Salt intake among Iranian population: national and subnational report from STEPS 2021

High salt intake is a major risk factor for non-communicable diseases, resulting in numerous deaths and disability-adjusted life-years worldwide. The study aimed to analyze data from a 2021 nationwide survey of 25,202 Iranian adults, investigating daily salt intake. Participants were randomly chosen by a systematic proportional size cluster sampling. All of them completed questionnaires and their anthropometric and physical measurements were taken. Using Tanaka method and necessary equations, spot urine samples were taken to estimate 24-hour urine sodium and evaluate daily sodium intake in grams. The mean amount of salt intake was 9.71g (95% CI: 9.66–9.76) in 2021. Furthermore, 98.0% of participants consumed more than 5g of salt daily. Salt intake in men was higher than in women (9.95g (95% CI: 9.87–10.3) vs 9.51g (9.44–9.58) daily. Rural areas’ residents and people with lower years of schooling consumed higher levels of salt per day, 10.02g (9.96–10.07) and 9.99g (9.88–10.1), respectively. Mean salt consumption in married people was higher than in single individuals by 0.37g per day. Salt consumption was higher in obese participants in comparison to people with normal BMI (10.16g (10.06–10.26) vs 8.72g (8.43–9.01)). The risk of high salt consumption was significantly lower in hypertensive participants than normotensive ones (adjusted OR = 0.467, 95% CI: 0.345–0.631), as well as being aware of hypertension in hypertensive patients (adjusted OR = 0.338, 95% CI: 0.190–0.603). Iranians’ salt intake was nearly double the WHO-recommendation. Approved effective interventions must be considered to lower salt consumption in Iran like food labeling, educating people, and using salt substitutes.