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

2021 ◽  
Vol 40 (S1) ◽  
Author(s):  
Siew Man Cheong ◽  
Rashidah Ambak ◽  
Fatimah Othman ◽  
Feng J. He ◽  
Ruhaya Salleh ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Sodium Intake ◽  
Dietary Sodium ◽  
Health Concern ◽  
Sodium Reduction ◽  
Salt Reduction ◽  
Complex Sample ◽  
Health Organization

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

scholarly journals Developing a Web-based dietary sodium screening tool for personalized assessment and feedback

2014 ◽  
Vol 39 (3) ◽  
pp. 413-414 ◽  
Author(s):  
JoAnne Arcand ◽  
Kasim Abdulaziz ◽  
Carol Bennett ◽  
Mary R. L’Abbé ◽  
Douglas G. Manuel
Keyword(s):  
Screening Tool ◽  
Sodium Intake ◽  
Public Health Problem ◽  
Canadian Community Health Survey ◽  
Dietary Sodium ◽  
Sodium Reduction ◽  
Important Public Health Problem ◽  
Web Based ◽  
University Of Toronto ◽  
Sodium Consumption

Dietary sodium reduction is commonly used in the treatment of hypertension, heart and liver failure, and chronic kidney disease. Sodium reduction is also an important public health problem since most of the Canadian population consumes sodium in excess of their daily requirements. Lack of awareness about the amount of sodium consumed and the sources of sodium in diet is common, and undoubtedly a major contributor to excess sodium consumption. There are few known tools available to screen and provide personalized information about sodium in the diet. Therefore, we developed a Web-based sodium intake screening tool called the Salt Calculator ( www.projectbiglife.ca ), which is publicly available for individuals to assess the amount and sources of sodium in their diet. The Calculator contains 23 questions focusing on restaurant foods, packaged foods, and added salt. Questions were developed using sodium consumption data from the Canadian Community Health Survey cycle 2.2 and up-to-date information on sodium levels in packaged and restaurant food databases from the University of Toronto. The Calculator translates existing knowledge about dietary sodium into a tool that can be accessed by the public as well as integrated into clinical practice to address the high levels of sodium presently in the Canadian diet.

scholarly journals Perceptions and Feasibility of Actions Related to Sodium Reduction among Restaurant Owners and Cooks in Seongnam, South Korea: Comparison According to Stages of Behavioral Change

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4375
Author(s):  
So-Hyun Ahn ◽  
Jong-Sook Kwon ◽  
Kyungmin Kim ◽  
Hye-Kyeong Kim
Keyword(s):  
Regression Analysis ◽  
South Korea ◽  
Behavioral Change ◽  
Sodium Intake ◽  
Sodium Reduction ◽  
Factors Associated ◽  
Low Sodium ◽  
Independent Variable ◽  
Restaurant Meals ◽  
Restaurant Owners

With the increase in meals eaten outside the home, sodium reduction in restaurant foods is essential for reducing sodium intake. This study aimed to assess the stages of behavioral change for reducing sodium and the differences in perceptions among restaurant staff by stage. Restaurant owners and cooks (n = 313) in Seongnam, South Korea were surveyed on their stage of behavioral change, practices, and perceptive factors related to sodium reduction in restaurant meals using a questionnaire. The proportion of behavioral change by stage was 20.4% in the maintenance and action (MA) stage, 32.3% in the preparation (P) stage, and 47.3% in the pre-preparation (PP) stage, which included contemplation and pre-contemplation stages. The items that represent differences among the groups were recognition of social environment for sodium reduction, practice of weighing condiments and measuring salinity, and feasibility of actions related to low-sodium cooking. Logistic regression analysis was used to estimate odds ratios for practice and perceptive factors by using stage of behavioral change as the independent variable. Factors associated with being in the MA stage were weighing condiments, measuring salinity, and high feasibility of actions related to low-sodium cooking. Recognition of sodium labeling and anticipation of better taste by reducing sodium increased the odds of being in the P stage rather than the PP stage. These results suggest that customized stepwise education and support are needed for the efficacy of restaurant-based sodium reduction programs.

