Salt as a public health challenge in continental European convenience and ready meals

AbstractObjectiveTo assess the salt content of continental European convenience and ready meals.DesignA multistage study in which, after laboratory analysis of the products’ salt contents (n32), new salt-reduced meals were developed through food reformulation. Additionally, a comprehensive survey of convenience meals from the Austrian market (n572) was conducted to evaluate the salt contents of a wider product range.SettingSix continental European countries participated.SubjectsNo subjects enrolled.ResultsThe salt contents of continental European convenience and ready meals mostly exceeded 1·8 g/100 g, which is 30 % of the targeted daily intake level; some contained even more than the recommended daily intake of 6 g. The highest salt contents were found in pizzas and pasta dishes, the lowest ones in sweet meals. Large variations in salt levels were found not only between and within meal type categories, but also between similar meals from different producers. In addition, our approach to develop new salt-reduced meals showed that a stepwise reduction of the ready meals’ salt contents is possible without compromising the sensory quality.ConclusionsTo address the problem of hypertension and increased risk for CVD through high salt intake, a reduction of the salt levels in continental European convenience and ready meals is urgently needed, since they are providing a major part of the daily salt intake. Successful national-wide salt reduction strategies in the UK or Finland have already demonstrated the public health impact of this setting.

Download Full-text

Salt and sugars content of breakfast cereals in the UK from 1992 to 2015

Public Health Nutrition ◽

10.1017/s1368980016003463 ◽

2017 ◽

Vol 20 (8) ◽

pp. 1500-1512 ◽

Cited By ~ 18

Author(s):

Sonia Pombo-Rodrigues ◽

Kawther M Hashem ◽

Feng J He ◽

Graham A MacGregor

Keyword(s):

Salt Intake ◽

Salt Content ◽

Nutrition Information ◽

Cross Sectional ◽

Product Packaging ◽

Salt Reduction ◽

Free Sugars ◽

Breakfast Cereals ◽

Sugar Reduction ◽

The Uk

AbstractObjectiveTo study the salt and sugars content of breakfast cereals sold in the UK between 1992 and 2015.DesignCross-sectional surveys on salt and sugars content collected from the nutrition information panel of breakfast cereals in 1992, 2004, 2006, 2009, 2012 and 2015.SettingAll major UK retailers operating at that moment in time (approximately ten).SubjectsThe salt and sugars content was collected from product packaging and the nutrition information panels.ResultsCereals consistently surveyed across all five years (n22) showed a significant reduction in salt content of 47 % (P<0·001). Sugars content of breakfast cereals (n 15), however, did not show a significant change; 25·65 g/100 g in 1992 and 22·45 g/100 g in 2015 (P=0·170). There was a large variation in salt and sugars content between different categories and within the same type of category.ConclusionsThe study shows the progressive reduction in salt content of breakfast cereals in the UK since 2004 as a result of the successful salt reduction programme, particularly the setting of incremental salt targets. Further reductions in salt content need to be made as cereals remain a major contributor to salt intake. Sugars content, however, has been consistently high due to the lack of a sugar reduction strategy. The research demonstrates that the sugars content of breakfast cereals in the UK is of concern, particularly in children’s breakfast cereals, with a typical serving (30 g) containing a third of a 4–6-year-old’s maximum daily recommendation (19 g/d) for free sugars intake in the UK. More can and should be done to reformulate, with an urgent need to set incremental sugar reduction targets.

Download Full-text

Reformulation of Romanian Meat Products and Cheeses: is this a Necessity for a Lower Salt Intake?

Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca Agriculture ◽

10.15835/buasvmcn-agr:6607 ◽

2011 ◽

Vol 68 (2) ◽

Author(s):

Corina Aurelia ZUGRAVU ◽

Monica PARVU ◽

Monica TARCEA ◽

Daniela PATRASCU ◽

Anca STOIAN-PANTEA

Keyword(s):

