Suchergebnisse

Excess sodium intake has an important, if not predominant, role in the pathogenesis of elevated blood pressure, one of the most important modifiable determinants of cardiovascular disease (CVD). In the United States, almost 80% of sodium in the diet comes from packaged and restaurant foods. Given the current food environment, educational efforts such as clinician counseling are useful, but a comprehensive public health approach is necessary to achieve meaningful reductions in sodium intake. A successful approach includes several key strategies, which together will both promote positive decisions by individuals and change the context in which they make those decisions. The strategies include: (1) public education, (2) individual dietary counseling, (3) food labeling, (4) coordinated, voluntary industry sodium reduction, (5) government and private sector food procurement policies, and (6) FDA regulations, as recommended by the Institute of Medicine, to modify sodium's generally regarded as safe (GRAS) status. Population-wide reduction in sodium intake has the potential to substantially reduce the public burden of preventable CVD and reduce health care costs.

Abstract
Sodium is an essential mineral, necessary for optimal development of an infant. However, its content in human milk is highly variable. The main factors influencing sodium content in human milk are the concentration of other osmoles (dominantly lactose) and time postpartum. It is still debatable if maternal sodium intake affects sodium content in human milk. Overall, Latvian inhabitants consume more sodium than recommended. Therefore, we aimed to analyse the relation between maternal sodium intake and human milk sodium content. In total, 64 human milk samples and food data from 64 participants were obtained. Sodium content was determined using inductively coupled plasma mass spectrometry. Food diary data was analysed using Finnish database Fineli. The results showed that median sodium content in human milk was 12.67 mg per 100 ml−1. Nevertheless, large inter-individual differences were observed (5.00–42.54 mg·100 ml−1). Sodium in-take among the participants was higher than the recommended 2000 mg per day (median intake — 2335.83 mg per day). Although a positive association was found between median maternal sodium intake and sodium content in human milk (ρ= 0.350, p = 0.010), a hierarchical multiple regression revealed that only infant's age was a significant factor (p = 0.038), explaining 13% of the variability of sodium content in human milk. Sodium content in human milk is not influenced directly by maternal sodium intake, and other factors (such as lactose and potassium concentration in human milk not considered in the study) could potentially influence sodium content in human milk.

Faced with soaring health-care costs, Canadian governments should consider creative ways to enable the population to stay healthy — and making it possible for Canadians to reduce their sodium intake is an extremely cost-effective way to do so. Excess sodium consumption is a risk factor for high blood pressure, stroke and heart disease. On average, Canadians consume 3,400 mg of sodium a day (1,100 mg over recommended levels), at least three-quarters of which comes from processed foods. Any attempt at sodium reduction must therefore involve the food industry. This paper surveys sodium reduction efforts in jurisdictions around the globe, as well as past Canadian attempts, to provide provincial and federal policymakers with a comprehensive suite of lessons learned and a host of far-sighted policy recommendations ranging from food procurement to legislation and private sector engagement. Provincial governments, individually or together, must launch multi-pronged efforts involving food service companies, manufacturers, post-secondary institutes and the media to ensure that low-sodium alternatives are readily available, and that consumers are aware of them. They must also support federal action on changing dietary guidelines and introducing restrictions on food advertising to children. The benefits to be had are very real. In light of evidence showing that population-level intervention is superior to clinical intervention in terms of cost-effectiveness, returning up to $11.10 for every dollar spent and generating tens of billions in direct health-care savings, there is a very strong case for investing in population-level sodium reduction interventions that will work. The time for governments to act is now.

Faced with soaring health-care costs, Canadian governments should consider creative ways to enable the population to stay healthy — and making it possible for Canadians to reduce their sodium intake is an extremely cost-effective way to do so. Excess sodium consumption is a risk factor for high blood pressure, stroke and heart disease. On average, Canadians consume 3,400 mg of sodium a day (1,100 mg over recommended levels), at least three-quarters of which comes from processed foods. Any attempt at sodium reduction must therefore involve the food industry. This paper surveys sodium reduction efforts in jurisdictions around the globe, as well as past Canadian attempts, to provide provincial and federal policymakers with a comprehensive suite of lessons learned and a host of far-sighted policy recommendations ranging from food procurement to legislation and private sector engagement. Provincial governments, individually or together, must launch multi-pronged efforts involving food service companies, manufacturers, post-secondary institutes and the media to ensure that low-sodium alternatives are readily available, and that consumers are aware of them. They must also support federal action on changing dietary guidelines and introducing restrictions on food advertising to children. The benefits to be had are very real. In light of evidence showing that population-level intervention is superior to clinical intervention in terms of cost-effectiveness, returning up to $11.10 for every dollar spent and generating tens of billions in direct health-care savings, there is a very strong case for investing in population-level sodium reduction interventions that will work. The time for governments to act is now.

