An Evaluation of the Sodium Content and Compliance with the National Sodium Reduction Targets among Packaged Foods Sold in Costa Rica in 2015 and 2018

High blood pressure is a leading cause of death in Costa Rica, with an estimated mortality rate of 30%. The average household sodium intake is two times higher than the World Health Organization recommendation. The consumption of processed foods is an important and growing contributor to sodium intake. The objective of this study was to describe the sodium content of packaged foods (mg/100 g) sold in Costa Rica in 2015 (n = 1158) and 2018 (n = 1016) and to assess their compliance with the national sodium reduction targets. All 6 categories with national targets were analyzed: condiments, cookies and biscuits, bread products, processed meats, bakery products, and sauces. A significant reduction in mean sodium content was found in only 3 of the 19 subcategories (cakes, tomato-based sauces, and tomato paste). No subcategories had statistically significant increases in mean sodium levels, but seasonings for sides/mains, ham, and sausage categories were at least 15% higher in sodium. Compliance with the national sodium targets among all foods increased from 80% in 2015 to 87% in 2018. The results demonstrate that it is feasible to reduce the sodium content in packaged foods in Costa Rica, but more work is needed to continually support a gradual reduction of sodium in packaged foods, including more stringent sodium targets.

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Sodium Levels of Processed Meat in Australia: Supermarket Survey Data from 2010 to 2017

Nutrients ◽

10.3390/nu10111686 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1686 ◽

Cited By ~ 5

Author(s):

Emalie Sparks ◽

Clare Farrand ◽

Joseph Santos ◽

Briar McKenzie ◽

Kathy Trieu ◽

...

Keyword(s):

Sodium Intake ◽

Meat Products ◽

Monitoring And Evaluation ◽

Sodium Content ◽

World Health ◽

Processed Meat ◽

High Sodium ◽

Processed Meats ◽

Health Organization ◽

Health Dialogue

High sodium intake increases blood pressure and consequently increases the risk of cardiovascular diseases. In Australia, the best estimate of sodium intake is 3840 mg sodium/day, almost double the World Health Organization (WHO) guideline (2000 mg/day), and processed meats contribute approximately 10% of daily sodium intake to the diet. This study assessed the median sodium levels of 2510 processed meat products, including bacon and sausages, available in major Australian supermarkets in 2010, 2013, 2015 and 2017, and assessed changes over time. The median sodium content of processed meats in 2017 was 775 mg/100 g (interquartile range (IQR) 483–1080). There was an 11% reduction in the median sodium level of processed meats for which targets were set under the government’s Food and Health Dialogue (p < 0.001). This includes bacon, ham/cured meat products, sliced luncheon meat and meat with pastry categories. There was no change in processed meats without a target (median difference 6%, p = 0.450). The new targets proposed by the current government’s Healthy Food Partnership capture a larger proportion of products than the Food and Health Dialogue (66% compared to 35%) and a lower proportion of products are at or below the target (35% compared to 54%). These results demonstrate that voluntary government targets can drive nutrient reformulation. Future efforts will require strong government leadership and robust monitoring and evaluation systems.

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

Current Developments in Nutrition ◽

10.1093/cdn/nzaa064_004 ◽

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).

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Sodium Content of Processed Foods Available in the Mexican Market

Nutrients ◽

10.3390/nu10122008 ◽

2018 ◽

Vol 10 (12) ◽

pp. 2008

Author(s):

Claudia Nieto ◽

Lizbeth Tolentino-Mayo ◽

Catalina Medina ◽

Eric Monterrubio-Flores ◽

Edgar Denova-Gutiérrez ◽

...

Keyword(s):

Sodium Intake ◽

Cross Sectional Study ◽

Sodium Content ◽

Processed Foods ◽

Cross Sectional ◽

Processed Meats ◽

Adverse Health Outcomes ◽

The United Kingdom ◽

Food Standards ◽

Health Organization

Background: Sodium intake is related to several adverse health outcomes, such as hypertension and cardiovascular diseases. Processed foods are major contributors to the population’s sodium intake. The aim of the present study was to determine sodium levels in Mexican packaged foods, as well as to evaluate the proportion of foods that comply with sodium benchmark targets set by the United Kingdom Food Standards Agency (UK FSA) and those set by the Mexican Commission for the Protection of Health Risks (COFEPRIS). We also evaluated the proportion of foods that exceeded the Pan American Health Organization (PAHO) targets. Methods: This was a cross-sectional study that comprised data collected from the package of 2248 processed foods from selected supermarkets in Mexico. Results: Many processed food categories contained an excessive amount of sodium. Processed meats, ham, bacon and sausages, had the highest concentrations. The proportion of foods classified as compliant in our sample was lower for international targets (FSA UK and PAHO) compared to the Mexican COFEPRIS criteria. Conclusions: These data provided a critical baseline assessment for monitoring sodium levels in Mexican processed foods.

