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Sodium and potassium intakes in the Kazakhstan population estimated using 24-h urinary excretion: evidence for national action

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Abstract

Purpose

There is strong scientific evidence for reducing sodium and increasing potassium intake to the recommended levels to lower blood pressure and cardiovascular risk, but consumption levels in Kazakhstan are unknown. This study sought to estimate mean sodium and potassium intake using 24-h urine samples and describe dietary knowledge and behavior among adults in Kazakhstan.

Methods

In two cross-sectional surveys, the same multi-stage cluster sampling method was used to randomly select participants aged 25–64 years from Almaty City in 2015 and Kyzylorda in 2016. Complete 24-h urine samples were available for 478 participants; 294 in Almaty City and 184 in Kyzylorda (response rates 86% and 54%, respectively) and were weighted for the age and sex distribution of the two regions.

Results

Weighted mean 24-h urinary sodium excretion was 6782 mg/day (17.2 g salt) (95% CI 6507–7058) in both regions combined, and not significantly different between the regions (P = 0.660). 99% of adults in the two regions combined consumed above the World Health Organization’s (WHO) recommended sodium maximum of 2000 mg/day; however, only 15% of adults perceived that they consumed excess sodium. Weighted mean 24-h urinary potassium excretion was 2271 mg/day (95% CI 2151–2391) for the regions combined.

Conclusion

Mean sodium consumption in Kazakhstan was more than triple the WHO’s recommended maximum, and mean potassium consumption was below the recommended minimum. National efforts to lower sodium intake and increase potassium intake are needed and would likely prevent ample premature deaths and disease burden.

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Acknowledgements

The authors wish to thank Oksana Dolmatova, Arailym Beisbekova and Marzhan Adlet for participation in for data collection and field work, and the participants for their support and interest in partaking in the survey.

Funding

KT is supported by an Early Career Fellowship (APP1161597) from the National Health and Medical Research Council of Australia (NHMRC) and a Postdoctoral Fellowship (Award ID 102140) from the National Heart Foundation of Australia. FO and ST were supported by Kazakh Academy of Nutrition from the grant of the Ministry of Education and Science, Republic of Kazakhstan. JAS is supported by the NHMRC Postgraduate Scholarship (#1168948). JW is supported by a National Heart Foundation Future Leaders Fellowship (#102039). KT, JAS and JW are part of the NHMRC Center for Research Excellence on food policy interventions to reduce salt (#1117300).

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Authors and Affiliations

  1. The George Institute for Global Health, University of New South Wales, Level 5, 1 King St. Newtown, Sydney, NSW, 2042, Australia

    Kathy Trieu, Joseph Alvin Santos & Jacqui Webster

  2. Kazakh Academy of Nutrition, Almaty, Kazakhstan

    Feruza Ospanova & Shamil Tazhibayev

  3. World Health Organization Regional Office for Europe, Copenhagen, Denmark

    Jo Jewell & Joao Breda

Authors
  1. Kathy Trieu
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  2. Feruza Ospanova
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  3. Shamil Tazhibayev
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  4. Jo Jewell
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  6. Joseph Alvin Santos
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  7. Jacqui Webster
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Contributions

FO and ST designed and conducted the research; JJ and JB provided essential materials; KT and JAS analysed the data, KT and JW wrote the paper; KT had primary responsibility for final content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kathy Trieu.

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Conflicts of interest

JW is Director of the WHO Collaborating Centre on Population Salt Reduction. The co-authors Jo Jewell and Joao Breda were staff members of the WHO Regional Office for Europe at the time of the study. The authors are responsible for the views expressed in this publication and they do not necessarily represent the decisions or stated policy of WHO. All other authors declare that they have no other competing interests related to this review.

Ethics approval

The project received ethical approval by the Kazakh Academy of Nutrition Ethics Committee (Project #2524/ГФ4).

Informed consent

Each participant was briefed on the project and provided written informed consent.

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Trieu, K., Ospanova, F., Tazhibayev, S. et al. Sodium and potassium intakes in the Kazakhstan population estimated using 24-h urinary excretion: evidence for national action. Eur J Nutr 60, 1537–1546 (2021). https://doi.org/10.1007/s00394-020-02354-6

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  • DOI: https://doi.org/10.1007/s00394-020-02354-6

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