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 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 Development of an online tool for sodium intake assessment in Mexico

2019 ◽  
Vol 43 ◽  
pp. 1
Author(s):  
Eloisa Colín-Ramírez ◽  
Raúl Cartas-Rosado ◽  
Paola Vannesa Miranda Alatriste ◽  
Ángeles Espinosa Cuevas ◽  
JoAnne Arcand ◽  
...  
Keyword(s):  
Screening Tool ◽  
Sodium Intake ◽  
Sodium Content ◽  
Face Validity ◽  
Dietary Sodium ◽  
Food Category ◽  
Web Based ◽  
Online Tool ◽  
Adverse Health Effects ◽  
Home Style

Excess sodium intake is associated with adverse health effects, and reducing its intake is a strategy that improves population health. However, estimating sodium intake is challenging and new options for assessment are needed. This review describes the design and development of a web-based, publicly-accessible, dietary sodium intake screening tool (Calculadora de Sodio) for individuals in Mexico. Sodium data from 2017 – 2018 for 3 429 packaged foods, 655 restaurant and cafeteria foods, and 320 home-style meals and street foods (determined by chemical analysis) comprised the 71-question tool. It was piloted with 10 nutrition experts for feedback on content and face validity; and with 30 potential users to test its usability and interface. Improvements were made to content, language, and formatting following the pilot. Its predictive validity will be established in the future. The Calculadora de Sodio provides instant feedback on an individual’s average daily sodium intake, computed by frequency of intake, average number of servings, and sodium content per serving of each sodium-focused food category. This is the first web-based dietary sodium screening tool developed for the general population of Mexico. It is an efficient and practical way to assess sodium intake and can serve as a model for similar tools for other countries and regions.

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 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 Mapping Dietary Sodium Reduction Policies and Initiatives in the Region of the Americas

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1714-1714
Author(s):  
Nadia Flexner ◽  
Mary L'Abbé ◽  
Barbara Legowski ◽  
Ruben Grajeda Toledo
Keyword(s):  
Sodium Intake ◽  
Cost Effective ◽  
Dietary Sodium ◽  
World Health ◽  
Significant Advance ◽  
Relative Reduction ◽  
Sodium Reduction ◽  
Pan American ◽  
Reduce Sodium Intake ◽  
Health Organization

Abstract Objectives To map existing country policies addressing population dietary sodium reduction in the Americas; to identify policy gaps in the region following what is outlined in the World Health Organization (WHO) “Best Buys” most cost-effective recommendations for the prevention and control of diet-related noncommunicable diseases (NCDs); and to discuss priorities for future work in the Region. Methods This study used mixed methods to analyze data from 34 countries. Data were collected through a structured review, of mostly national official sources, to identify current policies in place to reduce population sodium intake. Also, responses from the last Pan American Health Organization (PAHO) online Survey on National Initiatives for Sodium Reduction in the Americas were included. Finally, country profiles were prepared and sent to each country's Public Health Agency for validation and comments. Results Almost all countries (n = 23/34) had a recommendation to reduce salt intake included in policies related to NCDs. Only six countries had specific and comprehensive policies to reduce sodium intake, and only one of them was a National Law. Adoption of the WHO “Best Buys” in national policies included: reformulation of food products with voluntary (n = 9/34) and mandatory targets (n = 2/34); establishment of a supportive environment in public institutions (n = 14/34); and implementation of front-of-pack labelling (n = 5/34). Some countries have implemented regulations restricting marketing of foods high in sodium to children (n = 5/34); nutritional labelling that includes sodium content, either voluntary (n = 9/34) or mandatory (n = 10/34); and no country has yet implemented taxes on high sodium foods. Conclusions In recent years, there has been a significant advance in policies to reduce sodium intake in the Region of the Americas. However, this review identified that the level of implementation in practice is complex to assess and quite heterogeneous. Reducing sodium consumption is a cost-effective intervention that can save many lives, by preventing and reducing the burden of diet related NCD's. Therefore, a further call to action is needed for governments to accelerate efforts in order to meet the 2025 global target of a 30% relative reduction in mean population intake of sodium. Funding Sources Pan American Health Organization (PAHO/WHO).

scholarly journals Assessment of salt intake: how accurate is it?

