scholarly journals Salt reduction in bread: Is it enough? Preliminary results of a HIA in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Santos ◽  
P Braz ◽  
A Costa ◽  
L Costa ◽  
M Santos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Statistical Difference ◽  
Salt Intake ◽  
Statistical Significance ◽  
Systolic Pressure ◽  
Health Impact ◽  
World Health ◽  
Salt Reduction ◽  
Aggregated Data ◽  
The Impact

Abstract Issue Health Impact Assessment (HIA) is a methodology that aims at assessing the impact of policies in health. A pilot HIA is in progress to kick off the implementation of this methodology in Portugal with the support of the World Health Organization (WHO). In this context, the impact of a nation-wide policy that intends to achieve a maximum of 1 g of salt/100 gr in bread is under assessment. Description of the issue In 2017, Portugal approved a protocol between the industry and other stakeholders to gradually decrease the amount of salt in bread, as this is the main source of salt intake. The purpose of this study was to assess the impact in blood pressure from current (1.4 gr) to 1 g (29% reduction) of salt in bread. Data from two different surveys regarding blood pressure and salt intake was gathered. We estimated the decrease in blood pressure with respect to current average values according to sex, age, education and region. Results It is expected that a reduction of 29% in salt intake through bread contributes to a general decrease in systolic pressure for normotensive people (from 120.4mmHg to 120.0mmHg, p = 0.85) and hypertensive people (from 151.0mmHg to 150.1mmHg, p = 0.68), although not statistically significant. Older hypertensive individuals (65 to 75 years) are the group with the largest benefit (152.8mmHg to 152.0mmHg) but no statistical difference was found. Disaggregation by sex, region and education also didn’t show any statistical difference. Lessons The impact in blood pressure from a 29% reduction in salt intake from bread seems very small. We found no statistical significance between the current and expected values in blood pressure either for total or group stratification. The absence of statistical effect might be due to sample size as our sources only allowed us to work with aggregated data. Key messages Quality and access to data is needed to assess impact of policies. to increase effects in blood pressure either salt reduction from bread must be larger or a wider range of products should be considered.

Sodium and potassium intake, blood pressure, and cardiovascular prevention

ESC CardioMed ◽  
2018 ◽  
pp. 2431-2444
Author(s):  
Francesco P. Cappuccio
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
World Health Organization ◽  
Salt Intake ◽  
World Health ◽  
Salt Reduction ◽  
Potassium Intake ◽  
Salt Consumption ◽  
The World ◽  
Health Organization

Salt consumption is now much greater than needed for survival. High salt intake increases blood pressure in both animals and humans. Conversely, a reduction in salt intake causes a dose-dependent reduction in blood pressure in men and women of all ages and ethnic groups, and in patients already on medication. The risk of strokes and heart attacks rises with increasing blood pressure, but can be decreased by antihypertensive drugs. However, most cardiovascular disease events occur in individuals with ‘normal’ blood pressure levels. Non-pharmacological prevention is therefore the only option to reduce such events. Reduction in population salt intake reduces the number of vascular events. It is one of the most important public health measures to reduce the global cardiovascular burden. Salt reduction policies are powerful, rapid, equitable, and cost saving. The World Health Organization recommends reducing salt consumption below 5 g per day aiming at a global 30% reduction by 2025. A high potassium intake lowers blood pressure in people with and without hypertension. Its beneficial effects extend beyond blood pressure, and may include a reduction in the risk of stroke (independent of blood pressure changes). Potassium intake in the Western world is relatively low, and a lower potassium intake is associated with increased risks of cardiovascular disease, especially stroke. A moderate increase in potassium intake, either as supplement or with diet, reduces blood pressure, and the World Health Organization has issued global recommendations for a target dietary potassium intake of at least 90 mmol/day (≥3510 mg/day) for adults.

scholarly journals Assessment of Sodium Knowledge and Urinary Sodium Excretion among Regions of the United Arab Emirates: A Cross-Sectional Study

