Sources of dietary sodium and implications for a state-wide salt reduction program in Victoria, Australia

© 2020 The Authors. In Victoria, Australia, a state-wide salt reduction partnership was launched in 2015. The aim was to measure sodium intake, food sources of sodium (level of processing, purchase origin) and discretionary salt use in a cross-section of Victorian adults prior to a salt reduction initiative. In 2016/2017 participants completed a 24-hr urine collection (n=338) and a subsample completed a 24-hour dietary recall (n=142). The mean (SD) age of participants was 41.2 (13.9) years and 56% were females. Mean (95%CI) 24-hr urinary excretion was 138 (127-149) mmol/day for sodium. Salt equivalent was 8.1 (7.4-8.7) g/day, equating to ∼8.9 (8.1-9.6) g/day after 10% adjustment for non-urinary losses. Mean 24-hr intake estimated by diet recall was 118 (103-133) mmol/day for sodium (salt 6.9 (6.0-7.8 g/day)). Leading dietary sources of sodium were cereal-based mixed dishes (12%), English muffins, flat/savoury/sweet breads (9%), regular breads/rolls (9%), gravies and savoury sauces (7%), processed meats (7%). Over a third (38%) of sodium consumed derived from discretionary foods. Half of all sodium consumed came from ultra-processed foods. Dietary sodium derived from foods obtained from retail stores (51%), restaurants and fast-food/takeaway outlets (28%) and fresh food markets (9%). A third (32%) of participants reported adding salt at the table and 61% added salt whilst cooking. This study revealed that salt intake was above recommended levels with diverse sources of intake. Results from this study suggest a multi-faceted salt reduction strategy focusing on the retail sector and food reformulation would most likely benefit Victorians and have been used to inform the ongoing state-wide salt reduction initiative.