Sources of dietary sodium and implications for a statewide salt reduction initiative in Victoria, Australia

2020 ◽  
Vol 123 (10) ◽  
pp. 1165-1175 ◽  
Author(s):  
Kristy A. Bolton ◽  
Jacqui Webster ◽  
Elizabeth K. Dunford ◽  
Stephen Jan ◽  
Mark Woodward ◽  
...  
Keyword(s):  
Fast Food ◽  
Salt Intake ◽  
Dietary Sodium ◽  
Food Sources ◽  
Retail Sector ◽  
Food Markets ◽  
Salt Reduction ◽  
Dietary Recall ◽  
Processed Meats ◽  
Fresh Food

AbstractIn Victoria, Australia, a statewide salt reduction partnership was launched in 2015. The aim was to measure Na intake, food sources of Na (level of processing, purchase origin) and discretionary salt use in a cross-section of Victorian adults prior to a salt reduction initiative. In 2016/2017, participants completed a 24-h urine collection (n 338) and a subsample completed a 24-h dietary recall (n 142). Participants were aged 41·2 (sd 13·9) years, and 56 % were females. Mean 24-h urinary excretion was 138 (95 % CI 127, 149) mmol/d for Na. Salt equivalent was 8·1 (95 % CI 7·4, 8·7) g/d, equating to about 8·9 (95 % CI 8·1, 9·6) g/d after 10 % adjustment for non-urinary losses. Mean 24-h intake estimated by diet recall was 118 (95 % CI 103, 133) mmol/d for Na (salt 6·9 (95 % CI 6·0, 7·8 g/d)). Leading dietary sources of Na were cereal-based mixed dishes (12 %), English muffins, flat/savoury/sweet breads (9 %), regular breads/rolls (9 %), gravies and savoury sauces (7 %) and processed meats (7 %). Over one-third (38 %) of Na consumed was derived from discretionary foods. Half of all Na consumed came from ultra-processed foods. Dietary Na derived from foods was obtained from retail stores (51 %), restaurants and fast-food/takeaway outlets (28 %) and fresh food markets (9 %). One-third (32 %) of participants reported adding salt at the table and 61 % added salt whilst cooking. This study revealed that salt intake was above recommended levels with diverse sources of intake. Results from this study suggest a multi-faceted salt reduction strategy focusing on the retail sector, and food reformulation would most likely benefit Victorians and has been used to inform the ongoing statewide salt reduction initiative.

scholarly journals Sources of Dietary Salt in North and South India Estimated from 24 Hour Dietary Recall

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 318 ◽  
Author(s):  
Claire Johnson ◽  
Joseph Alvin Santos ◽  
Emalie Sparks ◽  
Thout Sudhir Raj ◽  
Sailesh Mohan ◽  
...  
Keyword(s):  
Dairy Products ◽  
South India ◽  
Salt Intake ◽  
North India ◽  
World Health ◽  
Food Sources ◽  
Quality Data ◽  
Salt Reduction ◽  
Dietary Recall ◽  
Added Salt

Recent data on salt intake levels in India show consumption is around 11 g per day, higher than the World Health Organization’s (WHO) recommended intake of 5 g per day. However, high-quality data on sources of salt in diets to inform a salt reduction strategy are mostly absent. A cross-sectional survey of 1283 participants was undertaken in rural, urban, and slum areas in North (n = 526) and South (n = 757) India using an age-, area-, and sex-stratified sampling strategy. Data from two 24-h dietary recall surveys were transcribed into a purpose-built nutrient database. Weighted salt intake was estimated from the average of the two recall surveys, and major contributors to salt intake were identified. Added salt contributed the most to total salt intake, with proportions of 87.7% in South India and 83.5% in North India (p < 0.001). The main food sources of salt in the south were from meat, poultry, and eggs (6.3%), followed by dairy and dairy products (2.6%), and fish and seafood (1.6%). In the north, the main sources were dairy and dairy products (6.4%), followed by bread and bakery products (3.3%), and fruits and vegetables (2.1%). Salt intake in India is high, and this research confirms it comes mainly from added salt. Urgent action is needed to implement a program to achieve the WHO salt reduction target of a 30% reduction by 2025. The data here suggest the focus needs to be on changing consumer behavior combined with low sodium, salt substitution.

