Didier Garriguet

1
Current sodium intake of Canadians

• Didier Garriguet
• Health Information and Research Division
  (Statistics Canada)
• May 31th, 2008

2
How high are sodium intakes?

• Trust no one unless you have eaten much salt
  with him.
• Cicero (106-43 BC)

3
Background

• Most sodium intake (90) comes from sodium
  chloride (NaCl, table salt)
• There is 1 mg of sodium in 2.5 mg of salt
• Main sources (Mattes 1991)
• Processed food 77
• Naturally occuring 12
• Added to cooking 6
• Added at table 5

4
Minimum and maximum requirements

• Sodium is required to maintain extracellular
  volume and plasma osmolality (IOM, 2004)
• IOM established Adequate Intakes (AI)

Sodium Adequate Intakes
Adequate intake is the recommended average daily
intake of a nutrient, based on observation,
testing or approximate estimates of the
nutritional intake of one or more groups of
apparently healthy people who appear to maintain
an adequate level of nutrition.
5
Minimum and maximum requirements

• Increase sodium intake ? high blood pressure
• IOM established Tolerable upper intake level (UL)

Sodium Tolerable Upper Intake Level
Tolerable upper intake level represents the
highest continuous daily intake of a nutrient
that does not appear to carry risks of adverse
health effects in most members of a given group,
defined by stage of life and sex. The risk of
adverse effects increases as intake exceeds the
UL.
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Data source

• 2004 Canadian Community Health Survey (CCHS) 2.2
  Nutrition
• Based on 24-hour recall
• Collected through a modified Automated Multiple
  Pass Method (AMPM) to maximize recall
• Sodium content derived from Canadian Nutrient
  File (CNF) 2001b, Supplement

7
Data source

• 35,000 respondents (first recall) with 10,000
  second recalls.
• Sodium intake from food and beverages only
• Questions on salt addition while cooking or at
  table (never, rarely, occasionally, very often)
• Excludes invalid or null intakes, breastfed
  children, children less than 1
• Bootstrap used for variance calculation

8
Average daily sodium intake (mg), by age group
and sex, household population aged 1 or older,
Canada excluding territories, 2004
UL
Note Excludes salt added at table or while
cooking
Source 2004 Canadian Community Health Survey -
Nutrition
9
Daily intake vs usual intake

• Daily intake varies between people and between
  days for the same person
• Usual intake represents typical long-term
  consumption in the population
• Need to remove day-to-day variation in an
  individual
• Software for Intake Distribution Estimation
  (SIDE) from Iowa State University was used to do
  so
• Using both recalls
• Adjusted for day of the week
• NOTE daily average for day 1 usual intake
  average

10
Daily intake vs usual intake
UL
11
Percentage of people with usual sodium intake
above the UL, by age group and sex, household
population aged 1 or older, Canada excluding
territories, 2004
Significantly different from estimate for
preceding age group of same sex (Plt0.05)
Significantly different from estimate for males
in same age group (Plt0.05)
Note Excludes salt added at table or while
cooking
Source 2004 Canadian Community Health Survey -
Nutrition
12
Percentage of people who never add salt to food
at the table, by age group and sex, household
population aged 1 or older, Canada excluding
territories, 2004
Significantly different from estimate for
preceding category (Plt0.05)
Source 2004 Canadian Community Health Survey -
Nutrition
13
Percentage of people who reported adding salt to
food at the table, by frequency and high blood
pressure status, household population aged 31 or
older, Canada excluding territories, 2004

Diagnosed with high blood pressure



Significantly different from estimate for no
diagnosed of high blood pressure (Plt0.05)
Source 2004 Canadian Community Health Survey -
Nutrition
14
Percentage of people who reported adding salt to
food at the table, by frequency and high blood
pressure status, household population aged 31 or
older, Canada excluding territories, 2004
Diagnosed with high blood pressure
Sodium intake (mg)
Source 2004 Canadian Community Health Survey -
Nutrition
15
Average daily sodium intake (mg), by frequency of
salt added at the table, household population
aged 1 or older, Canada excluding territories,
2004


Sodium intake (mg)
Significantly different from estimate for
preceding category (Plt0.05)
Note Excludes salt added at table or while
cooking
Source 2004 Canadian Community Health Survey -
Nutrition
16
Average daily sodium intake (mg), by province,
household population aged 1 or older, Canada
excluding territories, 2004

Canada (3,092 mg)


Significantly different from estimate for Canada
(Plt0.05)
Note Excludes salt added at table or while
cooking
Source 2004 Canadian Community Health Survey -
Nutrition
17
10 main sources of sodium

• Top 10 accounts for 55 of total sodium intake
• Combination of food popularity and sodium content

18
Average daily sodium intake (mg), by province,
household population aged 1 or older, Canada
excluding territories, 2004

Canada (3,092 mg)
Québec 258 mg Soups 66
mg Cheese 51 mg Pasta 49
mg White bread 60 mg


Significantly different from estimate for Canada
(Plt0.05)
Note Excludes salt added at table or while
cooking
Source 2004 Canadian Community Health Survey -
Nutrition
19
Average daily sodium intake (mg), by province,
household population aged 1 or older, Canada
excluding territories, 2004

B.C. 208 mg Soups 88
mg Sandwich category 54 mg Fish
shellfish 26 mg Legumes 23 mg
Canada (3,092 mg)


Significantly different from estimate for Canada
(Plt0.05)
Note Excludes salt added at table or while
cooking
Source 2004 Canadian Community Health Survey -
Nutrition
20
Average daily sodium intake (mg), by province,
household population aged 1 or older, Canada
excluding territories, 2004

Canada (3,092 mg)
Ontario (- 228) mg Soups (-
53) mg Sandwich category (- 28) mg


Significantly different from estimate for Canada
(Plt0.05)
Note Excludes salt added at table or while
cooking
Source 2004 Canadian Community Health Survey -
Nutrition
21
Protective factors

• Very active people loose more sodium (via
  perspiration)
• However there is no difference in sodium intake
  by leisure time physical activity level
• High potassium intake lowers blood pressure
• However average potassium intake are well below
  the Adequate Intake of potassium

22
Conclusion

• Sodium intakes are high
• Even among people trying to reduce their salt
  intake
• Young children
• People with high blood pressure
• People never adding salt at table
• Quebec, BC and Ontario stand out
• Soups and the sandwich category (top 2 sources of
  sodium) account for these differences

23
Contact information
Didier Garriguet Health Information and
Research Division (Statistics Canada) E-mail
didier.garriguet_at_statcan.ca
Thank you
24
Average daily sodium intake (mg), by age group
and sex, Canada excluding territories, 2004 and
United States, 2001-2002
Significantly different from estimate for United
States (Plt0.05)
Note Excludes salt added at table or while
cooking
Source 2004 Canadian Community Health Survey -
Nutrition