# Impact of Socioeconomic Factors and Lifestyle on Salt and Potassium Intake and Sodium-to-Potassium Ratio: EH-UH 2 Study

## TL;DR

This study explores how education, lifestyle, and diet influence salt and potassium intake and their ratio in adults, highlighting the need for targeted public health strategies.

## Contribution

The study identifies socioeconomic and lifestyle factors as key predictors of dietary salt and potassium intake and proposes actionable public health interventions.

## Key findings

- Low education and professional qualification are linked to higher salt and lower potassium intake.
- Processed meat consumption is a major driver of high salt intake and poor Na/K ratio.
- Adriatic/Mediterranean diet patterns are associated with better salt and potassium intake and improved Na/K ratio.

## Abstract

Background: There are conflicting reports on the association of socioeconomic (SES) characteristics and lifestyle with salt and potassium intake as well as with the sodium-to-potassium (Na/K) ratio. This paper examined how SES status and lifestyle habits affect salt, potassium intake, and the Na/K ratio in adults. Methods: Adults subjects (random sample) from the EH-UH 2 nationwide study with valid 24 h urine samples were included in these analyses. We used a questionnaire which included SES and questions related to lifestyle. Salt and potassium levels were measured using a 24 h urine collection. Results: A low level of professional qualification and education are important predictors of high salt and low potassium intake. SES affects salt intake more than potassium intake. Processed meat was the most important determinant of high salt intake. It significantly affected potassium intake, but this was not relevant due to a poor Na/K ratio. Non-smoking status was related to high daily salt and potassium intake, but with no significantly positive impact on Na/K ratio. Former smokers swapped one unhealthy habit for another, such as overeating or consuming too much salt. The Adriatic/Mediterranean diet, represented in this study with frequent olive oil and fish consumption, was related to more favourable salt and potassium intake and a better Na/K ratio. Targets of daily salt and potassium intake, as well as of Na/K ratio were achieved in a very low proportion of the population regardless of SES, lifestyle and behaviour. Conclusions: Our results emphasize the need for public-health strategies that consider both diet and individual characteristics to address nutritional inequalities and promote healthier eating habits. Targeted nutrition programmes for lower SES groups should emphasize salt reduction and encourage potassium-rich diets, thus reducing health imparities and the burden of diet-related chronic diseases. The prevention strategy should be more proactive and specifically designed for the food (meat) industry. A more holistic approach should be taken for smokers when quitting smoking is necessary, the whole population should be educated to change habits toward the Adriatic diet pattern, and the government should make olive oil and fish more affordable to all citizens, particularly to those with poor SES.