To estimate daily salt intake and salt-related knowledge, attitudes and behaviour in adults of two main regions in Kazakhstan.
Two surveys were undertaken in Almaty City in mid 2015 and Kyzylorda in mid 2016 using the same methodology. Multi-stage cluster sampling, stratified by sex and age groups, was used to randomly select individuals aged 25–64 years that were not pregnant, not on diuretics or not have kidney or liver disease. Salt intake was measured through 24 hour urine collection and suspected inaccurate collections were excluded based on an established criteria. The data were weighted by age and sex using census data of Almaty City and Kyzylorda.
Complete 24 hour urine samples were collected for 218 and 112 individuals in Almaty City and Kyzylorda, respectively. Weighted mean 24 hour urinary salt excretion was 17.2 g/d (95% CI 16.2–18.2) in Almaty City and 18.8 g/d (95% CI 17.0–20.5) in Kyzylorda. Significant differences in salt intake were seen in different gender (15.6 g/d in women vs 19.1 g/d in men, p = 0.001) and educational attainment groups (18.7 g/d in secondary school education vs 15.9 g/d in tertiary education, p = 0.01), only in the Almaty population. Although 77% and 75% of the population in Almaty and Kyzylorda respectively, were aware of the adverse health effects of excess salt intake, the majority (82% and 85%) thought they were consuming the correct amount or less.
This study provides the first 24 hour urinary estimates of salt consumption in Kazakhstan communities, confirming it is likely to be highest worldwide. As majority are unaware they are, on average, consuming more than triple the World Health Organization recommended maximum of 5 g/d, an effective population salt reduction strategy is urgently needed in Kazakhstan.