Salt Reduction Strategies Research Articles

Salt reduction strategies for dry cured meat products: The use of KCl and microencapsulated spices and aromatic plant extracts

The World Health Organization set a goal of reducing salt intake by 30 % by 2025. This study investigates the impact of replacing 33 % NaCl with KCl and microencapsulated spices and aromatic plant extracts (ME) in a dry-cured meat sausage (CMS). Microbial, physico-chemical, and sensory analyses were conducted throughout processing and storage. Three batches of CMS were prepared with four formulations: Control (1.5 % NaCl), F1 (1 % NaCl, 0.5 % KCl), F2 (1 % NaCl, 0.5 % ME, 0.3 % KCl), and F3 (1 % NaCl, 0.5 % ME). The absence of Listeria monocytogenes was confirmed. The formulations did not affect the growth of lactic acid bacteria (7.8 log cfu/g), Enterococci (6.5 log cfu/g), and coagulase-negative staphylococci (5.6 log cfu/g). Biogenic amines increased significantly (P < 0.05) during storage, with cadaverine (from 166 to 456 mg/kg), tyramine (163 to 424 mg/kg) and putrescine (from 31.0 to 90.5 mg/kg), being the most abundant. All low sodium CMS had lower TBARS values (F1 = 0.59 mg MDA/kg, F2 = 0.56 mg MDA/kg and F3 = 0.47 mg MDA/kg) compared to control (0.78 mg MDA/kg). Colour parameters lightness (L*) and yellowness (b*) remained stable (P > 0.05) while sausages with KCl and/or ME were redder. CMS F1 was considered with the ideal saltiness by 54 % consumers, that is usually considered enough to launch the product in the market. The use of ME in CMS has potential but still requires optimization. The study demonstrates that a 33 % NaCl replacement with KCl is feasible without jeopardize the organoleptic characteristics or safety of CMS.

Multifunctional curcumin/γ-cyclodextrin/sodium chloride complex: A strategy for salt reduction, flavor enhancement, and antimicrobial activity in low-sodium foods

Excessive salt consumption is strongly linked to the chronic diseases development, highlighting the urgent need for effective salt-reduction strategies in food products. However, reducing salt content often compromises both food preservation and flavor. In this study, we hypothesized that curcumin could enhance the flavor perception of sodium chloride while compensating for its antimicrobial effect in reduced-salt applications. To test this, we developed a curcumin/γ-cyclodextrin/sodium chloride complex (IC), using γ-cyclodextrin as a carrier, and evaluated its antimicrobial and flavor-enhancing properties. The complex's formation was confirmed through various analytical techniques. Results from electronic tongue and sensory evaluations demonstrated that the IC enhanced the perception of saltiness and imparted unique aromatic characteristics compared to standard sodium chloride. GC-IMS analysis identified key aroma contributors, such as aldehydes and alcohols. Additionally, antimicrobial tests revealed that the IC efficiently mediated the sono/photodynamic inactivation of Shewanella putrefaciens and Vibrio parahaemolyticus. In summary, the IC offers a multifunctional approach, enhancing flavor, reducing salt, and enabling antimicrobial activity, while promoting practical uses of sono/photodynamic technology in low-sodium foods.

Decoding of the saltiness enhancement taste peptides from Jinhua ham and its molecular mechanism of interaction with ENaC/TMC4 receptors

This study focused on unlocking the potential of Jinhua ham-derived peptides (JHP) for enhancing saltiness. JHP (<3 kDa) was obtained through ultrafiltration and desalting, reducing the salt content by 96 %. Four peptide fractions (JHP-P1/P2/P3/P4) were isolated using Sephadex G-25 gel filtration and anion-exchange chromatography. Sensory evaluation and electronic tongue analysis revealed that JHP-P2 (0.5 mg/mL) exhibited the highest saltiness which could replace four-fold NaCl salinity. Three peptides (DL, FMSALF, and HVRRK) identified by UPLC-QTOF-MS/MS were simulated with salty taste receptors ENaC/TMC4. Results indicated that Ser84 and Phe89 of ENaC and Asn404 and Lys567 of TMC4 are crucial for peptide docking related to salty taste. Molecular dynamics simulations showed that the three peptides bind to the TMC4 and ENaC through van der Waals forces, electrostatic interactions, and hydrogen bonds. These findings establish a robust theoretical foundation for salt reduction strategies and provide novel insights into the potential applications of Jinhua ham.

