Examination of food industry progress in reducing the sodium content of packaged foods in Canada: 2010 to 2013

Arcand, JoAnne; Jefferson, Katherine; Schermel, Alyssa; Shah, Ferdeela; Trang, Susan; Kutlesa, Daniela; Lou, Wendy; L’Abbé, Mary R.

doi:10.1139/apnm-2015-0617

Cited by 38 publications

(46 citation statements)

References 19 publications

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“…Risk of bias assessments for the four studies are included in Appendix S1. The studies were conducted in Australia, 8 Canada, 9 Spain 10 (high-income countries), and Iran 11 (an upper middle-income country); none were conducted in low-or lower middle-income countries. Two studies measured the effects of a multicomponent intervention (ie, advocacy, community mobilization, awareness campaigns, and salt substitution in Australia, and awareness campaigns and food reformulation in Iran)…”

Section: Resultsmentioning

confidence: 99%

The Science of Salt: A regularly updated systematic review of the implementation of salt reduction interventions (March–August 2016)

Santos

Trieu

Thout

et al. 2017

J of Clinical Hypertension

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This review aims to identify, summarize, and appraise studies reporting on the implementation of salt reduction interventions that were published between March and August 2016. Overall, 40 studies were included: four studies evaluated the impact of salt reduction interventions, while 36 studies were identified as relevant to the design, assessment, and implementation of salt reduction strategies. Detailed appraisal and commentary were undertaken on the four studies that measured the impact of the interventions. Among them, different evaluation approaches were adopted; however, all demonstrated positive health outcomes relating to dietary salt reduction. Three of the four studies measured sodium in breads and provided consistent evidence that sodium reduction in breads is feasible and different intervention options are available.None of the studies were conducted in low-or lower middle-income countries, which stresses the need for more resources and research support for the implementation of salt reduction interventions in these countries. | INTRODUCTIONHigh salt intake is one of the main contributors to premature death from cardiovascular diseases globally. of countries (China, Finland, France, England, and Ireland) had already achieved significant reductions in population salt intake. | METHODOLOGYA detailed description of the search strategy used to identify and screen studies in this review has been previously reported. In the current review, studies evaluating the impact of salt reduction interventions were appraised for risk of bias by two independent reviewers using a modified Cochrane risk of bias tool for nonrandomized trials of intervention studies. 4,7 Detailed appraisal and commentary were also performed on these studies. Other types of studies that provided information pertinent to the design, implementation, and assessment of salt reduction interventions were summarized in a table.These include (1) studies on monitoring and surveillance of salt intake;(2) salt content in foods; (3) consumers' knowledge, attitudes, and behaviors toward salt; (4) economic evaluation or modeling studies of salt reduction strategies; and (5) other studies related to implementation of salt reduction initiatives. | RESULTSThe MEDLINE search identified 3675 citations, of which 85 were considered potentially eligible for full review on the basis of their findings relevant to salt reduction interventions. Ultimately, a total of 40 studies met the inclusion criteria: four studies evaluated the impact of salt reduction interventions, 21 were surveillance or monitoring studies, five were modeling studies relating to salt reduction, and 10 other studies related to the implementation of salt reduction interventions (Figure 1). conducted at a community level, 8,11 one assessed the impact of salt substitution in breads employed at a community level, 10 and one evaluated the changes in sodium levels in foods achieved through voluntary sodium reduction targets implemented at a national level. 9The method for evaluating the impact ...

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Section: Resultsmentioning

confidence: 99%

The Science of Salt: A regularly updated systematic review of the implementation of salt reduction interventions (March–August 2016)

Santos

Trieu

Thout

et al. 2017

J of Clinical Hypertension

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“…In relation to the NSRI, by 2014, data from US packaged foods showed that 43% of food categories had significantly reduced sodium, but most categories did not meet 2014 NSRI targets, and US dietary data suggest that sodium intake has not substantially declined (2,20). With implementation of Health Canada benchmarks, significant sodium reductions were observed in w16% of processed food categories by 2013, and further data on sodium intake reduction are not available to our knowledge (21). A 2017 Cochrane review provided evidence to suggest that voluntary national food standards may have a greater potential to reduce sodium intake when they are part of a multicomponent strategy including monitoring (42).…”

