Special Issue "Advances in Dietary Sodium Research to Improve Human Health"

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 July 2019).

Special Issue Editor

Guest Editor
Assist. Prof. Dr. JoAnne Arcand Website E-Mail
Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON L1H 7K4, Canada
Interests: dietary sodium; cardiovascular disease; hypertension; nutrition policy; global health; knowledge translation

Special Issue Information

Dear Colleagues,

We invite you to contribute to a Special Issue of Nutrients, entitled “Advances in Dietary Sodium Research to Improve Human Health”. The purpose of this Special Issue is to advance knowledge to inform programs and policies for population-wide dietary sodium reduction. To supplement these contributions, we welcome the submission of manuscripts describing original research and systematic reviews/meta analyses. Manuscripts across a broad range of topics will be considered, but priority will be given to manuscripts that address the following themes:

  • Health impacts of population-wide dietary sodium reduction
  • Health economic analyses related to population-wide dietary sodium reduction
  • Changes in dietary sodium intake at the population level.
  • Effects of novel interventions to reduce dietary sodium at the patient, community or population level
  • Development and impact of social marketing campaigns to reduce dietary sodium
  • Sodium content in the food supply
  • Knowledge, attitudes and behaviors of the public and other stakeholders (i.e., food service, food industry, education sector) related to sodium
  • Analysis of the development and implementation of knowledge translation strategies that resulted in engaged and activated partners and networks and policy change related to sodium

Assist. Prof. Dr. JoAnne Arcand
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • salt
  • sodium
  • behaviour change
  • social marketing
  • food environment
  • program evaluation
  • health outcomes
  • health econonmics
  • policy
  • knowledge translation

Published Papers (10 papers)