Salt Intake ◽

Scientific Evidence ◽

Salt Content ◽

Daily Intake ◽

Meat Products ◽

Food Chains ◽

Average Value ◽

Salt Consumption ◽

Increased Risk ◽

Food Diaries

Reducing salt is a major task for companies all over the world. Scientific evidence has linked excessive salt consumption to increased risk of high blood pressure. The question we tried to answer to is if meat products and cheeses need to be reformulated, in order to bring down their salt content, taking in account the daily intake of cold cuts and diary products in our country. The intake was assessed by 7-days food diaries, completed by a representative sample of Romanians. The values used for the salt content were computed from data gathered in Romania since 2007. The average value of salt for Romanian cheeses is 2.4 g /100 g and for meat products, 2, 2 g /100 g. The food diaries showed that meat products and cheeses cover low percents of the daily salt intake (4%; 4%), with little variations between regions of the country. The present study concludes that cheeses and cold cuts, although consumed in all Romanian regions, have not a great contribution to the total salt intake in our country, so reformulation is not an emergency. However, the producers have to target in future a better management of the use of salt in the food chains, in the frame of advised descendent trends of the salt quantity introduced in human food. It has to be kept in mind that as long as the technological process allows it, every milligram of salt taken away from the product `s recipe is a helper of the consumer `s health.

Download Full-text

Health impact assessment of salt reduction in bread in Portugal: a pilot study

10.1101/2021.12.20.21267610 ◽

2021 ◽

Author(s):

Joana Santos ◽

Joana Alves ◽

Paula Braz ◽

Roberto Brazao ◽

Alexandra Costa ◽

...

Keyword(s):

Salt Intake ◽

Meta Analysis ◽

Salt Content ◽

Analysis Data ◽

Health Impact ◽

Portuguese Population ◽

Salt Reduction ◽

National Surveys ◽

Health Gains ◽

The Impact

Hypertension is a risk factor for cardiovascular diseases, which can be caused by excessive salt intake. In Portugal, one of the main foods to contribute to ingestion of salt is bread. Thus, a voluntary Protocol was signed between stakeholders with the aim to reduce salt content in bread by 2021. Herein, a retrospective HIA was carried out to assess the impact in blood pressure (BP) after this agreement. In order to find average values of salt intake and BP in Portuguese population, national surveys were used. Also, estimates of BP reduction and its size effects were calculated based upon meta-analysis data. It is expected that salt intake will be reduced mostly in individuals with low educational level, men, aged between 65-74 years old and residents in South region of Portugal. Results in hypertensive patients indicate that a higher effect on BP will occur in the same profile of individuals, except age (between 55 and 64 years old). However, the estimated effect is very low for all groups, suggesting that the Protocol will contribute to modest health gains. Complementary measures supported by HIA studies need to be adopted to actively promote salt intake reduction and effectively prevent hypertension.

Download Full-text

Salt Content in Traditional and Nontraditional Breads in Yazd City, Iran, 2015-2016

Journal of Nutrition and Food Security ◽

10.18502/jnfs.v3i4.162 ◽

2018 ◽

Author(s):

Seyedeh Mahdieh Namayandeh ◽

Mohammad Hassan Lotfi ◽

Vahid Jafari ◽

Vali Dad ◽

Javad Biabani ◽

...

Keyword(s):

Salt Intake ◽

Salt Content ◽

Dietary Factors ◽

Dietary Salt ◽

Cross Sectional ◽

High Salt Intake ◽

Increased Risk ◽

Standard Level ◽

The Mean ◽

Yazd City

Background: Cardiovascular diseases (CVDs) are the leading cause of premature death in the 21st century. Dietary factors, such as high salt intake, are related to increased risk of CVDs{Akpolat, 2009 #21}. One of the main sources of dietary salt is bread. On the other hand, salt content is a quality indicator of bread. Therefore, this study was conducted to evaluate the salt content in a variety of consumed breads in Yazd city, Iran. Methods: This study was a cross sectional research conducted in Yazd. The list of the bakeries obtained from their industry office. Ten percent of about 600 bakeries in Yazd (62 bakeries; 2 samples in each bakery) were selected using simple random sampling based on sample frame of ID number of each bakery. Finally, 9 types of bread included in this study. Sodium content was measured using flame photometer method. Salt content in breads was reported in each 100 g bread. Results: It was found that Nan-Taftoon Tanuri is the most popular bread among traditional breads in Yazd (45.2%). It had significantly more salt than Nan-Fantezi and Nan-Sangak (P < 0.02). Also, Nan-Sangak had the least salt among traditional breads. However, the mean salt of traditional breads was more than the standard level (1g salt/100g bread (P < 0.0001). Conclusion: The current study showed that the mean salt content of traditional breads was significantly more than the standard level. Furthermore, Nan-TaftoonTanuri had significantly more salt than others, such as Nan-Fantezi and Nan-Sangak.