The influence of salt reduction with encapsulated oleoresins on the quality of mayonnaise, mustard, and ketchup.

Mayonnaise, mustard, and ketchup are table sauces enjoyed worldwide, adding flavour and texture to many dishes. However, these products often contain high sodium content, which contributes to health issues such as high blood pressure and cardiovascular disease. To address these concerns, reducing salt content in the sauces has become a significant goal for both manufacturers and consumers. This study investigates the effects of three formulations of microencapsulated (ME) oleoresins (F1, F2, and F3), derived from aromatic plants and spices, on the mineral content, physical-chemical properties, colour, and sensory profiles of mayonnaise, mustard, and ketchup. The addition of ME ingredients resulted in significant reductions in salt content across all sauces, with reductions up to 50% in mayonnaise, 45% in mustard, and 52% in ketchup, aligning with EU sodium guidelines and allowing for a "reduced Na/NaCl content" nutrition claim. Potassium levels in mustard and ketchup were sufficient to support health claims related to blood pressure maintenance, while chloride content was reduced in ME formulations, better aligning with dietary reference values. Physical-chemical analysis revealed that ME ingredients had minimal impact on parameters like pH, lipid oxidation, and viscosity, although significant differences were observed in specific areas, such as the consistency of ketchup and chloride content in mustard and ketchup. The use of inulin, as a carrier agent, helped maintain the sauces rheological properties. Mustard showed the most similarity to the control in terms of physical-chemical parameters. Colour analysis indicated minimal changes in mayonnaise, moderate changes in mustard, and significant differences in ketchup, particularly with the ME-F3 formulation, where the light-yellow ME ingredients had a pronounced effect on the darker sauce. Despite these differences, the sensory analysis demonstrated that the overall sensory profiles of the ME formulations were similar the like control for all sauces. Mayonnaise showed the closest resemblance, while mustard had slightly lower scores in flavour and saltiness. Ketchup followed the same trend as mayonnaise, with no significant sensory differences compared to the control. These findings suggest that ME ingredients can be effectively used in condiment reformulation to achieve significant salt reduction without compromising sensory qualities, while also supporting health-related claims. By incorporating ME-based salt reduction strategies and exploring low-sodium alternatives, consumers can continue to enjoy their favourite sauces while minimising sodium intake. Embracing these changes not only benefits personal health but also aligns with the industry's commitment to offering more nutritious options.

Triple strategies for process salt reduction in industrial wastewater treatment: The case of coking wastewater

Human activities introduce nutrient elements into wastewater, yet the saline byproducts from treatment are poorly managed. Selecting a low-salt process, without compromising treatment efficacy, is essential for reaching the zero-discharge goal in water treatment. Based on the engineering treatment process of coking wastewater, the source and reduction strategy of salts were studied. The results showed that 73.21 % of the residual salt originated from raw coal, 10.87 % from raw water, and 15.92 % from chemicals, respectively. Triple strategies for process salt reduction (PSR): load salt reduction, technology salt reduction and cyclic salt reduction can bring 0.411 mS/cm·m3, 0.217 mS/cm·m3 and −0.070 mS/cm·m3 salt reduction, and also bring 1.455 CNY/m3, 0.836 CNY/m3 and 0.360 CNY/m3 net present value, respectively. Meanwhile, PSR is also a low-carbon strategy, which will bring about carbon emission reduction of 1.6948 kg CO2-eq/m3, 0.4898 kg CO2-eq/m3 and 1.4082 kg CO2-eq/m3 respectively. The Resource/Carbon source Management-Oxic − Hydrolytic & Denitrification − Oxic (A-OHO) process, incorporating PSR, cuts costs by 27.83–31.66 % and carbon emissions by 18.68–19.54 % compared to conventional wastewater treatment methods. It can be predicted that the PSR in the standard treatment stage can provide a guarantee for the subsequent water reuse and desalination process to reduce project investment and operating costs, and at the same time benefit the macro environment from the aspects of carbon emission reduction and sludge reduction.