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Research

Open AccessArticle
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
Nutrients 2019, 11(9), 2226; https://doi.org/10.3390/nu11092226 - 15 Sep 2019
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Advances in Dietary Sodium Research to Improve Human Health)
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Open AccessArticle
Changing Sodium Knowledge, Attitudes and Intended Behaviours Using Web-Based Dietary Assessment Tools: A Proof-Of-Concept Study
Nutrients 2019, 11(9), 2186; https://doi.org/10.3390/nu11092186 - 11 Sep 2019
Abstract
Despite public health efforts to reduce dietary sodium, sodium intakes in most countries remains high. The purpose of this study was to determine if using novel web-based tools that provide tailored feedback, the Sodium Calculator and Sodium Calculator Plus, improves users’ sodium-related knowledge, [...] Read more.
Despite public health efforts to reduce dietary sodium, sodium intakes in most countries remains high. The purpose of this study was to determine if using novel web-based tools that provide tailored feedback, the Sodium Calculator and Sodium Calculator Plus, improves users’ sodium-related knowledge, attitudes, and intended behaviours (KAB). In this single arm pre- and post-test study, 199 healthy adults aged 18–34 years completed a validated questionnaire to assess changes to sodium-related KAB before and after using the calculators. After using the calculators, the proportion of participants who accurately identified the sodium adequate intake and chronic disease risk reduction level increased (19% to 74% and 23% to 74%, respectively, both p = 0.021). The proportion accurately self-assessing their sodium intake as ‘high’ also increased (41% to 66%, p = 0.021). Several intended behavioural changes were reported, i.e., buying foods with sodium-reduced labels, using the Nutrition Facts table, using spices and herbs instead of salt, and limiting eating out. Evidence-based eHealth tools that assess and provide personalized feedback on sodium intake have the potential to aid in facilitating sodium reduction in individuals. This study is an important first step in evaluating and optimizing the implementation of eHealth tools to help reduce Canadians’ sodium intakes. Full article
(This article belongs to the Special Issue Advances in Dietary Sodium Research to Improve Human Health)
Open AccessArticle
Assessing Changes in Sodium Content of Selected Popular Commercially Processed and Restaurant Foods: Results from the USDA: CDC Sentinel Foods Surveillance Program
Nutrients 2019, 11(8), 1754; https://doi.org/10.3390/nu11081754 - 30 Jul 2019
Abstract
This report provides an update from the U.S. Department of Agriculture - Centers for Disease Control and Prevention Sentinel Foods Surveillance Program, exploring changes in sodium and related nutrients (energy, potassium, total and saturated fat, and total sugar) in popular, sodium-contributing, commercially processed [...] Read more.
This report provides an update from the U.S. Department of Agriculture - Centers for Disease Control and Prevention Sentinel Foods Surveillance Program, exploring changes in sodium and related nutrients (energy, potassium, total and saturated fat, and total sugar) in popular, sodium-contributing, commercially processed and restaurant foods with added sodium. In 2010–2013, we obtained 3432 samples nationwide and chemically analyzed 1654 composites plus label information for 125 foods, to determine baseline laboratory and label sodium concentrations, respectively. In 2014–2017, we re-sampled and chemically analyzed 43 of the Sentinel Foods (1181 samples), tested for significant changes of at least ±10% (p < 0.05), in addition to tracking changes in labels for 108 Sentinel Foods. Our results show that the label sodium levels of a majority of the Sentinel Foods had not changed since baseline (~1/3rd of the products reported changes, with twice as many reductions as increases). Laboratory analyses of the 43 Sentinel Foods show that eight foods had significant changes (p < 0.05); sodium content continues to be high and variable, and there was no consistent pattern of changes in related nutrients. Comparisons of changes in labels and laboratory sodium shows consistency for 60% of the products, i.e., similar changes (or no changes) in laboratory and label sodium content. The data from this monitoring program may help public health officials to develop strategies to reduce and monitor sodium trends in the food supply. Full article
(This article belongs to the Special Issue Advances in Dietary Sodium Research to Improve Human Health)
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Open AccessArticle
Monitoring Sodium Content in Processed Foods in Argentina 2017–2018: Compliance with National Legislation and Regional Targets
Nutrients 2019, 11(7), 1474; https://doi.org/10.3390/nu11071474 - 28 Jun 2019
Abstract
Sodium intake in Argentina has been estimated to be at least double the dose of 2000 mg/day recommended by WHO, mostly coming from processed foods. Argentina is one of the few countries in the world that have regulated sodium content in certain food [...] Read more.
