Trends and determinants of discretionary salt use: National Health and Nutrition Examination Survey, 2003-2012

Authors: QUADER, ZERLEEN - Centers For Disease Control And Prevention (CDC) - United States; PATEL, SHEENA - Centers For Disease Control And Prevention (CDC) - United States; GILLESPIE, CATHLEEN - Centers For Disease Control And Prevention (CDC) - United States; COGSWELL, MARY - Centers For Disease Control And Prevention (CDC) - United States; GUNN, JANELLE - Centers For Disease Control And Prevention (CDC) - United States; PERRINE, CRIA - Centers For Disease Control And Prevention (CDC) - United States; MATTES, RICHARD - Purdue University; Moshfegh, Alanna

Submitted to: Public Health Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/16/2016
Publication Date: 8/1/2016
Citation: Quader, Z.S., Patel, S., Gillespie, C., Cogswell, M.E., Gunn, J.P., Perrine, C.G., Mattes, R.D., Moshfegh, A.J. 2016. Trends and determinants of discretionary salt use: National Health and Nutrition Examination Survey 2003-2012. Public Health Nutrition. 19(12):2195-2203. https://doi.org/10.1017/S1368980016000392.
DOI: https://doi.org/10.1017/S1368980016000392

Interpretive Summary: Efforts targeting sodium reduction in the food supply make regular population monitoring of dietary sodium intake and discretionary use of salt in cooking and at the table vital. Average daily sodium intake is estimated to be 3,478 mg with nearly all adolescents and adults consuming sodium in excess of current recommendations, excluding salt added at the table. Discretionary salt is estimated to comprise approximately 11% of dietary sodium intake, with 6% coming from salt added at the table, and 5% added during cooking. With manufacturer reductions in sodium added to foods, some argue that individuals will add salt more frequently at the table or during cooking, decreasing the effectiveness of some sodium reduction strategies. Between 2003 and 2012, this has not been the case. The proportion of the population who reported never using salt at the table was two-thirds and did not change. Whereas, those who reported using it very often declined from 18% to 12% for use at the table and from 42% to 37% during home cooking. Most used salt during home cooking/preparation (97%). Use of discretionary salt was least commonly reported among young children and older adults and demographic and health subgroups at risk of cardiovascular disease. Regardless of the assessment method, current estimates indicate average United States sodium intake remains high.

Technical Abstract: The objective of this study was to examine the recent temporal trends and current determinants of discretionary salt use in the United States. We used data from the National Health and Nutrition Examination Survey (NHANES), 2003-2012. We used multiple logistic regression to assess temporal trends in discretionary salt use at the table and during home cooking/preparation, adjusting for age, sex, and race-ethnicity. We also examined prevalence and determinants of discretionary salt use using NHANES 2009-2012. Between 2003 and 2012, the proportion of the population who reported they “never” used discretionary salt did not change, whereas those who reported using it “very often” declined; from 18% to 12% for use at the table (P<0.01) and from 42% to 37% during home cooking (P<0.02). While two-thirds of the population reported never adding salt at the table, most used it during home cooking/preparation (97%). Use of discretionary salt was least commonly reported among young children and older adults and demographic and health subgroups at risk of cardiovascular disease. While most people reported using some salt during home cooking or preparation, a minority reported use at the table and reported frequent discretionary salt use (“very often”) has declined. Further, discretionary salt use, less common among those at risk of cardiovascular disease, suggests awareness of messages to limit discretionary salt.