An effective means to improve the flavor quality of traditional fermented sour meat: The salt reduction strategy

The flavor formation of fermented meat products is significantly influenced by salt. In this study, the flavor analysis methods of electronic tongue and nose, gas chromatography-mass spectrometry, and liquid chromatography-mass spectrometry were utilized to explore the effect of salt content on the formation of sour meat flavor. The results demonstrated a significant decrease in pH value with the reduction of salt content (P < 0.05), while there was a significant rise in thiobarbituric acid reactive substances (TBARS) value associated with the decline in salt content (P < 0.05). Alcohols, aldehydes, and esters such as 1-octen-3-ol, 3-methyl-1-butanol, hexanal, heptanal, ethyl octanoate, ethyl heptanoate, etc. were considered to have significant contributions to the overall flavor of sour meat. The rapid accumulation of these aroma compounds under low-salt conditions was regarded as one of the key factors in the overall flavor enhancement of sour meat products. Additionally, the low-salt fermentation also promoted the accumulation of free amino acids and free fatty acids in sour meat products, thereby facilitating the formation of more complex aroma compounds. This study offers new technological ways to improve the conventional method of fermenting sour meat and offers theoretical justification for studies on salt reduction in conventionally fermented meat products.

Salt Reduction and Iodine Fortification Policies Are Compatible: Perspectives for Public Health Advocacy.

Cardiovascular diseases account for almost 18 million deaths annually, the most of all non-communicable diseases. The reduction of dietary salt consumption is a modifiable risk factor. The WHO recommends a daily sodium intake of <2000 mg but average consumption exceeds this in many countries globally. Strategies proposed to aid effective salt reduction policy include product reformulation, front of pack labelling, behavioural change campaigns and establishing a low-sodium-supportive environment. Yet, salt for household and processed food use is, in countries wholly or partially adopting a universal salt iodisation policy, the principal vehicle for population-wide iodine fortification. With salt reduction policies in place, there is concern that iodine deficiency disorders may re-emerge. Recognising the urgency to tackle the rising prevalence of NCDs yet not risk the re-emergence and detrimental effect of inadequate iodine intakes, this review lays out the feasibility of integrating both salt reduction and salt iodine fortification strategies. Reducing the burden of health risks associated with an excessive sodium intake or inadequate iodine through population-tailored, cost-effective strategies involving salt is both feasible and achievable, and represents an opportunity to improve outcomes in public health.

Salt reduction strategies and enhanced saltiness perception mechanisms for prepared dishes: A review

AbstractHealthy prepared dishes are receiving increasing attention, with high salt content being their prominent feature, and a long‐term high sodium diet may lead to various diseases. At present, replacing NaCl with non‐sodium salts has become the main salt reduction method, but these substitutes will bring adverse flavors to the product, and excessive use of KCl will also affect health. Therefore, the study of flavor peptides combined with new green technologies is a potentially effective strategy to reduce salt without reducing saltiness. This article reviews the current salt reduction strategies, the effects of food matrix, basic amino acids, other tastes and odors on saltiness, and the relationship between saltiness and receptor structure and transduction mechanism. In addition, the saltiness assessment methods were introduced, and the current challenges faced by the strategy of reducing salt without reducing saltiness were discussed. The preparation of salty peptides and salty enhancing peptides from natural foods and the combination of them with new green technologies may be an effective method for salt reduction in the food industry. This review can provide theoretical reference for the prepared dishes industry to reduce salt without reducing saltiness.

Progress in Multisensory Synergistic Salt Reduction.