scholarly journals Salt and potassium intake among adult Ghanaians: WHO-SAGE Ghana Wave 3

BMC Nutrition ◽  
2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Elias K. Menyanu ◽  
Barbara Corso ◽  
Nadia Minicuci ◽  
Ilaria Rocco ◽  
Joanna Russell ◽  
...  
Keyword(s):  
Salt Intake ◽  
Population Based ◽  
Dietary Sodium ◽  
World Health ◽  
Adult Health ◽  
Salt Reduction ◽  
Hypertension Prevalence ◽  
Salt Consumption ◽  
Consumption Data

Abstract Though Ghana has high hypertension prevalence, the country lacks current national salt consumption data required to build and enhance advocacy for salt reduction. We explored the characteristics of a randomly selected sub sample that had valid urine collection, along with matched survey, anthropometric and BP data (n = 839, mean age = 60y), from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE), Ghana Wave 3, n = 3053). We also investigated the relationship between salt intake and blood pressure (BP) among the cohort. BP was measured in triplicate and 24 h urine was collected for the determination of urinary sodium (Na), potassium (K), creatinine (Cr) and iodine levels. Hypertension prevalence was 44.3%. Median salt intake was 8.3 g/day, higher in women compared to men (8.6, interquartile range (IQR) 7.5 g/day vs 7.5, IQR 7.4 g/day, p <  0.01), younger participants (18–49 y) compared to older ones (50+ y) (9.7, IQR 7.9 g/day vs 8.1, IQR 7.1 g/day, p <  0.01) and those with higher Body Mass Index (BMI) (> 30 kg/m2) compared to a healthy BMI (18.5–24.9 kg/m2) (10.04, IQR 5.1 g/day vs 6.2, IQR 5.6 g/day, p <  0.01). More than three quarters (77%, n = 647) of participants had salt intakes above the WHO maximum recommendation of 5 g/d, and nearly two thirds (65%, n = 548) had daily K intakes below the recommended level of 90 mmol. Dietary sodium to potassium (Na: K) ratios above 2 mmol/mmol were positively associated with increasing BP with age. Population-based interventions to reduce salt intake and increase K consumption are needed.

scholarly journals Sources of sodium in Australian children's diets and the effect of the application of sodium targets to food products to reduce sodium intake

2010 ◽  
Vol 105 (3) ◽  
pp. 468-477 ◽  
Author(s):  
Carley A. Grimes ◽  
Karen J. Campbell ◽  
Lynn J. Riddell ◽  
Caryl A. Nowson
Keyword(s):  
Sodium Intake ◽  
Food Sources ◽  
Dietary Recall ◽  
Processed Meats ◽  
Poultry Products ◽  
Food Standards ◽  
Nationally Representative ◽  
The Uk ◽  
Activity Survey ◽  
The Impact

The average reported dietary Na intake of children in Australia is high: 2694 mg/d (9–13 years). No data exist describing food sources of Na in Australian children's diets and potential impact of Na reduction targets for processed foods. The aim of the present study was to determine sources of dietary Na in a nationally representative sample of Australian children aged 2–16 years and to assess the impact of application of the UK Food Standards Agency (FSA) Na reduction targets on Na intake. Na intake and use of discretionary salt (note: conversion of salt to Na, 1 g of NaCl (salt) = 390 mg Na) were assessed from 24-h dietary recall in 4487 children participating in the Australian 2007 Children's Nutrition and Physical Activity Survey. Greatest contributors to Na intake across all ages were cereals and cereal-based products/dishes (43 %), including bread (13 %) and breakfast cereals (4 %). Other moderate sources were meat, poultry products (16 %), including processed meats (8 %) and sausages (3 %); milk products/dishes (11 %) and savoury sauces and condiments (7 %). Between 37 and 42 % reported that the person who prepares their meal adds salt when cooking and between 11 and 39 % added salt at the table. Those over the age of 9 years were more likely to report adding salt at the table (χ2199·5, df 6,P < 0·001). Attainment of the UK FSA Na reduction targets, within the present food supply, would result in a 20 % reduction in daily Na intake in children aged 2–16 years. Incremental reductions of this magnitude over a period of years could significantly reduce the Na intake of this group and further reductions could be achieved by reducing discretionary salt use.