Download Full-text

Salt content of sauces in the UK and China: cross-sectional surveys

BMJ Open ◽

10.1136/bmjopen-2018-025623 ◽

2019 ◽

Vol 9 (9) ◽

pp. e025623

Author(s):

Monique Tan ◽

Feng J He ◽

Jingmin Ding ◽

Yuan Li ◽

Puhong Zhang ◽

...

Keyword(s):

Outcome Measure ◽

Salt Intake ◽

Salt Content ◽

Nutrition Information ◽

Cross Sectional ◽

Salt Reduction ◽

The Past ◽

Department Of Health ◽

The Uk ◽

Relative Change

Objectives(1) To assess the changes in the salt content of sauces in the UK in the past 10 years; (2) to compare the salt content of sauces in China with equivalent products sold in the UK and (3) to calculate the proportion of sauce products meeting the salt targets set by the UK Department of Health (DoH).DesignCross-sectional surveys from the nutrition information panels of sauces.SettingMajor retailers in London, Beijing and Shijiazhuang operating at data collection times.Main outcome measureSalt content of sauces.ResultsRelative change in the median salt content of UK products ranged from −70.6% to +3.0% in sauces for which salt targets were set, whereas it ranged from −27.1% to +111.5% in sauces without targets. Median salt contents were on average 4.4-fold greater in Chinese sauces compared with their UK equivalents surveyed during the same period (2015–2017). Only 13.4% of the Chinese products met the UK 2017 salt targets, compared with 70.0% of UK products.ConclusionIn the UK, the target-based approach contributed to the reduction in the salt content of sauces over the course of the past 10 years. Currently, large variations in salt content exist within the same categories of sauces and 70% of the products have met DoH’s 2017 targets, demonstrating that further reductions are possible and lower salt targets should be set. In China, salt content of sauces is extremely high with similarly large variations within same categories of sauces, demonstrating the feasibility of reducing their salt content. As processed foods (including sauces) are expected to become an important contributor to salt intake in China, national salt reduction efforts such as setting salt targets would be a valuable, proactive strategy.

Download Full-text

Knowledge and behaviors regarding salt intake according to urinary Na excretion and blood pressure

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.188 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

T Silva-Santos ◽

P Moreira ◽

P Padrão ◽

S Abreu ◽

O Pinho ◽

...

Keyword(s):

Blood Pressure ◽

Sodium Excretion ◽

Salt Intake ◽

Disease Risk ◽

Salt Content ◽

Urinary Sodium Excretion ◽

Processed Foods ◽

Salt Reduction ◽

High Salt Intake ◽

And Behaviors

Abstract Background Understanding salt-related knowledge, attitudes and behaviors can help the design of effective health interventions. Therefore, our objective was to describe knowledge and behaviors related to salt intake according to urinary sodium excretion and blood pressure in University workers. Methods We performed our study in a subsample of the participants of the iMC Salt project (n = 60 subjects, 60.5% women, mean age 48±9.5 years). Sodium excretion were measured by one 24-h urinary collection, validated by creatinine excretion and participants were grouped according to the WHO sodium recommendations (<2.0 g/day; high, ≥2.0 g/day). Subjects were classified as hypertensive if the systolic blood pressure was ≥130 mmHg and/or diastolic blood pressure was ≥80mmHg. Knowledge and behaviors regarding salt intake were assessed by the WHO Stepwise Approach to Chronic Disease Risk Factor Surveillance. Results About 74.6% of the participants reported that reducing salt in their diet was very important and 93.2% think that salt is harmful to health. However, 76.3% always add salt during cooking, 42.4% said that they always or often consume processed foods high in salt, 79.7% reported that they don't look at the salt on food labels, 50.8% don't buy low salt alternatives and 30.5% don't use spices as one substitute for salt when cooking. Hypertensive subjects had a higher mean sodium excretion (3710±1508mg/day vs 2478±871mg/day, p = 0.002) and reported a significant higher frequency of consumption of processed foods high in salt (53.1% vs 29.6%, p = 0.024). No significant differences were found with the other variables. Conclusions Most university workers were aware that high salt intake can cause health problems, but they reported low adherence to behaviors to control their salt intake. Hypertensive subjects recognized that frequently consume processed foods high in salt, so reduce salt content on those products could have important impact on their daily salt consumption. Key messages This study provides evidence on knowledge and behaviors regarding salt intake to guide salt reduction policies. Hypertensive participants reported a higher frequency of eating processed foods rich in salt.

