Abstract
BackgroundNutrition labelling has been mandatory for pre-packaged foods since 2013 in China, and sodium is one of the nutrients required for display on the nutritional information panel (NIP). This study aimed to estimate the awareness, understanding of, and use of sodium labelling information among the population in China.MethodsA cross-sectional survey was carried out in urban Beijing in 2016 on pre-packaged foods. The researchers randomly selected 380 residents from four convenient but disconnected communities and 370 shoppers from four supermarkets owned by different companies and conducted face-to-face interviews. Questions on nutritional knowledge, health attitude, understanding and use of nutritional labels as well as other related factors were assessed.ResultsAll of the 380 community residents and 308 of the 370 supermarket shoppers successfully completed the survey. Of those 688 respondents, 91.3% understood that excessive salt intake was harmful, 19.5% were aware that sodium content is listed on the NIP, 5.5% understood the meaning of NRV% (Percentage of Nutrient Reference Values), 47.7% did not know the relationship between sodium and salt, and 12.6% reported they frequently read the label when shopping. Factors for why people were more likely to choose a product because of its low level of salt shown on the label include income level and their level of awareness of the link between salt and diet.ConclusionsAlthough the participants had a good understanding of the harmful effects of salt, the awareness, understanding and use of sodium labels was very low in Beijing, and even worse nationwide. Efforts should be taken to educate the public to understand and use the NIP better and design clearer ways of displaying such information, such as front-of pack (FoP) labelling or health-related smartphone applications to improve health and help people make better food choices.
Highlights
Nutrition labelling has been mandatory for pre-packaged foods since 2013 in China, and sodium is one of the nutrients required for display on the nutritional information panel (NIP)
The majority (91.3%) of the participants believed excessive salt intake to be harmful to their health; 76.0% believed that a reduction in salt intake could help to lower a person’s blood pressure; and the average score of attitude towards salt intake was 66.1 out of a perfect 100 points. 67.9% had the behavior of reducing salt intake in daily life
Understanding sodium labels About half (52.3%, 95% Confidence Intervals (CI): 48.6%–56.1%) of the participants understood the relationship between sodium and salt, but only 5.5% of all participants understood the meaning of NRV%
Summary
Nutrition labelling has been mandatory for pre-packaged foods since 2013 in China, and sodium is one of the nutrients required for display on the nutritional information panel (NIP). Pre-packaged processed foods are the major source of salt intake in developed countries and their consumption is rising in many developing countries [10]. Some governments have initiated national approaches to work He et al BMC Public Health (2018) 18:509 with the food industry to reduce salt in foods by setting salt reduction targets [12,13,14]. Labelling the amount of sodium and/or salt on the nutrition information panel (NIP) of pre-packaged foods is among health initiatives to reduce salt. Pre-packaged food is not the main source of salt intake in China, the sales and consumption of prepackaged food are increasing very quickly and becoming an important source of salt intake
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