Journal articles: 'Discretionary salt'

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Quader, Zerleen S., Sheena Patel, Cathleen Gillespie, Mary E. Cogswell, Janelle P. Gunn, Cria G. Perrine, Richard D. Mattes, and Alanna Moshfegh. "Trends and determinants of discretionary salt use: National Health and Nutrition Examination Survey 2003–2012." Public Health Nutrition 19, no. 12 (March 16, 2016): 2195–203. http://dx.doi.org/10.1017/s1368980016000392.

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AbstractObjectiveTo examine temporal trends and determinants of discretionary salt use in the USA.DesignMultiple logistic regression was used to assess temporal trends in discretionary salt use at the table and during home cooking/preparation, adjusting for demographic characteristics, using data from the National Health and Nutrition Examination Survey 2003–2012. Prevalence and determinants of discretionary salt use in 2009–2012 were also examined.SettingParticipants answered salt use questions after completing a 24 h dietary recall in a mobile examination centre.SubjectsNationally representative sample of non-institutionalized US children and adults, aged ≥2 years.ResultsFrom 2003 to 2012, the proportion of the population who reported using salt ‘very often’ declined; from 18 % to 12 % for use at the table (P<0·01) and from 42 % to 37 % during home cooking (P<0·02). While one-third of the population reported never adding salt at the table, most used it during home cooking/preparation (93 %). Use of discretionary salt was least commonly reported among young children and older adults and demographic and health subgroups at risk of CVD.ConclusionsWhile most people reported using salt during home cooking/preparation, a minority reported use at the table. Reported ‘very often’ discretionary salt use has declined. That discretionary salt use is less common among those at risk of CVD suggests awareness of messages to limit Na intake.

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McLean, Rachael Mira, Nan Xin Wang, Claire Cameron, and Sheila Skeaff. "Measuring Sodium from Discretionary Salt: Comparison of Methods." Nutrients 15, no. 24 (December 12, 2023): 5076. http://dx.doi.org/10.3390/nu15245076.

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(1) Background: The best method to assess discretionary salt intake in population surveys has not been established. (2) Methods: This secondary analysis compared three different methods of measuring sodium intake from discretionary salt in a convenience sample of 109 adults in New Zealand. Participants replaced their household salt with lithium-tagged salt provided by researchers over eight days. Baseline 24 h urine was collected, and two further 24 h urine and 24 h dietary recalls were collected between days six and eight. Discretionary salt was estimated from the lithium-tagged salt, focused questions in the 24 h dietary recall, and the ‘subtraction method’ (a combination of 24 h urine and 24 h dietary recall measures). (3) Results: Around one-third of estimates from the ‘subtraction method’ were negative and therefore unrealistic. The mean difference between 24 h dietary recall and lithium-tagged salt estimates for sodium from discretionary salt mean were 457 mg sodium/day and 65 mg/day for mean and median, respectively. (4) Conclusions: It is possible to obtain a reasonable estimate of discretionary salt intake from careful questioning regarding salt used in cooking, in recipes, and at the table during a 24 h recall process to inform population salt reduction strategies.

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Bhat, Saiuj, Matti Marklund, Megan E. Henry, Lawrence J. Appel, Kevin D. Croft, Bruce Neal, and Jason H. Y. Wu. "A Systematic Review of the Sources of Dietary Salt Around the World." Advances in Nutrition 11, no. 3 (January 6, 2020): 677–86. http://dx.doi.org/10.1093/advances/nmz134.

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ABSTRACT Excess salt intake contributes to hypertension and increased cardiovascular disease risk. Efforts to implement effective salt-reduction strategies require accurate data on the sources of salt consumption. We therefore performed a systematic review to identify the sources of dietary salt around the world. We systematically searched peer-reviewed and gray literature databases for studies that quantified discretionary (salt added during cooking or at the table) and nondiscretionary sources of salt and those that provided information about the food groups contributing to dietary salt intake. Exploratory linear regression analysis was also conducted to assess whether the proportion of discretionary salt intake is related to the gross domestic product (GDP) per capita of a country. We identified 80 studies conducted in 34 countries between 1975 and 2018. The majority (n = 44, 55%) collected data on dietary salt sources within the past 10 y and were deemed to have a low or moderate risk of bias (n = 75, 94%). Thirty-two (40%) studies were judged to be nationally representative. Populations in Brazil, China, Costa Rica, Guatemala, India, Japan, Mozambique, and Romania received more than half of their daily salt intake from discretionary sources. A significant inverse correlation between discretionary salt intake and a country's per capita GDP was observed (P < 0.0001), such that for every $10,000 increase in per capita GDP, the amount of salt obtained from discretionary sources was lower by 8.7% (95% CI: 5.1%, 12%). Bread products, cereal and grains, meat products, and dairy products were the major contributors to dietary salt intake in most populations. There is marked variation in discretionary salt use around the world that is highly correlated with the level of economic development. Our findings have important implications for the type of salt-reduction strategy likely to be effective in a country.

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FARRIMOND, SUSAN, PAUL AINSWORTH, and BRENDA PIPER. "The contribution of discretionary salt to total salt intake." Journal of Consumer Studies and Home Economics 19, no. 2 (June 1995): 135–43. http://dx.doi.org/10.1111/j.1470-6431.1995.tb00538.x.

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Wallace, Sharon, Nancy S. Wellman, Kathleen E. Dierkes, and Paulette M. Johnson. "Discretionary salt use in airline meal service." Journal of the American Dietetic Association 87, no. 2 (February 1987): 176–79. http://dx.doi.org/10.1016/s0002-8223(21)03086-8.

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Livingstone, Katherine, Carlos Celis-Morales, Santiago Navas-Carretero, Rodrigo San-Cristobal, Hannah Forster, Clara Woolhead, Clare O'Donovan, et al. "Personalized Nutrition Advice Reduces Intake of Discretionary Foods and Beverages: Findings From the Food4Me Randomized Controlled Trial." Current Developments in Nutrition 5, Supplement_2 (June 2021): 152. http://dx.doi.org/10.1093/cdn/nzab035_060.

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Abstract Objectives This study aimed to examine changes in intake of discretionary foods and beverages following a personalized nutrition intervention using two national classifications for discretionary foods. Methods Participants were recruited into a 6-month RCT across seven European countries (Food4Me) and were randomized to receive generalized dietary advice (Control) or one of three levels of personalized nutrition advice (based on dietary, phenotypic and genotypic information). Dietary intake from a FFQ was used to determine change between baseline and month 6 in (i) % energy, % contribution to total fat, SFA, total sugars and salt and (ii) contribution (%) made by sweets and snacks to intake of total fat, SFA, sugars and salt from discretionary foods and beverages, defined by Food Standards Scotland (FSS) and the Australian Dietary Guidelines (ADG). Results A total of 1270 adults (40.9 (SD 13.0) years; 57% female) completed the intervention. At month 6, percentage sugars from FSS discretionary items was lower in personalized nutrition vs control (19.0 ± 0.37 vs 21.1 ± 0.65; P = 0.005). Percentage energy (31.2 ± 0.59 vs 32.7 ± 0.59; P = 0.031), % total fat (31.5 ± 0.37 vs 33.3 ± 0.65; P = 0.021), SFA (36.0 ± 0.43 vs 37.8 ± 0.75; P = 0.034) and sugars (31.7 ± 0.44 vs 34.7 ± 0.78; P < 0.001) from ADG discretionary items were lower in personalized nutrition vs control. The % contribution of sugars from sweets and snacks was lower in personalized nutrition vs control (19.1 ± 0.36 vs 21.5 ± 0.63; P < 0.001). At 3 months, effects were consistent for ADG discretionary items, while there was no significant differences in personalized nutrition vs control for FSS discretionary items. Conclusions Compared with generalized dietary advice, personalized nutrition advice achieved greater reductions in intake of discretionary foods and beverages when the classification included all foods high in fat, added sugars and salt. Future personalized nutrition strategies may be used to target intake of discretionary foods and beverages. Funding Sources European Commission Food, Agriculture, Fisheries and Biotechnology Theme of the Seventh Framework Programme for Research and Technological Development [265494]. KML is supported by a NHMRC Emerging Leadership Fellowship (APP1173803).

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Grimes, Carley A., Lynn J. Riddell, Karen J. Campbell, and Caryl A. Nowson. "Dietary salt intake assessed by 24 h urinary sodium excretion in Australian schoolchildren aged 5–13 years." Public Health Nutrition 16, no. 10 (August 16, 2012): 1789–95. http://dx.doi.org/10.1017/s1368980012003679.