scholarly journals Sodium Sensitivity, Sodium Resistance, and Incidence of Hypertension

Hypertension ◽  
2021 ◽  
Author(s):  
Jiang He ◽  
Jian-Feng Huang ◽  
Changwei Li ◽  
Jing Chen ◽  
Xiangfeng Lu ◽  
...  
Keyword(s):  
Sodium Intake ◽  
Experimental Studies ◽  
Dietary Sodium ◽  
Cross Sectional ◽  
Incident Hypertension ◽  
High Sodium ◽  
Sodium Sensitivity ◽  
Sodium Diet ◽  
Low Sodium ◽  
Increased Risk

Cross-sectional studies have reported that high sodium sensitivity is more common among individuals with hypertension. Experimental studies have also reported various animal models with sodium-resistant hypertension. It is unknown, however, whether sodium sensitivity and resistance precede the development of hypertension. We conducted a feeding study, including a 7-day low-sodium diet (1180 mg/day) followed by a 7-day high-sodium diet (7081 mg/day), among 1718 Chinese adults with blood pressure (BP) <140/90 mm Hg. We longitudinally followed them over an average of 7.4 years. Three BP measurements and 24-hour urinary sodium excretion were obtained on each of 3 days during baseline observation, low-sodium and high-sodium interventions, and 2 follow-up studies. Three trajectories of BP responses to dietary sodium intake were identified using latent trajectory analysis. Mean (SD) changes in systolic BP were −13.7 (5.5), −4.9 (3.0), and 2.4 (3.0) mm Hg during the low-sodium intervention and 11.2 (5.3), 4.4 (4.1), and −0.2 (4.1) mm Hg during the high-sodium intervention ( P <0.001 for group differences) in high sodium-sensitive, moderate sodium-sensitive, and sodium-resistant groups, respectively. Compared with individuals with moderate sodium sensitivity, multiple-adjusted odds ratios (95% CIs) for incident hypertension were 1.43 (1.03–1.98) for those with high sodium sensitivity and 1.43 (1.03–1.99) for those with sodium resistance ( P =0.006 for nonlinear trend). Furthermore, a J-shaped association between systolic BP responses to sodium intake and incident hypertension was identified ( P <0.001). Similar results were observed for diastolic BP. Our study indicates that individuals with either high sodium sensitivity or sodium resistance are at an increased risk for developing hypertension.

scholarly journals Blood Pressure Effects of Sodium Reduction

Circulation ◽  
2021 ◽  
Vol 143 (16) ◽  
pp. 1542-1567 ◽  
Author(s):  
Tommaso Filippini ◽  
Marcella Malavolti ◽  
Paul K. Whelton ◽  
Androniki Naska ◽  
Nicola Orsini ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trials ◽  
Linear Relationship ◽  
Dose Response ◽  
Sodium Intake ◽  
Experimental Studies ◽  
Dietary Sodium ◽  
Response Analysis ◽  
Sodium Reduction

