Sodium and potassium adults 24h urine: Italian Health Examination Survey 2023-2025 - CUORE Project

Background

WHO recommends a 30% relative reduction in mean population intake of sodium within 2030 (baseline 2010) and an adequate potassium intake and suggests to monitor targets by periodic Health Examination Surveys (HESs). In Italy, the Ministry of Health has strengthened prevention/health promotion: a new HES started in 2023, promoted and financed by the Ministry of Health - CCM and the European Commission through JACARDI.

Methods

During the period 2023-2025, a 24h urinary sodium and potassium excretion assessment was implemented. Up to now, data from random samples of residents in 18 Regions (of 20 regions) distributed in North, Centre and South of Italy are available (1713 men, 1698 women, aged 35-74 years). Urinary excretion was assayed by a central lab. Persons with urinary volume < 500 ml and/or a body weight-adjusted urinary creatinine content outside the population mean ± 2 standard deviations were excluded. European standard age-sex distribution was used.

Results

An adequate salt intake level (< 5g/day) was detected in 11% (95% confidence interval: 8-14%) of men and 24% (20-28%) of women and an adequate potassium intake level (> 3510 mg/day) was detected in 26% (22-30%) and 12% (9-15%). Mean levels of salt per day was 9.3g (8.9-9.6g) and 7.1g (6.8-7.4g), and potassium per day was 3.0g (2.9-3.1g) and 2.5g (2.4-2.6g). In those with primary/secondary school, salt mean level per day was 9.8g (9.0-10.5g) in men and 7.5g (7.0-8.1g) in women, while with higher educational level was 9.1g (8.7-9.5g) and 7.0g (6.7-7.3g); identical mean levels of potassium per day comparing educational levels.

Conclusions

In Italy, compared to 2008, the habitual salt intake decreased of about 12% in 2018 and remained stable in 2023/2025; the habitual potassium intake remained stable in 2018 and seems increased in 2023/2025; the salt and potassium intake mean levels are still not adequate. These results encourage the ongoing preventive initiatives of the Ministry of Health.

Key messages

• The average salt intake is still higher than recommended and the habitual salt intake decreased compared to 15 years ago.

• The average potassium intake in Italian adults is still lower than recommended and seems increased in 2023/2025.