Mismatch between self-perceived and measured salt intake: implications for population salt reduction strategies

Background: Excessive salt intake is a major modifiable risk factor of cardiovascular disease and contributes substantially to the global disease burden. Assessing individuals' perception of their salt intake is essential for designing effective reduction strategies. This study aimed to assess the association between self-perceived and estimated salt intake in a sample of workers from one public university. Methods: This cross-sectional study included 107 participants (51.4% women, mean age 47 ± 10 years) from the iMC Salt trial. Self-perceived salt consumption was assessed using the WHO STEPS questionnaire. Salt intake was estimated through 24-hour urinary sodium excretion. Factors associated with perception were analyzed using ordinal logistic regression models. The results are expressed as cumulative odds ratio (OR) and respective 95% confidence intervals (CIs). Results: A total of 78.5% of participants exceeded the recommended daily sodium intake. Mean urinary sodium excretion was higher in men than in women (3862 mg/day vs. 2614 mg/day, P < .001). Most participants perceived their intake as “just the right amount” (43%). The correlation between perceived and estimated salt intake was weak and not statistically significant (ρ = 0.117, P = .229). In multivariable analysis, lower education level (OR = 6.17, 95% CI: 1.52–25.06) and absence of hypertension (OR = 0.38, 95% CI: 0.15–0.96) were associated with a higher likelihood of perceiving salt consumption as low. Conclusion: These findings suggest a mismatch between perceived and estimated salt intake. Lower education and nonhypertensive status were associated with perceiving salt intake as low. Because salt intake perception may influence eating behavior, strategies to improve awareness and better align perception with intake are warranted.