scholarly journals Food Consumption Pattern and the Intake of Sugar, Salt, and Fat in the South Jakarta City—Indonesia

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1289
Author(s):  
Nuri Andarwulan ◽  
Siti Madanijah ◽  
Dodik Briawan ◽  
Khoirul Anwar ◽  
Atikah Bararah ◽  
...  
Keyword(s):  
Public Health ◽  
Food Consumption ◽  
Fast Food ◽  
Salt Intake ◽  
Food Sources ◽  
Consumption Pattern ◽  
Fat Intake ◽  
Added Sugar ◽  
Increased Risk ◽  
Food Consumption Pattern

The excessive consumption of sugar, salt, and fat is associated with an increased risk of non-communicable diseases. Therefore, a study on estimating the added sugar, salt, and fat intake in certain populations is important for establishing specific recommendations aiming at improving diet quality, and thus public health. This study aimed to determine the food consumption pattern and the intakes of added sugar, salt, and fat from different food groups and food sources among the residents of South Jakarta, Indonesia. The study was conducted with a cross-sectional design, involving 323 respondents. Data on socio-economic conditions, health and nutritional status, and food consumption were collected. Food consumption data were acquired through the 2-day weighed food record. Results showed that the daily food consumption in the observed population reached 1868–2334 g/capita/day. The total added sugar intake in different groups of respondents ranged between 34.9 and 45.9 g/capita/day, with the highest values observed in school-age boys. Beverages and snacks were identified as the main added sugar sources in the respondents’ diet. The total salt intake ranged from 5.46 to 7.43 g/capita/day, while the observed fat intake reached 49.0–65.1 g/capita/day. The major food source contributing to the salt and fat intake included street/restaurant/fast food. Male subjects tended to consume a higher amount of salt and fat than female subjects. These findings can be used as baseline information for providing a strategy for reducing sugar, salt, and fat intakes, with strong implications for improving public health.

Abstract P421: Estimation Of Adult Dietary Sodium Intake And Source In Shandong China 2011: Finding From SMASH Project Baseline Survey

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Liuxia YAN ◽  
Zilong LU ◽  
Jixiang MA ◽  
Xiaolei GUO ◽  
Jiyu ZHANG ◽  
...  
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Monosodium Glutamate ◽  
Soy Sauce ◽  
Dietary Sodium ◽  
Baseline Survey ◽  
Dietary Salt ◽  
Ministry Of Health ◽  
Cross Sectional ◽  
Dietary Recall

