Achieving the WHO sodium target: estimation of reductions required in the sodium content of packaged foods and other sources of dietary sodium

Eyles, Helen; Shields, Emma; Webster, Jacqui; Mhurchú, Cliona Ní

doi:10.3945/ajcn.115.125146

Cited by 31 publications

(25 citation statements)

References 26 publications

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“…Public health strategies could refine approaches (ie, encouraging industry participation, sodium reduction targets for food manufacturers, nutrition label modifications, consumer education, and/or taxation on high-sodium foods) based on top dietary sources of sodium in target populations. 14 Our study…”

Section: Methodsmentioning

confidence: 85%

Asian American Dietary Sources of Sodium and Salt Behaviors Compared with Other Racial/Ethnic Groups, NHANES, 2011-2012

Firestone

Beasley

Kwon³

et al. 2017

Ethn Dis

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Objective: Asian Americans consume more sodium than other racial/ethnic groups. The purpose of this analysis was to describe major sources of sodium intake to inform sodium reduction initiatives. Methods: Cross-sectional data on adults (aged >18 years) from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 with one 24-hour dietary recall were analyzed (n=5,076). Population proportions were calculated from “What We Eat in America” (WWEIA) food categories. Results: Asian Americans had a higher sodium density vs adults of other racial/ ethnic groups (means in mg/1000kcal: Asian American, 2031.1; Hispanic,1691.6; White: 1666.5; Black: 1655.5; P<.05, all). Half of sodium consumed by Asian Americans came from the top 10 food categories, in contrast to Hispanics (43.6%), Whites (39.0%), and Blacks (36.0%). Four food categories were a top source of sodium for Hispanics, Whites, Blacks, and others, but not among Asian Americans: cold cuts and cured meats; meat mixed dishes; eggs and omelets; and cheese. The top three food category sources of sodium among Asians were soups, rice, and yeast breads accounting for 28.9% of dietary sodium. Asian Americans were less likely to add salt at the table, but used salt in food preparation ‘very often’ (P for both <.01). Conclusions: Mean sodium consumption and sources vary across racial/ethnic groups with highest consumption in Asian Americans. Given the smaller number of food categories contributing to sodium intake in Asian Americans, results imply that targeted activities on a few food items would have a large impact on reducing sodium intake in this group.Ethn Dis. 2017;27(3):241-248; doi:10.18865/ed.27.3.241

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Section: Methodsmentioning

confidence: 85%

Asian American Dietary Sources of Sodium and Salt Behaviors Compared with Other Racial/Ethnic Groups, NHANES, 2011-2012

Firestone

Beasley

Kwon³

et al. 2017

Ethn Dis

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“…In various countries, ongoing efforts are being made to determine strategies and to develop nationally applicable models for popularizing salt restriction in order to reduce the amount of daily salt intake within the limits defined by the World Health Organization [ 33 , 34 , 35 ]. To achieve the intended goals, it would be necessary to know the current status of salt intake and the sources of salt depending on the eating habits of each population.…”

Section: Discussionmentioning

confidence: 99%

Dietary Sources of High Sodium Intake in Turkey: SALTURK II

et al. 2017

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Previous research has shown daily salt intakes in Turkey to be far above the recommended limits. Knowing the sources of dietary salt could form a basis for preventive strategies aimed towards salt reduction. This study aimed to investigate dietary sources of salt in Turkey. A sub-group (n = 657) was selected from the PatenT2 study population, which represented the urban and rural areas of 4 major cities (Ankara, Istanbul, Izmir, and Konya). A questionnaire inquiring about sociodemographic characteristics, medical histories, detailed histories of diet, and salt consumption was completed. Participants were asked to collect a 24-h urine sample and to record their food intake (dietary recall) on the same day. Of 925 participants selected, 657 (71%) provided accurate 24-h urine collections, based on creatinine excretion data. The mean daily 24-h urinary sodium excretion was 252.0 ± 92.2 mmol/day, equal to daily salt intake of 14.8 ± 5.4 g. Of the 657 participants with accurate 24-h urine collections, 464 (70%) provided fully completed dietary recalls. Among these 464 participants, there was a significant difference between the 24-h urinary sodium excretion-based salt intake estimation (14.5 ± 5.1 g/day) and the dietary recall-based salt intake estimation (12.0 ± 7.0 g/day) (p < 0.001). On the other hand, a positive correlation was obtained between the dietary recall-based daily salt intake and 24-h urinary sodium excretion-based daily salt intake (r = 0.277, p < 0.001). Bread was the main source of salt (34%) followed by salt added during cooking and preparing food before serving (30%), salt from various processed foods (21%), and salt added at the table during food consumption (11%). Conclusively, this study confirmed a very high salt intake of the adult population in four major cities in Turkey. The present findings support the emerging salt reduction strategy in Turkey by promoting lower salt content in baked bread, and less salt use in habitual food preparation and during food consumption in the home.

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“…Sodium reduction is considered to be cost effective and one of the top 10 “best buys” interventions for preventing non-communicable diseases (NCDs) [ 63 , 64 ]. It was shown that a reduction of 2400 mg/day in sodium intake predicts a decrease of 5.8 mm Hg in systolic blood pressure after adjustment for age, ethnic group, and blood pressure status [ 65 ], which is expected to decrease stroke mortality, ischemic heart disease and other vascular diseases [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

Urinary Sodium and Potassium Excretion and Dietary Sources of Sodium in Maputo, Mozambique

et al. 2017

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This study aimed to evaluate the urinary excretion of sodium and potassium, and to estimate the main food sources of sodium in Maputo dwellers. A cross-sectional evaluation of a sample of 100 hospital workers was conducted between October 2012 and May 2013. Sodium and potassium urinary excretion was assessed in a 24-h urine sample; creatinine excretion was used to exclude unlikely urine values. Food intake in the same period of urine collection was assessed using a 24-h dietary recall. The Food Processor Plus® was used to estimate sodium intake corresponding to naturally occurring sodium and sodium added to processed foods (non-discretionary sodium). Salt added during culinary preparations (discretionary sodium) was computed as the difference between urinary sodium excretion and non-discretionary sodium. The mean (standard deviation) urinary sodium excretion was 4220 (1830) mg/day, and 92% of the participants were above the World Health Organization (WHO) recommendations. Discretionary sodium contributed 60.1% of total dietary sodium intake, followed by sodium from processed foods (29.0%) and naturally occurring sodium (10.9%). The mean (standard deviation) urinary potassium excretion was 1909 (778) mg/day, and 96% of the participants were below the WHO potassium intake recommendation. The mean (standard deviation) sodium to potassium molar ratio was 4.2 (2.4). Interventions to decrease sodium and increase potassium intake are needed in Mozambique.

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Achieving the WHO sodium target: estimation of reductions required in the sodium content of packaged foods and other sources of dietary sodium

Abstract: Achieving the WHO sodium target in New Zealand will take considerable efforts by both food manufacturers and consumers and will likely require a national government-led sodium reduction strategy.

Cited by 31 publications

References 26 publications

Asian American Dietary Sources of Sodium and Salt Behaviors Compared with Other Racial/Ethnic Groups, NHANES, 2011-2012

Asian American Dietary Sources of Sodium and Salt Behaviors Compared with Other Racial/Ethnic Groups, NHANES, 2011-2012

Dietary Sources of High Sodium Intake in Turkey: SALTURK II

Urinary Sodium and Potassium Excretion and Dietary Sources of Sodium in Maputo, Mozambique

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