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AbstractObjectiveTo measure total daily salt intake using 24 h urinary Na excretion within a sample of Victorian schoolchildren aged 5–13 years and to assess discretionary salt use habits of children and parents.DesignCross-sectional study.SettingCompleted within a convenience sample of independent primary schools (n9) located in Victoria, Australia.SubjectsTwo hundred and sixty children completed a 24 h urine collection over a school (34 %) or non-school day (66 %). Samples deemed incomplete (n18), an over-collection (n1) or that were incorrectly processed at the laboratory (n3) were excluded.ResultsThe sample comprised 120 boys and 118 girls with a mean age of 9·8 (sd1·7) years. The average 24 h urinary Na excretion (n238) was 103 (sd43) mmol/24 h (salt equivalent 6·0 (sd2·5) g/d). Daily Na excretion did not differ by sex; boys 105 (sd46) mmol/24 h (salt equivalent 6·1 (sd2·7) g/d) and girls 100 (sd41) mmol/24 h (salt equivalent 5·9 (sd2·4) g/d;P= 0·38). Sixty-nine per cent of children (n164) exceeded the recommended daily Upper Limit for Na. Reported discretionary salt use was common: two-thirds of parents reported adding salt during cooking and almost half of children reported adding salt at the table.ConclusionsThe majority of children had salt intakes exceeding the recommended daily Upper Limit. Strategies to lower salt intake in children are urgently required, and should include product reformulation of lower-sodium food products combined with interventions targeting discretionary salt use within the home.

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Mattes, Richard D. "Discretionary salt and compliance with reduced sodium diet." Nutrition Research 10, no. 12 (December 1990): 1337–52. http://dx.doi.org/10.1016/s0271-5317(05)80127-7.

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Piovesana, Paula de Moura, Karina de Lemos Sampaio, and Maria Cecília B. J. Gallani. "Association between Taste Sensitivity and Self-Reported and Objective Measures of Salt Intake among Hypertensive and Normotensive Individuals." ISRN Nutrition 2013 (October 24, 2013): 1–7. http://dx.doi.org/10.5402/2013/301213.

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This study investigated the gustatory threshold for salt and its relationship with dietary salt intake among hypertensive (n=54) and normotensive (n=54) subjects. Salt intake was evaluated through 24-hour urinary sodium excretion and self-reported measures (discretionary salt, Sodium- Food Frequence Questionnaire (Na-FFQ), and 24-hour recall). Detection and recognition thresholds were higher among hypertensive subjects, as well as the total sodium intake. Detection and recognition thresholds were positively related to discretionary salt and total intake of the group as whole. Hypertensive and normotensive subjects presented positive correlations between taste sensitivity and the different measures of salt intake. To conclude, a positive correlation exists between taste threshold and salt intake and both seem to be higher among hypertensive subjects. The combined use of methods of self-report and assessment of taste thresholds can be useful in health promotion and rehabilitation programs, by screening subjects at higher risk of elevated salt intake and the critical dietary behaviors to be targeted as well to evaluate the result of targeted interventions.

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Goh, Yvonne, Mari Manger, Shipra Saklani, Surbhi Agarwal, Deepmala Budhija, Manu Jamwal, Anshul Chauhan, et al. "Comparison of Methods for Estimating Discretionary Salt Intake in Field Settings." Current Developments in Nutrition 6, Supplement_1 (June 2022): 571. http://dx.doi.org/10.1093/cdn/nzac060.029.

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Abstract Objectives Accurate and precise estimates of discretionary salt (DS) intake are critical for designing salt fortification interventions and counseling on salt intake reduction. This study compared four methods of estimating DS intake among non-pregnant women of reproductive age (NPWRA) in northern India to inform the design of a trial of multiply-fortified salt. Methods Participants were NPWRA (18–49 y) in Punjab, India. Weighed food records (WFR), same-day duplicate diet (DD) composites, and samples of household (HH) salt were collected simultaneously from 100 women and repeated on a subset of 40. Sodium (Na) and iodine contents of the DD composites were analyzed using Inductively Coupled Plasma (ICP)-Optical Emission Spectrometry and ICP-Mass Spectrometry. HH salt samples were also analyzed for iodine. Methods for estimating DS intake included: 1) WFR: DS consumed from recipes or added at time of consumption were weighed; 2) HH salt disappearance (HHSD): total DS used by HH on the observation day divided by number of HH members; 3) Sodium estimation (NaE): Na content of 40 replicate DD composites prepared without DS were subtracted from the Na content of the corresponding original DD and difference multiplied by the molar mass of NaCl; 4) Iodine method (IM): analyzed iodine content of milk and milk products and commercial snacks were subtracted from DD iodine content, and difference divided by the iodine content of the HH's salt sample. The relations between methods were explored using Pearson correlation and Bland Altman analyses. Results Mean ± SD intake of DS according to the WFR, HHSD, and NaE methods were 4.7 ± 1.8 g/d, 5.8 ± 3.3 g/d, and 4.1 ± 2.1 g/d, respectively. Results of IM are pending. Pearson correlation coefficients for DS intake estimates obtained from WFR vs. NaE and WFR vs. HHSD were 0.82 (p < 0.001) and 0.48 (p < 0.001), respectively. Mean ± SD bias (limits of agreement) were 0.68 ± 1.25 g/d (−1.77, 3.13) for WFR vs. NaE, and 1.8 ± 2.93 g/d (−4.56, 6.92) for HHSD vs. WFR methods. Conclusions Discretionary salt intake from WFR and NaE showed good agreement and are feasible to implement in field settings. Funding Sources Bill & Melinda Gates Foundation.

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Grimes, Carley A., Lynn J. Riddell, Karen J. Campbell, Kelsey Beckford, Janet R. Baxter, Feng J. He, and Caryl A. Nowson. "Dietary intake and sources of sodium and potassium among Australian schoolchildren: results from the cross-sectional Salt and Other Nutrients in Children (SONIC) study." BMJ Open 7, no. 10 (October 2017): e016639. http://dx.doi.org/10.1136/bmjopen-2017-016639.

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ObjectivesTo examine sodium and potassium urinary excretion by socioeconomic status (SES), discretionary salt use habits and dietary sources of sodium and potassium in a sample of Australian schoolchildren.DesignCross-sectional study.SettingPrimary schools located in Victoria, Australia.Participants666 of 780 children aged 4–12 years who participated in the Salt and Other Nutrients in Children study returned a complete 24-hour urine collection.Primary and secondary outcome measures24-hour urine collection for the measurement of sodium and potassium excretion and 24-hour dietary recall for the assessment of food sources. Parent and child reported use of discretionary salt. SES defined by parental highest level of education.ResultsParticipants were 9.3 years (95% CI 9.0 to 9.6) of age and 55% were boys. Mean urinary sodium and potassium excretion was 103 (95% CI 99 to 108) mmol/day (salt equivalent 6.1 g/day) and 47 (95% CI 45 to 49) mmol/day, respectively. Mean molar Na:K ratio was 2.4 (95% CI 2.3 to 2.5). 72% of children exceeded the age-specific upper level for sodium intake. After adjustment for age, sex and day of urine collection, children from a low socioeconomic background excreted 10.0 (95% CI 17.8 to 2.1) mmol/day more sodium than those of high socioeconomic background (p=0.04). The major sources of sodium were bread (14.8%), mixed cereal-based dishes (9.9%) and processed meat (8.5%). The major sources of potassium were dairy milk (11.5%), potatoes (7.1%) and fruit/vegetable juice (5.4%). Core foods provided 55.3% of dietary sodium and 75.5% of potassium while discretionary foods provided 44.7% and 24.5%, respectively.ConclusionsFor most children, sodium intake exceeds dietary recommendations and there is some indication that children of lower socioeconomic background have the highest intakes. Children are consuming about two times more sodium than potassium. To improve sodium and potassium intakes in schoolchildren, product reformulation of lower salt core foods combined with strategies that seek to reduce the consumption of discretionary foods are required.

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Saqib, Muhammad Arif Nadeem, Ibrar Rafique, Muhammad Ansar, and Tayyaba Rahat. "HIGH SALT INTAKE IMPLICATIONS AS RISK FACTOR FOR HYPERTENSION AND COMPARISON OF THREE SALT ESTIMATION METHODS- FINDINGS FROM ISLAMABAD, PAKISTAN." Pakistan Heart Journal 54, no. 4 (January 8, 2022): 309–14. http://dx.doi.org/10.47144/phj.v54i4.2156.

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Objectives: The study was designed to estimate daily salt intake, its discretionary use in healthy individuals and to validate three common methods for salt estimation in Pakistani population. Methodology: Information on demography and discretionary salt use was collected from healthy adults (>18 years) along with a blood sample, spot and 24 hour urine samples. Sodium, chloride, potassium levels and serum creatinine were measured using standard methods. For daily salt estimation, three common methods i.e. INTERSALT, Tanaka and Kawasaki were validated for their applicability in local settings. Results: Overall 24 h sodium excretion was 158 mmol/l indicating intake of 8.64 (±4.43) grams salt per day which was significantly associated with male gender (p. <0.004) and adding salt during cooking (p. <0.0001). Most (73%) of the participants know about hazardous effects of high salt intake, however, only 25% consider important to lower salt intake. None of three methods i.e. INTERSALT (bias: -19.64; CCC -0.79), Tanaka (bias: 167.35; CCC -0.37) and Kawasaki (bias: -42.49, CCC -0.79) showed any agreement between measured and estimated 24 hour sodium. Conclusion: Daily intake of salt was high which increases the risk for hypertension. Comparison of methods for estimation revealed that none of the three methods could be used for estimating daily intake of salt in local settings of Pakistan.