Excessive salt intake, primarily from sodium chloride prevalent in modern food processing, poses a significant public health risk associated with hypertension, cardiovascular diseases and stroke. Researchers worldwide are exploring approaches to reduce salt consumption without compromising food flavor. One promising method is to enhance salty taste perception using multisensory synergies, leveraging gustatory, olfactory, auditory, visual, tactile and trigeminal senses to decrease salt intake while preserving food taste. This review provides a comprehensive overview of salt usage in foods, mechanisms of salty taste perception and evaluation methods for saltiness. Various strategies for reducing salt consumption while maintaining food flavor are examined, with existing salt reduction methods' advantages and limitations being critically analyzed. A particular emphasis is placed on exploring the mechanisms and potential of multisensory synergy in salt reduction. Taste interactions, olfactory cues, auditory stimulation, visual appearance and tactile sensations in enhancing saltiness perception are discussed, offering insights into developing nutritious, appealing low-sodium foods. Furthermore, challenges in current research are highlighted, and future directions for effective salt reduction strategies to promote public health are proposed. This review aims to establish a scientific foundation for creating healthier, flavorful low-sodium food options that meet consumer preferences and wellness needs.

Indian Thyroid society expert consensus on salt Iodisation

ABSTRACT Iodine, an essential micronutrient, is crucial for the production of thyroid hormones - triiodothyronine(T3) and thyroxine(T4). Thyroid hormones regulate the optimum mental development, physical growth and development, regulation of body metabolism, heat generation, and maintenance of body temperaturein an individual. Geological processes like flooding, soil erosion, deforestation, and rivers changing course, deplete the surface soil of iodine, as it is present in the top layers of soil and easily soluble in water. As a result, the population residing in the area with iodinedeficient soil, becomes susceptible to a spectrum of functional and developmental abnormalities due to dietary deficiency of iodine. Universal Salt Iodization (USI) for prevention of IDDs in India is a public health success story. The adoption of the salt iodization strategy serves as a textbook example of the journey of an intervention through the iterative loop of research to policy to programme. Salt iodization has proved to be a safe, accessible, available, affordable, and cost-effective strategy to address the burden of IDDs in India. India has been at the forefront of the efforts to control IDDs globally. India is on its way to achieving the target of &gt; 90 percent household coverage of adequately iodized salt. Revised Food Safety and Standards (Fortification of Foods) Regulations released in 2019 introduced an upper limit for iodine concentration in salt, the adequate iodine level required at the production and consumer level, including the distribution channel at 15 – 30 ppm. Universal Salt Iodisation (USI) is India's public health success story. There is a need to consolidate progress so far and focus on strategy to reach the “last mile”. Sustainable elimination of Iodine Deficiency Disorders (IDDs) with Universal Salt Iodisation (USI) being the primary strategy needs to also factor in harmonisation with salt reduction strategy for control of non-communicable diseases.

Salt reduction in myofibrillar protein gel via inhomogeneous distribution of sodium-containing encapsulated fish oil coacervate: Mucopenetration ability of sodium carboxymethyl cellulose

The potential application of fish oil microcapsules as salt reduction strategies in low-salt myofibrillar protein (MP) gel was investigated by employing soy protein isolates/carboxymethyl cellulose sodium (SPI-CMC) coacervates enriched with 25 mM sodium chloride and exploring their rheological characteristics, taste perception, and microstructure. The results revealed that the SPI-CMC coacervate phase exhibited the highest sodium content under 25 mM sodium level, albeit with uneven distribution. Notably, the hydrophilic and adhesive properties of CMC to sodium facilitated the in vitro release of sodium during oral digestion, as evidenced by the excellent wettability and mucopenetration ability of CMC. Remarkably, the fish oil microcapsules incorporating SPI-CMC as the wall material, prepared at pH 3.5 with a core-to-wall ratio of 1:1, demonstrated the highest encapsulation efficiency, which was supported by the strong hydrogen bonding. Interestingly, the presence of SPI-CMC coacervates and fish oil microcapsules enhanced the interaction between MPs and strengthened the low-salt MP gel network. Coupled with electronic tongue analysis, the incorporation of fish oil microcapsules slightly exacerbated the non-uniformity of sodium distribution. This ultimately contributed to an enhanced perception of saltiness, richness, and aftertaste in low-salt protein gels. Overall, the incorporation of fish oil microcapsules emerged as an effective salt reduction strategy in low-salt MP gel.

