trial. The validity of the methods was assessed using bias, Spearman correlation coefficient (SCC), intraclass correlation coefficient (ICC), and Bland-Altman analysis. Among the alternative methods, spot urine collection using the Kawasaki equation showed the strongest correlation (SCC 0.238; ICC 0.119, 95 % CI -0.079 to 0.323) but it exhibited a significant bias (1414 mg/day, p-value < 0.001) relative to 24-h urine collection. Conversely, dietary surveys had a smaller bias but wider limits of agreement. These findings underscore the complexities of accurately estimating dietary sodium intake using spot urine collection or dietary surveys in this specific population, suggesting that a combination or refinement of existing methodologies might improve accuracy. Further research with larger samples is necessary to develop more reliable methods for assessing sodium intake in this high-risk group.

Keywords

sodium intake assessment; 24-h urine; spot urine; 24-h dietary recall; food frequency questionnaire; elevated blood pressure; hypertension

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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