Participating organizations:
- Project lead: Ivan Eržen (National Institute of Public Health)
- Nutrition institute
- University Medical Centre Ljubljana
Project duration:
1.10.2021 - 30.09.2023
Financing:
Slovenian research agency, Ministry of Health
Purpose: Research shows that inadequate nutrition affects the development of chronic noncommunicable diseases. The cost of treating non-communicable chronic diseases in the population is high. There is convincing evidence (epidemiological, clinical, and animal experiments) of a direct link between salt intake and blood pressure and that current levels of salt intake in the population are a major factor in raising blood pressure. Some population groups have low potassium intake if they eat predominantly highly processed foods, but data on dietary potassium intake are still lacking. Low dietary potassium intake is associated with the management of high blood pressure in individuals, and at the population level, the World Health Organization recommends increasing dietary potassium intake to prevent cardiovascular disease. Adequate iodine intake is provided by most developed countries through the use of iodized table salt. Reducing dietary salt intake could therefore also reduce iodine intake. Therefore, it is very important to monitor iodine intake in the population at the same time as monitoring salt intake.
Methods: Monitoring the concentration of excreted sodium, potassium, and iodine in 24-hour urine will be a cross-sectional study on a nationally representative sample of the adult population of Slovenia, aged 25 to 64 years. The initial sample of the survey will be prepared by the Statistical Office of the Republic of Slovenia on the basis of the set criteria from the central population register. A field research protocol will be developed, including a general questionnaire (socio-demographic data, alcohol/tobacco use, eating habits, physical activity, knowledge/behavior/attitude towards salt, including salt iodization), health questionnaire (health status), implementation of anthropometric measurements, blood pressure, heart rate, and 24-hour urine collection. Field research will be conducted with the help of trained field staff. The subjects' containers with collected 24-hour urine will be delivered to the laboratory and analyzed for sodium, potassium, iodine, and creatinine. The total volume of urine collected will be recorded. Samples that do not meet the inclusion criteria for complete urine collection will be excluded from further processing. Based on the determined amounts of analytes in the 24-hour urine, the daily intake of salt (sodium), potassium, and iodine will be calculated for each subject included. The results of the analyzes will be statistically processed and population-weighted in the following. To estimate the salt content of food supply, we will use data on the composition of foods that were on the market in 2020 from the CLAS database, weigh them in terms of sales, and present them as the availability of salt/sodium in processed food products on the market.
Expected results: Nationally representative data on sodium (salt), potassium, and iodine intake in the adult population of Slovenia, which will be presented as indicators of the implementation of the National Program on Nutrition and Physical Activity for Health 2015-2025 and the public health measure of salt iodization in the Republic of Slovenia. The data will enable monitoring of the effectiveness of measures to reduce salt intake, and increase vegetable intake and iodine supply in the adult population in Slovenia.
