Evidence map›Paper›PMID 40647293›Full record

ReviewNutrients2025

Global Drinking Water Standards Lack Clear Health-Based Limits for Sodium.

Juliette Crowther, Aliyah Palu, Alicia Dunning, Loretta Weatherall, Wendy Spencer, Devanshi Gala, Damian Maganja, Katrina Kissock, Kathy Trieu, Sera Lewise Young and 3 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Polydopamine-Wool Textiles for Sustainable Interfacial Solar Vapor Generation.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Juliette CrowtherThe George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.ORCID 0009-0008-5713-7311
Aliyah PaluThe George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
Alicia DunningThe George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.ORCID 0009-0007-6286-695X
Loretta WeatherallDharriwaa Elders Group, Walgett, NSW 2832, Australia.
Wendy SpencerDharriwaa Elders Group, Walgett, NSW 2832, Australia.
Devanshi GalaWalgett Aboriginal Medical Service Limited, Walgett, NSW 2832, Australia.
Damian MaganjaThe George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.ORCID 0000-0003-1245-3288
Katrina KissockThe George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.ORCID 0000-0001-6665-2106
Kathy TrieuThe George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.ORCID 0000-0003-1848-2741
Sera Lewise YoungDepartment of Anthropology, Institute for Policy Research, Center for Water Research, Northwestern University, Evanston, IL 60208, USA.ORCID 0000-0002-1763-1218
Ruth McCauslandYuwaya Ngarra-li Partnership, University of New South Wales, Sydney, NSW 2052, Australia.ORCID 0000-0001-7323-0358
Greg LeslieGlobal Water Institute, University of New South Wales, Sydney, NSW 2052, Australia.
Jacqui WebsterThe George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.

Funding

National Health and Medical Research Council 2003862National Health and Medical Research Council 2018015
6 · The paper itself

Abstract

BACKGROUND/

objectivesHigh sodium consumption increases the risk of hypertension and cardiovascular disease. Although food remains the primary source of intake, elevated sodium levels in drinking water can further contribute to excessive intake, particularly in populations already exceeding recommendations. This review examines the extent to which national drinking water standards account for sodium-related health risks and aims to inform discussion on the need for enforceable, health-based sodium limits.

methodsNational standards for unbottled drinking water in 197 countries were searched for using the WHO 2021 review of drinking water guidelines, the FAOLEX database, and targeted internet and AI searches. For each country, data were extracted for the document name, year, regulatory body, regulation type, sodium limit (if stated), and rationale. Socio-geographic data were sourced from World Bank Open Data. A descriptive analysis was conducted using Microsoft Excel.

resultsStandards were identified for 164 countries. Of these, 20% (

conclusionsGlobally, drinking water standards give inadequate attention to sodium's health risks. Most either lack sodium limits or rely on palatability thresholds that are too high to protect health. Updating national and international standards to reflect current evidence is essential to support sodium reduction efforts. Health-based sodium limits would empower communities to better advocate for safe water. Amid rising water salinity, such reforms must be part of a broader global strategy to ensure universal and equitable access to safe, affordable drinking water as a basic human right.

Indexed as

Drinking WaterGlobal HealthSodium, DietaryHumansRecommended Dietary AllowancesDrinking WaterSodium, Dietarycardiovascular diseasedrinking waterguidelineshealth-based targetssalinitysodiumstandards

Identifiers

PMID40647293
PMCPMC12251560

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.