OBJECTIVES: To simulate the impact that sodium reductions in food categories that are the largest contributors to dietary sodium intake would have on population intake from packaged foods among US adults and children. DESIGN: 24hr dietary recall data were used. For each store-bought packaged food product reported by participants, we generated sales-weighted sodium content at the median and 25(th) percentile using Nutrition Facts Panel data from 193,195 products purchased by US households. The impact that sodium reductions would have on population intake, overall and by sociodemographic subgroup, was examined. SETTINGS: US households. PARTICIPANTS: 2,948 children 2-18y and 4,878 adults >18y from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). RESULTS: Sodium intake from packaged foods was 1258 (21) mg for adults and 1215 (35) mg for children. Top 10 packaged food group sources contributed 67% of sodium intake. For adults and children, there was a decrease of 8.7% (109mg) and 8.0% (97mg) respectively in sodium intake if the top 10 sources reduced sodium from the median to the 25(th) percentile. Although absolute reduction in intake varied between socio-demographic subgroups, significant differences weren't observed. CONCLUSIONS: This study demonstrated that if sodium reduction shifted the top 10 packaged food group sources of dietary sodium intake from the median to 25(th) percentile, that population intake would be reduced by 9% in US adults and children. These findings will help inform the US government's sodium reduction targets, as well as policymakers' understanding of differences in intake of critical sub-populations in the US.

Purpose. To describe the prevalence and determinants of sodium-related knowledge, attitudes, and behaviors among U.S. adults Design. A cross-sectional survey was used. Setting. The study was set in the United States in 2012. Subjects. Participants were 6122 U.S. adults. Measures. Sodium-related knowledge, attitudes, and behaviors were measured. Analysis. Chi-squared tests were used to determine differences in sodium-related knowledge, attitude, and behaviors by respondent characteristics; multiple logistic regression was used to examine associations between selected respondent characteristics and health professional advice, reported action, or knowledge, attitudes, and behaviors (adjusted for all other respondent characteristics). Results. About three-fourths of respondents answered eating too much sodium is "somewhat" or "very" harmful to their health. Twenty-six percent reported receiving health professional advice, and 45% reported taking action to reduce their sodium intake. The prevalence of reported action was highest among adults receiving advice, those with hypertension, blacks, and those aged ≥65 years. Sixty-two percent who reported action agreed that most of their sodium comes from processed or restaurant foods. Of those reporting action, the most common tactics to reduce sodium intake were checking nutrition labels, using other spices than salt, and choosing low-sodium foods; requesting lower-sodium options when eating out was the least common tactic. Conclusion. Results suggest almost half of adults overall and the vast majority of those receiving health professional advice are taking some action to watch or reduce sodium intake. Although a substantial proportion report using recommended tactics to lower intake, many are not using the most effective tactics. In order to reach the general population, health communication messages could be simpler and focus on the most effective tactics to reduce sodium intake. Furthermore, health professionals can help reduce sodium intake by discussing the benefits of sodium reduction and tactics to do so, regardless of a hypertension diagnosis.

Abstract
Scientific studies have regularly confirmed that nowadays the salt consumption through food is too much, and its consumption has to be reduced. The aim of the study was to ascertain the amount of salt consumed per day by 18–35 year-old Latvians as well as to identify the main sources of salt in their diets. The following research methods were used in the study: questionnaire based on an example recommended by the World Health Organisation, sociological research method, bread baking tests, and logically constructive, and statistical research methods. The results of this research showed that the average intake of salt in the diet of 18–35 year-old Latvians was 7.1 g per day. Of all the respondents, 63% consumed more than the recommended 5 g of salt per day, and none of them consumed less than necessary to meet their physiological needs. The results showed that women consumed less salt than men — approximately 6 g per day, while men consumed 8.2 g of salt per day. The main sources of salt in the diet of 18–35 year old Latvians were cereals and cereal products, as well as meat and meat products. Among cereal products, the key source of salt was represented by bread and pastry.