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2747
Author(s):  
Amjad H. Jarrar ◽  
Lily Stojanovska ◽  
Vasso Apostolopoulos ◽  
Leila Cheikh Ismail ◽  
Jack Feehan ◽  
...  
Keyword(s):  
United Arab Emirates ◽  
Sodium Excretion ◽  
Salt Intake ◽  
Urinary Sodium Excretion ◽  
World Health ◽  
High Potassium ◽  
Cross Sectional ◽  
Salt Reduction ◽  
High Salt Intake ◽  
The Impact

Non-communicable diseases (NCDs) such as cardiovascular disease, cancer and diabetes, are increasing worldwide and cause 65% to 78% of deaths in the Gulf Cooperation Council (GCC). A random sample of 477 healthy adults were recruited in the United Arab Emirates (UAE) in the period March–June 2015. Demographic, lifestyle, medical, anthropometric and sodium excretion data were collected. A questionnaire was used to measure knowledge, attitude and practice regarding salt. Mean sodium and potassium excretion were 2713.4 ± 713 mg/day and 1803 ± 618 mg/day, respectively, significantly higher than the World Health Organization (WHO) recommendations for sodium (2300 mg/day) and lower for potassium (3150 mg/day). Two-thirds (67.4%) exceeded sodium guidelines, with males 2.6 times more likely to consume excessively. The majority of the participants add salt during cooking (82.5%) and whilst eating (66%), and 75% identified processed food as high source of salt. Most (69.1%) were aware that excessive salt could cause disease. Most of the UAE population consumes excess sodium and insufficient potassium, likely increasing the risk of NCDs. Despite most participants being aware that high salt intake is associated with adverse health outcomes, this did not translate into salt reduction action. Low-sodium, high-potassium dietary interventions such as the Mediterranean diet are vital in reducing the impact of NCDs in the UAE.

P1691Impact of dose and duration of dietary salt reduction on blood pressure levels: systematic review and meta-analysis of randomised trials

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Huang ◽  
K Trieu ◽  
S Yoshimura ◽  
M Woodward ◽  
N Campbell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Sodium Excretion ◽  
Salt Intake ◽  
Meta Analysis ◽  
Dietary Salt ◽  
Baseline Blood Pressure ◽  
Salt Reduction ◽  
The Impact

Abstract Background Authoritative medical and public health agencies in most countries advise to reduce population dietary salt intake to under 5–6 g/day as a strategy for preventing high blood pressure and cardiovascular disease. However, there is still dispute about whether salt reduction should be adopted by all populations. In addition, the effect of duration of dietary salt reduction has not been sufficiently investigated. Purpose To understand the effect of dietary salt reduction on blood pressure and the impact of intervention duration. Methods A systematic review and meta-analysis was conducted. Randomized controlled trials that allocated participants to low and high salt intake, without confounding from unequal concomitant interventions, were included. We excluded studies done in individuals younger than 18 years, pregnant women, individuals with renal disease or heart failure, and studies with sodium excretion estimated from spot urine. Random effect meta-analysis was used to generate pooled estimates of the effect on 24-hour urinary sodium excretion, systolic and diastolic blood pressure. Multivariate meta-regression was used to quantify the dose response effect of dietary salt on blood pressure change and to understand the impact of the intervention duration. Results 125 studies were included with 162 data points extracted. Ninety-nine data points (61%) had interventions under 4 weeks. Overall, 24-hour urinary sodium excretion changed by −141 mmol (95% CI: −156; −126), systolic blood pressure changed by −4.4 mm Hg (95% CI: −5.2; −3.7) and diastolic blood pressure changed by −2.4 mm Hg (95% CI: −2.9; −1.9). Sodium reduction resulted in a significant decrease of systolic blood pressure in all subgroups except in participants with low baseline sodium intake (<109 mmol) (Figure 1). Each 100 mmol reduction of sodium was associated with 2.7 mm Hg (95% CI: 1.0; 4.4; p=0.002) reduction of systolic blood pressure and 1.2 mm Hg (95% CI: 0.0; 2.4; p=0.046) reduction of diastolic blood pressure after adjusting for intervention duration, age, sex, race, baseline blood pressure, baseline sodium intake and interaction between age and baseline blood pressure. For the same amount of salt reduction, a 10 mm Hg higher baseline systolic blood pressure would result in 2.5 mm Hg greater reduction of systolic blood pressure. There is not enough evidence to show the impact of intervention duration. Figure 1 Conclusions Our meta-analysis showed that sodium reduction could reduce blood pressure in all adult populations regardless of age, sex and race. The effect of salt reduction on systolic blood pressure increases with higher baseline blood pressure. Further studies, designed to investigate the impact of intervention duration, are needed to understand the significance of the duration. Acknowledgement/Funding None

