Salt reduction in seafood – A review

BackgroundReducing dietary sodium (salt) intake has been proposed as a population-wide strategy to reduce blood pressure and cardiovascular disease (CVD). The cost-effectiveness of such strategies has hitherto not been investigated in Cameroon.MethodsA multicohort multistate life table Markov model was used to evaluate the cost-effectiveness of three population salt reduction strategies: mass media campaign, school-based salt education programme and low-sodium salt substitute. A healthcare system perspective was considered and adults alive in 2016 were simulated over the life course. Outcomes were changes in disease incidence, mortality, health-adjusted life years (HALYs), healthcare costs and incremental cost-effectiveness ratios (ICERs) over the lifetime. Probabilistic sensitivity analysis was used to quantify uncertainty.ResultsOver the life span of the cohort of adults alive in Cameroon in 2016, substantial numbers of new CVD events could be prevented, with over 10 000, 79 000 and 84 000 CVD deaths that could be averted from mass media, school education programme and salt substitute interventions, respectively. Population health gains over the lifetime were 46 700 HALYs, 348 800 HALYs and 368 400 HALYs for the mass media, school education programme and salt substitute interventions, respectively. ICERs showed that all interventions were dominant, with probabilities of being cost-saving of 84% for the school education programme, 89% for the mass media campaign and 99% for the low sodium salt substitute. Results were largely robust in sensitivity analysis.ConclusionAll the salt reduction strategies evaluated were highly cost-effective with very high probabilities of being cost-saving. Salt reduction in Cameroon has the potential to save many lives and offers good value for money.

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Salt Intake in Nigeria: a nationwide population survey

European Heart Journal ◽

10.1093/ehjci/ehaa946.2866 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A.N Odili ◽

B.S Chori ◽

B Danladi ◽

P.C Nwakile ◽

J.O Ogedengbe ◽

...

Keyword(s):

Salt Intake ◽

Sodium Intake ◽

Population Analysis ◽

Cost Effective ◽

Rural Site ◽

Urban Site ◽

Funding Source ◽

Salt Reduction ◽

High Salt Intake ◽

The Impact

Abstract Background Population wide salt reduction programmes are cost effective strategies for control of cardiovascular diseases (CVDs). Obtaining a nationwide salt consumption data in a multi-cultural setting as Nigeria's is key for proper implementation and monitoring of such strategy. Methods We measured sodium in 24-hour urine of free-living adult Nigerians selected from an urban and a rural site each from the 6 geopolitical zones of Nigeria to evaluate patterns of salt intake and its associations with blood pressures (BP). Results Across the 12 sites, sodium intake ranged from 97.9 in the rural South-South to 210 mmol/day in the urban site of the same zone. Overall, the median (IQR) daily sodium intake was 143.5 (97.8) mmol; with higher (p=0.0028) levels among the urban 149.7 (113.8) compared to the rural 133.1 (105.2) dwellers. Overall, 20% of the subjects consumed less than the recommended 2g (86mmol) of sodium daily. After adjustment for age, sex and BMI; sodium intake and BP (systolic and diastolic) were positively associated in 8 out of the 12 sites; significantly so in 2 (p<0.05) for systolic. Within population analysis; which included 973 individuals, increasing sodium intake tended (not significantly) to increase SBP but decrease DBP. However, among subjects whose sodium intake was in excess of 257mmol/day, a 100 mmol/day increase in sodium intake was significantly (p=0.04) associated with a 3.3 mmHg increase in SBP. Conclusion Salt intake among Nigerians is higher than the recommended. The impact of sodium intake on BP appears to be evident only among individuals with high salt intake. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Wellcome Trust

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Knowledge, perception, and practice related to sodium intake among Malaysian adults: findings from the Malaysian Community Salt Study (MyCoSS)

Journal of Health Population and Nutrition ◽

10.1186/s41043-021-00231-4 ◽

2021 ◽

Vol 40 (S1) ◽

Author(s):

Siew Man Cheong ◽

Rashidah Ambak ◽

Fatimah Othman ◽

Feng J. He ◽

Ruhaya Salleh ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Sodium Intake ◽

