Brief Office Sodium Screener: Assessing Sodium Intake from High Sodium Foods in the Outpatient Setting

Excessive dietary sodium intake contributes to approximately five million deaths annually, mainly due to its association with hypertension and cardiovascular disease. However, healthcare providers have no practicable method to estimate the dietary intake of their patients.

We conceived and developed the Brief Office Sodium Screener (BOSS), a self-administered survey to be completed in three minutes. Using data from the National Health and Nutrition Examination Survey and U.S. Department of Agriculture Food Data Central, high sodium foods (those with ≥300 mg/serving) were compiled into a 30-item survey assessing both frequency and serving size. Automated scoring utilizes the median sodium content per serving, and the report estimates total sodium (mg/day) from high salt sources and the top three contributing items. From September 2023 to August 2024, patients at a tertiary hypertension clinic completed the BOSS and queries about the survey's usability and perceived accuracy during rooming.

We included 131 patients; 43% were male, mean age 61 years, range 27-91), and 81% self-identified as white race. The median estimated sodium intake from high sodium foods was 1,699 mg/day (range 0-7,901 mg/day). Top sodium sources were poultry dishes, bread, pasta, and cheese. Among 118 patients who provided feedback, 85% found the BOSS easy to use, 96% felt it was somewhat, moderately or very accurate.

The study provides evidence that the BOSS questionnaire is usable and efficient in estimating excessive sodium consumption during outpatient encounters.