scholarly journals Blood Pressure Screening Campaign in the Adult Population

Health Scope ◽  
2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Seyed Farzad Jalali ◽  
Mostafa Javanian ◽  
Reza Ghadimi ◽  
Ali Bijani ◽  
Simin Mouodi
Keyword(s):  
Blood Pressure ◽  
Diastolic Pressure ◽  
Screening Program ◽  
Adult Population ◽  
Systolic Pressure ◽  
World Health ◽  
Historical Cohort ◽  
Urban Regions ◽  
Significant Difference ◽  
The Impact

Background: World Health Organization estimated that 1 in 4 men and 1 in 5 women have hypertension (HTN). Considering the impact of high blood pressure (BP) identification to prevent its related complications. Objectives: this study was performed to describe the first national BP screening program conducted in Babol, north of Iran. Methods: In this historical cohort carried out at Babol University of Medical Sciences, data related to the 2019 BP screening mass campaign in adult people ≥ 30 years were collected. BP less than 120/80 mm Hg was considered as normal, and mean BP ≥ 140/90 mm Hg or taking antihypertensive medication was defined as hypertension. When the systolic pressure was 120 - 139 or the diastolic pressure was 80 - 90 mm Hg, the person was classified as a prehypertensive case. Results: Totally, 220,241 adult people, with a mean age of 49.82 ± 14.26 years were screened, of whom 42,107 cases (19.1%; 95% CI: 18.95 - 19.28%) had hypertension, 112,406 cases (51.0%) had normal BP, and 65,728 cases (29.8%) were diagnosed as prehypertensive cases. After controlling for demographic covariates, the logistic regression models showed significantly higher odds of hypertension for married individuals (adjusted OR = 1.23; 95% CI: 1.19 - 1.27; P < 0.0001) and those living in urban regions (adjusted OR = 1.84; 95% CI: 1.79 - 1.88; P < 0.0001). The prevalence of hypertension showed no significant difference between men and women (P = 0.476). Conclusions: As nearly one in five adults had hypertension, and nearly 30% were diagnosed as prehypertensive individuals, a continuous BP screening program is recommended in this region. High BP was observed more in older and married cases and in people living in urban regions.

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

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.

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 Salt and Bread: Latvia’S Experience

2013 ◽  
Vol 67 (4-5) ◽  
pp. 383-388
Author(s):  
Daiga Kunkulberga ◽  
Endija Mūrniece
Keyword(s):  
Blood Pressure ◽  
Salt Intake ◽  
Positive Impact ◽  
Critical Role ◽  
Blood Pressure Level ◽  
World Health ◽  
Salt Reduction ◽  
Lower Blood ◽  
Health Organization ◽  
Common Vision

