**3. Results**

#### *3.1. Characteristics of the Study Population*

A total of 530 participants provided urine specimens, out of which 41 participants were excluded due to limited urine sample collection (<500 mL urine), and 12 participants due to creatinine levels below 500 mg in the urine, to give a final sample size of 477. One urine sample was excluded from the sample during analysis, due to excessive creatinine levels, leading to one less participant in the urine analysis (n = 476). The mean age was 37.31 years (standard deviation (SD) = 12.5 years, range 20–65 years), of which 55% were female (Table 2). The mean weight, height and BMI for participants were 73.37 ± 15.4 kg, 165.8 ± 8.95 cm and 26.7 ± 5.15 kg/m2, respectively (Table 2). The prevalence of underweight, normal weight, overweight and obese individuals was 3.14%, 37.11%, 36.06% and 23.69%, respectively.


**Table 2.** Summary of study population demographics (N = 477).

1 Geographic divisions of United Arab Emirates; 2 Dubai, Sharjah, Ajman, Umm Al Quwain and Fujairah.

#### *3.2. Major Findings of the Knowledge, Attitude and Practice (KAP) Questionnaire*

The knowledge, attitude and practice (KAP) questionnaire (Table 3) indicated that the majority of the participants added salt during cooking (N = 393; 82.4%) and while eating (N = 315; 66%). Most participants reported that they always or sometimes use stock cubes during cooking (N = 346; 72.6%), and 69.1% reported that they were aware that high salt intake could cause serious health problems. However, a large proportion (62.1%) thought that their salt consumption was within the recommended amounts, with 60% claiming to have tried to control their salt or sodium intake. Most of the participants (45.2%) reported that high salt intake was associated with high blood pressure, followed by kidney stones (18.7%) and obesity (17.8%), but only 11.7% associated it with heart disease, and 6.5% with T2D. More than 75% of the participants reported that they considered processed foods as a high source of salt.


**Table 3.** Knowledge, attitude and practice (KAP) of salt intake and participants' knowledge on health consequences (N = 477). \* This question is multiple choice

#### *3.3. High Levels of Sodium Secretion in the UAE Population within 24-h Urine Collection*

The mean 24-h urine volume was 1338.3 ± 553 mL, with a range of 550–4000 mL. The mean sodium excretion in urine was 2713.4 ± 713 mg. The average values for sodium excretion in urine exceeded the WHO recommendations of sodium intake of less than 2300 mg (Table 4) [23]. Of the 476 participants, 320 (67.4%) had a sodium excretion above the WHO recommended level of 2300 mg. Males were more likely (51.6%) to exceed the WHO recommendation compared to females (odds ratio (OR): 2.60; 95% confidence interval (CI): 1.71 to 3.96; *p* < 0.001). However, there were no significant differences by age of those surpassing the recommendation (OR: 0.99; 95% CI: 0.98 to 1.02; *p* = 0.98).

**Table 4.** Mean sodium, potassium and creatinine urinary excretion and ratio of sodium to potassium (n = 476).


Mean urinary excretion for potassium and creatinine and the sodium to potassium ratio were 1803.30 ± 618.03 mg, 1284.81 ± 607.0 mg and 1.64 ± 0.55 mg, respectively (Table 4). While it is challenging to use potassium excretion to estimate intake, it is likely that it is well below the WHO recommendations of 3500 mg/day [24]. Moreover, mean urinary excretion for creatinine for female participants was 13.42 ± 1.95 mg/kg body mass, with a minimum to maximum reading of 10.23 to 19.87 mg/kg body mass, while for male participants it was 21.81 ± 3.80 mg/kg body mass, with a minimum to maximum reading of 13.60 to 28.63 mg/kg body mass (Table 4). Mean urinary excretions for sodium, potassium and creatinine for male and female participants according to the different age groups are shown in Figure 2.

**Figure 2.** Mean creatinine, sodium and potassium levels for male (left panel) and female (right panel) participants according to age groups. The capped bars represent the 95% confidence intervals of the means.
