Assessment of salt intake to consider salt as a fortification vehicle for thiamine in Cambodia

• Main Authors: Baldwin, D.A (Author), Borath, M. (Author), Chan, K. (Author), Gallant, J. (Author), Green, T.J (Author), Kroeun, H. (Author), Leemaqz, S. (Author), Measelle, J.R (Author), Ngik, R. (Author), Prak, S. (Author), Whitfield, K.C (Author), Wieringa, F.T (Author), Yelland, L.N (Author)
• Format: Article
• Language: English
• Published: John Wiley and Sons Inc 2021
• Subjects: administration and dosage; adult; Adult; Article; beriberi; blood; Cambodia; controlled study; dietary supplement; Dietary Supplements; disease management; Disease Management; disease predisposition; Disease Susceptibility; Family Characteristics; family size; female; Female; Food, Fortified; fortification; fortified food; health survey; human; human milk; Humans; lactation; male; Male; metabolism; outcome assessment; pregnancy; Pregnancy; Public Health Surveillance; salt; salt intake; Sociodemographic Factors; sodium chloride; Sodium Chloride, Dietary; sodium excretion; sodium urine level; thiamine; Thiamine; thiamine deficiency; Thiamine Deficiency; urinary sodium
• Online Access: View Fulltext in Publisher

 Thiamine deficiency is a public health issue in Cambodia. Thiamine fortification of salt has been proposed; however, the salt intake of lactating women, the target population, is currently unknown. We estimated salt intakes among lactating women (<6 months postpartum) using three methods: repeat observed-weighed intake records and 24-h urinary sodium excretions (n = 104), and household salt disappearance (n = 331). Usual salt intake was estimated by adjusting for intraindividual intakes using the National Cancer Institute method, and a thiamine salt fortification scenario was modeled using a modified estimated average requirement (EAR) cut-point method. Unadjusted salt intake from observed intakes was 9.3 (8.3–10.3) g/day, which was not different from estimated salt intake from urinary sodium excretions, 9.0 (8.4–9.7) g/day (P = 0.3). Estimated salt use from household salt disappearance was 11.3 (10.7–11.9) g/person/day. Usual (adjusted) salt intake from all sources was 7.7 (7.4–8.0) g/day. Assuming no stability losses, a modeled fortification dose of 275 mg thiamine/kg salt could increase thiamine intakes from fortified salt to 2.1 (2.0–2.2) mg/day, with even low salt consumers reaching the EAR of 1.2 mg/day from fortified salt alone. These findings, in conjunction with future sensory and stability research, can inform a potential salt fortification program in Cambodia. © 2021 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of New York Academy of Sciences.