Dietary Salt Intake and Discretionary Salt Use in Two General Population Samples in Australia: 2011 and 2014

The limited Australian measures to reduce population sodium intake through national initiatives targeting sodium in the food supply have not been evaluated. The aim was, thus, to assess if there has been a change in salt intake and discretionary salt use between 2011 and 2014 in the state of Victoria, Australia. Adults drawn from a population sample provided 24 h urine collections and reported discretionary salt use in 2011 and 2014. The final sample included 307 subjects who participated in both surveys, 291 who participated in 2011 only, and 135 subjects who participated in 2014 only. Analysis included adjustment for age, gender, metropolitan area, weekend collection and participation in both surveys, where appropriate. In 2011, 598 participants: 53% female, age 57.1(12.0)(SD) years and in 2014, 442 participants: 53% female, age 61.2(10.7) years provided valid urine collections, with no difference in the mean urinary salt excretion between 2011: 7.9 (7.6, 8.2) (95% CI) g/salt/day and 2014: 7.8 (7.5, 8.1) g/salt/day (p = 0.589), and no difference in discretionary salt use: 35% (2011) and 36% (2014) reported adding salt sometimes or often/always at the table (p = 0.76). Those that sometimes or often/always added salt at the table and when cooking had 0.7 (0.7, 0.8) g/salt/day (p = 0.0016) higher salt excretion. There is no indication over this 3-year period that national salt reduction initiatives targeting the food supply have resulted in a population reduction in salt intake. More concerted efforts are required to reduce the salt content of manufactured foods, together with a consumer education campaign targeting the use of discretionary salt.

[1]  C. Nowson,et al.  Salt reduction in Australia: from advocacy to action. , 2015, Cardiovascular diagnosis and therapy.

[2]  R. Magnusson,et al.  Food reformulation and the (neo)-liberal state: new strategies for strengthening voluntary salt reduction programs in the UK and USA. , 2015, Public health.

[3]  F. Paccaud,et al.  New anthropometry-based age- and sex-specific reference values for urinary 24-hour creatinine excretion based on the adult Swiss population , 2015, BMC Medicine.

[4]  P. Kowal,et al.  To Legislate or Not to Legislate? A Comparison of the UK and South African Approaches to the Development and Implementation of Salt Reduction Programs , 2014, Nutrients.

[5]  B. Neal,et al.  An Evaluation of the Effects of the Australian Food and Health Dialogue Targets on the Sodium Content of Bread, Breakfast Cereals and Processed Meats , 2014, Nutrients.

[6]  Elizabeth Dunford,et al.  Target Salt 2025: A Global Overview of National Programs to Encourage the Food Industry to Reduce Salt in Foods , 2014, Nutrients.

[7]  G. MacGregor,et al.  Salt reduction in the United Kingdom: a successful experiment in public health , 2014, Journal of Human Hypertension.

[8]  M. Cogswell,et al.  Urine sodium excretion increased slightly among U.S. adults between 1988 and 2010. , 2014, The Journal of nutrition.

[9]  B. Neal,et al.  Changes in the sodium content of leading Australian fast‐food products between 2009 and 2012 , 2014, The Medical journal of Australia.

[10]  G. MacGregor,et al.  Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality , 2014, BMJ Open.

[11]  K. Charlton,et al.  Iodine status similarly suboptimal in Australian women who have desirable salt intakes compared to those with excessive intakes. , 2014, Nutrition.

[12]  B. Swinburn,et al.  A systematic interim assessment of the Australian Government's Food and Health Dialogue , 2014, The Medical journal of Australia.

[13]  M. Woodward,et al.  Salt intake assessed by 24 h urinary sodium excretion in a random and opportunistic sample in Australia , 2014, BMJ Open.

[14]  C. Nowson,et al.  Dietary sources and meal distribution of sodium and potassium in a sample of Australian adults , 2013 .