Characteristics of saltiness-enhancing peptides derived from yeast proteins and elucidation of their mechanism of action by molecular docking

This study aimed to identify saltiness-enhancing peptides from yeast protein and elucidate their mechanisms by molecular docking. Yeast protein hydrolysates with optimal saltiness-enhancing effects were prepared under conditions determined using an orthogonal test. Ten saltiness-enhancing peptide candidates were screened using an integrated virtual screening strategy. Sensory evaluation demonstrated that these peptides exhibited diverse taste characteristics (detection thresholds: 0.13–0.50 mmol/L). Peptides NKF, LGLR, WDL, NMKF, FDSL and FDGK synergistically or additively enhanced the saltiness of a 0.30% NaCl solution. Molecular docking revealed that these peptides predominantly interacted with TMC4 by hydrogen bonding, with hydrophilic amino acids from both peptides and TMC4 playing a pivotal role in their binding. Furthermore, Leu217, Gln377, Glu378, Pro474 and Cys475 were postulated as the key binding sites of TMC4. These findings establish a robust theoretical foundation for salt reduction strategies in food and provide novel insights into the potential applications of yeast proteins.

Strengthening national salt reduction strategies using mixed methods process evaluations – case studies from Malaysia and Mongolia

Almost half of countries globally are implementing national strategies to lower population salt intake towards the World Health Organization’s target of a 30% reduction by 2025(1). However, most are yet to lower population salt intake(1). We conducted process evaluations of national salt reduction strategies in Malaysia and Mongolia to understand the extent to which they were implemented and achieving their intended outcomes, using the findings to generate insights on how to strengthen strategies and accelerate population salt reduction. Mixed methods process evaluations were conducted at the mid-point of implementation of the strategies in Malaysia (2018-19) and Mongolia (2020-21)(2). Guided by theoretical frameworks, information on the implementation, mechanism and contextual barriers and enablers of the strategies were collected through desk-based reviews of documents related to salt reduction, interviews with key stakeholders (n = 12 Malaysia, n = 10 Mongolia), and focus group discussions with health professionals in Malaysia (n = 43) and health provider surveys in Mongolia (n = 12). Both countries generated high-quality evidence about salt intake and salt levels in foods, and culturally-specific education resources in 3 and 5 years respectively. However, in Malaysia there was moderate dose delivered and low reach in terms of education and reformulation activities. Within 5 years, Mongolia implemented education among schools, health professionals and food producers on salt reduction with high reach but with moderate dose and reach among the general population. There were challenges in both countries with respect to implementing legislative interventions and both could improve the scaling up of their reformulation and education activities to have population-wide reach and impact. In the first half of Malaysia’s and Mongolia’s strategies, both countries generated necessary evidence and education materials, mobilised health professionals to deliver salt reduction education and achieved small-scale salt reformulation in foods. However, both faced challenges in implementing regulatory policies and the scaling up of their reformulation and education activities to have population-wide reach and impact could be strengthened. Similar process evaluations of existing salt reduction strategies are needed to strengthen intervention delivery and inform areas for adaptation, to aid achievement of the WHO’s global target of a 30% reduction in population salt intake by 2025.

