Labelling the salt content in foods: a useful tool in reducing sodium intake in Finland

AbstractObjectiveTo estimate the impact of choosing food products labelled either as low or high in salt on salt intake in the Finnish adult population.Setting and subjectsThe National FINDIET 2002 survey with 48-hour recalls from 2007 subjects aged 25–64 years. Sodium intake was calculated based on the Fineli® food composition database including the sodium content of natural and processed foods as well as the salt content of recipes. The distribution of salt intake was calculated in different ways: the present situation; assuming that all breads, cheeses, processed meat and fish, breakfast cereals and fat spreads consumed would be either ‘lightly salted’ or ‘heavily salted’ based on the current labelling practice; and, in addition, assuming that all foods would be prepared with 50% less or more salt.ResultsExcluding underreporters, the mean salt intake would be reduced by 1.8 g in men and by 1.0 g in women if the entire population were to choose lightly salted products and further by 2.5 and 1.8 g, respectively, if also salt used in cooking were halved. Choosing heavily salted products would increase salt intake by 2.1 g in men and by 1.4 g in women. In the worst scenarios, salt intake would be further increased by 2.3 g in men and by 1.6 g in women.ConclusionsThese calculations show that the potential impact of labelling and giving consumers the possibility to choose products with less salt is of public health importance. In addition, strategies to reduce the salt content of all food groups are needed.

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Sodium Content of Foods Sold in the Spanish Market. Results from the BADALI Project

Nutrients ◽

10.3390/nu13103410 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3410

Author(s):

Marta Beltrá ◽

Fernando Borrás ◽

Ana B. Ropero

Keyword(s):

Sodium Salt ◽

Salt Intake ◽

Sodium Intake ◽

Salt Content ◽

Daily Intake ◽

Food Group ◽

Sodium Content ◽

High Sodium ◽

Low Sodium ◽

Pan American

High sodium/salt intake is a risk factor for Non-Communicable Diseases (NCDs). Excess sodium intake has been associated with high coronary heart disease, stroke and high blood pressure. The sodium daily intake is above the recommendations in the world as well as in Spain. Reducing salt content in processed foods and ready meals is one of the main strategies for reducing sodium intake. The aim of the present work is to characterise the presence of sodium in foods sold in the Spanish market. We also study a possible shift in sodium content in products over the last few years. For this purpose, 3897 products included in the BADALI food database were analysed, classified into 16 groups (G). We found that 93.3% of all foods displayed the sodium/salt content in the nutrition declaration. Meat—processed and derivatives (G8) had the highest mean and median values for sodium content, followed by snacks (G15) and sauces (G14). Only 12.7% of foods were sodium-free (≤ 5 mg/100 g or 100 mL), 32.4% had very low sodium (≤ 40 mg/100 g or 100 mL) and 48.2% were low in sodium (≤ 120 mg/100 g or 100 mL). On the contrary, 47.2% were high in sodium according to the Pan American Health Organisation Nutrient Profile Model (PAHO-NPM), while there were 31.9% according to the Chile-NPM. The agreement between the two NPMs was considered ‘substantial’ (κ = 0.67). When sodium content was compared over the years, no decrease was observed. This analysis was performed in the entire food population, by food group and in matched products. Therefore, more effort should be made by all parties involved in order to decrease the sodium/salt intake in the population.

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Abstract P355: Sodium and Potassium 24 Hours Excretion in The Italian Adult Population: Preliminary Results of The MINISAL-GIRCSI Study

Circulation ◽

10.1161/circ.125.suppl_10.ap355 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Chiara Donfrancesco ◽

Renato Ippolito ◽

Cinzia Lo Noce ◽

Luigi Palmieri ◽

Roberto Iacone ◽

...

Keyword(s):