Sodium intake in Argentina has been estimated to be at least double the dose of 2000 mg/day recommended by WHO, mostly coming from processed foods. Argentina is one of the few countries in the world that have regulated sodium content in certain food products. This study presents an assessment of sodium content in a selection of food groups and categories as reported in the nutrient information panels. We surveyed 3674 food products, and the sodium content of 864 and 1375 of them was compared to the maximum levels according to the Argentinean law and the regional targets, respectively. All food categories presented high variability of sodium content. Over 90% of the products included in the national sodium reduction law were found to be compliant. Food groups with high median sodium, such as condiments, sauces and spreads, and fish and fish products, are not included in the national law. In turn, comparisons with the lower regional targets indicated that almost 50% of the products analyzed had sodium contents above the recommended values. This evidence suggests that enhancing sodium reduction in processed foods may be a necessity for public health objectives and it is also technically feasible in Argentina. Full article
(This article belongs to the Special Issue Advances in Dietary Sodium Research to Improve Human Health)
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Open AccessArticle
Sodium Levels in Packaged Foods Sold in 14 Latin American and Caribbean Countries: A Food Label Analysis
Nutrients 2019, 11(2), 369; https://doi.org/10.3390/nu11020369 - 11 Feb 2019
Cited by 2
Abstract
Population-wide sodium reduction is a cost-effective approach to address the adverse health effects associated with excess sodium consumption. Latin American and Caribbean (LAC) countries consume excess dietary sodium. Packaged foods are a major contributor to sodium intake and a target for sodium reduction [...] Read more.
Population-wide sodium reduction is a cost-effective approach to address the adverse health effects associated with excess sodium consumption. Latin American and Caribbean (LAC) countries consume excess dietary sodium. Packaged foods are a major contributor to sodium intake and a target for sodium reduction interventions. This study examined sodium levels in 12 categories of packaged foods sold in 14 LAC (n = 16,357). Mean sodium levels and percentiles were examined. Sodium levels were compared to regional sodium reduction targets. In this baseline analysis, 82% of foods met the regional target and 47% met the lower target. The greatest proportion of products meeting the regional target were uncooked pasta and noodles (98%), flavored cookies/crackers (97%), seasonings for sides/main dishes (96%), mayonnaise (94%), and cured/preserved meats (91%). A large proportion of foods met the lower target among uncooked pasta and noodles (88%), cooked pasta and noodles (88%), and meat/fish seasonings (88%). The highest the highest median sodium levels were among condiments (7778 mg/100 g), processed meats (870 mg/100 g), mayonnaise (755 mg/100 g), bread products (458 mg/100 g), cheese (643 mg/100 g), and snack foods (625 mg/100 g). These baseline data suggest that sodium reduction targets may need to be more stringent to enable effective lowering of sodium intake. Full article
(This article belongs to the Special Issue Advances in Dietary Sodium Research to Improve Human Health)
Open AccessArticle
Sources of Dietary Salt in North and South India Estimated from 24 Hour Dietary Recall
Nutrients 2019, 11(2), 318; https://doi.org/10.3390/nu11020318 - 01 Feb 2019
Abstract
Recent data on salt intake levels in India show consumption is around 11 g per day, higher than the World Health Organization’s (WHO) recommended intake of 5 g per day. However, high-quality data on sources of salt in diets to inform a salt [...] Read more.
Recent data on salt intake levels in India show consumption is around 11 g per day, higher than the World Health Organization’s (WHO) recommended intake of 5 g per day. However, high-quality data on sources of salt in diets to inform a salt reduction strategy are mostly absent. A cross-sectional survey of 1283 participants was undertaken in rural, urban, and slum areas in North (n = 526) and South (n = 757) India using an age-, area-, and sex-stratified sampling strategy. Data from two 24-h dietary recall surveys were transcribed into a purpose-built nutrient database. Weighted salt intake was estimated from the average of the two recall surveys, and major contributors to salt intake were identified. Added salt contributed the most to total salt intake, with proportions of 87.7% in South India and 83.5% in North India (p < 0.001). The main food sources of salt in the south were from meat, poultry, and eggs (6.3%), followed by dairy and dairy products (2.6%), and fish and seafood (1.6%). In the north, the main sources were dairy and dairy products (6.4%), followed by bread and bakery products (3.3%), and fruits and vegetables (2.1%). Salt intake in India is high, and this research confirms it comes mainly from added salt. Urgent action is needed to implement a program to achieve the WHO salt reduction target of a 30% reduction by 2025. The data here suggest the focus needs to be on changing consumer behavior combined with low sodium, salt substitution. Full article
(This article belongs to the Special Issue Advances in Dietary Sodium Research to Improve Human Health)
Open AccessArticle
Sodium and Potassium Intake, Knowledge Attitudes and Behaviour Towards Salt Consumption Amongst Adults in Podgorica, Montenegro
Nutrients 2019, 11(1), 160; https://doi.org/10.3390/nu11010160 - 13 Jan 2019
Abstract
Excess salt and inadequate potassium intakes are associated with high cardiovascular disease (CVD). In Montenegro, CVD is the leading cause of death and disability. There is no survey that has directly measured salt and potassium consumption in Montenegro. The aim is to estimate [...] Read more.
