Salt Reduction Strategies in Portuguese School Meals, from Pre-School to Secondary Education—The Eat Mediterranean Program

Rito, Ana Isabel; Mendes, Sofia; Santos, Mariana; Goiana-da-Silva, Francisco; Cappuccio, Francesco P.; Whiting, Stephen; Dinis, Ana; Rascôa, Carla; Castanheira, Isabel; Darzi, Ara; Breda, João

doi:10.3390/nu12082213

Cited by 4 publications

(6 citation statements)

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“…Whilst men consume more salt than women, there are many more older women in Portugal, such that 46 averted deaths were among men (95% CI: 19-74) and 61 were among women (95% CI: 25-99). If we focus exclusively on deaths averted in those aged under 75 years, we find that 16 deaths were averted among males (95% CI: 6-26) vs. 9 among women (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

Section: Resultsmentioning

confidence: 99%

“…Data from the latest National Food, Nutrition and Physical Activity Survey ( 5 , 6 ) shows that after salt added to food ( 11 ), bread is the second largest source of salt in the Portuguese diet, constituting 18.2% of daily salt intake in Portugal. The same survey showed that the mean daily consumption of bread was 100.3 g/person/day, which is higher than the consumption of cereals, cereal products and tubers ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…Another study also highlighted the high salt content of school meals which commonly, in Portugal, include an added piece of bread. The study showed that not only this bread serving portion was double the recommended values (45 g instead of 25 g) but was the major contributor of salt when compared with the main dish and soup, adding a mean value of 0.48 g of salt/serving to the school meal ( 11 ). Controlling salt consumption in bread plays a central part in Portugal's salt reduction strategy.…”

Section: Introductionmentioning

confidence: 99%

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Modeling the health impact of legislation to limit the salt content of bread in Portugal: A macro simulation study

Goiana-da-Silva

Cruz-e-Silva

Rito

et al. 2022

Front. Public Health

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BackgroundExcessive salt consumption—associated with a range of adverse health outcomes—is very high in Portugal, and bread is the second largest source. Current Portuguese legislation sets a maximum limit of 1.4 g salt per 100 g bread, but imported and traditional breads are exempted. In 2017 the Ministry of Health proposed reducing the salt threshold to 1.0/100 g by 2022, however the legislation was vetoed by the European Commission on free-trade grounds.AimsTo estimate the health impact of subjecting imported and traditional breads to the current 1.4 g threshold, and to model the potential health impact of implementing the proposed 1.0 g threshold.MethodsWe gathered bread sales, salt consumption, and epidemiological data from robust publicly available data sources. We used the open source WHO PRIME modeling tool to estimate the number of salt-related deaths that would have been averted in 2016 (the latest year for which all data were available) from; (1) Extending the 1.4 g threshold to all types of bread, and (2) Applying the 1.0 g threshold to all bread sold in Portugal. We used Monte Carlo simulations to generate confidence intervals.ResultsApplying the current 1.4 g threshold to imported and traditional bread would have averted 107 deaths in 2016 (95% CI: 43–172). Lowering the current threshold from 1.4 to 1.0 g and applying it to all bread products would reduce daily salt consumption by 3.6 tons per day, saving an estimated 286 lives a year (95% CI: 123–454).ConclusionsSalt is an important risk factor in Portugal and bread is a major source. Lowering maximum permissible levels and removing exemptions would save lives. The European Commission should revisit its decision on the basis of this new evidence.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Modeling the health impact of legislation to limit the salt content of bread in Portugal: A macro simulation study

Goiana-da-Silva

Cruz-e-Silva

Rito

et al. 2022

Front. Public Health

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“…O teor de sódio inicial das sopas (baseline) encontra-se no intervalo de resultados apresentados noutros trabalhos realizados em estabelecimentos de ensino portugueses (18)(19)(20). Tendo em conta os resultados obtidos, e considerando a porção de sopa entre 200 a 250 g, a ingestão de sódio, pode chegar aos 308 a 385 mg (0,78 a 0,97 g de sal), uma quantidade muito superior à recomendada para toda a refeição do almoço (21).…”

Section: Discussão Dos Resultadosunclassified

Redução do teor de sódio da sopa para crianças e avaliação do impacto no desperdício alimentar