Background: The relationship between dietary sodium intake and blood pressure (BP) has been tested in clinical trials and nonexperimental human studies, indicating a direct association. The exact shape of the dose–response relationship has been difficult to assess in clinical trials because of the lack of random-effects dose–response statistical models that can include 2-arm comparisons. Methods: After performing a comprehensive literature search for experimental studies that investigated the BP effects of changes in dietary sodium intake, we conducted a dose–response meta-analysis using the new 1-stage cubic spline mixed-effects model. We included trials with at least 4 weeks of follow-up; 24-hour urinary sodium excretion measurements; sodium manipulation through dietary change or supplementation, or both; and measurements of systolic and diastolic BP at the beginning and end of treatment. Results: We identified 85 eligible trials with sodium intake ranging from 0.4 to 7.6 g/d and follow-up from 4 weeks to 36 months. The trials were conducted in participants with hypertension (n=65), without hypertension (n=11), or a combination (n=9). Overall, the pooled data were compatible with an approximately linear relationship between achieved sodium intake and mean systolic as well as diastolic BP, with no indication of a flattening of the curve at either the lowest or highest levels of sodium exposure. Results were similar for participants with or without hypertension, but the former group showed a steeper decrease in BP after sodium reduction. Intervention duration (≥12 weeks versus 4 to 11 weeks), type of study design (parallel or crossover), use of antihypertensive medication, and participants’ sex had little influence on the BP effects of sodium reduction. Additional analyses based on the BP effect of difference in sodium exposure between study arms at the end of the trial confirmed the results on the basis of achieved sodium intake. Conclusions: In this dose–response analysis of sodium reduction in clinical trials, we identified an approximately linear relationship between sodium intake and reduction in both systolic and diastolic BP across the entire range of dietary sodium exposure. Although this occurred independently of baseline BP, the effect of sodium reduction on level of BP was more pronounced in participants with a higher BP level.

scholarly journals Repeated Exposure to Low-Sodium Cereal Affects Acceptance but Does not Shift Taste Preferences or Detection Thresholds of Children in a Randomized Clinical Trial

2019 ◽  
Vol 149 (5) ◽  
pp. 870-876 ◽  
Author(s):  
Nuala Bobowski ◽  
Julie A Mennella
Keyword(s):  
Repeated Measures ◽  
Salt Intake ◽  
Energy Content ◽  
Sodium Intake ◽  
Dietary Sodium ◽  
Taste Preferences ◽  
Detection Thresholds ◽  
Salt Taste ◽  
Low Sodium ◽  
Secondary Outcomes

ABSTRACT Background Although salt taste preference is malleable in adults, no research to date has focused on children, whose dietary sodium intake exceeds recommended intake and whose salt taste preferences are elevated. Objective This proof-of-principle trial determined whether 8-wk exposure to low-sodium cereal (LSC) increased children's acceptance of its taste and changed their salty and sweet taste preferences. Methods Children (n = 39; ages 6–14 y; 67% female) were randomly assigned to ingest LSC or regular-sodium cereal (RSC) 4 times/wk for 8 wk. The cereals, similar in sugar (3 g/cup compared with 2 g/cup) and energy content (100 kcal/cup) yet different in sodium content (200 mg sodium/cup compared with 64 mg sodium/cup), were chosen based on taste evaluation by a panel of children. Mothers completed daily logs on children's cereal intake. At baseline and after the exposure period, taste tests determined which cereal children preferred and measured children's most preferred amount of salt (primary outcomes), and most preferred amount of sucrose and salt taste detection thresholds (secondary outcomes). Repeated measures ANOVAs were conducted on primary and secondary outcomes, and generalized estimating equations were conducted on amount of cereal ingested at home over time. Results Both treatment groups accepted and ate the assigned cereal throughout the 8-wk exposure. There were no group × time interactions in salt detection thresholds (P = 0.32) or amount of salt (P = 0.30) and sucrose (P = 0.77) most preferred, which were positively correlated (P = 0.001). At baseline and after the exposure, the majority in both groups preferred the taste of the RSC relative to LSC (P > 0.40). Conclusions Children showed no change in salt preference but readily ate the LSC for 8 consecutive weeks. Findings highlight the potential for reducing children's dietary salt intake by incorporating low-sodium foods in the home environment without more preferred higher-salt versions of these foods. This trial was registered at clinicaltrials.gov as NCT02909764.

