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Campbell NR, Whelton PK, Orias M, Cobb LL, Jones ES, Garg R, Willliams B, Khan N, Chia YC, Jafar TH, Ide N. It is strongly recommended to not conduct, fund, or publish research studies that use spot urine samples with estimating equations to assess individuals' sodium (salt) intake in association with health outcomes: a policy statement of the World Hypertension League, International Society of Hypertension and Resolve to Save Lives. J Hypertens 2023; 41:683-686. [PMID: 36723484 PMCID: PMC10090307 DOI: 10.1097/hjh.0000000000003385] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 02/02/2023]
Abstract
Spot urine samples with estimating equations have been used to assess individuals' sodium (salt) intake in association with health outcomes. There is large random and systematic error in estimating sodium intake using this method and spurious health outcome associations. Substantial controversy has resulted from false claims the method is valid. Hence, the World Hypertension League, International Society of Hypertension and Resolve to Save Lives, supported by 21 other health organizations, have issued this policy statement that strongly recommends that research using spot urine samples with estimating equations to assess individuals' sodium (salt) intake in association with health outcomes should not be conducted, funded or published. Literature reviews on the health impacts of reducing dietary sodium that include studies that have used spot and short duration timed urine samples with estimating equations need to explicitly acknowledge that the method is not recommended to be used and is associated with spurious health outcome associations.
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Affiliation(s)
| | - Paul K. Whelton
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | | | | | - Erika S.W. Jones
- Division of Nephrology and Hypertension, Department of Medicine, Groote Schuur Hospital, University of Cape Town, South Africa
| | - Renu Garg
- Resolve to Save Lives, New York, New York, USA
| | - Bryan Willliams
- University College London, NIHR University College London, Hospitals Biomedical Research Centre, London, UK
| | - Nadia Khan
- Center for Health Evaluation and Outcomes Sciences, University of British Columbia, Vancouver, Canada
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Medical and Live Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
| | - Tazeen H. Jafar
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Nicole Ide
- Resolve to Save Lives, New York, New York, USA
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Campbell NRC, He FJ, McLean RM, Cappuccio FP, Woodward M, MacGregor GA, Guichon J, Mitchell I. Dietary sodium and cardiovascular disease in China: addressing the authors' response, statements and claims. J Hypertens 2022; 40:1831-1836. [PMID: 35943106 DOI: 10.1097/hjh.0000000000003122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Norman R C Campbell
- Departments of Medicine, Physiology and Pharmacology and Community Health Sciences, and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Feng J He
- Wolfson Institute of Population Health, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
| | - Rachael M McLean
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Mark Woodward
- The George Institute for Global Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Graham A MacGregor
- Wolfson Institute of Population Health, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London, UK
| | - Juliet Guichon
- Departments of Community Health Sciences and Pediatrics, Cumming School of Medicine
| | - Ian Mitchell
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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