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Perin, Milena Sia, Marilia Estevam Cornélio, Henrique Ceretta Oliveira, Thais Moreira São-João, Caroline Rhéaume, and Maria-Cecília Bueno Jayme Gallani. "Dietary sources of salt intake in adults and older people: a population-based study in a Brazilian town." Public Health Nutrition 22, no. 8 (November 26, 2018): 1388–97. http://dx.doi.org/10.1017/s1368980018003233.

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AbstractObjectiveTo assess salt intake and its dietary sources using biochemical and self-report methods and to characterize salt intake according to sociodemographic and disease-related variables in a sample of the Brazilian population.DesignPopulation-based cross-sectional survey.SettingSalt intake was assessed by biochemical (24 h urinary Na excretion) and self-report methods (sodium FFQ, 24 h dietary recall, seasoned-salt questionnaire, discretionary-salt questionnaire and total reported salt intake).ParticipantsAdults and older people (n 517) aged 20–80 years, living in Artur Nogueira, São Paulo, Brazil.ResultsMean salt intake based on 24 h urinary Na excretion and total reported salt intake was 10·5 and 11·0 g/d, respectively; both measures were significantly correlated. Discretionary salt and seasoned salt were the most important sources of salt intake (68·2 %). Men in the study consumed more salt than women as estimated by 24 h urinary Na excretion (11·7 v. 9·6 g salt/d; P<0·0001). Participants known to be hypertensive added more salt to their meals but consumed less salty ultra-processed foods. Waist circumference in both sexes and BMI were positively correlated with salt intake estimated by 24 h urinary Na excretion. In addition, regression analysis revealed that being a young male or having a high waist circumference was a predictor of higher salt intake.ConclusionsSalt intake in this population was well above the recommended amount. The main source of salt intake came from salt added during cooking. Salt intake varied according to sex and waist circumference.

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Verkaik-Kloosterman, Janneke, Pieter van 't Veer, and Marga C. Ocké. "Reduction of salt: will iodine intake remain adequate in The Netherlands?" British Journal of Nutrition 104, no. 11 (July 19, 2010): 1712–18. http://dx.doi.org/10.1017/s0007114510002722.

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Salt is the main vehicle for iodine fortification in The Netherlands. A reduction in salt intake may reduce the supply of iodine. Our aim was to quantify the effect of salt reduction on the habitual iodine intake of the Dutch population and the risk of inadequate iodine intake. We used data of the Dutch National Food Consumption Survey (1997–8) and an update of the food composition database to estimate habitual salt and iodine intake. To take into account uncertainty about the use of iodised salt (industrial and discretionary) and food supplements, a simulation model was used. Habitual iodine and salt intakes were simulated for scenarios of salt reduction and compared with no salt reduction. With 12, 25 and 50 % salt reduction in industrially processed foods, the iodine intake remained adequate for a large part of the Dutch population. For the extreme scenario of a 50 % reduction in both industrially and discretionary added salt, iodine intake might become inadequate for part of the Dutch population (up to 10 %). An increment of the proportion of industrially processed foods using iodised salt or a small increase in iodine salt content will solve this. Nevertheless, 8–35 % of 1- to 3-year-old children might have iodine intakes below the corresponding estimated average requirement (EAR), depending on the salt intake scenario. This points out the need to review the EAR value for this age group or to suggest the addition of iodine to industrially manufactured complementary foods.

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Ferreira-Sae, Maria-Carolina S., Maria-Cecilia BJ Gallani, Wilson Nadruz, Roberta CM Rodrigues, Kleber G. Franchini, Poliana C. Cabral, and Maria Lilian Sales. "Reliability and validity of a semi-quantitative FFQ for sodium intake in low-income and low-literacy Brazilian hypertensive subjects." Public Health Nutrition 12, no. 11 (May 28, 2009): 2168–73. http://dx.doi.org/10.1017/s1368980009005825.

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AbstractObjectiveTo assess the reliability and validity of an FFQ to evaluate dietary patterns of Na consumption among low-income and low-literacy Brazilian hypertensive subjects.DesignThe initial FFQ was submitted to content analysis with the pre-test administered to fifteen subjects. Reliability was evaluated according to the reproducibility criterion, with interviewer administration of the FFQ twice within a 15 d interval. Validity was assessed against a 24 h recall (132 subjects), a 3 d diet record (121 subjects) and a biomarker (24 h urinary Na; 121 subjects). To test the correlation with the biomarker, discretionary salt was added to the FFQ Na values.SettingA large urban teaching hospital in south-eastern Brazil.SubjectsThe study was based on 132 randomly selected subjects (eighty-three women and forty-nine men) aged 18 to 85 years.ResultsKappa coefficients ranged from 0·79 to 0·98, confirming the reproducibility of the FFQ. There was no correlation between urinary Na excretion, the FFQ and the 24 h recall for the general sample, although significant correlations had been observed when methods were summed up (24 h recall + discretionary salt + FFQ; 0·32, P = 0·01). The addition of discretionary salt significantly improved the biomarker-based FFQ validity, with correlation coefficients varying from 0·19 (general sample) to 0·31 (female sub-sample).ConclusionsThe developed FFQ demonstrated satisfactory evidence of validity and reliability and can be used as an important complementary tool for the evaluation of Na intake among Brazilian hypertensive subjects.

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Nowson, C. A., K. Lim, C. A. Grimes, S. O'Halloran, M. A. Land, J. Webster, J. Shaw, et al. "Dietary salt intake and discretionary salt use in an Australian population sample: 2011 and 2014." Journal of Nutrition & Intermediary Metabolism 4 (June 2016): 44. http://dx.doi.org/10.1016/j.jnim.2015.12.318.

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Iacone, Roberto, Paola Iaccarino Idelson, Ornella Russo, Chiara Donfrancesco, Vittorio Krogh, Sabina Sieri, Paolo Emidio Macchia, et al. "Iodine Intake from Food and Iodized Salt as Related to Dietary Salt Consumption in the Italian Adult General Population." Nutrients 13, no. 10 (September 30, 2021): 3486. http://dx.doi.org/10.3390/nu13103486.

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Since the Italian iodoprophylaxis strategy is based on the use of iodized salt, we assessed the relationship between dietary salt consumption and iodine intake in the Italian adult population. We estimated the relative contribution given by the use of iodized salt and by the iodine introduced by foods to the total iodine intake. The study population included 2219 adults aged 25–79 years (1138 men and 1081 women) from all Italian regions, participating to the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008–2012 (OEC/HES), and examined for sodium and iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary sodium and total iodine intake were assessed by the measurement of 24 h urinary excretion, while the EPIC questionnaire was used to evaluate the iodine intake from food. Sodium and iodine intake were significantly and directly associated, upon accounting for age, sex, and BMI (Spearman rho = 0.298; p < 0.001). The iodine intake increased gradually across quintiles of salt consumption in both men and women (p < 0.001). The European Food Safety Authority (EFSA) adequacy level for iodine intake was met by men, but not women, only in the highest quintile of salt consumption. We estimated that approximately 57% of the iodine intake is derived from food and 43% from salt. Iodized salt contributed 24% of the total salt intake, including both discretionary and non-discretionary salt consumption. In conclusion, in this random sample of the Italian general adult population examined in 2008–2012, the total iodine intake secured by iodized salt and the iodine provision by food was insufficient to meet the EFSA adequate iodine intake.

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Bolton, Kristy A., Jacqui Webster, Elizabeth K. Dunford, Stephen Jan, Mark Woodward, Bruce Bolam, Bruce Neal, et al. "Sources of dietary sodium and implications for a statewide salt reduction initiative in Victoria, Australia." British Journal of Nutrition 123, no. 10 (January 29, 2020): 1165–75. http://dx.doi.org/10.1017/s000711452000032x.

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AbstractIn Victoria, Australia, a statewide salt reduction partnership was launched in 2015. The aim was to measure Na intake, food sources of Na (level of processing, purchase origin) and discretionary salt use in a cross-section of Victorian adults prior to a salt reduction initiative. In 2016/2017, participants completed a 24-h urine collection (n 338) and a subsample completed a 24-h dietary recall (n 142). Participants were aged 41·2 (sd 13·9) years, and 56 % were females. Mean 24-h urinary excretion was 138 (95 % CI 127, 149) mmol/d for Na. Salt equivalent was 8·1 (95 % CI 7·4, 8·7) g/d, equating to about 8·9 (95 % CI 8·1, 9·6) g/d after 10 % adjustment for non-urinary losses. Mean 24-h intake estimated by diet recall was 118 (95 % CI 103, 133) mmol/d for Na (salt 6·9 (95 % CI 6·0, 7·8 g/d)). Leading dietary sources of Na were cereal-based mixed dishes (12 %), English muffins, flat/savoury/sweet breads (9 %), regular breads/rolls (9 %), gravies and savoury sauces (7 %) and processed meats (7 %). Over one-third (38 %) of Na consumed was derived from discretionary foods. Half of all Na consumed came from ultra-processed foods. Dietary Na derived from foods was obtained from retail stores (51 %), restaurants and fast-food/takeaway outlets (28 %) and fresh food markets (9 %). One-third (32 %) of participants reported adding salt at the table and 61 % added salt whilst cooking. This study revealed that salt intake was above recommended levels with diverse sources of intake. Results from this study suggest a multi-faceted salt reduction strategy focusing on the retail sector, and food reformulation would most likely benefit Victorians and has been used to inform the ongoing statewide salt reduction initiative.