Zilong LU, Liuxia YAN, Jixiang MA, Xiaolei GUO, Jiyu ZHANG, Junli TANG, Huicheng WANG, Xiaoning CAI Background: Moderate population salt reduction could reduce blood pressure and the cardiovascular and stroke mortality in the long-term. In 2002, China’s national average dietary salt intake is twice of the recommendation sodium intake limit by Chinese Nutrition Association. To tackle the health burden of excessive salt intake, the former Ministry of Health has chosen Shandong province as national pilot and launched the Shandong & Ministry of Health Action on Salt and Hypertension (SMASH, 2011[[Unable to Display Character: &#8211;]]2015) project. Objective: To develop and target intervention priority, a cross-sectional population survey was conducted to collect baseline data on sodium intake and sources in Shandong adults in 2011. Methods: We used multi-stage clustering sampling method to select the provincial representative sample for Shandong adults aged 18~69 years old. The selected adults were invited to participate the questionnaire survey and consecutive three-round 24-hour dietary recall. The Chinese 24-hour dietary recall includes two parts, cooking condiment weighting and the food (exclude the condiment) intake diary. The sodium contents in the condiments and food were calculated by using reference values from China Food Composition 2004. Results: Overall, 2140 community adult residents were included in the data analysis. The total average dietary sodium intake estimated by 24-hour dietary recall was 5745mg (95%CI: 5428-6063). Men (6147mg/d, 5824-6471) consumed higher sodium than women (5339 mg/d, 5006-5673) (P<0.05). The majority of dietary sodium (81%) was from cooking condiments including salt, soy sauce, sauce and monosodium glutamate (MSG), with a mean sodium intake of 4640mg (4360-4920). Out of the cooking condiments, salt added during food preparation was the leading source (63%) of sodium intake, up to 3638mg/d (3397-3879) sodium intake. Sodium intake from processed food was account for 10% of the total sodium intake, averaged at 582 mg (498-666) sodium intake for Shandong adults. Conclusion: The Shandong adults consume excessive sodium than the recommendation intake and most is from the condiments added at cooking.

Salt and high blood pressure

2009 ◽  
Vol 117 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Sailesh Mohan ◽  
Norm R. C. Campbell
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Blood Pressure ◽  
Intervention Studies ◽  
Salt Intake ◽  
Dietary Sodium ◽  
World Health ◽  
Dietary Salt ◽  
Salt Reduction ◽  
The World

HBP (high blood pressure) is the leading risk of death in the world. Unfortunately around the world, blood pressure levels are predicted to become even higher, especially in developing countries. High dietary salt is an important contributor to increased blood pressure. The present review evaluates the association between excess dietary salt intake and the importance of a population-based strategy to lower dietary salt, and also highlights some salt-reduction strategies from selected countries. Evidence from diverse sources spanning animal, epidemiology and human intervention studies demonstrate the association between salt intake and HBP. Furthermore, animal studies indicate that short-term interventions in humans may underestimate the health risks associated with high dietary sodium. Recent intervention studies have found decreases in cardiovascular events following reductions in dietary sodium. Salt intake is high in most countries and, therefore, strategies to lower salt intake could be an effective means to reduce the increasing burden of HBP and the associated cardiovascular disease. Effective collaborative partnerships between governments, the food industry, scientific organizations and healthcare organizations are essential to achieve the WHO (World Health Organization)-recommended population-wide decrease in salt consumption to less than 5 g/day. In the milieu of increasing cardiovascular disease worldwide, particularly in resource-constrained low- and middle-income countries, salt reduction is one of the most cost-effective strategies to combat the epidemic of HBP, associated cardiovascular disease and improve population health.

scholarly journals Progress on sodium reduction in South Korea

2020 ◽  
Vol 5 (5) ◽  
pp. e002028 ◽  
Author(s):  
Hye-Kyung Park ◽  
Yoonna Lee ◽  
Baeg-Won Kang ◽  
Kwang-il Kwon ◽  
Jong-Wook Kim ◽  
...  
Keyword(s):  
South Korea ◽  
Sodium Intake ◽  
Home Monitoring ◽  
Monitoring And Evaluation ◽  
Dietary Sodium ◽  
Food Sources ◽  
Sodium Reduction ◽  
Salt Reduction ◽  
Low Sodium ◽  
Sodium Consumption