2013 ◽  
Vol 72 (3) ◽  
pp. 342-347 ◽  
Author(s):  
Catherine M. Champagne ◽  
Katherine C. Cash
Keyword(s):  
Cardiovascular Health ◽  
Salt Intake ◽  
Sodium Intake ◽  
Food Products ◽  
Sodium Content ◽  
Dietary Sodium ◽  
Cvd Risk ◽  
Average Intake ◽  
Health Related ◽  
Sodium Consumption

The aims of this review paper are to provide an overview of the association of sodium intake with cardiovascular health, to identify sodium in our global food supply and to describe problems associated with assessment of dietary sodium intake. Excess sodium intake may contribute to the development of hypertension in some individuals, consequently increasing CVD risk. The average intake of sodium in populations around the world far exceeds the actual body's needs. Processed and restaurant foods contribute the most dietary sodium for Americans and other populations worldwide. There is a worldwide focus on reducing sodium content of food products in an effort to reduce health related issues associated with excessive salt and sodium intake in individuals. In several countries, regulations have been introduced to lower the sodium content of foods. Manufacturers are complying with these regulations by formulating new products to meet these standards. However, the variability in food sodium content poses challenges to researchers to accurately assess dietary sodium intakes of individuals. There are differences in sodium content of foods in databases compared with nutritional information provided by manufacturers for the same food products. Variations also exist in restaurant foods, where values differ from those available on restaurant websites. Sodium may be either underestimated or overestimated; it is not always on target. Awareness of the variability among food products is crucial but capturing sodium content of every food in the market is not feasible. Whenever possible, updating databases is critical. In conclusion, it is not feasible to capture the sodium content of every food in the marketplace but being aware of these differences is essential to assessing actual sodium consumption. Since biological determinations are burdensome and impractical, it is imperative for researchers and other health professionals to participate in the development and implementation of tools to accurately assess sodium intake in individuals.

Policy Progress in Reducing Sodium in the American Diet, 2010–2019

2020 ◽  
Vol 40 (1) ◽  
pp. 407-435
Author(s):  
Aviva A. Musicus ◽  
Vivica I. Kraak ◽  
Sara N. Bleich
Keyword(s):  
Cardiovascular Disease ◽  
Sodium Intake ◽  
The United States ◽  
Dietary Sodium ◽  
Historical Overview ◽  
Sodium Reduction ◽  
The Us ◽  
Packaged Foods ◽  
Excess Sodium ◽  
Evidence For Policy

Most Americans consume dietary sodium exceeding age-specific government-recommended targets of 1,500–2,300 mg/day per person. The majority (71%) of US dietary sodium comes from restaurant and packaged foods. Excess sodium intake contributes to hypertension and cardiovascular disease, which is the leading cause of death in the United States. This review summarizes evidence for policy progress to reduce sodium in the US food supply and the American diet. We provide a historical overview of US sodium-reduction policy (1969–2010), then examine progress toward implementing the 2010 National Academy of Medicine (NAM) sodium report's recommendations (2010–2019). Results suggest that the US Food and Drug Administration made no progress in setting mandatory sodium-reduction standards, industry made some progress in meeting voluntary targets, and other stakeholders made some progress on sodium-reduction actions. Insights from countries that have significantly reduced population sodium intake offer strategies to accelerate US progress toward implementing the NAM sodium-reduction recommendations in the future.

scholarly journals Changing Sodium Knowledge, Attitudes and Intended Behaviours Using Web-Based Dietary Assessment Tools: A Proof-Of-Concept Study

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2186
Author(s):  
Katherine Jefferson ◽  
Zhila Semnani-Azad ◽  
Christina Wong ◽  
Mary R. L’Abbé ◽  
JoAnne Arcand
Keyword(s):  
Disease Risk ◽  
Sodium Intake ◽  
Dietary Assessment ◽  
Assessment Tools ◽  
Dietary Sodium ◽  
Web Based ◽  
Test Study ◽  
Validated Questionnaire ◽  
Before And After ◽  
Post Test

Despite public health efforts to reduce dietary sodium, sodium intakes in most countries remains high. The purpose of this study was to determine if using novel web-based tools that provide tailored feedback, the Sodium Calculator and Sodium Calculator Plus, improves users’ sodium-related knowledge, attitudes, and intended behaviours (KAB). In this single arm pre- and post-test study, 199 healthy adults aged 18–34 years completed a validated questionnaire to assess changes to sodium-related KAB before and after using the calculators. After using the calculators, the proportion of participants who accurately identified the sodium adequate intake and chronic disease risk reduction level increased (19% to 74% and 23% to 74%, respectively, both p = 0.021). The proportion accurately self-assessing their sodium intake as ‘high’ also increased (41% to 66%, p = 0.021). Several intended behavioural changes were reported, i.e., buying foods with sodium-reduced labels, using the Nutrition Facts table, using spices and herbs instead of salt, and limiting eating out. Evidence-based eHealth tools that assess and provide personalized feedback on sodium intake have the potential to aid in facilitating sodium reduction in individuals. This study is an important first step in evaluating and optimizing the implementation of eHealth tools to help reduce Canadians’ sodium intakes.