Purpose: To describe changes in consumer knowledge, attitudes, and behaviors related to sodium reduction from 2012 to 2015. Design: A cross-sectional analysis using 2 online, national research panel surveys. Setting: United States. Participants: A total of 7796 adults (18+ years). Measures: Sodium-related knowledge, attitudes, and behaviors. Analysis: Data were weighted to match the US population survey proportions using 9 factors. Wald χ2 tests were used to examine differences by survey year and hypertensive status. Results: Despite the lack of temporal changes observed in respondent characteristics (mean age: 46 years, 67% were non-Hispanic white, and 26% reported hypertension), some changes were found in the prevalence of sodium-related knowledge, attitudes, and behaviors. The percentage of respondents who recognized processed foods as the major source of sodium increased from 54% in 2012 to 57% in 2015 ( P = .04), as did the percentage of respondents who buy or choose low/reduced sodium foods, from 33% in 2012 to 37% in 2015 ( P = .016). In contrast, the percentage of self-reported receipt of health professional advice among persons with hypertension decreased from 59% in 2012 to 45% in 2015 ( P < .0001). Other sodium-related knowledge, attitudes, and behaviors did not change significantly during 2012 to 2015. Conclusion: In recent years, some positive changes were observed in sodium-related knowledge and behaviors; however, the decrease in reported health professional advice to reduce sodium among respondents with hypertension is a concern.

Background: Blood pressure is a primary cardiovascular disease risk factor. Population-wide governmental strategies aim to reduce lifestyle and dietary risk factors for hypertension, one of which is an unbalanced diet with high sodium and low potassium intakes. Nutrition interventions in the workplace are considered a promising approach in encouraging health-promoting behaviors. We developed and conducted the health promoting sodium reduction trial "Healthful & Tasty: Sure!" in worksites in the German-speaking part of Switzerland from May 2015 to Nov 2016, for which we present the study protocol and baseline characteristics. Methods: Healthful & Tasty, a cluster nonrandomized single-arm trial with calibration arm, aimed to demonstrate the effectiveness of a combined educational and environmental intervention in the workplace in reducing employees' average daily sodium/salt intake by 15%. To this end, health and food literacy of employees and guideline compliance among the catering facility team needed to be improved. The primary outcome measure was sodium/salt intake estimated from sodium excretion in a 24-h urine sample. Secondary outcome measures included changes in the overall qualitative diet composition, blood pressure, anthropometric indices, and health and food literacy. Of eight organizations with catering facilities, seven organizations took part in the nutrition education and catering salt reduction interventions, and one organization participated as a control. Overall, 145 consenting employees were included in the staggered, one-year four-phase trial, of which 132 participated in the intervention group. In addition to catering surveys and food sampling, the trial included five follow-up health assessments including questionnaires, blood pressure measurements, anthropometrics, and sodium, potassium, and iodine intake measurements obtained from 24-h and spot urine samples, and a food record checklist. Exploratory and hypothesis generating baseline statistical analysis included 141 participants with adequate 24-h urine samples. Discussion: Despite practice-driven limitations to the study design and small cluster and participant numbers, this trial has methodological strength and will provide important insights into the effectiveness of a combined educational and environmental intervention to reduce salt intake among female and male Swiss employees. Trial registration: German Clinical Trials Register, DRKS00006790. Registered 23 September 2014.

BACKGROUND Blood pressure is a primary cardiovascular disease risk factor. Population-wide governmental strategies aim to reduce lifestyle and dietary risk factors for hypertension, one of which is an unbalanced diet with high sodium and low potassium intakes. Nutrition interventions in the workplace are considered a promising approach in encouraging health-promoting behaviors. We developed and conducted the health promoting sodium reduction trial "Healthful & Tasty: Sure!" in worksites in the German-speaking part of Switzerland from May 2015 to Nov 2016, for which we present the study protocol and baseline characteristics. METHODS Healthful & Tasty, a cluster nonrandomized single-arm trial with calibration arm, aimed to demonstrate the effectiveness of a combined educational and environmental intervention in the workplace in reducing employees' average daily sodium/salt intake by 15%. To this end, health and food literacy of employees and guideline compliance among the catering facility team needed to be improved. The primary outcome measure was sodium/salt intake estimated from sodium excretion in a 24-h urine sample. Secondary outcome measures included changes in the overall qualitative diet composition, blood pressure, anthropometric indices, and health and food literacy. Of eight organizations with catering facilities, seven organizations took part in the nutrition education and catering salt reduction interventions, and one organization participated as a control. Overall, 145 consenting employees were included in the staggered, one-year four-phase trial, of which 132 participated in the intervention group. In addition to catering surveys and food sampling, the trial included five follow-up health assessments including questionnaires, blood pressure measurements, anthropometrics, and sodium, potassium, and iodine intake measurements obtained from 24-h and spot urine samples, and a food record checklist. Exploratory and hypothesis generating baseline statistical analysis included 141 participants with adequate 24-h urine samples. DISCUSSION Despite practice-driven limitations to the study design and small cluster and participant numbers, this trial has methodological strength and will provide important insights into the effectiveness of a combined educational and environmental intervention to reduce salt intake among female and male Swiss employees. TRIAL REGISTRATION German Clinical Trials Register, DRKS00006790 . Registered 23 September 2014.