May 14, 2015Annual Review of Nutrition142 citationsOpen Access
Use of Urine Biomarkers to Assess Sodium Intake: Challenges and Opportunities
Key Result
A review of 29 studies on population sodium intake and 13 prospective cohort studies supports the continued use of 24-h urine collections for assessing sodium intake despite logistic challenges.
Structured PICO
What are the current approaches and challenges in using urine biomarkers to assess sodium intake?
P
Population
Individuals and populations assessed for sodium intake
E
Exposure
Urine biomarkers (24-h urine collections, spot/casual, overnight, or 12-h specimens) to estimate sodium intake
O
Outcome
Accuracy and utility of estimating population and individual sodium intake
This review reinforces 24-hour urine collection as the standard for assessing sodium intake in research, while highlighting the need for alternative modeling approaches due to logistical barriers.
Limitations
- Logistic challenges of 24-h urine collection remain a barrier for research on the relationship of sodium intake and chronic disease.
Abstract
This article summarizes current data and approaches to assess sodium intake in individuals and populations. A review of the literature on sodium excretion and intake estimation supports the continued use of 24-h urine collections for assessing population and individual sodium intake. Since 2000, 29 studies used urine biomarkers to estimate population sodium intake, primarily among adults. More than half used 24-h urine; the rest used a spot/casual, overnight, or 12-h specimen. Associations between individual sodium intake and health outcomes were investigated in 13 prospective cohort studies published since 2000. Only three included an indicator of long-term individual sodium intake, i.e., multiple 24-h urine specimens collected several days apart. Although not insurmountable, logistic challenges of 24-h urine collection remain a barrier for research on the relationship of sodium intake and chronic disease. Newer approaches, including modeling based on shorter collections, offer promise for estimating population sodium intake in some groups.