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Davis, Jennie, Sika Kumordzie, Charles Arnold, Xiuping Tan, Emily Becher, Kimberly Wessells, Seth Adu-Afarwuah, et al. "Estimated Consumption of Discretionary Salt and Salt From Bouillon Among Households, Women, and Children in the Northern Region of Ghana: CoMIT Project." Current Developments in Nutrition 6, Supplement_1 (June 2022): 357. http://dx.doi.org/10.1093/cdn/nzac054.012.

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Abstract Objectives To 1) estimate discretionary salt (‘table salt’) consumption and the proportion of salt from bouillon, among households, women and children; 2) compare estimated salt consumption of women and children to recommendations; and 3) identify factors related to household salt consumption in 2 districts in the Northern Region, Ghana. Methods We enrolled households in the Condiment Micronutrient Innovation Trial (CoMIT) Project pilot survey from 14 urban and 14 rural clusters in the Tolon and Kumbungu districts. Using the Fortification Assessment Coverage Toolkit (FACT), households (n = 369) reported most recent purchases of discretionary salt (DS) and bouillon cubes (SB, ‘salt from bouillon’; bouillon assumed to be 55% salt). From the purchase data, we calculated median (IQR) household salt consumption (g/d) by summing DS and SB, and calculated the proportion from SB. Salt consumption for women of reproductive age (15–49 yrs, WRA) and children 2–5 yrs was estimated by the Adult Male Equivalent method and compared to recommendations from the World Health Organization (WRA < 5 g/d) and the National Academy of Sciences (children 2–5 yrs < 3.75 g/d). We used Spearman's rank test to assess partial correlations between household salt consumption and household size, food insecurity (USAID Household Food Insecurity Access Scale score), socioeconomic status (SES, index score of home asset ownership), and household head education level while controlling for district, setting (urban/rural), and cluster. Results Median (IQR) household salt consumption was 56.2 (40.3,116.2) g/d, 23% of which was contributed by SB. Median household size was 10 (8, 14) members. Estimated salt consumption was 6.0 (4.0, 10.2) g/d for WRA and 2.9 (1.9, 5.2) g/d for children; an estimated 50% of WRA and 31% of children potentially exceeded recommendations. Household size and food insecurity, but not education level or SES, were positively correlated with household salt consumption (r = 0.3, p < 0.001; r = 0.2, p < 0.001). Conclusions Household salt and bouillon purchase data suggest that salt consumption among women and children in this area exceeds recommendations; food prepared outside the home may further contribute to salt consumption. Salt reduction interventions may be warranted in this context. Funding Sources Helen Keller International through support from the Bill & Melinda Gates Foundation.

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Grimes, Carley A., Karen J. Campbell, Lynn J. Riddell, and Caryl A. Nowson. "Sources of sodium in Australian children's diets and the effect of the application of sodium targets to food products to reduce sodium intake." British Journal of Nutrition 105, no. 3 (September 28, 2010): 468–77. http://dx.doi.org/10.1017/s0007114510003673.

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The average reported dietary Na intake of children in Australia is high: 2694 mg/d (9–13 years). No data exist describing food sources of Na in Australian children's diets and potential impact of Na reduction targets for processed foods. The aim of the present study was to determine sources of dietary Na in a nationally representative sample of Australian children aged 2–16 years and to assess the impact of application of the UK Food Standards Agency (FSA) Na reduction targets on Na intake. Na intake and use of discretionary salt (note: conversion of salt to Na, 1 g of NaCl (salt) = 390 mg Na) were assessed from 24-h dietary recall in 4487 children participating in the Australian 2007 Children's Nutrition and Physical Activity Survey. Greatest contributors to Na intake across all ages were cereals and cereal-based products/dishes (43 %), including bread (13 %) and breakfast cereals (4 %). Other moderate sources were meat, poultry products (16 %), including processed meats (8 %) and sausages (3 %); milk products/dishes (11 %) and savoury sauces and condiments (7 %). Between 37 and 42 % reported that the person who prepares their meal adds salt when cooking and between 11 and 39 % added salt at the table. Those over the age of 9 years were more likely to report adding salt at the table (χ2199·5, df 6,P < 0·001). Attainment of the UK FSA Na reduction targets, within the present food supply, would result in a 20 % reduction in daily Na intake in children aged 2–16 years. Incremental reductions of this magnitude over a period of years could significantly reduce the Na intake of this group and further reductions could be achieved by reducing discretionary salt use.

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Goh, Yvonne E., Mari S. Manger, Mona Duggal, Reena Das, Shipra Saklani, Surbhi Agarwal, Deepmala Budhija, et al. "Women in Selected Communities of Punjab, India Have a High Prevalence of Iron, Zinc, Vitamin B12, and Folate Deficiencies: Implications for a Multiply-Fortified Salt Intervention." Nutrients 15, no. 13 (July 3, 2023): 3024. http://dx.doi.org/10.3390/nu15133024.

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Dietary intake and biomarkers of micronutrient status of 100 non-pregnant women of reproductive age (NPWRA) were assessed to determine optimal levels of iron, zinc, vitamin B12, and folic acid to include in multiply-fortified salt (MFS) that will be evaluated in an upcoming trial. Weighed food records were obtained from participants to measure intake of micronutrients and discretionary salt, and to assess adequacy using Indian Nutrient Reference Values (NRVs). Statistical modeling was used to determine optimal fortification levels to reduce inadequate micronutrient intake while limiting intake above the upper limit. Fasting blood samples were obtained to assess iron, zinc, vitamin B12, and folate status. In usual diets, inadequate intake of iron (46%), zinc (95%), vitamin B12 (83%), and folate (36%) was high. Mean intake of discretionary salt was 4.7 g/day. Prevalence estimates of anemia (37%), iron deficiency (67%), zinc deficiency (34%), vitamin B12 insufficiency (37%), and folate insufficiency (70%) were also high. Simulating the addition of optimized MFS to usual diets resulted in percentage point (pp) reductions in inadequate intake by 29 pp for iron, 76 pp for zinc, 81 pp for vitamin B12, and 36 pp for folate. MFS holds potential to reduce the burden of micronutrient deficiencies in this setting.

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Nowson, Caryl, Karen Lim, Carley Grimes, Siobhan O’Halloran, Mary Land, Jacqui Webster, Jonathan Shaw, et al. "Dietary Salt Intake and Discretionary Salt Use in Two General Population Samples in Australia: 2011 and 2014." Nutrients 7, no. 12 (December 16, 2015): 10501–12. http://dx.doi.org/10.3390/nu7125545.

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Abtahi, Mitra, Ashraf Pirasteh, Hamed Pouraram, and Nahid Kholdi. "Discretionary salt intake and readiness for behavioral change among women in Tehran." International Journal of Preventive Medicine 10, no. 1 (2019): 167. http://dx.doi.org/10.4103/ijpvm.ijpvm_523_18.

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Agbemafle, Isaac, Meseret Woldeyohannes, Masresha Tessema, Mengistu Fereja, Charles D. Arnold, Biniyam T. Banjaw, Alemayhu Hussen, et al. "Assessment of Women’s Discretionary Salt Intake and Household Salt Utilization in Preparation for a Salt Fortification Trial in Oromia Region, Ethiopia." Current Developments in Nutrition 8 (July 2024): 102913. http://dx.doi.org/10.1016/j.cdnut.2024.102913.

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de Freitas Agondi, Rúbia, Marilia Estevam Cornélio, Roberta Cunha Matheus Rodrigues, and Maria-Cecilia Gallani. "Implementation Intentions on the Effect of Salt Intake among Hypertensive Women: A Pilot Study." Nursing Research and Practice 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/196410.

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This experimental study was aimed at assessing the potential effect of a theory-driven intervention—implementation intentions—on reducing salt intake among hypertensive Brazilian women. Ninety-eight participants were randomly assigned to participate in an implementation intentions intervention aimed at promoting lower salt intake through decreased addition of salt and salty spices to meals (intervention group,n=49; group,n=49). Endpoints were assessed at baseline and at the 2-month follow-up. Primary endpoints were a self-reporting measure of salt intake given by salt addition to meals (discretionary salt + salty spices = total added salt) and the 24 h urinary-sodium excretion. Secondary endpoints included intention, self-efficacy, and habit related to adding salt to meals. Patients in the intervention group showed a significant reduction in salt intake as assessed by 24 h urinary-sodium excretion. A significant reduction in the measure of habit was observed for both groups. No differences were observed for intention and self-efficacy. The results of this pilot study suggest the efficacy of planning strategies to help hypertensive women reduce their salt intake.