2022

Acta Port Nutr

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INTRODUÇÃO:Na infância, a redução do consumo de sal e o aumento de potássio apresentam benefícios para a saúde. A redução do teor de sal nos alimentos pode diminuir a aceitabilidade do consumidor, implicando um aumento do desperdício alimentar. A minimização do desperdício alimentar deve ser uma prioridades das escolas, por se tratar de uma problemática atual, aliada à melhoria do perfil nutricional da oferta alimentar.OBJETIVOS: Analisar o teor de sódio e potássio da sopa antes e após uma intervenção de redução da quantidade de sal adicionada, num estabelecimento de ensino, e avaliar a sua relação com o desperdício alimentar . METODOLOGIA:No estudo, foram incluídas as sopas servidas no refeitório às crianças, com idades entre os 3 e os 10 anos, nos dias em análise. Na Fase I, quantificou-se o teor de sódio e potássio da sopa e o seu desperdício alimentar durante 5 dias. Na Fase II, reduziu-se a quantidade de sal adicionada em 49%, avaliando-se, novamente, os parâmetros mencionados. A quantificação do teor de sódio e potássio foi realizada por espectrofotometria de emissão atómica e a do desperdício alimentar por pesagem agregada dos componentes do prato. RESULTADOS:A mediana do teor de sódio na sopa na Fase I foi de 154 ± 37 mg/100 g, diminuindo na Fase II para 96 ± 17 mg/100 g. A mediana do desperdício alimentar na Fase I foi de 8,6 ± 1,8% e diminuiu para 5,3 ± 0,8% na Fase II. Encontrou-se uma relação positiva moderada entre o teor de sódio e o desperdício alimentar (r=0,669; p < 0,001). CONCLUSÕES:A quantidade de sal adicionada à sopa na Fase I foi superior às recomendações. A redução do teor de sal da sopa deverá ser uma prioridade das escolas, não sendo expectável que aumente o desperdício alimentar.

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“…Therefore, promoting a healthy food environment -including food systems that promote a diversified, balanced, and healthy diet -requires the mutual cooperation of multiple sectors and stakeholders (WHO, 2020a). The most common place for health promotion among children has previously been in the school setting, mostly with children aged 6-12 years-old (Rito et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Exploring possibilities for the development of healthy eating habits in preschool settings: parent's and teacher's perspectives

Niškanović,

Stojisavljević,

Stojisavljević

et al. 2023

Food Science & Nutrition

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Adoption of eating habits starts early in life, through interaction with family members and alongside preschool settings that offer context for developing healthy lifestyles among children. The aim of this study was to explore the perceptions and practices of teachers and parents related to the development of healthy eating habits among preschool children. Focus groups were conducted with a total sample of 48 parents and teachers (three focus groups among parents and three among teachers) from 15 kindergartens in the Republic of Srpska, Bosnia, and Herzegovina. All of the mentioned kindergartens are part of the “Nutrition friendly preschool/school initiative”, a program aimed at creating and developing settings that support and improve children's health. Focus groups were audiotaped, transcribed verbatim, and analyzed according to the Framework Method. Teachers emphasized that good communication and support from parents are important factors for the development of healthy eating habits. During COVID‐19, direct communication with parents was restricted, and mutual activities among teachers, children, and parents were reduced. Lack of knowledge, finance, and time are perceived by parents as main obstacles to the improvement of children's healthy eating habits. All participants in the focus groups agreed that more education and informative material are needed so their skills related to good nutrition can be improved and adopted in a culture‐sensitive way. Mutual support, education, and dissemination of informative materials are imposed as particularly important needs by all actors involved in the upbringing of children in order to support the development of children's healthy eating habits.

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Salt Reduction Strategies in Portuguese School Meals, from Pre-School to Secondary Education—The Eat Mediterranean Program

Cited by 4 publications

References 25 publications

Modeling the health impact of legislation to limit the salt content of bread in Portugal: A macro simulation study

Modeling the health impact of legislation to limit the salt content of bread in Portugal: A macro simulation study

Redução do teor de sódio da sopa para crianças e avaliação do impacto no desperdício alimentar

Exploring possibilities for the development of healthy eating habits in preschool settings: parent's and teacher's perspectives

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