Excess salt and inadequate potassium intakes are associated with high cardiovascular disease (CVD). In Montenegro, CVD is the leading cause of death and disability. There is no survey that has directly measured salt and potassium consumption in Montenegro. The aim is to estimate population salt and potassium intakes and explore knowledge, attitudes and behaviour (KAB), amongst the adult population of Podgorica. Random samples of adults were obtained from primary care centres. Participants attended a screening including demographic, anthropometric and physical measurements. Dietary salt and potassium intakes were assessed by 24 h urinary sodium (UNa) and potassium (UK) excretions. Creatinine was measured. KAB was collected by questionnaire. Six hundred and thirty-nine (285 men, 25–65 years) were included in the analysis (response rate 63%). Mean UNa was 186.5 (SD 90.3) mmoL/day, equivalent to 11.6 g of salt/day and potassium excretion 62.5 (26.2) mmoL/day, equivalent to 3.2 g/day. Only 7% of them had a salt intake below the World Health Organization (WHO) recommended target of 5 g/day and 13% ate enough potassium (>90 mmoL/day). The majority (86%) knew that high salt causes ill-health. However, only 44% thought it would be useful to reduce consumption. Salt consumption is high and potassium consumption is low, in men and women living in Podgorica. Full article
(This article belongs to the Special Issue Advances in Dietary Sodium Research to Improve Human Health)
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Open AccessArticle
Sodium Content of Processed Foods Available in the Mexican Market
Nutrients 2018, 10(12), 2008; https://doi.org/10.3390/nu10122008 - 19 Dec 2018
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Advances in Dietary Sodium Research to Improve Human Health)
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Open AccessArticle
Bread Consumption Is Associated with Elevated Blood Pressure among Adults Living in Mexico City–A Sub-Analysis of the Tlalpan 2020 Study
Nutrients 2018, 10(12), 1969; https://doi.org/10.3390/nu10121969 - 13 Dec 2018
Cited by 1
Abstract
Excessive dietary sodium is associated with elevated blood pressure (EBP). Bread products are identified as one of the main sources of daily sodium intake. The objective of this cross-sectional study was to evaluate the association between bread and others cereal products consumption with [...] Read more.
Excessive dietary sodium is associated with elevated blood pressure (EBP). Bread products are identified as one of the main sources of daily sodium intake. The objective of this cross-sectional study was to evaluate the association between bread and others cereal products consumption with EBP. Frequency intake of a standard serving of bread and other cereal products was recorded and categorized as: ≤3 times/month or never (reference category group) and ≥ once/week. EBP was defined as systolic blood pressure (SBP) ≥120 mmHg and/or diastolic blood pressure (DBP) ≥80 mmHg. Raw and adjusted odds ratios (OR) for the association between consumption of the studied food products and blood pressure status were estimated. Overall, 2011 participants aged 37.3 ± 9.1 years old were included. In the models adjusted for relevant covariates, consumption of one piece of bolillo or telera (OR = 1.39; 95% CI = 1.01–1.89) ≥ once/week was associated with an increased risk of EBP, compared to the reference category. Also, participants consuming one bowl of high-fiber breakfast cereal once/week were less likely to have EBP (OR = 0.73; 95% CI = 0.53–0.98). Initiatives to reduce sodium levels in bread products such as bolillo and telera are needed in Mexico to help manage the cardiovascular risk at the population level. Full article
(This article belongs to the Special Issue Advances in Dietary Sodium Research to Improve Human Health)
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Open AccessArticle
Sources of Dietary Sodium in Food and Beverages Consumed by Spanish Schoolchildren between 7 and 11 Years Old by the Degree of Processing and the Nutritional Profile
Nutrients 2018, 10(12), 1880; https://doi.org/10.3390/nu10121880 - 03 Dec 2018
Abstract
Excessive salt intake has negative effects on health and persists as a dietary problem in Spanish children. However, the analysis of dietary sodium sources has not been extensively studied. A group of 321 children between 7 and 11 years old from five Spanish [...] Read more.
Excessive salt intake has negative effects on health and persists as a dietary problem in Spanish children. However, the analysis of dietary sodium sources has not been extensively studied. A group of 321 children between 7 and 11 years old from five Spanish regional communities was studied. A three-day dietary record was used to determine the contribution of food and beverages to dietary sodium intake. The food consumed was classified based on the level of processing (NOVA classification) and the nutritional profile. Boys consumed more dietary sodium and sodium from ultra-processed food (UPF) than girls (p < 0.05). The main sources of dietary sodium from discretionary food were meat and meat products (25.1%), some ready-to-eat and pre-cooked dishes (7.4%) and sugars and sweets (6.3%). More than 4/5 of the total dietary sodium consumed came from processed foods (PF) and UPF. Ready-to-eat and pre-cooked dishes (14.4%), meat and meat products (10.6%), and cereals (10.2%) were the most relevant UPF. These results demonstrate that a key point for Spanish children is a reduction in the sodium content in PF and UPF, whether these foods are for basic or discretionary consumption. Furthermore, a decrease in the frequency and the quantity of discretionary food consumption should be encouraged. Full article
(This article belongs to the Special Issue Advances in Dietary Sodium Research to Improve Human Health)
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