Sodium Chloride ◽

Potassium Chloride ◽

Salt Intake ◽

Adult Population ◽

Salt Content ◽

Processed Meat ◽

Health Examination ◽

Preliminary Results ◽

Italian Regions ◽

Sodium And Potassium

Background: According to the recommendation of the High Level Group of the European Union within the “Gaining health: make healthy choices easy choice” Preventive Program of the Italian Ministry of Health, the agreement with bread makers' associations was signed for the gradual reduction of the salt content in bread. In Italy, information about habitual sodium and potassium intake is scanty. In order to monitor preventive actions of this Preventive Programme the MINISAL-GIRCSI Study is to assess the dietary intake of sodium and potassium in representative samples of the Italian adult population. Methods: Baseline data from 12 different random samples collected within the MINISAL-GIRCSI-Health Examination Survey started in 2008, with completed screening and laboratory determinations, were considered: 1196 men and 1231 women aged 35-79 years. Sodium and potassium daily intakes were assessed through 24-hour urine collection using standardized procedures. Determinations of sodium, potassium and creatinine were assessed in a centralized laboratory. Information on habit of adding salt to food and the consumption of high salt content food were collected through a questionnaire. Results: Mean of sodium chloride per day resulted 11 g in men and 8 g in women with a range of 1-27 g and 2-27 g respectively. Mean of potassium chloride per day resulted 5 g in men and 4 g in women with a range of 1-13 g and 1-9 g respectively. Mean of creatinine per day resulted 1463 mg in men and 942 mg in women. Mean of urine volume per day resulted 1861 ml in men and 1827 ml in women. In both men and women, higher intake of sodium chloride was found in Southern regions; no geographical differences were found for potassium chloride. Sodium and potassium chloride excretions were not found higher with increasing age. Most of persons (72%) eat three slices of bread per day and 22% eat cheese and processed meat more than 4 times per week. Thirteen percent of persons usually add salt during meals and 19% are usually thirsty after meals. Conclusions: Preliminary results show that Italian adult population take more than double of WHO recommended salt intake; this is typical in industrialized countries. Further analyses considering data from other Italian regions are needed to confirm these values. The prevention actions at population level should include recommendations for reducing salt intake.

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Abstract P352: Trend of Salt Consumption in Italy From 2008 to 2018: Preliminary Results of the Cuore Project

Circulation ◽

10.1161/circ.141.suppl_1.p352 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Chiara Donfrancesco ◽

Cinzia Lo Noce ◽

Ornella Russo ◽

Daniela Minutoli ◽

Anna Di Lonardo ◽

...

Keyword(s):

Sodium Chloride ◽

Confidence Interval ◽

Salt Intake ◽

Sodium Intake ◽

Action Plan ◽

Adult Population ◽

Salt Content ◽

Relative Reduction ◽

Salt Reduction ◽

Random Samples

Introduction: The WHO Global Action Plan for the Prevention of Non-Communicable Diseases (NCDs) recommends a 30% relative reduction in mean population intake of salt/sodium. To this end, the Italian Ministry of Health (MoH) has strengthened prevention and health promotion through the “Gaining health: making healthy choices easy” Programme and the National Preventive Plan (NPP) 2014-2019, with the collaboration of the Interdisciplinary Working group for Salt Reduction in Italy (GIRCSI). Hypothesis: Agreements between the MoH and the associations of artisan bakers and food industry companies were signed since 2009 to reduce the salt content in bread and in other food products. Within the NPP, initiatives as local inter-sectors agreements and information activities for the population and training for food sector operators are implemented. In order to estimate the habitual salt intake and its trend in the general adult population, national surveys, funded by the MoH-CCM, are conducted within the CUORE Project. Methods: Baseline salt intake by the use of 24h urine collections was assessed in 2008-2012 from random samples of persons aged 35-79 years, resident in all Italian 20 Regions. A new survey is ongoing (2018-2019) involving random samples of persons aged 35-74 years, resident in 10 Regions. Urinary sodium excretion is assayed by a central lab at Federico II University of Naples, subjected to strict quality controls. Comparisons are made considering, for both periods, the seven regions examined up to now in the ongoing survey and the age range of 35-74 years. Results: Within the 2018-2019 survey, mean level of sodium chloride per day in 673 men and 709 women was 161 mmol (95% confidence interval: 156-166 mmol) and 122 mmol (119-126 mmol) respectively, whereas in the 2008-2012 survey the corresponding mean levels in 642 men and 627 women was 183 mmol (95% confidence interval: 178-189 mmol) and 140 mmol (135-144 mmol), respectively. A sodium chloride intake level within the WHO recommended upper level of 85 mmol (or 5 grams of salt) per day was detected in 9% (6-11%) of men and 24% (20-27%) of women examined in 2018-2019 vs 5% (3-6%) of men and 16% (13-19%) of women examined in 2008-2012. Conclusions: These preliminary data show that the average habitual sodium intake in Italy is still largely higher than recommended but a significant reduction seems to occur. These results fully justify and encourage the ongoing preventive initiatives for reduction of sodium intake and its monitoring in the population.

