Abstract MP37: Effects of a Behavioral Intervention that Emphasizes Spices and Herbs on Adherence to Recommended Sodium Intake
Introduction: Adherence to the recommended dietary sodium intake is challenging given the ubiquity of sodium in the US food supply. We hypothesized that a multifactorial, behavioral intervention that emphasized spices and herbs would facilitate adherence to dietary sodium recommendations. Methods: SPICE was a two-phase study including adults, 18 years or older, for whom Dietary Guidelines for Americans recommends 1500 mg/d of sodium. In phase one, 55 individuals were fed a low sodium diet for 4 weeks to acclimatize them to eating according to dietary sodium recommendations. Participants were provided all food, snacks and calorie-containing drinks. In phase two, 40 participants from phase 1 were randomized to either a multifactorial behavioral intervention designed to reduce sodium intake (n=20) or a self-directed control group (n=20), for 20 weeks. The intervention included advice on replacing sodium with spices and herbs. The primary study outcome was 24-hour urinary sodium excretion. We used linear regression analyses to determine the effects of the intervention on urinary sodium excretion. Results: Participants were 65% female, 88% African American; 63% had hypertension, 18% had diabetes; mean(sd) age was 61(9.7) years, and BMI was 30(8.9) kg/m 2 . During phase one (controlled feeding), mean 24-hour urinary sodium excretion decreased (150 mmol/d to 72 mmol/d). At the end of the 20-week behavioral intervention, 24-hour urinary sodium excretion increased in both arms but was 42 mmol/d lower in the intervention group than in the control group, p=0.002 (Figure). These findings were robust to methods excluding incomplete urine collections (Mage equation: mean difference -47.4, p=0.001, Joosens equation: mean difference -34.6, p=0.04). Conclusions: A multi-factorial behavioral intervention that emphasizes spices and herbs facilitates adherence to the recommended dietary sodium intake.