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Perin, Milena Sia, Marilia Estevam Cornelio, Roberta Cunha Matheus Rodrigues, and Maria Cecilia Bueno Jayme Gallani. "Characterization of salt consumption among hypertensives according to socio-demographic and clinical factors." Revista Latino-Americana de Enfermagem 21, no. 5 (September 2013): 1013–21. http://dx.doi.org/10.1590/s0104-11692013000500002.

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OBJECTIVE: to evaluate the relationship between the behaviors of salt consumption and socio-demographic and clinical variables. METHOD: sodium consumption was evaluated using the methods: self-reporting (considering 3 different behaviors related to salt consumption), 24- hr dietary recall, discretionary salt, food frequency questionnaire, estimation of total sodium intake and 24-hr urinary excretion of sodium (n=108). RESULTS: elevated salt intake according to the different measurements of consumption of the nutrient was associated with the variables: male sex, low level of schooling and monthly income, being Caucasian, and being professionally inactive; and with the clinical variables: elevated Body Mass Index, tensional levels, ventricular hypertrophy and the number of medications used. CONCLUSION: the data obtained shows a heterogenous association between the different behaviors related to salt consumption and the socio-demographic and clinical variables. This data can be used to optimize the directing of educational activities with a view to reducing salt consumption among hypertensives.

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Antúnez, Lucía, Leticia Vidal, Ana Giménez, María Rosa Curutchet, and Gastón Ares. "Age, time orientation and risk perception are major determinants of discretionary salt usage." Appetite 171 (April 2022): 105924. http://dx.doi.org/10.1016/j.appet.2022.105924.

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Marakis, Georgios, Ana Marques Domingues, Anna Crispo, Emmanuella Magriplis, Eleni Vasara, Lamprini Kontopoulou, Christos Triantafyllou, et al. "Pertinence of Salt-Related Knowledge and Reported Behaviour on Salt Intake in Adults: A Cross-Sectional Study." Nutrients 15, no. 19 (September 23, 2023): 4114. http://dx.doi.org/10.3390/nu15194114.

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The association between salt-related knowledge, attitude, behaviour (KAB) and actual salt consumption in Greek adults is uncertain. This study investigates the correlation between salt intake, gauged by 24-h urinary sodium excretion, with salt-related KAB. It further explores how socio-demographic factors influence these behaviors. Salt consumption was evaluated using a 24-h urinary sodium test, and compared to self-reported KAB data. Knowledge and behavior scores related to salt were computed. An overall cohort-adjusted model examined the relationship between daily salt consumption, knowledge and behavior scores, and certain covariates. Through the stratification by the cohort random effect, two models were established (Cohort I Adults; Cohort II Students) examining the same relationships of the overall cohort model. 463 Greek adults participated. The average salt intake was 9.54 g/day, nearly double the WHO recommendation. Significant differences in knowledge scores were noted based on sex, age, education, and BMI. A trend suggesting lower discretionary salt use with increased salt intake was observed (p = 0.06). However, comprehensive analysis revealed no direct correlation between salt intake and either knowledge (p = 0.562) or behavior scores (p = 0.210). The results emphasize the need for food product reforms by industry stakeholders and accelerated efforts towards reducing salt intake.

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Marateb, Hamid Reza, Mahsa Mansourian, Amirhossein Koochekian, Mehdi Shirzadi, Shadi Zamani, Marjan Mansourian, Miquel Angel Mañanas, and Roya Kelishadi. "Prevention of Cardiometabolic Syndrome in Children and Adolescents Using Machine Learning and Noninvasive Factors: The CASPIAN-V Study." Information 15, no. 9 (September 13, 2024): 564. http://dx.doi.org/10.3390/info15090564.

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Cardiometabolic syndrome (CMS) is a growing concern in children and adolescents, marked by obesity, hypertension, insulin resistance, and dyslipidemia. This study aimed to predict CMS using machine learning based on data from the CASPIAN-V study, which involved 14,226 participants aged 7–18 years, with a CMS prevalence of 82.9%. We applied the XGBoost algorithm to analyze key noninvasive variables, including self-rated health, sunlight exposure, screen time, consanguinity, healthy and unhealthy dietary habits, discretionary salt and sugar consumption, birthweight, and birth order, father and mother education, oral hygiene behavior, and family history of dyslipidemia, obesity, hypertension, and diabetes using five-fold cross-validation. The model achieved high sensitivity (94.7% ± 4.8) and specificity (78.8% ± 13.7), with an area under the ROC curve (AUC) of 0.867 ± 0.087, indicating strong predictive performance and significantly outperformed triponderal mass index (TMI) (adjusted paired t-test; p < 0.05). The most critical selected modifiable factors were sunlight exposure, screen time, consanguinity, healthy and unhealthy diet, dietary fat type, and discretionary salt consumption. This study emphasizes the clinical importance of early identification of at-risk individuals to implement timely interventions. It offers a promising tool for CMS risk screening. These findings support using predictive analytics in clinical settings to address the rising CMS epidemic in children and adolescents.

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Sari, Afifah Nurma, Farapti Farapti, and Norfezah Md Nor. "SALT TASTE THRESHOLD AS A DETECTION OF SALT INTAKE IN HYPERTENSIVE INDIVIDUALS." Jurnal Berkala Epidemiologi 10, no. 3 (September 26, 2022): 227–36. http://dx.doi.org/10.20473/jbe.v10i32022.227-236.

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Background: High sodium consumption is one of the risk factors for hypertension. Excess salt intake may be affected by an individual’s ability to detected taste. However, decreased salt sensitivity can increase consumption of salty foods. Purpose: This review aims to analyze the salt taste threshold and its relation to salt intake among hypertensive and normotensive individuals. Methods: The review was conducted using five electronic databases and fourteen articles reporting on salt taste threshold, salt intake, and blood pressure. Open access articles, original research, published over the past ten years, and subject’s age over eighteen years both healthy and with specific clinical conditions, and have blood pressure data were identified and included in the study. Results: There were fourteen studies that measured salt taste threshold through detection threshold and/ or recognition threshold. Ten studies reported salt consumption through Na-FFQ, SQ-FFQ, 24-hour food recall, discretionary salt, adding salt questionnaire, salt use behavior questionnaire, salt preference questionnaire, and sodium excretion. Most studies showed that high salt consumption is higher in the group with high salt taste threshold and high salt taste threshold tends to be more in hypertensive group. The result also showed a significant correlation between salt consumption both through self-reported questionnaire and 24-hour urinary sodium excretion. Conclusion: Although the correlation between salt taste threshold, salt intake, and hypertension can be found a matching method with adequate statistical power is needed to get more accurate results.

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Hartley, Isabella, Andrew Costanzo, Djin Gie Liem, and Russell Keast. "Glutamate-Sodium Discrimination Status in Adults Is Associated with Salt Recognition Threshold and Habitual Intake of Discretionary Food and Meat: A Cross-Sectional Study." International Journal of Environmental Research and Public Health 19, no. 17 (September 5, 2022): 11101. http://dx.doi.org/10.3390/ijerph191711101.

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Umami non-discriminators (NDs) are a sub-group of the population with a reduced ability to discriminate between monosodium glutamate (MSG) and sodium chloride (NaCl) compared to umami discriminators (UDs). No research has investigated umami and salty taste perception associations across detection threshold (DT), recognition threshold (RT), and suprathreshold intensity perception (ST) or the habitual dietary intake of ND. Adults (n = 61, mean age of 30 ± 8 years, n = 40 females) completed taste assessments measuring their DT, RT, and ST for salty, umami (MSG and monopotassium glutamate (MPG)), and sweet tastes. To determine the umami discrimination status, participants completed 24 triangle tests containing 29 mM NaCl and 29 mM MSG, and those with ≥13 correct identifications were considered UDs. Habitual dietary intake was recorded via a food frequency questionnaire. NDs made up 14.8% (n = 9) of the study population, and UDs made up 85.2% (n = 52). NDs were less sensitive to salt at RT (mean step difference: −1.58, p = 0.03), and they consumed more servings of meat and poultry daily (1.3 vs. 0.6 serves, p = 0.006); fewer servings of discretionary food (1.6 vs. 2.4, p = 0.001); and, of these, fewer salty discretionary foods (0.9 vs. 1.3, p = 0.003) than NDs. Identifying these NDs may provide insight into a population at risk of the overconsumption of discretionary foods and reduced intake of protein-rich meat foods.

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Cuadrado-Soto, Esther, África Peral-Suarez, Aránzazu Aparicio, Jose Perea, Rosa Ortega, and Ana López-Sobaler. "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 10, no. 12 (December 3, 2018): 1880. http://dx.doi.org/10.3390/nu10121880.

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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.

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Leclercq, C., V. Avalle, L. Ranaldi, E. Toti, and A. Ferro-Luzzi. "Simplifying the Lithium-Marker Technique Used to Assess the Dietary Intake of Discretionary Sodium in Population Studies." Clinical Science 79, no. 3 (September 1, 1990): 227–31. http://dx.doi.org/10.1042/cs0790227.