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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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Potential impact of a modest reduction in salt intake on blood pressure, cardiovascular disease burden and premature mortality: a modelling study

Open Heart ◽

10.1136/openhrt-2018-000943 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000943 ◽

Cited By ~ 4

Author(s):

Leopold Ndemnge Aminde ◽

Linda J Cobiac ◽

J Lennert Veerman

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Heart Disease ◽

Salt Intake ◽

Sodium Intake ◽

Premature Mortality ◽

Relative Reduction ◽

Life Years ◽

Potential Impact ◽

The Impact

ObjectiveTo assess the potential impact of reduction in salt intake on the burden of cardiovascular disease (CVD) and premature mortality in Cameroon.MethodsUsing a multicohort proportional multistate life table model with Markov process, we modelled the impact of WHO’s recommended 30% relative reduction in population-wide sodium intake on the CVD burden for Cameroonian adults alive in 2016. Deterministic and probabilistic sensitivity analyses were conducted and used to quantify uncertainty.ResultsOver the lifetime, incidence is predicted to decrease by 5.2% (95% uncertainty interval (UI) 4.6 to 5.7) for ischaemic heart disease (IHD), 6.6% (95% UI 5.9 to 7.4) for haemorrhagic strokes, 4.8% (95% UI 4.2 to 5.4) for ischaemic strokes and 12.9% (95% UI 12.4 to 13.5) for hypertensive heart disease (HHD). Mortality over the lifetime is projected to reduce by 5.1% (95% UI 4.5 to 5.6) for IHD, by 6.9% (95% UI 6.1 to 7.7) for haemorrhagic stroke, by 4.5% (95% UI 4.0 to 5.1) for ischaemic stroke and by 13.3% (95% UI 12.9 to 13.7) for HHD. About 776 400 (95% UI 712 600 to 841 200) health-adjusted life years could be gained, and life expectancy might increase by 0.23 years and 0.20 years for men and women, respectively. A projected 16.8% change (reduction) between 2016 and 2030 in probability of premature mortality due to CVD would occur if population salt reduction recommended by WHO is attained.ConclusionAchieving the 30% reduction in sodium intake recommended by WHO could considerably decrease the burden of CVD. Targeting blood pressure via decreasing population salt intake could translate in significant reductions in premature CVD mortality in Cameroon by 2030.

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Blood Pressure and Intra-Erythrocyte Sodium during Normal and High Salt Intake in Middle-Aged Men: Relationship to Family History of Hypertension, and Neurogenic and Hormonal Variables

Clinical Science ◽

10.1042/cs0660427 ◽

1984 ◽

Vol 66 (4) ◽

pp. 427-433 ◽

Cited By ~ 8

Author(s):

Ottar Gudmundsson ◽

Hans Herlitz ◽

Olof Jonsson ◽

Thomas Hedner ◽

Ove Andersson ◽

...

Keyword(s):

Blood Pressure ◽

Family History ◽

Salt Intake ◽

Sodium Intake ◽

Positive Family History ◽

Sodium Content ◽

High Salt Intake ◽

History Of ◽

Family History Of Hypertension ◽

Erythrocyte Sodium

1. During 4 weeks 37 normotensive 50-year-old men identified by screening in a random population sample were given 12 g of NaCl daily, in addition to their usual dietary sodium intake. Blood pressure, heart rate, weight, urinary excretion of sodium, potassium and catecholamines, plasma aldosterone and noradrenaline and intra-erythrocyte sodium content were determined on normal and increased salt intake. The subjects were divided into those with a positive family history of hypertension (n = 11) and those without such a history (n = 26). 2. Systolic blood pressure and weight increased significantly irrespective of a positive family history of hypertension. 3. On normal salt intake intra-erythrocyte sodium content was significantly higher in those with a positive family history of hypertension. During high salt intake intra-erythrocyte sodium content decreased significantly in that group and the difference between the hereditary subgroups was no longer significant. 4. In the whole group urinary excretion of noradrenaline, adrenaline and dopamine increased whereas plasma aldosterone decreased during the increased salt intake. 5. Thus, in contrast to some earlier studies performed in young subjects, our results indicate that moderately increased sodium intake acts as a pressor agent in normotensive middle-aged men whether there was a positive family history of hypertension or not. We confirm that men with positive family history of hypertension have an increased intra-erythrocyte sodium content, and that an increase in salt intake seems to increase overall sympathetic activity.

