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Salt intake among adults in Kuwait: a nationally representative study using 24-hour urinary sodium excretion
Journal article   Open access   Peer reviewed

Salt intake among adults in Kuwait: a nationally representative study using 24-hour urinary sodium excretion

Dana AlTarrah, Joseph Craig Longenecker, Wajd AlOthman, Ebaa Al Ozairi, Jaakko Tuomilehto, Rihab AlWotayan and Nawal AlHamad
BMC public health, v 26(1), Forthcoming
24 Apr 2026
DOI: https://doi.org/10.1186/s12889-026-27506-x
PMID: 42026574
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https://doi.org/10.1186/s12889-026-27506-xView
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Abstract

Body Mass Index Sodium Consumption Salt Intake 24-Hour Urine Collection Public Health Nutrition Cardiovascular Disease Hypertension Kuwait
<p>Background Excess dietary salt (NaCl) intake is a major modifiable risk factor for hypertension and cardiovascular disease. 24-hour urine collection (24-hUC) is the gold standard for accurately estimating population-level salt consumption. This study aimed to assess salt intake using 24-hUC among adults in Kuwait, with the goal of informing public health policy and guiding intervention strategies for reducing excess salt intake. Methods This cross-sectional study enrolled 531 randomly selected Kuwaiti adults, of whom 308 (58.0%) provided adequate 24-hUCs.Trained data collectors conducted face-to-face interviews, physical examinations and blood draws at Ministry of Health primary healthcare centers. Participants first collected a spot sample during a first void, discarding any remaining urine, followed by collection of all urine over the subsequent 24 h. Sampling weights based on six age-sex strata were applied to generate nationally representative estimates from the adult Kuwaiti population. Primary analyses were restricted to participants who provided adequate 24-hUC specimens. Results The mean age of participants was 49.0 +/- 11.6 years, and 62.0% were women.The weighted mean salt intake (NaCl, g/day [95% confidence interval]) was 7.5 [6.9, 8.0].The weighted prevalence of high salt intake exceeding 5 g/d was 73.8% [67.2, 79.5], and 19.9% [14.5, 26.6] exceeded 10 g/d. The weighted mean salt intake was higher among men (8.2 g/d) than women (6.8 g/d; p = 0.01).The prevalence of severely elevated salt intake (> 10 g/d) was also higher in men (27.8%) compared with women (13.1%) (p = 0.04). However, prevalence of moderately elevated salt intake (> 5-9.9 g/d) did not differ significantly by sex. In unadjusted analysis, none of the weighted measures of salt intake were associated with age. After adjustment, men consumed more salt than women (adjusted mean difference 1.4 g/d; 0.006), and the odds of severely elevated salt intake (> 10 g/d) was significantly higher in men (AOR = 2.6 [1.3, 5.4]; p = 0.008). Adjusted analyses also revealed a weak inverse association between the weighted mean salt intake and age (ptrend=0.046), and a strong direct association with body mass index (ptrend=0.001). A validation study demonstrated that spot urine collection was not a valid method for estimating habitual salt intake. Conclusions Salt intake is high in Kuwaiti adults, exceeding recommended levels across all subgroups. necessitating targeted efforts to reduce the consumption in this population. Although men and individuals with elevated BMI had significantly higher salt intake, excess consumption was observed throughout the population.Therefore, these findings underscore the need for population-wide strategies to reduce salt intake in Kuwait, alongside targeted interventions for high-risk groups.</p>

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