Dietary Sodium ◽

Health Concern ◽

Sodium Reduction ◽

Salt Reduction ◽

Complex Sample ◽

Health Organization

Abstract Background Excessive intake of sodium is a major public health concern. Information on knowledge, perception, and practice (KPP) related to sodium intake in Malaysia is important for the development of an effective salt reduction strategy. This study aimed to investigate the KPP related to sodium intake among Malaysian adults and to determine associations between KPP and dietary sodium intake. Methods Data were obtained from Malaysian Community Salt Survey (MyCoSS) which is a nationally representative survey with proportionate stratified cluster sampling design. A pre-tested face-to-face questionnaire was used to collect information on socio-demographic background, and questions from the World Health Organization/Pan American Health Organization were adapted to assess the KPP related to sodium intake. Dietary sodium intake was determined using single 24-h urinary sodium excretion. Respondents were categorized into two categories: normal dietary sodium intake (< 2000 mg) and excessive dietary sodium intake (≥ 2000 mg). Out of 1440 respondents that were selected to participate, 1047 respondents completed the questionnaire and 798 of them provided valid urine samples. Factors associated with excessive dietary sodium intake were analyzed using complex sample logistic regression analysis. Results Majority of the respondents knew that excessive sodium intake could cause health problems (86.2%) and more than half of them (61.8%) perceived that they consume just the right amount of sodium. Overall, complex sample logistic regression analysis revealed that excessive dietary sodium intake was not significantly associated with KPP related to sodium intake among respondents (P > 0.05). Conclusion The absence of significant associations between KPP and excessive dietary sodium intake suggests that salt reduction strategies should focus on sodium reduction education includes measuring actual dietary sodium intake and educating the public about the source of sodium. In addition, the relationship between the authority and food industry in food reformulation needs to be strengthened for effective dietary sodium reduction in Malaysia.

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Developing a policy to reduce the salt content of food consumed outside the home in Malaysia: protocol of a qualitative study

BMJ Open ◽

10.1136/bmjopen-2020-044628 ◽

2021 ◽

Vol 11 (7) ◽

pp. e044628

Author(s):

Mhairi Karen Brown ◽

Suzana Shahar ◽

Yee Xing You ◽

Viola Michael ◽

Hazreen Abdul Majid ◽

...

Keyword(s):

Medical Research ◽

Research Ethics ◽

Salt Intake ◽

Salt Content ◽

Ethics Committee ◽

Salt Reduction ◽

Reduction Strategy ◽

Research Ethics Committee ◽

School Canteen ◽

Medical Research Ethics

IntroductionCurrent salt intake in Malaysia is high. The existing national salt reduction policy has faced slow progress and does not yet include measures to address the out of home sector. Dishes consumed in the out of home sector are a known leading contributor to daily salt intake. This study aims to develop a salt reduction strategy, tailored to the out of home sector in Malaysia.Methods and analysisThis study is a qualitative analysis of stakeholder views towards salt reduction. Participants will be recruited from five zones of Malaysia (Western, Northern, Eastern and Southern regions and East Malaysia), including policy-makers, non-governmental organisations, food industries, school canteen operators, street food vendors and consumers, to participate in focus group discussions or in-depth interviews. Interviews will be transcribed and analysed using thematic analysis. Barriers will be identified and used to develop a tailored salt reduction strategy.Ethics and disseminationEthical approval has been obtained from the Universiti Kebangsaan Malaysia Medical Research Ethics Committee (UKM PPI/1118/JEP-2020–524), the Malaysian National Medical Research Ethics Committee (NMRR-20-1387-55481 (IIR)) and Queen Mary University of London Research Ethics Committee (QMERC2020/37) . Results will be presented orally and in report form and made available to the relevant ministries for example, Ministry of Health, Ministry of Education and Ministry of Trade to encourage adoption of strategy as policy. The findings of this study will be disseminated through conference presentations, peer-reviewed publications and webinars.

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Strengthening Knowledge to Practice on Effective Salt Reduction Interventions in Low- and Middle-Income Countries

Current Nutrition Reports ◽

10.1007/s13668-021-00365-1 ◽

2021 ◽

Author(s):

Joseph Alvin Santos ◽

Briar McKenzie ◽

Emalie Rosewarne ◽

Martyna Hogendorf ◽

Kathy Trieu ◽

...

Keyword(s):

Salt Reduction ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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An evaluation of the Victorian Salt Reduction Partnership’s advocacy strategy for policy change

Health Research Policy and Systems ◽

10.1186/s12961-021-00759-1 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Emalie Rosewarne ◽

Michael Moore ◽

Wai-Kwan Chislett ◽

Alexandra Jones ◽

Kathy Trieu ◽

...