Section: Discussionmentioning

confidence: 95%

“…Both standards were based on the sodium content of foods that are produced by major food manufacturers. Although declines occurred in the sodium content of some US and Canadian commercially processed foods after the publication of these standards, sodium standards were not met for all food categories, and the potential impact on the change in sodium intake has been unclear (2,(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Modeled changes in US sodium intake from reducing sodium concentrations of commercially processed and prepared foods to meet voluntary standards established in North America: NHANES

Cogswell

Patel

Yuan

et al. 2017

The American Journal of Clinical Nutrition

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Background: Approximately 2 in 3 US adults have prehypertension or hypertension that increases their risk of cardiovascular disease. Reducing sodium intake can decrease blood pressure and prevent hypertension. Approximately 9 in 10 Americans consume excess sodium ($2300 mg/d). Voluntary sodium standards for commercially processed and prepared foods were established in North America, but their impact on sodium intake is unclear. Objective: We modelled the potential impact on US sodium intake of applying voluntary sodium standards for foods. Design: We used NHANES 2007-2010 data for 17,933 participants aged $1 y to model predicted US daily mean sodium intake and the prevalence of excess sodium intake with the use of the standards of the New York City's National Salt Reduction Initiative (NSRI) and Health Canada for commercially processed and prepared foods. The Food and Nutrient Database for Dietary Studies food codes corresponding to foods reported by NHANES participants were matched to NSRI and Health Canada food categories, and the published sales-weighted mean percent reductions were applied. Results: The US population aged $1 y could have reduced their usual daily mean sodium intake of 3417 mg by 698 mg (95% CI: 683, 714 mg) by applying NSRI 2014 targets and by 615 mg (95% CI: 597, 634 mg) by applying Health Canada's 2016 benchmarks. Significant reductions could have occurred, regardless of age, sex, race/ethnicity, income, education, or hypertension status, up to a mean reduction in sodium intake of 850 mg/d in men aged $19 y by applying NSRI targets. The proportion of adults aged $19 y who consume $2300 mg/d would decline from 88% (95% CI: 86%, 91%) to 71% (95% CI: 68%, 73%) by applying NSRI targets and to 74% (95% CI: 71%, 76%) by applying Health Canada benchmarks. Conclusion: If established sodium standards are applied to commercially processed and prepared foods, a significant reduction of US sodium intake could occur.Am J Clin Nutr 2017;106:530-40.

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“…Sodium claims were not significantly higher in 2013 compared to 2010 [24], despite huge efforts directed towards sodium reduction in Canada during this time [19]. For example, other research has shown that little sodium reduction progress overall has been achieved in the food supply during this period, although significant improvement has been achieved in some food categories [38]. One reason for the lack of low/reduced sodium claims could be that food manufacturers are using a step wise approach to reduce sodium in foods, as suggested by Health Canada's sodium guidance document [19]; therefore, reductions are maybe not sufficient to reach the threshold of at least 25%, for a food to be allowed to carry a lower sodium nutrient content claim [13].…”

Section: Discussionmentioning

confidence: 99%

Assessing nutrition and other claims on food labels: a repeated cross-sectional analysis of the Canadian food supply

et al. 2017

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Background: In 2010, nutrition claims were investigated in Canadian foods; however, many nutrition and other claims have been introduced since then. This study aimed to determine: i) the proportion of foods carrying claims in 2013, ii) the types and prevalence of nutrition claims (nutrient content claims, health claims, general health claims) and other claims displayed on labels in 2013, iii) and trends in use of nutrition claims between 2010 and 2013. Methods: Repeated cross-sectional analysis of the University of Toronto Food Label Information Program (FLIP) of Canadian foods (2010/11 n = 10,487; 2013 n = 15,342). Regulated nutrition claims (nutrient content, health claims) were classified according to Canadian regulations. A decision tree was used to classify non-regulated general health claims (e.g., front-of-pack claims). Other claims (e.g., gluten-free) were also collected. Proportions of claims in 2013 were determined and χ 2 was used to test significant differences for different types of claims between 2010 and 2013.

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Examination of food industry progress in reducing the sodium content of packaged foods in Canada: 2010 to 2013

Cited by 38 publications

References 19 publications

The Science of Salt: A regularly updated systematic review of the implementation of salt reduction interventions (March–August 2016)

The Science of Salt: A regularly updated systematic review of the implementation of salt reduction interventions (March–August 2016)

Modeled changes in US sodium intake from reducing sodium concentrations of commercially processed and prepared foods to meet voluntary standards established in North America: NHANES

Assessing nutrition and other claims on food labels: a repeated cross-sectional analysis of the Canadian food supply

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