IntroductionHigh dietary sodium is a leading contributor to hypertension, and hypertension is the leading underlying cause of death globally. There is a robust body of evidence supporting the health benefits of sodium reduction. Sodium intake in South Korea is high, with about half the population consuming >4000 mg/day, twice the recommended upper limit.MethodsIn 2012, South Korea implemented its National Plan to Reduce Sodium Intake, with a goal of reducing population sodium consumption by 20%, to 3900 mg/day, by 2020. The plan included five key components: (1) a consumer awareness campaign designed to change food consumption behaviours; (2) increased availability of low-sodium foods at schools and worksites; (3) increased availability of low-sodium meals in restaurants; (4) voluntary reformulation of processed foods to lower sodium content; and (5) development of low-sodium recipes for food prepared at home. Monitoring and evaluation included tracking sodium intake and sources of dietary sodium using the Korea National Health and Nutrition Examination Survey.ResultsBy 2014, South Korea had reduced dietary sodium consumption among adults by 23.7% compared to a survey conducted in 2010 prior to implementation of a nationwide salt reduction campaign that used this comprehensive, multipronged approach. The reductions in sodium intake were accompanied by reductions in population blood pressure and hypertension prevalence. Although causal associations between the sodium reduction programme and reduced sodium intake cannot be made, the declines occurred with the introduction of the programme.ConclusionMulticomponent interventions have great potential to reduce population sodium intake. Lessons learnt from South Korea could be applied to other countries and are likely very relevant to other Asian countries with similar food sources and consumption profiles.

scholarly journals Protocol for developing the evidence base for a national salt reduction programme for India

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006629 ◽  
Author(s):  
Claire Johnson ◽  
Sailesh Mohan ◽  
Deversetty Praveen ◽  
Mark Woodward ◽  
Pallab K Maulik ◽  
...  
Keyword(s):  
Rural Areas ◽  
Population Survey ◽  
Salt Intake ◽  
Scientific Evidence ◽  
Stakeholder Analysis ◽  
Urban Slum ◽  
Evidence Base ◽  
Nutritional Composition ◽  
Dietary Sodium ◽  
Salt Reduction

IntroductionThe scientific evidence base in support of salt reduction is strong but the data required to translate these insights into reduced population salt intake are mostly absent. The aim of this research project is to develop the evidence base required to formulate and implement a national salt reduction programme for India.Methods and analysisThe research will comprise three components: a stakeholder analysis involving government, industry, consumers and civil society organisations; a population survey using an age-stratified and sex-stratified random samples drawn from urban (slum and non-slum) and rural areas of North and South India; and a systematic quantitative evaluation of the nutritional components of processed and restaurant foods. The stakeholder interviews will be analysed using qualitative methods to summarise the main themes and define the broad range of factors influencing the food environment in India. The population survey will estimate the mean daily salt consumption through the collection of 24 h urine samples with concurrent dietary surveys identifying the main sources of dietary sodium/salt. The survey of foods will record the nutritional composition of the chief elements of food supply. The findings from this research will be synthesised and proposals for a national salt reduction strategy for India will be developed in collaboration with key stakeholders.Ethics and disseminationThis study has been approved by the Human Research Ethics Committees of the University of Sydney and the Centre for Chronic Disease Control in New Delhi, and also by the Indian Health Ministry's Screening Committee. The project began fieldwork in February 2014 and will report the main results in 2016. The findings will be targeted primarily at public health policymakers and advocates, but will be disseminated widely through other mechanisms including conference presentations and peer-reviewed publications, as well as to the participating communities.

scholarly journals National survey to estimate sodium and potassium intake and knowledge attitudes and behaviours towards salt consumption of adults in the Sultanate of Oman

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037012
Author(s):  
Adhra Al-Mawali ◽  
Lanfranco D'Elia ◽  
Sathish Kumar Jayapal ◽  
Magdi Morsi ◽  
Waleed Nasser Al-Shekaili ◽  
...  
Keyword(s):  
Salt Intake ◽  
Dietary Sodium ◽  
Secondary Outcome ◽  
Potassium Excretion ◽  
Sultanate Of Oman ◽  
Cross Sectional ◽  
Salt Reduction ◽  
Salt Consumption ◽  
Physical Measurements ◽  
Sodium And Potassium

