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Epidemiology
Original research
National survey to estimate sodium and potassium intake and knowledge attitudes and behaviours towards salt consumption of adults in the Sultanate of Oman
  1. Adhra Al-Mawali1,2,
  2. Lanfranco D'Elia3,4,
  3. Sathish Kumar Jayapal1,
  4. Magdi Morsi1,
  5. Waleed Nasser Al-Shekaili1,
  6. Avinash D Pinto1,
  7. Hilal Al-Kharusi1,
  8. Zainab Al-Balushi1,
  9. John Idikula1,
  10. Ayaman Al-Harrasi1,
  11. Francesco P Cappuccio3,5,6
  1. 1Centre of Studies & Research, Ministry of Health, Muscat, Oman
  2. 2The Research Council, Seeb, Oman
  3. 3WHO Collaborating Centre for Nutrition, University of Warwick, Coventry, UK
  4. 4Department of Clinical Medicine and Surgery, “Federico II” University of Naples Medical School, Naples, Italy
  5. 5Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
  6. 6Division of Medicine, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
  1. Correspondence to Professor Francesco P Cappuccio; f.p.cappuccio{at}warwick.ac.uk

Abstract

Objectives To estimate population sodium and potassium intakes and explore knowledge, attitudes and behaviour (KAB) towards the use of salt in adults in the Sultanate of Oman.

Design National cross-sectional population-based survey.

Setting Proportional random samples, representative of Omani adults (18 years or older), were obtained from all governorates of the Sultanate of Oman.

Participants Five hundred and sixty-nine (193 men, 376 women; 18 years or older) were included in the analysis (response rate 57%). Mean age was 39.4 years (SD 13.1). Participants attended a screening including demographic, anthropometric and physical measurements.

Primary and secondary outcome measures We assessed dietary sodium, potassium and creatinine by 24-hour urinary sodium (UNa), potassium (UK) and creatinine (UCr) excretions. We collected KAB by a questionnaire on an electronic tablet.

Results Mean UNa was 144.3 (78.8) mmol/day, equivalent to 9.0 g of salt/day and potassium excretion 52.6 (32.6) mmol/day, equivalent to 2.36 g/day, after adjusting for non-urinary losses. Men ate significantly more sodium and potassium than women. Only 22% of the sample had a salt intake below the WHO recommended target of 5 g/day and less than 10% met WHO targets for potassium excretion (>90 mmol/day). While 89.1% of those interviewed knew that consuming too much salt could cause serious health problems and only 6.9% felt they were using too much added salt, one in two participants used always or often salt, salty seasonings or salty sauces in cooking or when preparing food at home.

Conclusions In the Sultanate of Oman, salt consumption is higher and potassium consumption lower than recommended by WHO, both in men and in women. The present data provide, for the first time, evidence to support a national programme of population salt reduction to prevent the increasing burden of cardiovascular disease in the area.

  • epidemiology
  • nutrition & dietetics
  • public health
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjopen-2020-037012

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    Supplementary materials

    Footnotes

    • Contributors FPC developed the study design and protocol, contributed to the analysis and drafted the manuscript, AA-M trained local teams, coordinated quality control and data collection. MM and LD carried out quality control and statistical analysis. AA-M, SKJ, WNA-S, ADP, HA-K, ZA-B, JI, AA-H coordinated the study, carried out the fieldwork and liaised with the local laboratory. MM helped with the drawing of the stratified random sample from the sampling frame. All authors contributed to the interpretation of the findings and they contributed significantly to the final version of the manuscript. FPC is the guarantor.

    • Funding The Ministry of Health of the Sultanate of Oman and the EMRO Regional Office of the World Health Organization supported the study.

    • Competing interests AA-M, SKJ, MM, WNA-S, ADP, HA-K, ZA-B, JI, AA-H are all staff of the Ministry of Health of the Sultanate of Oman. FPC is a technical advisor to the World Health Organization, unpaid member of Action on Salt and WASH. LD was a technical advisor to the World Health Organization and is a member of the Scientific Committee of the Italian Society of Human Nutrition.

    • Patient consent for publication Not required.

    • Ethics approval We obtained ethical approval for the survey from the Research and Ethics Review and Approval Committee (RERAC) of the Ministry of Health of the Sultanate of Oman and participants provided written informed consent to take part.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. No individual participant data will be available. Study protocol available in Supplementary Material. Any other data sharing proposal must be submitted in writing to the Ministry of Health of the Sultanate of Oman.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.