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1. Lithium has been used by Sanchez-Castillo et al. (Clin. Sci. 1987; 72, 81–6) for tracking sodium in order to monitor the domestic use of salt. The present study was designed to simplify the original protocol, which is too cumbersome for epidemiological studies. 2. A preliminary study conducted on nine volunteers showed that sharp modifications of lithium intake are detected within 24 h in urinary excretion. The average intake over a 5-day period could be predicted by the mean excretion of the last 3 days. Lithium recovery established from 1 baseline day and 3 plateau days was 95 ± 6% (mean ± sd), not significantly different from the recovery obtained by the integrated excretion curve over 12 days. 3. A simplified protocol was therefore developed, reducing to 4 the 12 days of urine collection originally required. 4. This simplified protocol was tested on five households (14 adults and five children). All domestic salt was substituted with lithium-tagged salt. Urine samples were collected on 1 baseline day and on 3 plateau days. The lithium/sodium ratio of all urine collections (both complete and incomplete) could be used to estimate the proportion of discretionary sodium. In our sample it was about 29% of total sodium intake. 5. The simplified protocol can thus be proposed for population studies.

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Sanchez-Castillo, C. P., S. Warrender, T. P. Whitehead, and W. P. T. James. "An assessment of the sources of dietary salt in a British population." Clinical Science 72, no. 1 (January 1, 1987): 95–102. http://dx.doi.org/10.1042/cs0720095.

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1. An epidemiological study was conducted in the market town of March, Cambridgeshire, to assess the quantitative importance of cooking and table salt to total dietary salt intake by the use of a fused mixture of lithium carbonate and sodium chloride. 2. Men and women aged 20–60 participated in a 12 day study with sequential 24 h urine collections to assess salt sources over a 7 day period. 3. Total salt consumption estimated from urinary chloride excretion amounted to 10.6 ± 0.55 (sem) g in 33 men and 7.4 ± 0.29 (sem) g in 50 women. The cooking salt eaten was only 0.45 ± 0.09 (sem) g in men and women, with men eating more table salt (0.77 g/day) than women (0.46 g/day). 4. Discretionary sources, i.e. cooking and table salt use, contributed only 15% to the total intake. Salt from manufacturing foods and catering in purchased food therefore provided on average 85% of total salt intake. These results are consistent even when an allowance is made for the slightly poorer pouring quality of the lithium-tagged salt. 5. The importance of food as a source of salt was reflected in the significant relationship between the weight of the individual and the amount of salt eaten (for males P < 0.05 and for females P < 0.001). 6. Cooking salt consumption did not relate to the amount of salt derived from purchased food nor did table salt use relate to the amount of salt in cooked foods. 7. Husbands and wives showed a high correlation in their salt use but the husbands had higher intakes of salt from purchased food and from cooking salt. They also used more table salt than their wives.

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Saliou, Diombo KEBE, DIOUF Adama, Mamadou Dit Doudou SYLLA Papa, THIAM Mbeugué, Baba COLY Ousseynou, Hélène FAYE Mane, BADIANE Abdou, and IDOHOU-DOSSOU Nicole. "Consumption of discretionary salt and bouillon in Senegalese households and related knowledge, attitudes and practices." African Journal of Food Science 17, no. 8 (August 31, 2023): 154–61. http://dx.doi.org/10.5897/ajfs2023.2254.

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Pilic, Leta, and Yiannis Mavrommatis. "Genetic predisposition to salt-sensitive normotension and its effects on salt taste perception and intake." British Journal of Nutrition 120, no. 7 (August 14, 2018): 721–31. http://dx.doi.org/10.1017/s0007114518002027.

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AbstractSalt sensitivity is an independent CVD and mortality risk factor, which is present in both hypertensive and normotensive populations. It is genetically determined and it may affect the relationship between salt taste perception and salt intake. The aim of this study was to explore the genetic predisposition to salt sensitivity in a young and a middle-aged adult population and its effects on salt taste perception and salt intake. The effects of Na loading on blood pressure (BP) were investigated in twenty normotensive subjects and salt sensitivity defined as the change in BP after 7 d of low-Na (51·3 mmol Na/d) and 7 d of high-Na diet (307·8 mmol Na/d). Salt taste perception was identified using the British Standards Institution sensory analysis method (BS ISO 3972:2011). Salt intake was assessed with a validated FFQ. DNA was genotyped for SNP in the SLC4A5, SCNN1B and TRPV1 genes. The subjects with AA genotype of the SLC4A5 rs7571842 exhibited the highest increase in BP (∆ systolic BP=7·75 mmHg, P=0·002, d=2·4; ∆ diastolic BP=6·25 mmHg, P=0·044, d=1·3; ∆ mean arterial pressure=6·5 mmHg, P=0·014, d=1·7). The SLC4A5 rs10177833 was associated with salt intake (P=0·037), and there was an association between salt taste perception and salt sensitivity (rs 0·551, P=0·041). In conclusion, there is a genetic predisposition to salt sensitivity and it is associated with salt taste perception. The association between salt taste perception and discretionary salt use suggests that preference for salty taste may be a driver of salt intake in a healthy population and warrants further investigation.

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Gallani, Maria Cecilia, Alexandra Proulx-Belhumeur, Natalie Almeras, Jean-Pierre Després, Michel Doré, and Jean-François Giguère. "Development and Validation of a Salt Food Frequency Questionnaire (FFQ-Na) and a Discretionary Salt Questionnaire (DSQ) for the Evaluation of Salt Intake among French-Canadian Population." Nutrients 13, no. 1 (December 30, 2020): 105. http://dx.doi.org/10.3390/nu13010105.

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We assessed the reliability and validity of a Salty Food Frequency Questionnaire for Sodium (FFQ-Na) and a Discretionary Salt Questionnaire (DSQ) developed for the French-Canadian population. The reliability was evaluated according to temporal stability over a 7–15 day interval (n = 36). Validity was evaluated by testing the tools against a 24-h urine sodium excretion (24 h Uri-Na) and a 3-day food record, and this at individual and group levels (n = 164). The intra-class coefficients (ICC) values for the test-retest of the DSQ, the FFQ-Na and the two questionnaires combined were 0.73, 0.97 and 0.98 respectively. Correlations of the FFQ-Na with the 24 h Uri-Na and the 3-day food record were 0.3 (p < 0.001) and 0.35 (p < 0.001) respectively. The DSQ showed no significant correlation with the reference measures. The correlation between the two methods combined were 0.29 (p < 0.001) with the 24 h Uri-Na and 0.31 (p < 0.001) with the 3-day food record. The results of Bland–Altman indicated that for the combined questionnaires, there was a bias of measurement (underestimation of intake), but it was constant for every level of intake according to the reference measures. Finally, the cross-classification indicated an acceptable proportion of agreement, but a rate between 20% and 30% of classification in the opposite quartile. In conclusion, the developed tools are reliable and showed some facets of validity.

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Mushoriwa, Fadzai, Nick Townsend, and Sunitha Srinivas. "Knowledge, attitudes and perception on dietary salt reduction of two communities in Grahamstown, South Africa." Nutrition and Health 23, no. 1 (January 3, 2017): 33–38. http://dx.doi.org/10.1177/0260106016685725.

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Introduction: Dietary salt reduction has been identified as a cost effective way of addressing the global burden of non-communicable diseases (NCDs), particularly cardiovascular diseases. The World Health Organization has recommended three main strategies for achieving population-wide salt reduction in all member states: food reformulation, policies and consumer awareness campaigns. In 2013, the South African Ministry of Health announced the mandatory salt reduction legislation for the food manufacturing sector. These were set to come into effect on 30 June 2016. This decision was influenced by the need to reduce the incidence of NCDs and the fact that processed food is the source of 54% of the salt consumed in the South African diet. However, with discretionary salt also being a significant contributor, there is need for consumer awareness campaigns. The aim of this study was to assess the knowledge, attitudes and practices of guardians and cooks at two non-governmental organisations based in Grahamstown, South Africa, towards dietary salt reduction. Method: Data was collected through observation and explorative, voice-recorded semi-structured interviews and transcribed data was analysed using NVivo®. Results: At both centres, salt shakers were not placed on the tables during mealtimes. Only 14% the participants perceived their personal salt intake to be a little. No participants were aware of the recommended daily salt intake limit or the relationship between salt and sodium. Only five out of the 19 participants had previously received information on dietary salt reduction from sources such as healthcare professionals and the media. Conclusion: The results from the first phase of this study highlighted gaps in the participants’ knowledge, attitudes and practices towards dietary salt reduction. The aim of the second phase of the research is to design and implement a context specific and culturally appropriate educational intervention on dietary salt reduction.

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Sutherland, Jennifer, Phil Edwards, Bhavani Shankar, and Alan D. Dangour. "Fewer adults add salt at the table after initiation of a national salt campaign in the UK: a repeated cross-sectional analysis." British Journal of Nutrition 110, no. 3 (January 3, 2013): 552–58. http://dx.doi.org/10.1017/s0007114512005430.