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Change in Salt Intake Affects Blood Pressure of Chimpanzees

Circulation ◽

10.1161/circulationaha.106.675579 ◽

2007 ◽

Vol 116 (14) ◽

pp. 1563-1568 ◽

Cited By ~ 78

Author(s):

Paul Elliott ◽

Lesley L. Walker ◽

Mark P. Little ◽

John R. Blair-West ◽

Robert E. Shade ◽

...

Keyword(s):

Blood Pressure ◽

Confidence Interval ◽

Human Population ◽

Salt Intake ◽

Homo Sapiens ◽

Sodium Intake ◽

Systolic Pressure ◽

Sodium Content ◽

Standard Diet ◽

Arterial Blood

Background— Addition of up to 15.0 g/d salt to the diet of chimpanzees caused large rises in blood pressure, which reversed when the added salt was removed. Effects of more modest alterations to sodium intakes in chimpanzees, akin to current efforts to lower sodium intakes in the human population, are unknown. Methods and Results— Sodium intakes were altered among 17 chimpanzees in Franceville, Gabon, and 110 chimpanzees in Bastrop, Tex. In Gabon, chimpanzees had a biscuit diet of constant nutrient composition except that the sodium content was changed episodically over 3 years from 75 to 35 to 120 mmol/d. In Bastrop, animals were divided into 2 groups; 1 group continued on the standard diet of 250 mmol/d sodium for 2 years, and sodium intake was halved for the other group. Lower sodium intake was associated with lower systolic, diastolic, and mean arterial blood pressures in Gabon (2-tailed P <0.001, unadjusted and adjusted for age, sex, and baseline weight) and Bastrop ( P <0.01, unadjusted; P =0.08 to 0.10, adjusted), with no threshold down to 35 mmol/d sodium. For systolic pressure, estimates were −12.7 mm Hg (95% confidence interval, −16.9 to −8.5, adjusted) per 100 mmol/d lower sodium in Gabon and −10.9 mm Hg (95% confidence interval, −18.9 to −2.9, unadjusted) and −5.7 mm Hg (95% confidence interval, −12.2 to 0.7, adjusted) for sodium intake lower by 122 mmol/d in Bastrop. Baseline systolic pressures higher by 10 mm Hg were associated with larger falls in systolic pressure by 4.3/2.9 mm Hg in Gabon/Bastrop per 100 mmol/d lower sodium. Conclusions— These findings from an essentially single-variable experiment in the species closest to Homo sapiens with high intakes of calcium and potassium support intensified public health efforts to lower sodium intake in the human population.

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Sodium Levels of Processed Meat in Australia: Supermarket Survey Data from 2010 to 2017

Nutrients ◽

10.3390/nu10111686 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1686 ◽

Cited By ~ 5

Author(s):

Emalie Sparks ◽

Clare Farrand ◽

Joseph Santos ◽

Briar McKenzie ◽

Kathy Trieu ◽

...

Keyword(s):

Sodium Intake ◽

Meat Products ◽

Monitoring And Evaluation ◽

Sodium Content ◽

World Health ◽

Processed Meat ◽

High Sodium ◽

Processed Meats ◽

Health Organization ◽

Health Dialogue

High sodium intake increases blood pressure and consequently increases the risk of cardiovascular diseases. In Australia, the best estimate of sodium intake is 3840 mg sodium/day, almost double the World Health Organization (WHO) guideline (2000 mg/day), and processed meats contribute approximately 10% of daily sodium intake to the diet. This study assessed the median sodium levels of 2510 processed meat products, including bacon and sausages, available in major Australian supermarkets in 2010, 2013, 2015 and 2017, and assessed changes over time. The median sodium content of processed meats in 2017 was 775 mg/100 g (interquartile range (IQR) 483–1080). There was an 11% reduction in the median sodium level of processed meats for which targets were set under the government’s Food and Health Dialogue (p < 0.001). This includes bacon, ham/cured meat products, sliced luncheon meat and meat with pastry categories. There was no change in processed meats without a target (median difference 6%, p = 0.450). The new targets proposed by the current government’s Healthy Food Partnership capture a larger proportion of products than the Food and Health Dialogue (66% compared to 35%) and a lower proportion of products are at or below the target (35% compared to 54%). These results demonstrate that voluntary government targets can drive nutrient reformulation. Future efforts will require strong government leadership and robust monitoring and evaluation systems.

