The high salt intake in adults with metabolic syndrome is related to increased waist circumference and blood pressure: the Brazilian Longitudinal Study of Adult Health study (ELSA-Brasil)

Objectives: The association between metabolic syndrome (MetS), a cluster of cardiometabolic risk factors, and salt consumption has fed intense debate in recent years, although it is yet to be fully elucidated. We aimed to evaluate whether individuals with MetS have a high salt consumption and to identify which components of the MetS diagnosis could be independently related to high salt consumption. Methods: We analyzed data from 11 982 adults, ages 35 to 74 y, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort study, from which clinical and anthropometric data were assessed, and a validated 12-h overnight urine collection was used to estimate salt intake. MetS was defined according to the Adult Treatment Panel III criteria. Results: Salt intake was increased in individuals with MetS compared with individuals without MetS, regard-less of sex (men: 14.3 +/- 6.4 g/d versus 12.2 +/- 5.5 g/d, P < 0.001; women: 10.6 +/- 4.9 g/d versus 8.9 +/- 4.0 g/d, P < 0.001) and increased progressively as the MetS criteria accumulated. The high salt intake in MetS partici-pants, however, was observed only in the presence of elevated waist circumference and/or blood pressure and not with the other MetS criteria (reduced high-density lipoprotein, increased triglycerides, and impaired fasting blood glucose), regardless of the presence of MetS. When diabetes was incorporated as a MetS crite-rion, increased salt intake was observed in men but not in women. Conclusions: Salt intake should be reduced worldwide, but strategies must be more intense in people with elevated blood pressure and waist circumference, regardless of MetS diagnosis, to avoid the associated mor-bidity and mortality. (c) 2023 Elsevier Inc. All rights reserved.