scholarly journals The Equity and Effectiveness of Achieving Canada’s Voluntary Sodium Reduction Guidance Targets: A Modelling Study Using the 2015 Canadian Community Health Survey—Nutrition

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 779
Author(s):  
Brendan T. Smith ◽  
Salma Hack ◽  
Mahsa Jessri ◽  
JoAnne Arcand ◽  
Lindsay McLaren ◽  
...  
Keyword(s):  
Community Health ◽  
Health Survey ◽  
Disease Risk ◽  
Sodium Intake ◽  
Canadian Community Health Survey ◽  
Sodium Reduction ◽  
High Sodium ◽  
Full Compliance ◽  
Social Inequities ◽  
Community Health Survey

Background: High sodium intake is a leading modifiable risk factor for cardiovascular diseases. This study estimated full compliance to Canada’s voluntary sodium reduction guidance (SRG) targets on social inequities and population sodium intake. Methods: We conducted a modeling study using n = 19,645, 24 h dietary recalls (Canadians ≥ 2 years) from the 2015 Canadian Community Health Survey—Nutrition (2015 CCHS-N). Multivariable linear regressions were used to estimate mean sodium intake in measured (in the 2015 CCHS-N) and modelled (achieving SRG targets) scenarios across education, income and food security. The percentage of Canadians with sodium intakes above chronic disease risk reduction (CDRR) thresholds was estimated using the US National Cancer Institute (NCI) method. Results: In children aged 2–8, achieving SRG targets reduced mean sodium intake differences between food secure and insecure households from 271 mg/day (95%CI: 75,468) to 83 mg/day (95%CI: −45,212); a finding consistent across education and income. Mean sodium intake inequities between low and high education households were eliminated for females aged 9–18 (96 mg/day, 95%CI: −149,341) and adults aged 19 and older (males: 148 mg/day, 95%CI: −30,327; female: −45 mg/day, 95%CI: −141,51). Despite these declines (after achieving the SRG targets) the majority of Canadians’ are above the CDRR thresholds. Conclusion: Achieving SRG targets would eliminate social inequities in sodium intake and reduce population sodium intake overall; however, additional interventions are required to reach recommended sodium levels.

scholarly journals Mapping dietary salt/sodium reduction policies and initiatives in the Region of the Americas

2021 ◽  
Keyword(s):  
Online Survey ◽  
Sodium Intake ◽  
Cost Effective ◽  
Dietary Sodium ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Significant Advance ◽  
Relative Reduction ◽  
Sodium Reduction ◽  
Dietary Salt

The aim of this study was to map existing country policies and initiatives addressing population dietary sodium reduction in the Region of the Americas; to identify policy gaps following what is outlined in the World Health Organization (WHO) “Best Buys” most cost-effective recommendations for the prevention and control of diet-related noncommunicable diseases (NCDs); and to discuss priorities for future work to reduce population salt/sodium intake. We analyzed data from 34 countries in the Region. A review of different databases informed the mapping. Databases included (1) responses from the online Survey on National Initiatives for Salt/Sodium Reduction in the Americas carried out by PAHO in 2016; (2) the databases from the 2017 and 2019 PAHO Country Capacity Surveys for NCDs and Risk Factors; and (3) the repositories of legislation of the PAHO REGULA initiative as of 2018. Research in these databases was complemented by electronic searches on official websites from the ministries of health, education, and agriculture and the library of the national congress in each country. Additionally, when available, government regulatory gazettes were reviewed. National policies that have adopted the most cost-effective interventions for preventing and controlling diet-related NCDs of WHO “Best Buys” included reformulating food products with both voluntary (n=11/34) and mandatory (n=2/34) targets; establishing a supportive environment in public institutions (n=13/34); consumer awareness programs (n=26/34) and behavior-change communication and mass media campaigns (n=(0/34); and implementing front-of-pack labeling (n=5/34). We also found that some countries have implemented regulations that restrict marketing of foods high in salt/sodium to children (n=5/34), or are using nutritional labeling that includes sodium content, either voluntary (n=9/34) or mandatory (n=10/34). However, no country in the Region has implemented taxes on high salt/sodium foods. Based on our review, we concluded that there has been a significant advance in policies to reduce sodium intake in the Region of the Americas in recent years. However, we identified that the level of implementation is quite varied and is challenging to assess. Despite the progress, there remains much work to do on this issue, especially in countries where there is limited or no action yet. Reducing sodium consumption is a cost-effective intervention that can save many lives by preventing and reducing the burden of diet-related NCDs. Therefore, a further call to action is needed for governments to accelerate efforts to meet the 2025 global target of a 30% relative reduction in mean population intake of sodium.

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