(P19-45-26) Factors Associated With Discretionary Salt Intake Among Non-pregnant Adult Females in the Oromia Region of Ethiopia: Cross-Sectional Analysis of Community-Based Trial Data

Objectives: To identify factors associated with discretionary salt intake among non-pregnant adult females (NPAF) in Ethiopia.

Methods: This cross-sectional analysis used data from the intervention phase of a community-based, three-arm, household-randomized trial. Participants received fortified salt containing iodine and one of two levels of folic acid or just iodine bi-weekly for 26 weeks. Participants were NPAF 18–49 years old who were using long-acting contraceptives and planning to stay in the community for ≥ 6 months and use the study salt for all cooking and seasoning. Exclusion criteria were illnesses potentially affecting dietary intake or folate status, medications affecting folate metabolism, and prescribed salt restriction. Dietary intake was assessed using observed weighed food records (WFRs). All NPAF who completed WFRs were included (n=342). The primary outcome was discretionary salt intake, defined as salt added during preparation or at consumption. Preliminary analyses found similar salt intakes by study arm; therefore, results are presented for the combined groups. Usual discretionary salt intake was estimated using the National Cancer Institute method. Multivariable linear regression was used to examine factors associated with discretionary salt intake. Salt densities per 100 g and 100 kcal were calculated for major contributors to total salt intake.

Results: The mean ± SD of observed total salt intake was 9.0 ± 3.8 g/day, of which 93% was discretionary. Nearly all NPAF (99.2%) exceeded the World Health Organization (WHO) recommended limit of 5 g salt/day. Each 100 kcal increase in energy intake was associated with 2% higher salt intake (Geometric Mean Ratio [GMR] = 1.02; 95% CI: 1.01–1.03; P < 0.0001), and each 10-year increase in age was associated with 9% lower salt intake (GMR = 0.91; 95% CI: 0.81–1.00; P = 0.04). A small number of commonly consumed dishes, especially stews, accounted for ~75% of discretionary salt intake.

Conclusions: Total salt intake exceeded the WHO limit, with the vast majority coming from discretionary salt. Energy intake was positively associated and age was negatively associated with discretionary salt intake. Salt-reduction strategies should prioritize lowering the salt content of high-salt recipes.

Funding Sources: This study was supported by Nutrition International with funds provided by the Gates Foundation.