Dietary Salt Intake in a Suburban Nepali Community: A Cross-sectional Study Using 24-Hour Urinary Sodium

Background High dietary salt intake is a recognized contributor to hypertension and cardiovascular diseases, particularly in low- and middle-income countries. Despite the high burden of hypertension in Nepal, robust estimates of salt intake using the gold standard 24- hour urinary sodium collection remain scarce, especially in suburban populations. Objective To accurately assess dietary salt intake using 24-hour urinary sodium excretion and evaluate factors influencing salt consumption in a suburban Nepali population. Method A cross-sectional study was conducted in 2023-2024 as part of the Dhulikhel Heart Study's second phase. A total of 381 adult participants were recruited from randomly selected wards of Dhulikhel Municipality. Data on sociodemographic characteristics, dietary habits, salt-related knowledge, and anthropometry were collected. Salt intake was estimated from 24-hour urinary sodium excretion. Generalized Estimating Equations (GEE) and multivariate analyses were used to identify associated factors. Result The mean age of the participants was 49.9 ± 15.5 years and average salt consumption was 9.55 ± 3.2 g/day. The mean dietary salt intake significantly exceeded WHO recommendations, with notable variations by sex, education, and frequency of eating out. Conclusion This study highlights alarmingly high salt intake in a suburban Nepali community and underscores the need for population-specific strategies to reduce sodium consumption. Policy action, public education, and promotion of healthier dietary behaviors are essential to combat the growing burden of salt-related noncommunicable diseases.