Estimation of Sodium Availability and Food Sources from 2018 to 2019 and Its Trends during the 2004–2019 Period in Costa Rica

Abstract

Sodium availability and food sources in 2018–2019 were estimated and trends analyzed for 15 years (2004–2019) in Costa Rica. Food purchase records from the National Household Income and Expenditure Survey (ENIGH) 2018–2019 were converted to energy and sodium using food composition tables measuring “apparent consumption”. Foods were classified by sodium content. ENIGH is a probabilistic, stratified, two-stage and replicated national survey, carried out regularly by the national statistics institution. Results from the 2004–2005 and 2012–2013 ENIGHs came from previous analysis. Differences between periods were determined through descriptive and inferential statistics. The available sodium adjusted to 2000 kcal/person/day was 3.40, 3.86, and 3.84 g/person/day (g/p/d) for periods 2004–2005, 2013–2014, and 2018–2019, respectively. In this last period, this was 3.94 urban and 3.60 g/p/d rural (p < 0.05), with a non-linear increase with income. During 2004–2019 sodium from salt and salt-based condiments increased from 69.5 to 75.5%; the contribution of common salt increased, from 60.2 to 64.8% and condiments without added salt from 9.3 to 10.7%. From 2012–2013 to 2018–2019, processed and ultra-processed foods with added sodium intake increased from 14.2 to 16.9% and decreased in prepared meals (7.2 to 2.8%). Costa Rica has been successful in reducing salt/sodium available for consumption; after a 12% increase of salt consumption between 2004–2005 and 2012–2013, to a level almost twice as high as recommended, it has stabilized in the last period.

Monitoring sodium content in packaged foods sold in the Americas and compliance with the Updated Regional Sodium Reduction Targets

“…However, this suggests that the current local limits are too lax compare with the regional targets and require further adjustment; and the necessity to include sodium source food groups that are currently not included, such as cheese and puff pastries 20 . While Costa Rica has a voluntary sodium reduction strategy to reduce sodium levels in some key food categories , progress has been monitored continuously [21][22][23] . A study published by Vega-Solano et al in 2019 showed 87% compliance with the voluntary national sodium targets.…”

“…While Costa Rica has a voluntary sodium reduction strategy to reduce sodium levels in some key food categories, progress has been monitored continuously 21–23 . A study published by Vega-Solano et al in 2019 showed 87% compliance with the voluntary national sodium targets.…”

Estimation of the economic benefits for the public health system related to salt reduction in Costa Rica

“…In the country, the most recent studies indicate that sodium intake (4.42 grams/person/day (g/p/d)) was more than double the maximum recommendation established by the Organization World Health Organization (WHO) (2000mg of sodium equivalent to 5 g of salt/p/d) [6,7]. Recent modeling studies estimated that a 15 to 46% decrease in daily salt intake could prevent 5 to 13% of deaths due to CVD [4].…”

Knowledge, Attitudes, Practices, and Perceptions for Salt/Sodium Reduction in the Gastronomic Sector of Costa Rica

“…This is why international organizations such as the World Health Organization (WHO) address out-of-home eating as an environmental determinant of health [11] [12] [13]. In Costa Rica, the main sources of sodium are "processed culinary ingredients" (salt and condiments) and "ultra-processed foods and beverages" [6] [7] [8].…”