Why the study?
Using spot urine samples with estimating equations to assess sodium intake has large random and systematic error, leading to spurious health outcome associations and substantial controversy from false claims of validity.
This policy statement establishes that spot urine samples with estimating equations are invalid for assessing individual sodium intake and should not be used in research.
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Clinicians and researchers must abandon spot urine sodium estimates; this guideline invalidates prior spurious associations and mandates validated methods.
Spot urine samples with estimating equations have been used to assess individuals' sodium (salt) intake in association with health outcomes. There is large random and systematic error in estimating sodium intake using this method and spurious health outcome associations. Substantial controversy has resulted from false claims the method is valid. Hence, the World Hypertension League, International Society of Hypertension and Resolve to Save Lives, supported by 21 other health organizations, have issued this policy statement that strongly recommends that research using spot urine samples with estimating equations to assess individuals' sodium (salt) intake in association with health outcomes should not be conducted, funded or published. Literature reviews on the health impacts of reducing dietary sodium that include studies that have used spot and short duration timed urine samples with estimating equations need to explicitly acknowledge that the method is not recommended to be used and is associated with spurious health outcome associations.
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Campbell et al. (2023) studied Dietary sodium intake assessment. Spot urine samples with estimating equations vs. Multiple 24-hour urine samples was evaluated. The World Hypertension League and other organizations strongly recommend against using spot urine samples with estimating equations to assess individual sodium intake due to large errors and spurious health outcome associations.
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