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Potential use of glasswort powder as a salt replacer for production of healthier dry-cured ham products

Czech Journal of Food Sciences ◽

10.17221/152/2016-cjfs ◽

2017 ◽

Vol 35 (No. 2) ◽

pp. 149-159 ◽

Cited By ~ 1

Author(s):

Seong Pil-Nam ◽

Seo Hyun-Woo ◽

Cho Soo-Hyun ◽

Kim Yoon-Seok ◽

Kang Sun-Moon ◽

...

Keyword(s):

Salt Marshes ◽

Sodium Intake ◽

Biceps Femoris ◽

Sodium Content ◽

World Health ◽

Biceps Femoris Muscle ◽

Dry Cured Ham ◽

The World ◽

Health Organization ◽

Femoris Muscle

The World Health Organization has recommended reducing sodium intake as well as its content in food products to reduce the risk of hypertension and cardiovascular diseases. Glasswort (Salicornia herbacea L.), a halophyte naturally growing in the salt marshes over the world, has widely been used as a salt replacer in the production of many food types. In this study, the impacts of replacement of 50% NaCl with 20 and 40 g/kg of glasswort powder on the quality characteristics of four different dry-cured pork cuts including Bulgi (semimembranosus, semitendinosus, and adduct muscles), Seolgit (biceps femoris muscle), Dogani (quadriceps femoris muscle), and Boseop (middle gluteal and gracilis muscles) were investigated. Our results revealed that the replacement of 50% salt with glasswort powder did not cause any defects of technological quality, colour, texture, and sensory quality of the finished products. As expected, the replacement of 50% salt with glasswort powder (20 g/kg) resulted in a reduction of approximately 37.30, 23.80, 33.33, and 30.89% in Bulgi, Seolgit, Dogani, and Boseop products, respectively. The present work demonstrates that the glasswort powder represents a potentially natural ingredient to be used as a salt replacer for the production of healthier dry-cured hams with lowered sodium content.

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Estimating the health and economic effects of the voluntary sodium reduction targets in Brazil: microsimulation analysis

BMC Medicine ◽

10.1186/s12916-021-02099-x ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Eduardo Augusto Fernandes Nilson ◽

Jonathan Pearson-Stuttard ◽

Brendan Collins ◽

Maria Guzman-Castillo ◽

Simon Capewell ◽

...

Keyword(s):

Cardiovascular Disease ◽

Health System ◽

National Health ◽

Sodium Intake ◽

National Health System ◽

Sodium Content ◽

Economic Effects ◽

World Health ◽

Sodium Reduction ◽

Potential Health

Abstract Background Excessive sodium consumption is one of the leading dietary risk factors for non-communicable diseases, including cardiovascular disease (CVD), mediated by high blood pressure. Brazil has implemented voluntary sodium reduction targets with food industries since 2011. This study aimed to analyse the potential health and economic impact of these sodium reduction targets in Brazil from 2013 to 2032. Methods We developed a microsimulation of a close-to-reality synthetic population (IMPACTNCD-BR) to evaluate the potential health benefits of setting voluntary upper limits for sodium content as part of the Brazilian government strategy. The model estimates CVD deaths and cases prevented or postponed, and disease treatment costs. Model inputs were informed by the 2013 National Health Survey, the 2008–2009 Household Budget Survey, and high-quality meta-analyses, assuming that all individuals were exposed to the policy proportionally to their sodium intake from processed food. Costs included costs of the National Health System on CVD treatment and informal care costs. The primary outcome measures of the model are cardiovascular disease cases and deaths prevented or postponed over 20 years (2013–2032), stratified by age and sex. Results The study found that the application of the Brazilian voluntary sodium targets for packaged foods between 2013 and 2032 could prevent or postpone approximately 110,000 CVD cases (95% uncertainty intervals (UI): 28,000 to 260,000) among men and 70,000 cases among women (95% UI: 16,000 to 170,000), and also prevent or postpone approximately 2600 CVD deaths (95% UI: − 1000 to 11,000), 55% in men. The policy could also produce a net cost saving of approximately US$ 220 million (95% UI: US$ 54 to 520 million) in medical costs to the Brazilian National Health System for the treatment of CHD and stroke and save approximately US$ 71 million (95% UI: US$ 17 to170 million) in informal costs. Conclusion Brazilian voluntary sodium targets could generate substantial health and economic impacts. The reduction in sodium intake that was likely achieved from the voluntary targets indicates that sodium reduction in Brazil must go further and faster to achieve the national and World Health Organization goals for sodium intake.

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Sodium Levels of Processed Meat in Australia: Supermarket Survey Data from 2010 to 2017

10.20944/preprints201810.0234.v1 ◽

2018 ◽

Author(s):

Emalie Sparks ◽

Clare Farrand ◽

Joseph Alvin Santos ◽

Briar McKenzie ◽

Kathy Trieu ◽

...