Sodium reduction in butter using microparticulated salt

2019 ◽  
Vol 121 (4) ◽  
pp. 874-881 ◽  
Author(s):  
Daniela da Costa de Oliveira ◽  
Amanda Cristina Cristina Andrade ◽  
Jéssica Guimarães ◽  
Jéssica Ferreira Rodrigues ◽  
Mariana Mirelle Pereira Natividade ◽  
...  
Keyword(s):  
Sodium Intake ◽  
Scientific Information ◽  
Salt Content ◽  
Sodium Content ◽  
Sodium Reduction ◽  
Salt Reduction ◽  
Content Type ◽  
Significant Difference ◽  
Liquid Products ◽  
The Ideal

Purpose Excessive sodium intake is associated with several diseases. Accordingly, several measures, including microparticulate salt, have been adopted to reduce the salt contents of food products. However, no studies have reported the effectiveness of microparticulate salt in semisolid and liquid products. Accordingly, the purpose of this paper is to evaluate the application of microparticulate salt to reduce sodium contents in semisolid products. Design/methodology/approach The optimal salt content to be added in butter was defined by the just-about-right-scale test. Butter samples were prepared using microparticulate salt to achieve 25, 50 and 75 per cent reductions in conventional salt concentrations. Multiple comparison tests were performed to evaluate sample taste. Findings The ideal concentration of conventional salt to be added to butter was 2.16 per cent. Discriminative tests showed that samples with 25 and 75 per cent salt reduction showed significant differences (p ⩽ 0.05) compared with butter prepared at the ideal salt content, whereas the sample with 50 per cent salt reduction had no significant difference (p > 0.05). Thus, microparticulate salt showed higher salting power than conventional salt. These results indicated the effectiveness of microparticulate salt in the preparation of semisolid products with sodium reduction. Research limitations/implications More detailed studies about the reduced-sodium butter shelf life are necessary to verify the microparticulate salt application in the product preparation. Moreover, microparticulate salt application in semisolid and liquid products elaboration must be more investigated to better elucidate its practicability of reducing sodium content in these kinds of products. Therefore, researchers are encouraged to test the proposed propositions further. Practical implications Microparticulate salt has been successfully applied to reduce sodium in solid products, being added to the finished product surface. However, there are no studies that report its effectiveness in semisolid and liquid products, such as the butter, in which the salt is added during the product preparation. Thus, this research provides new scientific information to the food industry and research fields, to expand the knowledge of reduced-sodium products development using microparticulate salt with sensory quality. Originality/value No studies have evaluated the application of microparticulate salt for semisolid product preparation. Therefore, the findings will support the development of healthy products.

Sodium chloride supplementation of high-grain diets for fattening Merino sheep

1957 ◽  
Vol 8 (1) ◽  
pp. 83 ◽  
Author(s):  
GL McClymont ◽  
KN Wynne ◽  
PK Briggs ◽  
MC Franklin
Keyword(s):  
Sodium Chloride ◽  
Sodium Intake ◽  
The Other ◽  
Dietary Sodium ◽  
Limiting Factor ◽  
Food Utilization ◽  
Merino Sheep ◽  
Low Sodium ◽  
Cent Sodium ◽  
The One

In an experiment lasting 60 days the effect of adding sodium chloride to five types of diet was studied in young Merino wethers. The diets used were 100 per cent. oat grain, and 50 : 50 as well as 75 : 25 mixtures of oat grain with lucerne chaff on the one hand, and with wheaten chaff on the other. The addition of 0.25 per cent. sodium chloride to these diets resulted in increased food consumption and improved efficiency of food utilization, with significant increases of 19-58 per cent. in body-weight gains. The unsupplemented diets contained 0.009-0.062 per cent. sodium and 0.05-0.42 per cent. chlorine. There were indications that the lack of sodium was the limiting factor in these diets, and that the sodium requirement of these sheep was greater than 0.06 per cent. of the diet, or 0.88 g per day. Dietary sodium intake did not affect serum-sodium levels, except those of sheep fed on the 50 : 50 mixture of oats and lucerne chaff in which they were significantly higher. Serum-potassium levels were slightly, but significantly, higher in sheep fed on the low-sodium diets. In a second experiment the two groups which had received the 75 : 25 mixture of oat grain and wheaten chaff were fed on the mixture for a further 29 days, but the group which had not received sodium chloride was given 0.37 per cent. sodium bicarbonate. The response was similar to that of the group which received sodium chloride.

