Salt intakes and salt reduction initiatives in Southeast Asia: a review

Asia Pac J Clin Nutr. 2013;22(4):490-504. doi: 10.6133/apjcn.2013.22.4.04.

Abstract

Increased dietary sodium intake is a modifiable risk factor for cardiovascular disease. The monitoring of population sodium intake is a key part of any salt reduction intervention. However, the extent and methods used for as-sessment of sodium intake in Southeast Asia is currently unclear. This paper provides a narrative synthesis of the best available evidence regarding levels of sodium intake in six Southeast Asian countries: Indonesia, Malaysia, Philippines, Singapore, Thailand, Vietnam, and describes salt reduction measures being undertaken in these countries. Electronic databases were screened to identify relevant articles for inclusion up to 29 February 2012. Reference lists of included studies and conference proceedings were also examined. Local experts and researchers in nutrition and public health were consulted. Quality of studies was assessed using a modified version of the Downs and Black Checklist. Twenty-five studies fulfilled the inclusion criteria and were included in this review. Full texts of 19 studies including government reports were retrieved, with most studies being of good quality. In-sufficient evidence exists regarding salt intakes in Southeast Asia. Dietary data suggest that sodium intake in most SEA countries exceeded the WHO recommendation of 2 g/day. Studies are needed that estimate sodium intake using the gold standard 24-hour urinary sodium excretion. The greatest proportion of dietary sodium came from added salt and sauces. Data on children were limited. The six countries had salt reduction initiatives that differed in specificity and extent, with greater emphasis on consumer education.

飲食鹽攝取量增加是心血管疾病一個可修飾危險因子。監測族群鈉攝取量是任 何減鹽介入的重要部分。然而,東南亞地區評估鈉攝取的程度及方法目前並不 清楚。此篇文章提供六個東南亞國家關於鈉攝取量的最佳可用證據的統整性描 述:包括印尼、馬來西亞、菲律賓、新加坡、泰國及越南,並描述在這些國家 進行的減鹽措施。篩選電子資料庫以確認至2012 年2 月29 日的相關文章,還 檢視參考文獻中所列的研究及研討會報告。諮詢營養及公共衛生背景的當地專 家及研究學者。使用Downs and Black 檢核表修訂版以評估研究品質。計25 個 研究符合納入標準而被描述於本篇回顧文章中。檢索出有全文的19 個研究, 包括政府報告,大部分的研究具有良好的品質。關於東南亞的鹽攝取量證據仍 不足。飲食資料顯示,大部分的東南亞國家鹽攝取量超過世界衛生組織建議的 每日2 克。極需要使用24 小時尿鈉排泄量當作黃金標準以評估鈉攝取量的研 究。飲食鈉攝取量大部分是來自於外加鹽及醬汁。兒童的數據極有限。這六個 國家著重於消費者教育的減鹽行動,各有不同的特異性及程度。

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Asia, Southeastern
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Child
  • Child, Preschool
  • Diet, Sodium-Restricted* / methods
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Nutrition Policy
  • Recommended Dietary Allowances
  • Sodium, Dietary / administration & dosage*
  • Sodium, Dietary / adverse effects

Substances

  • Sodium, Dietary