[15]  B. Neal,et al.  The Australian Food and Health Dialogue – the implications of the sodium recommendation for pasta sauces , 2013, Public Health Nutrition.

[16]  B. Neal,et al.  Changes in the sodium content of Australian ready meals between 2008 and 2011. , 2013, Asia Pacific journal of clinical nutrition.

[17]  A. Worsley,et al.  An examination of the mediating role of salt knowledge and beliefs on the relationship between socio-demographic factors and discretionary salt use: a cross-sectional study , 2013, International Journal of Behavioral Nutrition and Physical Activity.

[18]  C. Nowson,et al.  Is socioeconomic status associated with dietary sodium intake in Australian children? A cross-sectional study , 2013, BMJ Open.

[19]  P. Edwards,et al.  Fewer adults add salt at the table after initiation of a national salt campaign in the UK: a repeated cross-sectional analysis , 2013, British Journal of Nutrition.

[20]  P. Clifton,et al.  Foods contributing to sodium intake and urinary sodium excretion in a group of Australian women , 2012, Public Health Nutrition.

[21]  P. Clifton,et al.  Sodium intake and excretion in individuals with type 2 diabetes mellitus: a cross-sectional analysis of overweight and obese males and females in Australia. , 2012, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[22]  D. English,et al.  Relationship of urinary sodium and sodium‐to‐potassium ratio to blood pressure in older adults in Australia , 2011, The Medical journal of Australia.

[23]  L. Wyness,et al.  Reducing the population's sodium intake: the UK Food Standards Agency's salt reduction programme , 2011, Public Health Nutrition.

[24]  T. Vos,et al.  Cost-effectiveness of interventions to reduce dietary salt intake , 2010, Heart.

[25]  Ian J. Brown,et al.  Dietary sources of sodium in China, Japan, the United Kingdom, and the United States, women and men aged 40 to 59 years: the INTERMAP study. , 2010, Journal of the American Dietetic Association.

[26]  P. Clifton,et al.  Achieving the salt intake target of 6 g/day in the current food supply in free-living adults using two dietary education strategies. , 2010, Journal of the American Dietetic Association.

[27]  C. Nowson,et al.  The use of table and cooking salt in a sample of Australian adults. , 2010, Asia Pacific Journal of Clinical Nutrition.

[28]  Ian J. Brown,et al.  Salt intakes around the world: implications for public health. , 2009, International journal of epidemiology.

[29]  C. Nowson,et al.  Low-sodium Dietary Approaches to Stop Hypertension-type diet including lean red meat lowers blood pressure in postmenopausal women. , 2009, Nutrition research.

[30]  G. Brinkworth,et al.  Reductions in Blood Pressure Following Energy Restriction for Weight Loss Do Not Rebound after Re-Establishment of Energy Balance in Overweight and Obese Subjects , 2008, Clinical and experimental hypertension.

[31]  M. Noakes,et al.  Long-term weight maintenance and cardiovascular risk factors are not different following weight loss on carbohydrate-restricted diets high in either monounsaturated fat or protein in obese hyperinsulinaemic men and women , 2007, British Journal of Nutrition.

[32]  J. Hodgson,et al.  Partial substitution of carbohydrate intake with protein intake from lean red meat lowers blood pressure in hypertensive persons. , 2006, The American journal of clinical nutrition.

[33]  C. Nowson,et al.  Dietary intake and 24-hour excretion of sodium and potassium , 2006 .

[34]  R. Mattes,et al.  Relative contributions of dietary sodium sources. , 1991, Journal of the American College of Nutrition.

[35]  W. James,et al.  THE DOMINANCE OF SALT IN MANUFACTURED FOOD IN THE SODIUM INTAKE OF AFFLUENT SOCIETIES , 1987, The Lancet.

[36]  G. Beauchamp,et al.  Long-term reduction in dietary sodium alters the taste of salt. , 1982, The American journal of clinical nutrition.