Microbial community variation and flavor metabolism in low-salt Chinese horse bean-chili-paste: Insights from bioturbation fermentation

Chinese horse bean-chili-paste (CHCP) is a traditional and famous high-salt fermented condiment in southwest China, and salt reduction strategy in this industry is imperative. In this study, we investigated the effect of inoculation with two endogenous strains (Tetragenococcus halophilus and Wickerhamiella versatilis) on the products quality at different salinity. The results showed that salt reduction combined with microbial inoculation showed prominent impact on the volatile profile. A total of 15 compounds was identified as key flavors, and bioturbation fermentation could significantly promote the concentrations of many pleasant aroma volatiles. Quantitative microbial profile analysis identified 29 key genera that might benefit microbial stability. In addition, bioturbation fermentation stimulated more microbial communities to contribute to the formation of key flavors. Moreover, the metabolic pathways of key flavor compounds were further investigated and preliminary results suggest that bioturbation under low-salt conditions promotes high expression of enzymes involved in the formation of these compounds, thereby increasing the abundance of key flavor compounds. These results revealed the variations of microbial communities in low-salt CHCP after biofortification fermentation and their influences on flavor metabolism, which could provide references for the manufacture of low-salt fermented foods.

Effect of a Salt Substitute on Incidence of Hypertension and Hypotension Among Normotensive Adults

BackgroundReports on the effects of salt substitution among individuals with normal blood pressure are scarce and controversial. ObjectivesThis study sought to assess the effects of a salt substitute (62.5% NaCl, 25% KCl, and 12.5% flavorings) on incidence of hypertension and hypotension among older adults with normal blood pressure. MethodA post hoc analysis was conducted among older adults with normal blood pressure participating in DECIDE-Salt, a large, multicenter, cluster-randomized trial in 48 elderly care facilities for 2 years. We used the frailty survival model to compare risk of incident hypertension and the generalized linear mixed model to compare risk of hypotension episodes. ResultsCompared with usual salt group (n = 298), the salt substitute group (n = 313) had a lower hypertension incidence (11.7 vs 24.3 per 100 person-years; adjusted HR: 0.60; 95% CI: 0.39 to 0.92; P = 0.02) but did not increase incidence of hypotension episodes (9.0 vs 9.7 per 100 person-years; P = 0.76). Mean systolic/diastolic blood pressure did not increase from the baseline to the end of intervention in the salt substitute group (mean changes: −0.3 ± 11.9/0.2 ± 7.1 mm Hg) but increased in the usual salt group (7.0 ± 14.3/2.1 ± 7.5 mm Hg), resulting in a net reduction of −8.0 mm Hg (95% CI: −12.4 to –3.7 mm Hg) in systolic and −2.0 mm Hg (95% CI: −4.1 to 0.1 mm Hg) in diastolic blood pressure between intervention groups. ConclusionsIn Chinese older adults with normal blood pressure, replacing usual salt with a salt substitute may reduce the incidence of hypertension without increasing hypotension episodes. This suggests a desirable strategy for population-wide prevention and control of hypertension and cardiovascular disease, deserving further consideration in future studies. (Diet Exercise and Cardiovascular Health [DECIDE]—Salt Reduction Strategies for the Elderly in Nursing Homes in China [DECIDE-Salt]; NCT03290716)

Strengthening national salt reduction strategies using multiple methods process evaluations: case studies from Malaysia and Mongolia.

To understand the extent to which national salt reduction strategies in Malaysia and Mongolia were implemented and achieving their intended outcomes. Multiple methods process evaluations conducted at the mid-point of strategy implementation, guided by theoretical frameworks. Malaysia (2018-2019) and Mongolia (2020-2021). Desk-based reviews of related documents, interviews with key stakeholders (n 12 Malaysia, n 10 Mongolia), focus group discussions with health professionals in Malaysia (n 43) and health provider surveys in Mongolia (n 12). Both countries generated high-quality local evidence about salt intake and levels in foods and culturally specific education resources. In Malaysia, education and reformulation activities were delivered with moderate dose (quantity) but reach among the population was low. Within 5 years, Mongolia implemented education among schools, health professionals and food producers on salt reduction with high reach, but with moderate dose (quantity) and reach among the general population. Both countries faced challenges in implementing legislative interventions (mandatory salt labelling and salt limits in packaged foods) and both could improve the scaling up of their reformulation and education activities. In the first half of Malaysia's and Mongolia's strategies, both countries generated necessary evidence and education materials, mobilised health professionals to deliver salt reduction education and achieved small-scale reformulation in foods. Both subsequently should focus on implementing regulatory policies and achieving population-wide reach and impact. Process evaluations of existing salt reduction strategies can help strengthen intervention delivery, aiding achievement of WHO's 30 % reduction in salt intake by 2025 target.

