Dietary Sources of Sodium in Nigerian Adults From 3 Geographic Regions: A Population-Based Cross-Sectional Study

Background To address the growing burden of hypertension and related diseases, Nigeria seeks to reduce excess dietary sodium through policymaking. The current study aims to describe the levels and sources of dietary sodium intake among Nigerian adults to inform targeted policies for reducing sodium intake. Methods From June 2023 to July 2023, adults aged 18 to 70 years old were recruited from the Federal Capital Territory, Kano States, and Ogun States to participate in a population-based, cross-sectional non-communicable diseases survey. Data were also collected to assess levels and dietary sources of sodium through four 24-hour dietary recalls by trained study personnel with 90.7% response rate. Concurrent 24-hour urine sodium data were collected. The primary analyses included the distribution of sodium intake and sources of sodium, overall and by sex and state. Results were adjusted to the Nigerian population. Multivariate regression models evaluated associations between baseline sociodemographic factors and sodium intake. Results Among 537 participants, 365 (68.0%) were female, and median (Interquartile range) age was 38 (27, 48) years. Adjusted median (IQR) daily sodium intake according to 24-hour dietary recalls was 3,803 (2,663, 5,085) mg per day with higher intake reported among males (males: 3,878 [2,663, 5,032] mg/dl; females: 3,415 [2,373, 4,689], p<.0001). Two-thirds (67.0%) of the sodium intake was from home-cooked meals. Nearly half (48.7%) of sodium came from discretionary sources, including 21.4% from bouillon. Salt and yaji spice added at the table accounted for 9.1% of sodium intake and was highest among females (18.8%) and males (13.7%) in Kano. On the other hand, sodium from street food was highest in males (35.9%) and females (34.2%) in Ogun. After adjustment, older participants and those with higher education had lower daily sodium intake compared to younger participants and those with less education, respectively. Results were similar when excluding individuals with cardiovascular disease or hypertension. Conclusions Adults in the Federal Capital Territory, Kano, and Ogun consume nearly twice the recommended level of dietary sodium. Most dietary sodium intake came from home cooked foods, nearly half of which came from discretionary sources, which has important policy implications for SHAKE package implementation. Registration number: NCT04765865