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Sodium intake and dietary sources of sodium in undergraduate students from Novi Sad, Serbia

Vojnosanitetski pregled ◽

10.2298/vsp141010063j ◽

2016 ◽

Vol 73 (7) ◽

pp. 651-656 ◽

Cited By ~ 7

Author(s):

Jelena Jovicic-Bata ◽

Maja Grujicic ◽

Slavica Radjen ◽

Budimka Novakovic

Keyword(s):

Undergraduate Students ◽

Sodium Intake ◽

Sodium Content ◽

Bakery Products ◽

Food Groups ◽

High Sodium ◽

Dietary Recall ◽

Novi Sad ◽

The University ◽

Total Sodium

Background/Aim. Data on sodium intake and sources of sodium in the diet in Serbia are limited. The aim of this study was to estimate the sodium intake and identify the sources of sodium in the diet of undergraduate students attending the University of Novi Sad. Methods. Students completed a questionnaire to gather data on their gender, age and university faculty attended, and then a 24 h dietary recall. The sodium intake of the students was calculated using the dietary recall data and data on the sodium content of foods. The contribution of different food groups as well as of specific foodstuffs to the total sodium intake was calculated. Results. The mean estimated sodium intake of the students was 3,938.5 ? 1,708.1 mg/day. The sodium intake of 89.1% of the surveyed students exceeded the guideline for sodium intake, the majority of the sodium coming from processed foods (78.9% of the total sodium intake). The food groups that contributed the most to the total sodium intake of the students were meat and meat products (21.7%) and cereals and cereal-based products (18.6%). Bread and other bakery products were responsible for 13.1% of the total sodium intake. Conclusion. High sodium intake in students of the University of Novi Sad puts them at high risk of developing high blood pressure. The food industry should work towards reformulating products with high sodium content, especially bread and other bakery products. Efforts should be taken to reduce sodium intake among undergraduate students in Novi Sad.

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Associations of eating and drinking habits with cardiovascular disease and diabetes in the adult population: data from the ESSE-RF epidemiological study

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2021-2982 ◽

2021 ◽

Vol 20 (5) ◽

pp. 2982

Author(s):

N. S. Karamnova ◽

A. I. Rytova ◽

O. B. Shvabskaya ◽

Yu. K. Makarova ◽

S. A. Maksimov ◽

...

Keyword(s):

Salt Intake ◽

Eating Habits ◽

Adult Population ◽

Daily Intake ◽

Population Data ◽

Processed Meat ◽

Daily Consumption ◽

Frequency Method ◽

Animal Fats ◽

Drinking Habits

The presence of a disease, the prognosis of which can be improved by dietary modification, motivates a patient to change their eating habits.Aim. To study the associations of dietary patterns and alcohol consumption with cardiovascular diseases (CVDs), diabetes, myocardial infarction (MI), and stroke in the adult population.Material and methods. The analysis was carried out using data from representative samples of population from 13 Russian regions aged 2564 years (n=19520; men, 7329; women, 12191). The response rate was ~80%. Dietary characteristics were assessed by frequency method.Results. In the diet of people with CVDs, the daily intake of vegetables/ fruits increases by 84% in men and by 19% in women, while the use of animal fats in cooking decreases by 28% and 20%m respectively (p<0,0001). Women with CVDs reduce the consumption of processed meat and sweets by 16 and 19%, respectively (p<0,005). Persons with prior MI reduce the consumption of sweets in the diet: men by 38% and women by 30%. Men with prior MI have higher daily consumption of cereals by 31%, vegetables and fruits by 46%, low-fat dairy products — 2,4 times. In addition, they are more adherent to a healthy and cardioprotective diet by 3,65 and 1,75 times, respectively. Dietary changes in those with prior stroke were noted only in women in the form of a 29% decrease in excess salt intake (p=0,0075). In the diet of people with diabetes, there is decreased consumption of sweets and an increased intake of vegetables/fruits: by 77 and 69% in men and by 79 and 69% in women, respectively (p<0,0001). Men with diabetes are 3 times more likely to adhere to a healthy diet, and women — 2,3 times (p=0,0039 and p<0,0001, respectively).Conclusion. Patients with CVDs, MI, and diabetes have a healthier diet than healthy persons.

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