Download Full-text

Monitoring of salt content during the dry salting of ham

Progress in Agricultural Engineering Sciences ◽

10.1556/446.2020.20006 ◽

2020 ◽

Author(s):

Anna Visy ◽

Karina Ilona Hidas ◽

József Surányi ◽

Gábor Jónás ◽

László Friedrich

Keyword(s):

Surface Layer ◽

Salt Intake ◽

Salt Content ◽

Daily Intake ◽

Salt Reduction ◽

Codex Alimentarius ◽

System Disease ◽

Excessive Consumption ◽

The Difference ◽

Atmosphere Storage

AbstractExcessive consumption of salt causes many diseases, including high blood pressure and cardiovascular system disease. In most countries, salt intake is above the WHO guideline daily intake. In Hungary, the average salt intake is more than double the recommended value. Based on these, significant changes are needed in food technology and recipes. To avoid excessive salt intake Hungary has joined the European Union's community program for salt reduction.The aim of this study was to compare the salt content in different areas of Mangalitsa ham during the dry salting, and compare the average salt content with the regulations of the Codex Alimentarius Hungaricus. The ham was dry salted with 10% by weight of the meat and placed in a controlled atmosphere storage room. The curing took 21 days. The NaCl uptake was measured with Mohr method. The ham was cut at 3 points Cushion (C), Fore Cushion (FC) and Butt End (BE). The salt content of BE was generally higher than the other two areas (C, FC). The differences can be explained by the difference in the thickness of the pieces of meat and fat. The average salt content of the different areas did not exceed the threshold limit in the Codex Alimentarius Hungaricus. At the beginning of the experiment, the salt content of each meat layer was very different, the absorbed salt was concentrated in the surface layer. Over time, as the ham lost a lot of water and due to the lack of outer salt, a significant increase in salt content began in the meat centrum. By day 80, the salt content of the meat centrum exceeded the salt content of both the fat and the surface layer.

Download Full-text

Innovative equipments to monitor and control salt usage during culinary

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.583 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C Gonçalves ◽

O Pinho ◽

P Padrão ◽

T Silva-Santos ◽

S Abreu ◽

...

Keyword(s):

Salt Intake ◽

Salt Content ◽

Clinical Intervention ◽

Health Impact ◽

Salt Reduction ◽

Salt Consumption ◽

Catering Industry ◽

And Control ◽

The Impact ◽

At Home

Abstract Issue In Portugal, most of the salt consumed comes from the salt added during preparation/cooking. Therefore, it is urgent to introduce mechanisms to allow the quantification of the salt in foods, and the salt added during culinary. Description of the Problem To tackle salt reduction, we considered: having a portable and user-friendly instrument that measure salt content of foods; and controlling the amount of salt added to foods during culinary, assessing its impact on health. The first project was SALT QUANTI (co-funded by NORTE 2020), promoted by a consortium between EVOLEO Technologies and the University of Porto (finished in September 2018, duration 18 months); its major deliverable was to obtain a prototype of a portable device and the analytical procedure that enabled the analysis of salt content in foods/meals produced in catering kitchens, in less than 5 minutes. The second project was iMC SALT (supported by FCT, Grant POCI-01-0145-FEDER-029269), started in July 2018 (duration 36 months), aiming to develop prototypes for controlling the amount of salt added to foods during culinary, at home and catering, according international recommendations; one clinical intervention to assess the impact on health of the prototype at home is underway. Results The SALT QUANTI and iMC SALT prototypes showed good results in validation tests. The preliminary results of the health impact of the iMC SALT prototype will be presented at the conference. Lessons The implementation of innovative equipments to help consumers and catering industry to monitor or control the addition of salt during preparation of food or cooking are expected to be available soon and to be useful to consumers and catering industry to reduce salt intake. Key messages Innovative equipments may contribute to estimate salt in foods, and to reduce salt added during culinary. The implementation of an equipment to control culinary salt could be one valid approach to reduce salt consumption with impact on health.

Download Full-text

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

Download Full-text

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.

Download Full-text