A review of the world's salt reduction policies and strategies - preparing for the upcoming year 2025.

Excessive consumption of dietary sodium is a significant contributor to non-communicable diseases, including hypertension and cardiovascular disease. There is now a global consensus that regulating salt intake is among the most cost-effective measures for enhancing public health. More than half of the countries worldwide have implemented multiple strategies to decrease salt consumption. Nevertheless, a report on sodium intake reduction published by the World Health Organization revealed that the world is off-track to meet its targeted reduction of 30% by 2025. The global situation regarding salt reduction remains concerning. This review will center on domestic and international salt reduction policies, as well as diverse strategies, given the detrimental effects of excessive dietary salt intake and the existing global salt intake scenario. Besides, we used visualization software to analyze the literature related to salt reduction research in the last five years to explore the research hotspots in this field. Our objective is to enhance public awareness regarding the imperative of reducing salt intake and promoting the active implementation of diverse salt reduction policies.

Effects of Behavioral Interventions for Salt Reduction on Blood Pressure and Urinary Sodium Excretion: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Hypertension is a prevalent cardiovascular condition, with excessive sodium intake being a significant risk factor. Various studies have investigated measures to reduce salt intake, including integrated lifestyle interventions and health education. However, the effectiveness of behavioral interventions focused solely on salt reduction remains unclear. This systematic review and meta-analysis aimed to investigate the effects of a behavioral intervention based on salt reduction on blood pressure and urinary sodium excretion. A comprehensive search of the Cochrane Central Register of Controlled Trials, EMBASE, PubMed, and Web of Science was conducted to identify relevant literature. Study and intervention characteristics were extracted for descriptive synthesis, and the quality of the included studies was assessed. A total of 10 studies, comprising 4,667 participants (3,796 adults and 871 children), were included. The interventions involved the provision of salt-restriction spoons or devices, salt-reduction education, self-monitoring devices for urinary sodium, and salt-reduction cooking classes. Meta-analysis results showed that behavioral interventions focused on salt reduction significantly reduced systolic blood pressure (SBP) (-1.17 mmHg; 95% CI, -1.86 to -0.49), diastolic blood pressure (DBP) (-0.58 mmHg; 95% CI, -1.07 to -0.08) and urinary sodium excretion (-21.88 mmol/24 hours; 95% CI, -32.12 to -11.64). These findings suggest that behavioral change interventions centered on salt reduction can effectively lower salt intake levels and decrease blood pressure levels. However, to enhance effectiveness, behavioral interventions for salt reduction should be combined with other salt-reduction strategies.

Measuring Sodium from Discretionary Salt: Comparison of Methods.

(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.

Sodium Content in Pre-Packaged Foods in China: A Food Label Analysis

Sodium intake from pre-packaged foods is increasing in China and is well above the WHO recommendation of 5 g per day. The purpose of this study is to analyze the sodium content of pre-packaged foods collected by the National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention (NINH, China CDC) in 20 provinces of China from 2017 to 2022. The proportion of pre-packaged foods that meet or exceed the low-sodium, medium-sodium, and high-sodium classifications were analyzed. The proportion of pre-packaged foods that meet and do not meet the WHO global sodium benchmarks and the difference in sodium content between these foods was also calculated. High-sodium foods include sauces, dips, and dressings (3896 mg/100 g), convenience foods (1578 mg/100 g), processed fish products (1470 mg/100 g), processed meat products (1323 mg/100 g), processed poultry products (1240 mg/100 g), snack foods (750 mg/100 g), processed egg products (741 mg/100 g), and fine dried noodles (602 mg/100 g). A large number of pre-packaged foods currently collected in China have a sodium content above sodium benchmarks. This study provided data to support the assessment of sodium intake from pre-packaged foods in the Chinese population and the implementation of comprehensive salt reduction strategies.