Keyword(s):

Public Health ◽

Policy Change ◽

Action Plan ◽

Evaluation Framework ◽

Decision Makers ◽

Health Advocacy ◽

Salt Reduction ◽

Public Health Advocacy ◽

The Creation ◽

The Impact

Abstract Background Public health advocacy strategies facilitate policy change by bringing key health issues to the forefront of public and political discourse, influencing decision-makers and public opinion, and increasing policy demand. The Victorian Salt Reduction Partnership (VSRP) was established in 2014 in response to inadequate government action to improve population diets in Australia. This study aimed to evaluate the success of the VSRP’s advocacy strategy in achieving policy change. Methods Documentation of VSRP activities and outputs were collected, and semi-structured interviews conducted as part of a comprehensive process evaluation. For this study, the Kotter Plus 10-step public health advocacy evaluation framework was used to guide data extraction, analysis, and synthesis. Results A sense of urgency for salt reduction was generated by producing evidence and outlining the potential impact of a state-based salt reduction programme. This enabled the creation of a coalition with diverse skills and expertise, which facilitated the development of an innovative and collaborative advocacy action plan. A clear change vision was established, but communication of the vision to decision-makers was lacking, which reduced the impact of the programme as decision-makers were not provided with a clear incentive for policy change. As a result, while programme outputs were achieved, these did not translate to achieving broader strategic goals during a limited-term intervention in a political climate unconcerned with salt. Conclusions The Kotter Plus 10-step framework was a useful tool for evaluating the success of the VSRP advocacy strategy. The framework enabled the identification of key strengths, including the creation of the guiding coalition, and areas where efforts could be improved in future similar strategies, such as effective communication within partnerships and to decision-makers, to better influence policy and improve public health impact.

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Tuning the Covering on Gold Surfaces by Grafting Amino-Aryl Films Functionalized with Fe(II) Phthalocyanine: Performance on the Electrocatalysis of Oxygen Reduction

Molecules ◽

10.3390/molecules26061631 ◽

2021 ◽

Vol 26 (6) ◽

pp. 1631

Author(s):

Camila F. Olguín ◽

Nicolás Agurto ◽

Carlos P. Silva ◽

Carolina P. Candia ◽

Mireya Santander-Nelli ◽

...

Keyword(s):

Oxygen Reduction ◽

Diazonium Salt ◽

Gold Surface ◽

Catalytic Performance ◽

Reduction Reaction ◽

Salt Reduction ◽

Surface Electrodes ◽

Custom Made ◽

Aryl Diazonium Salt ◽

Inorganic Molecules

Current selective modification methods, coupled with functionalization through organic or inorganic molecules, are crucial for designing and constructing custom-made molecular materials that act as electroactive interfaces. A versatile method for derivatizing surfaces is through an aryl diazonium salt reduction reaction (DSRR). A prominent feature of this strategy is that it can be carried out on various materials. Using the DSRR, we modified gold surface electrodes with 4-aminebenzene from 4-nitrobenzenediazonium tetrafluoroborate (NBTF), regulating the deposited mass of the aryl film to achieve covering control on the electrode surface. We got different degrees of covering: monolayer, intermediate, and multilayer. Afterwards, the ArNO2 end groups were electrochemically reduced to ArNH2 and functionalized with Fe(II)-Phthalocyanine to study the catalytic performance for the oxygen reduction reaction (ORR). The thickness of the electrode covering determines its response in front of ORR. Interestingly, the experimental results showed that an intermediate covering film presents a better electrocatalytic response for ORR, driving the reaction by a four-electron pathway.

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Factors Affecting Salt Reduction Measure Adoption among Chinese Residents

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020445 ◽

2021 ◽

Vol 18 (2) ◽

pp. 445

Author(s):

Zeying Huang ◽

Di Zeng

Keyword(s):

Logistic Regression ◽

Food Intake ◽

Nutrition Education ◽

Online Survey ◽

Adaptive Lasso ◽

Stepwise Logistic Regression ◽

Salt Reduction ◽

Salt Restriction ◽

Salt Diet ◽

Factors Affecting

China has the highest mortality rate caused by diseases and conditions associated with its high-salt diet. Since 2016, China has initiated a national salt reduction campaign that aims at promoting the usage of salt information on food labels and salt-restriction spoons and reducing condiment and pickled food intake. However, factors affecting individuals’ decisions to adopt these salt reduction measures remain largely unknown. By comparing the performances of logistic regression, stepwise logistic regression, lasso logistic regression and adaptive lasso logistic regression, this study aims to fill this gap by analyzing the adoption behaviour of 1610 individuals from a nationally representative online survey. It was found that the practices were far from adopted and only 26.40%, 22.98%, 33.54% and 37.20% reported the adoption of labelled salt information, salt-restriction spoons, reduced condiment use in home cooking and reduced pickled food intake, respectively. Knowledge on salt, the perceived benefits of salt reduction, participation in nutrition education and training programs on sodium reduction were positively associated with using salt information labels. Adoption of the other measures was largely explained by people’s awareness of hypertension risks and taste preferences. It is therefore recommended that policy interventions should enhance Chinese individuals’ knowledge of salt, raise the awareness of the benefits associated with a low-salt diet and the risks associated with consuming excessive salt and reshape their taste choices.

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