A Systematic Review and Meta-analysis on the Salt and Sodium Intake in India

Summary Background: In India, estimates of salt intake vary widely due to cultural and regional dietary patterns, and an updated comprehensive synthesis was lacking. Objective: The objective of this study is to estimate the pooled mean salt and sodium intake and the prevalence of high salt intake across diverse Indian populations, and to explore regional, demographic, and temporal variations. Data Sources: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Embase until December 2, 2024, following PROSPERO registration (CRD42024618201). Methods: Studies reporting mean salt or sodium intake or the prevalence of excess intake were included in the study. A random-effects meta-analysis was conducted, and heterogeneity was assessed using the I² statistic. Subgroup analyses were performed by region, locality, sex, hypertension status, and study year. Results: Eighty-three studies were included in the study. The pooled mean salt intake from 30 studies was 9.01 g/day (95% confidence interval [CI]: 8.23–9.79), whereas the mean sodium intake from 23 studies was 3.49 g/day (95% CI: 2.72–4.25), both exceeding the World Health Organization-recommended limits. The pooled prevalence of high salt intake was 61% (95% CI: 48%–73%), with wide variation by intake definition. Subgroup analyses showed higher intake in rural populations, males, and hypertensive individuals. Conclusion: Salt and sodium intake in India remains significantly above recommended levels, with considerable variability across regions and populations.