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Review
. 2019 Aug;21(8):1043-1056.
doi: 10.1111/jch.13628. Epub 2019 Jul 13.

The Science of Salt: A global review on changes in sodium levels in foods

Joseph Alvin Santos  1 , Emalie Sparks  1 , Sudhir Raj Thout  2 , Briar McKenzie  1 , Kathy Trieu  1 , Annet Hoek  1 , Claire Johnson  1 , Rachael McLean  3 , JoAnne Arcand  4 , Norman R C Campbell  5 , Jacqui Webster  1
Affiliations
Review

The Science of Salt: A global review on changes in sodium levels in foods

Joseph Alvin Santos et al. J Clin Hypertens (Greenwich). 2019 Aug.

Abstract

This review aims to summarize and synthesize studies reporting on changes in sodium levels in packaged food products, restaurant foods, and hospital or school meals, as a result of salt reduction interventions. Studies were extracted from those published in the Science of Salt Weekly between June 2013 and February 2018. Twenty-four studies were identified: 17 assessed the changes in packaged foods, four in restaurant foods, two in hospital or school meals, and one in both packaged and restaurant foods. Three types of interventions were evaluated as part of the studies: voluntary reductions (including targets), labeling, and interventions in institutional settings. Decreases in sodium were observed in all studies (n = 8) that included the same packaged foods matched at two time points, and in the studies carried out in hospitals and schools. However, there was little to no change in mean sodium levels in restaurant foods. The pooled analysis of change in sodium levels in packaged foods showed a decrease in sodium in unmatched food products (-36 mg/100 g, 95% CI -51 to -20 mg/100 g) and in five food categories-breakfast cereals, breads, processed meats, crisps and snacks, and soups. Twenty-two of the 24 studies were from high-income countries, limiting the applicability of the findings to lower resource settings.

Keywords: packaged foods; restaurant foods; salt; school or hospital meals; sodium.

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Conflict of interest statement

JW is Director of the World Health Organization Collaborating Centre on Population Salt Reduction and is supported by a National Heart Foundation Future Leaders Fellowship Level II (102039). JW has funding from the World Health Organization, the Victorian Health Promotion Foundation (20122), and the National Health and Medical Research Council of Australia for research on salt reduction (1052555 and 1111457). KT is supported by the National Health and Medical Research Council of Australia Early Career Fellowship (1161597). JAS is supported by the National Health and Medical Research Council of Australia Postgraduate Scholarship (1168948). NRCC was a paid consultant to the Novartis Foundation (2016‐2017) to support their program to improve hypertension control in low‐ to middle‐income countries which includes travel support for site visits and a contract to develop a survey. NRCC has provided paid consultative advice on accurate blood pressure assessment to Midway Corporation (2017) and is an unpaid member of World Action on Salt and Health (WASH). Of the studies reviewed, CJ, SRT, and JW were authors on Johnson C et al (2017), and JA was an author on Arcand J et al (2016). ES, BM, AH, and RM have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Studies included in the current review, June 2013 to February 2018
Figure 2
Figure 2
Random‐effects meta‐analysis of the change in sodium levels in packaged food products
See this image and copyright information in PMC

References

    1. World Health Organization . Global Status Report on Noncommunicable Diseases. Geneva, Switzerland: World Health Organization; 2014.
    1. GBD 2017 Risk Factor Collaborators . Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2018;392(10159):1923‐1994. - PMC - PubMed
    1. Elliott P, Stamler J, Nichols R, et al. Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations. BMJ. 1996;312(7041):1249. - PMC - PubMed
    1. Dyer AR, Elliott P, Marmot M, Kesteloot H, Stamler R, Stamler J. Commentary: strength and importance of the relation of dietary salt to blood pressure. Intersalt Steering and Editorial Committee. BMJ. 1996;312(7047):1661‐1664. - PMC - PubMed
    1. Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl JJ. Effect of lower sodium intake on health: systematic review and meta‐analyses. BMJ. 2013;346(apr03 3):f1326‐f1326. - PMC - PubMed

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