ObjectivesTo estimate population sodium and potassium intakes and explore knowledge, attitudes and behaviour (KAB) towards the use of salt in adults in the Sultanate of Oman.DesignNational cross-sectional population-based survey.SettingProportional random samples, representative of Omani adults (18 years or older), were obtained from all governorates of the Sultanate of Oman.ParticipantsFive hundred and sixty-nine (193 men, 376 women; 18 years or older) were included in the analysis (response rate 57%). Mean age was 39.4 years (SD 13.1). Participants attended a screening including demographic, anthropometric and physical measurements.Primary and secondary outcome measuresWe assessed dietary sodium, potassium and creatinine by 24-hour urinary sodium (UNa), potassium (UK) and creatinine (UCr) excretions. We collected KAB by a questionnaire on an electronic tablet.ResultsMean UNa was 144.3 (78.8) mmol/day, equivalent to 9.0 g of salt/day and potassium excretion 52.6 (32.6) mmol/day, equivalent to 2.36 g/day, after adjusting for non-urinary losses. Men ate significantly more sodium and potassium than women. Only 22% of the sample had a salt intake below the WHO recommended target of 5 g/day and less than 10% met WHO targets for potassium excretion (>90 mmol/day). While 89.1% of those interviewed knew that consuming too much salt could cause serious health problems and only 6.9% felt they were using too much added salt, one in two participants used always or often salt, salty seasonings or salty sauces in cooking or when preparing food at home.ConclusionsIn the Sultanate of Oman, salt consumption is higher and potassium consumption lower than recommended by WHO, both in men and in women. The present data provide, for the first time, evidence to support a national programme of population salt reduction to prevent the increasing burden of cardiovascular disease in the area.

scholarly journals Effect of salt reduced bread alone or with dietary counselling on 24-hour excretion of sodium, potassium and sodium/potassium ratio

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Nanna Louise Riis ◽  
Kirsten Bjørnsbo ◽  
Anne Dahl Lassen ◽  
Ellen Trolle ◽  
Amalie Frederiksen ◽  
...  
Keyword(s):  
Risk Factor ◽  
Salt Intake ◽  
Salt Content ◽  
Dietary Sodium ◽  
Wheat Bread ◽  
Control Group ◽  
Sodium Potassium ◽  
Salt Reduction ◽  
Potassium Intake ◽  
Dietary Counselling

AbstractExcess dietary sodium plays an important role in hypertension, a leading risk factor for cardiovascular disease (CVD). To counteract some of the negative effects of sodium, an increased intake of potassium has shown beneficial effects on blood pressure. In fact, the sodium to potassium ratio might be a stronger risk factor for CVD than either sodium or potassium alone. The objective of the present study was to estimate the effect of A) a salt reduction strategy (providing salt reduced bread) and B) a salt reduction and potassium promoting strategy (providing salt reduced bread combined with dietary counselling), on intake of sodium, potassium and the sodium/potassium ratio. The study is a 4-month cluster randomized controlled trial with families randomly assigned to either intervention A, intervention B or control. Participants in intervention A received bread gradually reduced in salt content from 1.2 g salt/100 g to 0.6 g salt/100 g in ryebread and 0.4 g salt/100 g in wheat bread. Participants in intervention B received the same salt reduced bread and in addition dietary counselling on how to eat food with less salt and more potassium. The control group received standard bread (1.2 g salt/100g). Sodium and potassium intake were measured through three consecutive 24-hour urine measurements in adults and one in children at baseline and follow-up. Changes in outcomes were assessed using linear mixed models. Eighty-nine families, including 155 adults (46.5 % men) and 156 children (51.9 % boys), from the suburb of Copenhagen, Denmark, participated in the study. The sodium/potassium ratio was significantly reduced by -0.57 ± 0.19 mmol/L (P = 0.003) in intervention B compared to control group, resulting from a non-significant lower sodium and increased potassium intake. No significant differences were found between intervention A and control group (preliminary results). These findings support future actions to reduce salt intake, focusing on a combination of structural and educational strategies.

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