Abstract Much research has shown that reduction in salt intake can have a very positive impact on human health, as salt intake plays a critical role in regulating blood pressure. According to the World Health Organization, populations with low salt intake, all other factors being equal, usually have lower blood pressure level, in that way decreasing the risk of cardiovascular disease. The main source of salt in the diet is ready-made food, and only about 11% of overall salt intake is the salt people add to their food themselves. A common EU framework for salt reduction has been developed, which describes a common vision for a general European approach towards salt reduction. Bread has been identified as an important contributor to the daily salt intake in many countries. On the other hand, salt has important technological functions in bakery products. It improves the qualities of dough, fermentation, and flavour of bread. The aim of this paper was to evaluate the amount of salt in Latvian bread and to assess the need for decreasing the amount of salt in bread. The majority of Latvian bread contains 1.1 to 1.2% salt in flour, but in some other kinds of bread it is even less.

scholarly journals Qual é o Impacto da Redução da Ingestão de Sal na Pressão Arterial? Análise da Revisão Sistemática Cochrane “Effect of longer-term modest salt reduction on blood pressure. He FJ, Li J, Macgregor GA. Cochrane Database Syst Rev. 2013 Apr 30;4:CD004937.

2013 ◽  
Vol 26 (5) ◽  
pp. 490
Author(s):  
Daniel Caldeira ◽  
António Vaz-Carneiro ◽  
João Costa
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Salt Intake ◽  
Plasma Renin ◽  
Cochrane Collaboration ◽  
Salt Reduction ◽  
Arterial Blood ◽  
Cochrane Database ◽  
The Impact

In the present article we evaluate and comment the systematic review from Cochrane Collaboration “Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev. 2013 Apr 30;4:CD004937”.Clinical Question: What is the impact of long-term (≥ 4 weeks) modest salt (sodium chloride) reduction on arterial blood pressure?Conclusions: This systematic review concluded that a moderate reduction in salt intake (mean reduction -4.4 g per day) resulted in statistically significant decreases in blood pressure (BP) that may be helpful in normotensive (-2.42 mmHg systolic BP; -1.00 mmHg diastolic BP) and hypertensive patients (-5.39 mmHg systolic BP; -2.82 mmHg diastolic BP). There were slight increases in physiological plasma renin activity, aldosterone and norepinephrine, without significant changes in lipid profile.

scholarly journals Impact of an Innovative Equipment to Monitor and Control Salt Usage during Cooking at Home on Salt Intake and Blood Pressure—Randomized Controlled Trial iMC SALT

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 8
Author(s):  
Tânia Silva-Santos ◽  
Pedro Moreira ◽  
Olívia Pinho ◽  
Patrícia Padrão ◽  
Sandra Abreu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Salt Intake ◽  
Intervention Group ◽  
World Health ◽  
Salt Consumption ◽  
Urinary Potassium ◽  
And Control ◽  
The Impact ◽  
Monitor And Control ◽  
At Home

(1) Background: Excessive salt consumption is associated with an increased risk of hypertension and cardiovascular disease, and it is essential to reduce it to the level recommended by the World Health Organization (<5 g/day). The main objective of this study is to verify the impact of an intervention, which used the Salt Control H equipment to reducing salt consumption; (2) Methods: The study was an 8-week randomized control trial with 114 workers from a public university. The intervention group (n = 57) used the equipment to monitor and control the use of salt during cooking (Salt Control H) at home for 8 weeks. The primary outcome was 24 h urinary sodium excretion as a proxy of salt intake. Secondary outcomes included changes in 24 h urinary potassium excretion, sodium to potassium ratio (Na:K), and blood pressure. (3) Results: There was a decrease in sodium intake after the intervention but with no statistical significance. When analyzing the results by sex and hypertension status, there was a reduction in sodium (−1009 (−1876 to −142), p = 0.025) and in Na:K ratio (−0.9 (−1.5 to −0.3), p = 0.007) in hypertensive men in the intervention group. (4) Conclusions: Interventions with dosage equipment can be valid approaches in individual salt reduction strategies, especially in hypertensive men.

scholarly journals Innovative equipments to monitor and control salt usage during culinary

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.

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