Locked on Salt? Increased Consumption of High Sodium Foods During COVID-19 Presents an Underappreciated Public Health Risk

Abstract

Abrupt changes in food preferences and eating habits pose an overlooked public health risk during the coronavirus disease (COVID-19) pandemic. Emerging evidence suggests an ongoing, population-level shift to consumption of high-sodium foods, during COVID-19 and lockdowns, in the general population surveyed in different countries and cultures. High-sodium foods are defined as those with sodium contents exceeding 500 mg per 100 g, and many processed and preserved foods fall into this particular category. Excessive dietary sodium intake is associated with chronic diseases including hypertension, cardiovascular diseases, and kidney diseases, and poses confounding risks during COVID-19. Here, we review food categories in consumers’ shopping lists and food parcels delivered to those who need assistance during the current pandemic, when frozen meals, canned foods, instant foods, snacks, and other high-sodium foods gained substantial popularity. Such emerging trends in consumers’ behavior are driven by a multitude of factors. Specifically, the perceived risk of COVID-19 infection in grocery shopping trips, limited supplies and inflated prices of fresh produce, preference on foods with long shelf lives, emotional eating, and the general low awareness of sodium contents in food have all contributed to the increased consumption of high-sodium foods during COVID-19. We also discuss the possible effects on COVID-19 infection and severity caused by excessive sodium intake, by reviewing current reports and hypotheses examining their relations. In light of the evidence, it is advisable to educate the public to maintain a healthy sodium intake during the current pandemic, and measures could be adopted by governments and private donors in procuring food parcels with more balanced sodium contents to lower the risks of prolonged and excessive sodium intakes in vulnerable population groups.