SALT INTAKE LEVELS AND ASSOCIATED RISKS AMONG SCHOOL CHILDREN IN IBADAN, SOUTH-WEST NIGERIA

Abstract

A substantial increase in the incidence of chronic non-communicable diseases (NCD'S) are occurring in developing countries including Nigeria, One of such is Hypertension. High blood pressure in childhood predisposes people to hypertension in adulthood and is associated with early development of cardiovascular diseases. High Salt Intake and overweight/obesity are recognized risk factors for hypertension in children. The study was therefore carried out to assess the association between sodium intake and blood pressure among School Children in Ibadan South West LGA (IBSWLGA). This study was an analytical cross-sectional study involving a total of 327 school children aged 8-17 years. Participants were chosen by a multi-stage sampling technique from selected public and private secondary schools in IBSWLGA. An interviewer administered questionnaire including socio-demographic and socioeconomic characteristics and a food frequency questionnaire was used to elicit information from participants. Anthropometric measures, blood pressure and spot urine samples were taken from all participants. Urine samples were sent to the laboratory where they were analyzed by flame photometric method. Data were analyzed using descriptive statistics such as means and proportions to summarize data. Chi square was used to test association between categorical variables and multiple logistic regression was used to assess the association between the risk of prehypertension/hypertension and salt intake groups at 5% level of significance. Mean age of participants was 13:58±1.93years and males were 46.5%. Participants consumed an average of 2713mg/day of Sodium, with 67% of all participants having intake above WHO recommended ≤2300mg/day. Overweight/obese was present in 17.2% of participants. The prevalence of pre-hypertension and hypertension in the study were 28.4% and 9.5%, respectively, and dietary pattern (fast food and soft drink consumption) was associated with both high sodium intake and blood pressure. Mean adjusted SBP increased progressively with sodium intake quartile from 104.2mmHg to 114.7mmHg among all participants (P<0.001); from 108.1mmHg to 121.0mmHg among those overweight/obese (P=0.003). Adjusted odds ratio comparing risk for preHBP/ HBP among participants in the highest versus lowest sodium intake quartile were 2.1 (95% CI: 0.86-5.29) for all participants and 2.9 (95% CI: 1.48-8.03) among those overweight/obese. Sodium intake and weight status had synergistic effects on the risk for Pre-HBP/HBP (Relative excess risk for interaction=0.24). Average sodium consumption of school children in this study was high compared with WHO standard. The findings corroborates the association between high salt intake and hypertension and obesity. There is therefore a need to initiate salt reduction programme and promote school based interventions to improve healthier dietary choices and increased levels of physical activity among school children.