Keyword(s):

Sodium Intake ◽

Meat Products ◽

Monitoring And Evaluation ◽

Sodium Content ◽

World Health ◽

Processed Meat ◽

High Sodium ◽

Processed Meats ◽

The Government ◽

Health Dialogue

High sodium intake increases blood pressure and consequently increases the risk of cardiovascular diseases. In Australia, the best estimate of sodium intake is 3840 mg sodium/day, almost double the World Health Organization guideline (2000 mg/day), and processed meats contribute approximately 10% of daily sodium intake to the diet. This study assessed the median sodium levels of 2510 processed meat products, including bacon and sausages, available in major Australian supermarkets in 2010, 2013, 2015 and 2017, and assessed changes over time. The median sodium content of processed meats in 2017 was 775 mg/100 g (IQR 483–1080). There was an 11% reduction in the median sodium level of processed meats for which targets were set under the government’s Food and Health Dialogue (p < 0.001). This includes bacon, ham/cured meat products, sliced luncheon meat and meat with pastry categories. There was no change in processed meats without a target (median difference 6%, p = 0.093). The new targets proposed by the current government’s Healthy Food Partnership, capture a larger proportion of products than the Food and Health Dialogue (66% compared to 36%) and a lower proportion of products are at or below the target (35% compared to 54%). These results demonstrate that voluntary government targets can drive nutrient reformulation. Future efforts will require strong government leadership and robust monitoring and evaluation systems.

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Sodium Content of Processed Foods Available in the Mexican Market

10.20944/preprints201810.0556.v1 ◽

2018 ◽

Author(s):

Claudia Nieto ◽

Lizbeth Tolentino-Mayo ◽

Catalina Medina ◽

Eric Monterrubio-Flores ◽

Edgar Denova-Gutiérrez ◽

...

Keyword(s):

Sodium Intake ◽

Cross Sectional Study ◽

Sodium Content ◽

Dietary Sodium ◽

Processed Foods ◽

Cross Sectional ◽

Processed Meats ◽

Adverse Health Outcomes ◽

Health Organization ◽

The Uk

Background: Sodium intake has been related to several adverse health outcomes; such as, hypertension, and cardiovascular diseases. Processed foods are major contributors to the population’s dietary sodium intake. The aim of the present study was to determine sodium levels in Mexican packaged foods; also to evaluate the proportion of foods that comply with sodium benchmark targets set by the UK Food Standards Agency (UK FSA) and those set by the Mexican Commission for the Protection of Health Risks (COFEPRIS). We also evaluated the proportion of foods that exceeded the Pan American Health Organization (PAHO) targets. Methods: This was a cross-sectional study that comprised data collected from the package of 2,248 processed foods from selected supermarkets of Mexico. Results: Many processed food categories contained excessive amount of sodium, being the processed meats (ham, bacon and sausages) those that have the highest concentrations. The proportion of foods classified as compliant in our sample was lower for international targets (FSA UK and PAHO) compared to the Mexican COFEPRIS criteria. Conclusions: These data provide a critical baseline assessment for monitoring sodium levels in Mexican processed foods.

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Impact of salt intake reduction on CVD mortality in Costa Rica: A scenario modelling study

PLoS ONE ◽

10.1371/journal.pone.0245388 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245388

Author(s):

Jaritza Vega-Solano ◽

Adriana Blanco-Metzler ◽

Karol Madriz-Morales ◽

Eduardo-Augusto Fernandes-Nilson ◽

Marie Eve Labonté

Keyword(s):

Costa Rica ◽

Salt Intake ◽

Sodium Intake ◽

Costa Rican ◽

World Health ◽

Salt Consumption ◽

Policies And Programs ◽

Health Organization ◽

The Impact ◽

Cvd Mortality

Cardiovascular diseases (CVD) represent the leading cause of death in Costa Rica and high blood pressure was associated with a mortality rate of 29% in 2018. The average household sodium intake in the country is also two times higher than the World Health Organization recommendation. The objective of this study was to estimate the impact of reducing salt intake on CVD mortality in Costa Rica using a scenario simulation model. The Preventable Risk Integrated ModEl (PRIME) was used to estimate the number of deaths that would be averted or delayed in the Costa Rican population by following the national and the international guidelines to reduce salt consumption, according to two scenarios: A) 46% reduction and B) 15% reduction, both at an energy intake of 2171 kcal. The scenarios estimated that between 4% and 13%, respectively, of deaths due to CVD would be prevented or postponed. The highest percentages of deaths prevented or postponed by type of CVD would be related to Coronary heart disease (39% and 38%, respectively), Hypertensive disease (32% and 33%, respectively), and Stroke (22% in both). The results demonstrate that reducing salt consumption could prevent or postpone an important number of deaths in Costa Rica. More support for existing policies and programs urges.

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

Journal of Health Population and Nutrition ◽

10.1186/s41043-021-00231-4 ◽

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.

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Sodium reduction in butter using microparticulated salt

British Food Journal ◽

10.1108/bfj-02-2019-0113 ◽

2019 ◽

Vol 121 (4) ◽

pp. 874-881 ◽

Cited By ~ 1

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.

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