Adrenergic control of renin during dietary sodium deprivation in conscious dogs

1989 ◽  
Vol 256 (6) ◽  
pp. E863-E871 ◽  
Author(s):  
H. Hisa ◽  
Y. H. Chen ◽  
K. J. Radke ◽  
J. L. Izzo ◽  
C. D. Sladek ◽  
...  
Keyword(s):  
Sodium Intake ◽  
Conscious Dogs ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Adrenergic Stimulation ◽  
Sodium Diet ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
Dietary Sodium Restriction

These experiments evaluated the contribution of alpha- and beta-adrenergic stimulation to plasma renin activity (PRA) during early and long-term dietary sodium restriction, compared with normal sodium intake. Uninephrectomized conscious dogs with catheters in the aorta, vena cava, and remaining renal artery were studied during normal sodium diet (approximately 70 meq/day), after 2-3 days of low-sodium diet (5-7 meq/day), and after greater than or equal to 2 wk of low-sodium diet. Direct renal arterial (ira) infusion of phenoxybenzamine plus propranolol decreased PRA by similar proportions (39-48%) during all three states of dietary sodium intake. The PRA achieved after adrenergic blockade remained higher (P less than 0.05) during early and long-term sodium restriction than during normal sodium intake. The effect on PRA of ira infusion of propranolol alone was not different from that of phenoxybenzamine plus propranolol during normal or low-sodium diet, and the magnitude of decrease in PRA during low-sodium diet was the same whether propranolol (1 microgram.kg-1.min-1) was infused ira or intravenously. In summary, beta-adrenergic stimulation accounts for similar proportions of PRA during early and long-term dietary sodium restriction and during normal sodium intake. Renal alpha-adrenoceptors appear to play little or no role in control of PRA under these conditions.

Salt and cardiovascular disease: insufficient evidence to recommend low sodium intake

2020 ◽  
Vol 41 (35) ◽  
pp. 3363-3373 ◽  
Author(s):  
Martin O’Donnell ◽  
Andrew Mente ◽  
Michael H Alderman ◽  
Adrian J B Brady ◽  
Rafael Diaz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Events ◽  
Sodium Intake ◽  
Dietary Factors ◽  
Dietary Sodium ◽  
Current Evidence ◽  
Current Guideline ◽  
Current Recommendation ◽  
Low Sodium

Abstract Several blood pressure guidelines recommend low sodium intake (&lt;2.3 g/day, 100 mmol, 5.8 g/day of salt) for the entire population, on the premise that reductions in sodium intake, irrespective of the levels, will lower blood pressure, and, in turn, reduce cardiovascular disease occurrence. These guidelines have been developed without effective interventions to achieve sustained low sodium intake in free-living individuals, without a feasible method to estimate sodium intake reliably in individuals, and without high-quality evidence that low sodium intake reduces cardiovascular events (compared with moderate intake). In this review, we examine whether the recommendation for low sodium intake, reached by current guideline panels, is supported by robust evidence. Our review provides a counterpoint to the current recommendation for low sodium intake and suggests that a specific low sodium intake target (e.g. &lt;2.3 g/day) for individuals may be unfeasible, of uncertain effect on other dietary factors and of unproven effectiveness in reducing cardiovascular disease. We contend that current evidence, despite methodological limitations, suggests that most of the world’s population consume a moderate range of dietary sodium (2.3–4.6g/day; 1–2 teaspoons of salt) that is not associated with increased cardiovascular risk, and that the risk of cardiovascular disease increases when sodium intakes exceed 5 g/day. While current evidence has limitations, and there are differences of opinion in interpretation of existing evidence, it is reasonable, based upon observational studies, to suggest a population-level mean target of &lt;5 g/day in populations with mean sodium intake of &gt;5 g/day, while awaiting the results of large randomized controlled trials of sodium reduction on incidence of cardiovascular events and mortality.

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