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In 2003, the UK Food Standards Agency and the Department of Health began attempts to reduce national salt intakes via reformulation of processed foods and a consumer awareness campaign on the negative impacts of salt on health. The present study uses large nationally representative samples of households in England to assess whether discretionary salt use was affected by the national salt reduction campaign. Large cross-sectional datasets from the Health Survey for England were used to analyse trends in adults adding salt at the table between 1997 and 2007. Since 1997, there has been a steady decline in salt use at the table. Ordinal logistic regression analysis controlling for age, sex, total household income, region, ethnicity and background trends revealed that the reduction in salt use was significantly greater after the campaign (OR 0·58; 95 % CI 0·54, 0·63). Women (OR 0·71; 95 % CI 0·68, 0·74), non-white ethnic groups (OR 0·69; 95 % CI 0·62, 0·77), high-income households (OR 0·75; 95 % CI 0·69, 0·82), middle-income households (OR 0·79; 95 % CI 0·75, 0·84) and households in central (OR 0·90; 95 % CI 0·84, 0·98) or the south of England (OR 0·82; 95 % CI 0·77, 0·88) were less likely to add salt at the table. The results extend previous evidence of a beneficial response to the salt campaign by demonstrating the effect on salt use at the table. Future programmatic and research efforts may benefit from targeting specific population groups and improving the evidence base for evaluating the impact of the campaign.

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Schiess, Sonja, Peter J. Cressey, and Barbara M. Thomson. "Predictive modelling of interventions to improve iodine intake in New Zealand." Public Health Nutrition 15, no. 10 (January 25, 2012): 1932–40. http://dx.doi.org/10.1017/s1368980011003545.

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AbstractObjectiveThe potential effects of four interventions to improve iodine intakes of six New Zealand population groups are assessed.DesignA model was developed to estimate iodine intake when (i) bread is manufactured with or without iodized salt, (ii) recommended foods are consumed to augment iodine intake, (iii) iodine supplementation as recommended for pregnant women is taken and (iv) the level of iodization for use in bread manufacture is doubled from 25–65 mg to 100 mg iodine/kg salt.SettingNew Zealanders have low and decreasing iodine intakes and low iodine status. Predictive modelling is a useful tool to assess the likely impact, and potential risk, of nutrition interventions.SubjectsFood consumption information was sourced from 24 h diet recall records for 4576 New Zealanders aged over 5 years.ResultsMost consumers (73–100 %) are predicted to achieve an adequate iodine intake when salt iodized at 25–65 mg iodine/kg salt is used in bread manufacture, except in pregnant females of whom 37 % are likely to meet the estimated average requirement. Current dietary advice to achieve estimated average requirements is challenging for some consumers. Pregnant women are predicted to achieve adequate but not excessive iodine intakes when 150 μg of supplemental iodine is taken daily, assuming iodized salt in bread.ConclusionsThe manufacture of bread with iodized salt and supplemental iodine for pregnant women are predicted to be effective interventions to lift iodine intakes in New Zealand. Current estimations of iodine intake will be improved with information on discretionary salt and supplemental iodine usage.

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Melse-Boonstra, A., M. Rozendaal, H. Rexwinkel, M. J. Gerichhausen, T. van den Briel, J. Bulux, N. W. Solomons, and C. E. West. "Determination of discretionary salt intake in rural Guatemala and Benin to determine the iodine fortification of salt required to control iodine deficiency disorders: studies using lithium-labeled salt." American Journal of Clinical Nutrition 68, no. 3 (September 1, 1998): 636–41. http://dx.doi.org/10.1093/ajcn/68.3.636.

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Partearroyo, Teresa, Mª de Lourdes Samaniego-Vaesken, Emma Ruiz, Javier Aranceta-Bartrina, Ángel Gil, Marcela González-Gross, Rosa M. Ortega, Lluis Serra-Majem, and Gregorio Varela-Moreiras. "Sodium Intake from Foods Exceeds Recommended Limits in the Spanish Population: The ANIBES Study." Nutrients 11, no. 10 (October 14, 2019): 2451. http://dx.doi.org/10.3390/nu11102451.

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Excessive sodium consumption is associated with adverse health effects. An elevated dietary intake of salt (sodium chloride) has been related to high blood pressure or hypertension, a major but modifiable risk factor for cardiovascular disease, as well as to other ill health conditions. In the present work, our aim was to describe the contribution of foods to sodium consumption within the Spanish population in a representative sample from the “anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles in Spain” (ANIBES) study (9–75 years), to identify high consumer groups, as well as the major food groups that contribute to sodium intake in the Spanish diet. Intakes were assessed by 3-day food records collected on a tablet device. Sodium intakes across the ANIBES study population exceeded recommendations, as total intakes reached 2025 ± 805 mg of sodium per day, that is approximately 5.06 g/day of salt (excluding discretionary salt, added at the table or during cooking). Sodium intakes were higher in males than in females and within the youngest groups. Main dietary sources of sodium were meat and meat products (27%), cereals and grains (26%), milk and dairy products (14%) and ready-to-eat meals (13%). Given the established health benefits of dietary salt reduction, it would be advisable to continue and even improve the current national initiatives of awareness and educational campaigns and particularly food reformulation to decrease overall salt intakes across the Spanish population.

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De Keyzer, Willem, Marcela Dofková, Inger Therese L. Lillegaard, Mieke De Maeyer, Lene Frost Andersen, Jirí Ruprich, Irena Řehůřková, et al. "Reporting accuracy of population dietary sodium intake using duplicate 24 h dietary recalls and a salt questionnaire." British Journal of Nutrition 113, no. 3 (January 13, 2015): 488–97. http://dx.doi.org/10.1017/s0007114514003791.

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High dietary Na intake is associated with multiple health risks, making accurate assessment of population dietary Na intake critical. In the present study, reporting accuracy of dietary Na intake was evaluated by 24 h urinary Na excretion using the EPIC-Soft 24 h dietary recall (24-HDR). Participants from a subsample of the European Food Consumption Validation study (n 365; countries: Belgium, Norway and Czech Republic), aged 45–65 years, completed two 24 h urine collections and two 24-HDR. Reporting accuracy was calculated as the ratio of reported Na intake to that estimated from the urinary biomarker. A questionnaire on salt use was completed in order to assess the discretionary use of table and cooking salt. The reporting accuracy of dietary Na intake was assessed using two scenarios: (1) a salt adjustment procedure using data from the salt questionnaire; (2) without salt adjustment. Overall, reporting accuracy improved when data from the salt questionnaire were included. The mean reporting accuracy was 0·67 (95 % CI 0·62, 0·72), 0·73 (95 % CI 0·68, 0·79) and 0·79 (95 % CI 0·74, 0·85) for Belgium, Norway and Czech Republic, respectively. Reporting accuracy decreased with increasing BMI among male subjects in all the three countries. For women from Belgium and Norway, reporting accuracy was highest among those classified as obese (BMI ≥ 30 kg/m2: 0·73, 95 % CI 0·67, 0·81 and 0·81, 95 % CI 0·77, 0·86, respectively). The findings from the present study showed considerable underestimation of dietary Na intake assessed using two 24-HDR. The questionnaire-based salt adjustment procedure improved reporting accuracy by 7–13 %. Further development of both the questionnaire and EPIC-Soft databases (e.g. inclusion of a facet to describe salt content) is necessary to estimate population dietary Na intakes accurately.

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Setiadi, Adji Prayitno, Anita Febriandini, Eltia Trinanda, Wiweka Aryaguna, Irene Mutho’atin Chusna, Yulia Nurlaili, Bruce Sunderland, and Yosi Irawati Wibowo. "Knowing the gap: medication use, adherence and blood pressure control among patients with hypertension in Indonesian primary care settings." PeerJ 10 (March 25, 2022): e13171. http://dx.doi.org/10.7717/peerj.13171.

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Background Hypertension is a major risk factor for global disease burden, however, little is known regarding the profiles of patients with hypertension in Indonesian primary care settings. Objective This study aimed to profile medication use, adherence to medications and lifestyle modifications as well as blood pressure control among patients with hypertension in Indonesian primary health centres (PHCs). Methods A cross-sectional study design used a structured data collection tool (questionnaire and checklist). Patients aged ≥18 years with a diagnosis of hypertension, and prescribed an antihypertensive medication, and attending follow-up visits in the five PHCs in Surabaya, Indonesia, during a two-week study period (May–October 2019) were included. Descriptive analyses summarised the data, while binary logistic regression provided any independent associations between adherence profiles and blood pressure control. Results Of 457 eligible patients, 276 patients consented: PHC A (n = 50/91), PHC B (n = 65/116), PHC C (n = 47/61), PHC D (n = 60/88), PHC E (n = 54/101), giving an overall response rate of 60.4%. Patients were mainly treated with a single antihypertensive medication, i.e., amlodipine (89.1%), and many had not achieved blood pressure targets (68.1%). A majority reported notable levels of non-adherence to medication (low/intermediate, 65.2%) and poor healthy lifestyle behaviours, particularly physical activity (inadequate, 87.7%) and discretionary salt use (regularly, 50.4%). Significant associations were found between low medication adherence, discretionary salt use and smoking, with blood pressure control. Conclusions The study findings provide the evidence needed to improve the current level of sub-optimal blood pressure management among patients with hypertension in these Indonesian primary care settings. Particular emphasis should be placed on antihypertensive medication adherence and healthy lifestyle behaviours through locally tailored hypertension-related interventions.

