Effectof25%SodiumReductiononSalesof aTop-SellingBreadinRemoteIndigenousAustralian CommunityStores:AControlledInterventionTrial.

Emma Mcmahon,Julie Brimblecombe,Jacqui Webster

doi:10.3390/nu9030214

Abstract

Reducing sodium in the food supply is key to achieving population salt targets, but maintaining sales is important to ensuring commercial viability and maximising clinical impact. We investigated whether 25% sodium reduction in a top-selling bread affected sales in 26 remote Indigenous community stores. After a 23-week baseline period, 11 control stores received the regular-salt bread (400 mg Na/100 g) and 15 intervention stores received the reduced-salt version (300 mg Na/100 g) for 12-weeks. Sales data were collected to examine difference between groups in change from baseline to follow-up (effect size) in sales (primary outcome) or sodium density, analysed using a mixed model. There was no significant effect on market share (−0.31%; 95% CI −0.68, 0.07; p = 0.11) or weekly dollars ($58; −149, 266; p = 0.58). Sodium density of all purchases was not significantly reduced (−8 mg Na/MJ; −18, 2; p = 0.14), but 25% reduction across all bread could significantly reduce sodium (−12; −23, −1; p = 0.03). We found 25% salt reduction in a top-selling bread did not affect sales in remote Indigenous community stores. If achieved across all breads, estimated salt intake in remote Indigenous Australian communities would be reduced by approximately 15% of the magnitude needed to achieve population salt targets, which could lead to significant health gains at the population-level.

Highlights

Excess salt intake is one of the main contributors to the high rates of hypertension, cardiovascular disease, renal disease, and premature mortality experienced by many countries around the world [1].It is estimated that 2.5 million deaths could be prevented globally each year if population salt intakes were reduced to 5 g/day (2000 mg) [1]
Of the 21 Outback Stores (OBS)-managed stores that consented to the study, nine could not receive the reduced salt bread due to their supply route and were allocated to the control group; the remaining twelve were allocated to the intervention group
We found that 25% salt reduction did not affect sales of one of the top-selling breads in remote

Summary

Introduction

Excess salt intake is one of the main contributors to the high rates of hypertension, cardiovascular disease, renal disease, and premature mortality experienced by many countries around the world [1].It is estimated that 2.5 million deaths could be prevented globally each year if population salt intakes were reduced to 5 g/day (2000 mg) [1]. Australian population [3,4] Those living in remote areas of Australia have even higher burden of disease and lower life expectancy than those living in non-remote areas [3,4]. The factors driving these disparities are complex, including cultural and social dispossession; considerable socioeconomic disadvantage; poorer access to health services; and high-risk health behaviours such as smoking, physical inactivity, and poor nutrition [5]. The diet of those living in remote Indigenous communities

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