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. 2023 Sep 12;15(18):3942.
doi: 10.3390/nu15183942.

Salt-Intake-Related Behavior Varies between Sexes and Is Strongly Associated with Daily Salt Consumption in Obese Patients at High Risk for MASLD

Bianca Heller  1 , Florian P Reiter  1 , Hans Benno Leicht  1 , Cornelia Fiessler  2 , Ina Bergheim  3 , Peter U Heuschmann  2 , Andreas Geier  1 , Monika Rau  1
Affiliations

Salt-Intake-Related Behavior Varies between Sexes and Is Strongly Associated with Daily Salt Consumption in Obese Patients at High Risk for MASLD

Bianca Heller et al. Nutrients. .

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) imposes a significant burden on Westernized regions. The Western diet, high in salt intake, significantly contributes to disease development. However, there are a lack of data on salt literacy and salt intake among MASLD patients in Germany. Our study aims to analyze daily salt intake and salt-intake-related behavior in MASLD patients.

Methods: 234 MASLD patients were prospectively included. Daily salt intake and salt-intake-related behavior were assessed via a food frequency questionnaire (FFQ-DEGS) and a salt questionnaire (SINU). Statistical analyses were performed using SPSS.

Results: Mean daily salt intake was higher in men than in women (7.3 ± 5 g/d vs. 5.3 ± 4 g/d; p < 0.001). There was significant agreement between increased daily salt intake (>6 g/d) and the behavioral salt index (SI) (p < 0.001). Men exhibited higher SI scores compared to women, indicating lower awareness of salt in everyday life. Multivariate analysis identified specific salt-intake-related behaviors impacting daily salt consumption.

Conclusions: Our study reveals a strong link between daily salt intake and salt-intake-related behavior, highlighting sex-specific differences in an MASLD cohort. To enhance patient care in high-cardiovascular-risk populations, specific behavioral approaches may be considered, including salt awareness, to improve adherence to lifestyle changes, particularly in male patients.

Keywords: MASLD; salt consumption; salt-intake-related behavior; steatotic liver disease.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Boxplots of SI in the total cohort of MASLD patients stratified by age (≤55 years and >55 years). ** = p < 0.01.
Figure A2
Figure A2
Gender-specific analysis of salt-related behavior questions. Mean ± SD are shown for each salt-intake-related behavior question for the group with high (>6 g/d, n = 114) and low (≤6 g/d, n = 120) daily salt intake and further separated by gender.
Figure 1
Figure 1
Boxplots of SI in the total cohort of MASLD patients stratified by daily salt intake (≤6 g/d and >6 g/d). *** = p ≤ 0.001.
Figure 2
Figure 2
Mean ± SD are shown for each salt-intake-related behavior question for the group with high (>6 g/d, n = 114) and low (≤6 g/d, n = 120) daily salt intake.
Figure 3
Figure 3
Mean ± SD are depicted for each item of the “Würzburg salt questionnaire” for the group with high (>6 g/d, n = 114) and low (≤6 g/d, n = 120) daily salt intake.
Figure 4
Figure 4
Gender-specific differences in daily salt intake and salt-intake-related behavior: (A) gender-specific daily salt intake shown as bars with median ± IQR. (B) Boxplots of salt index in men and women; (C) boxplots of salt index in men and women with low and high daily salt intake (≤6 g/d, >6 g/d). *** p ≤ 0.001, * p < 0.05.
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