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Lewis, Meron, Sarah A. McNaughton, Lucie Rychetnik, Mark D. Chatfield, and Amanda J. Lee. "Dietary Intake, Cost, and Affordability by Socioeconomic Group in Australia." International Journal of Environmental Research and Public Health 18, no. 24 (December 17, 2021): 13315. http://dx.doi.org/10.3390/ijerph182413315.

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Few Australians consume diets consistent with the Australian Dietary Guidelines. A major problem is high intake of discretionary food and drinks (those not needed for health and high in saturated fat, added sugar, salt and/or alcohol). Low socioeconomic groups (SEGs) suffer particularly poor diet-related health. Surprisingly, detailed quantitative dietary data across SEGs was lacking. Analysis of the most recent national nutrition survey data produced habitual intakes of a reference household (two adults and two children) in SEG quintiles of household income. Cost and affordability of habitual and recommended diets for the reference household were determined using methods based on the Healthy Diets Australian Standardised Affordability and Pricing protocol. Low SEGs reported significantly lower intakes of healthy food and drinks yet similarly high intakes of discretionary choices to high SEGs (435 serves/fortnight). Total habitual diets of low SEGs cost significantly less than those of high SEGs (AU$751/fortnight to AU$853/fortnight). Results confirmed low SEGs cannot afford a healthy diet. Lower intakes of healthy choices in low SEGs may help explain their higher rates of diet-related disease compared to higher SEGs. The findings can inform potential policy actions to improve affordability of healthy foods and help drive healthier diets for all Australians.

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Melse-Boonstra, A., H. Rexwinkel, J. Bulux, NW Solomons, and CE West. "Comparison of three methods for estimating daily individual discretionary salt intake: 24 hour recall, duplicate-portion method, and urinary lithium-labelled household salt excretion." European Journal of Clinical Nutrition 53, no. 4 (April 1999): 281–87. http://dx.doi.org/10.1038/sj.ejcn.1600723.

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Quader, Zerleen S., Lixia Zhao, Lisa J. Harnack, Christopher D. Gardner, James M. Shikany, Lyn M. Steffen, Cathleen Gillespie, Alanna Moshfegh, and Mary E. Cogswell. "Self-Reported Measures of Discretionary Salt Use Accurately Estimated Sodium Intake Overall but not in Certain Subgroups of US Adults from 3 Geographic Regions in the Salt Sources Study." Journal of Nutrition 149, no. 9 (June 10, 2019): 1623–32. http://dx.doi.org/10.1093/jn/nxz110.

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ABSTRACT Background Excess sodium intake can increase blood pressure, and high blood pressure is a major risk factor for cardiovascular disease. Accurate population sodium intake estimates are essential for monitoring progress toward reduction, but data are limited on the amount of sodium consumed from discretionary salt. Objectives The aim of this study was to compare measured sodium intake from salt added at the table with that estimated according to the Healthy People 2020 (HP 2020) methodology. Methods Data were analyzed from the 2014 Salt Sources Study, a cross-sectional convenience sample of 450 white, black, Asian, and Hispanic adults living in Alabama, Minnesota, and California. Sodium intake from foods and beverages was assessed for each participant through the use of 24-h dietary recalls. Estimated sodium intake from salt used at the table was assessed from self-reported frequency and estimated amounts from a previous study (HP 2020 methodology). Measured intake was assessed through the use of duplicate salt samples collected on recall days. Results Among all study participants, estimated and measured mean sodium intakes from salt added at the table were similar, with a nonsignificant difference of 8.9 mg/d (95% CI: −36.6, 54.4 mg/d). Among participants who were non-Hispanic Asian, Hispanic, had a bachelor's degree or higher education, lived in California or Minnesota, did not report hypertension, or had normal BMI, estimated mean sodium intake was 77–153 mg/d greater than measured intake (P < 0.05). The estimated mean sodium intake was 186–300 mg/d lower than measured intake among participants who were non-Hispanic black, had a high school degree or less, or reported hypertension (P < 0.05). Conclusions The HP 2020 methodology for estimating sodium consumed from salt added at the table may be appropriate for the general US adult population; however, it underestimates intake in certain population subgroups, particularly non-Hispanic black, those with a high school degree or less, or those with self-reported hypertension. This study was registered at clinicaltrials.gov as NCT02474693.

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Marklund, Matti, Fikru Tullu, Sudhir Raj Thout, Jie Yu, Tammy M. Brady, Lawrence J. Appel, Bruce Neal, Jason H. Y. Wu, and Rachita Gupta. "Estimated Benefits and Risks of Using a Reduced-Sodium, Potassium-Enriched Salt Substitute in India: A Modeling Study." Hypertension 79, no. 10 (October 2022): 2188–98. http://dx.doi.org/10.1161/hypertensionaha.122.19072.

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Background: Salt substitution (ie, replacement of table and cooking salt with potassium-enriched salt substitutes) is a promising strategy to reduce blood pressure and prevent cardiovascular disease, particularly in countries like India where there is high sodium intake, mainly from discretionary salt, and low potassium intake. Life-threatening hyperkalemia from increased potassium intake is a postulated concern for individuals with chronic kidney disease. methods: We used comparative risk assessment models to estimate the number of (1) cardiovascular deaths averted due to blood pressure reductions; (2) potential hyperkalemia-related deaths from increased potassium intake in individuals with advanced chronic kidney disease; and (3) net averted deaths from nationwide salt substitution in India. We evaluated a conservative scenario, based on a large, long-term pragmatic trial in rural China; and an optimistic scenario informed by our recent trial in India. Sensitivity analyses were conducted to assess the robustness of the findings. Results: In the conservative scenario, a nationwide salt substitution intervention was estimated to result in ≈214 000 (95% uncertainty interval, 92 764–353 054) averted deaths from blood pressure reduction in the total population and ≈52 000 (22 961–80 211) in 28 million individuals with advanced chronic kidney disease, while ≈22 000 (15 221–31 840) hyperkalemia-deaths might be caused by the intervention. The corresponding estimates for the optimistic scenario were ≈351 000 (130 470–546 255), ≈66 000 (24 925–105 851), and ≈9000 (4251–14 599). Net benefits were consistent across sensitivity analyses. Conclusions: Modeling nationwide salt substitution in India consistently estimated substantial net benefits, preventing around 8% to 14% of annual cardiovascular deaths. Even allowing for potential hyperkalemia risks there were net benefits estimated for individuals with chronic kidney disease.

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Teoli Nunciaroni, Andressa, Rúbia de Freitas Agondi, Henrique Ceretta Oliveira, Rafaela Batista dos Santos Pedrosa, Roberta Cunha Matheus Rodrigues, and Maria Cecília Gallani. "Implementation Intention Strategy to Reduce Salt Intake among Heart Failure Patients: A Randomized Controlled Trial." Science of Nursing and Health Practices 4, no. 2 (February 16, 2022): 30–46. http://dx.doi.org/10.7202/1086400ar.

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Introduction: An Implementation Intention strategy might be effective in transforming a positive intention to reduce salt intake into effective action among heart-failure patients. Objective: To assess the potential efficacy of an Implementation Intention intervention to reduce salt intake among heart-failure patients. Methods: Randomized controlled trial. The 60 heart-failure patients recruited were first randomized into 2 groups: an experimental group (EG) and a control group (CG). The study population was further broken down into 4 groups depending on whether the individuals prepared their own meals: 2 individual groups (EG-Individual and CG-Individual); and 2 collaborative groups, involving the patient and a social referent (EG-Collaborative and CG- Collaborative). The experimental groups developed action and coping plans based on the Implementation Intention. Total salt intake was calculated through discretionary salt, sodium-food frequency questionnaires, and 24-hour recall, obtained at the baseline (T0) and at the 2-month follow-up (T3). Results: 56 patients ended the follow-up. A reduction in the total salt intake was observed in the EGs (Individual and Collaborative) compared to baseline (5.04g/day vs. 12.21g/day for the EG-Individual (p≤0.001); 4.79g/day vs. 11.43g/day for the EG-Collaborative; p≤0.001). The multivariate analysis showed that the 2 EGs had lower salt intake at T3 than the 2 CGs (95% CI 4.19-9.29 for individual groups vs. 95% CI 4.84-10.22 for collaborative groups). There were no differences between the 2 EGs (95% CI –2.77 to 2.41). The total variance explained (R2) by these comparisons was 0.70. Discussion and conclusion: This study suggests that Implementation Intention might be effective in reducing salt intake among heart-failure patients, either individually or collaboratively. Further research testing mediator and moderator effects of the psychosocial variables are recommended.

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Johnson, Brittany, Lucinda Bell, Dorota Zarnowiecki, Anna Rangan, and Rebecca Golley. "Contribution of Discretionary Foods and Drinks to Australian Children’s Intake of Energy, Saturated Fat, Added Sugars and Salt." Children 4, no. 12 (December 1, 2017): 104. http://dx.doi.org/10.3390/children4120104.

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Journal articles on the topic 'Discretionary salt'

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