Salt reduction: Moving from consumer awareness to action

Effect of salt concentration on the quality and microbial community during pickled peppers fermentation

This work aimed to investigate the effect of salt concentration on the quality and microbial community of pickled peppers during fermentation, and the cross-correlation between microorganisms and quality was also revealed. The results showed that 9 volatile flavor compounds were unique to the low salt concentration group (D group), which also contained higher content of FAA, lactic acid and acetic acid than high salt concentration group (G group). Meanwhile, the samples of D2 group have a better texture properties. Firmicutes, Proteobacteria, Ascomycota, Lactobacillus, Pectobacterium, and Pseudomonas were detected as the main microbial community during the fermentation with different salt concentrations. Furthermore, the correlations analysis results indicated that the salt concentration has a significant effect on the microbial community of pickled peppers (p < 0.001), and Pediococcus, Lactobacillus, Cedecca, Issatchenkia, Pichia, Kazachstania, and Hanseniaspora were significantly correlated with flavors, which played crucial roles in the unique flavor formation of pickled peppers.

Process evaluation of an mHealth-based school education program to reduce salt intake scaling up in China (EduSaltS): a mixed methods study using the RE-AIM framework

BACKGROUND

An mHealth-based school health education platform (EduSaltS) was promoted in real-world China to reduce salt intake among children and their families. This progress evaluation explores its implementation process and influencing factors using mixed methods.

METHODS

The mixed-methods process evaluation employed the RE-AIM framework. Quantitative data were collected from a management website monitoring 54,435 third-grade students across two cities. Questionnaire surveys (n = 27,542) assessed pre- and post-education effectiveness. Mixed-effects models were used to control cluster effects. Qualitative interviews (23 individuals and 8 focus groups) identified program performance, facilitators, and barriers. Findings were triangulated using the RE-AIM framework.

RESULTS

The program achieved 100% participation among all the third-grade classes of the 208 invited primary schools, with a 97.7% registration rate among all the 54,435 families, indicating high "Reach." Qualitative interviews revealed positive engagement from children and parents through the "small hands leading big hands" strategy. The high completion rate of 84.9% for each health cloud lesson and the significant improvement in salt reduction knowledge and behaviors scores from 75.0 (95%CI: 74.7-75.3) to 80.9 (95%CI: 80.6-81.2) out of 100 demonstrated the "Effect" of EduSaltS. The program's "Adoption" and "Implementation" were supported by attractive materials, reduced workload via auto-delivered lessons/activities and performance evaluation, and high fidelity to recommended activities, with medians 3.0 (IQR: 2.0-8.0)/class and 9.0 (IQR: 5.0-14.0)/school. Stable course completion rates (79.4%-93.4%) over one year indicated promising "Maintenance." Apart from the facilitating features praised by the interviewees, government support was the basis for the scaling up of EduSaltS. Barriers included the lack of smartphone skills among some parents and competing priorities for schools. Unhealthy off-campus environments, such as excessive use of salt in pre-packaged and restaurant foods, also hindered salt reduction efforts. The program's scalability was evident through its integration into existing health education, engagement of local governments and adaptation across various mobile devices.

CONCLUSIONS

The mHealth-based school health education program is scalable and effective for public salt reduction in China. Identified barriers and facilitators can inform future health program scale-ups. The program's successful implementation demonstrates its potential for broader application in public health initiatives aimed at reducing dietary salt intake.

Synergistic effect of combining umami substances enhances perceived saltiness

Umami substances have the potential to enhance the perception of saltiness and thus reduce sodium intake. Two sensory evaluation experiments were conducted, involving participants tasting salt solutions, and solutions with added umami substances at equal sodium concentrations. Umami substances included sodium glutamate (MSG), disodium inosinate (IMP), and the combination of them which has a synergistic effect and is a closer match to commonly-consumed foods. In Experiment 1, using the two-alternative forced-choice (2-AFC) method by 330 consumers, paired comparisons were conducted at three different sodium concentrations. The combination of MSG and IMP enhanced the perception of saltiness (p < .001 in the difference test), whereas presenting either umami substance in isolation failed to do so (p > .05 in the similarity test). Significant order effects occurred in paired comparisons. In Experiment 2, a two-sip time-intensity (TI) analysis with trained panellists verified these results and found that tasting MSG and IMP either simultaneously or successively enhanced saltiness perception at equal sodium concentrations. These findings indicate that the synergistic effect of umami substances may be the cause of saltiness enhancement, and represents a potential strategy for sodium reduction while satisfying the consumer demand for saltiness perception. Considering the application in food processing and in food pairing, umami substances can potentially be used to help to reduce salt intake in food consumption.

Technology-supported behavior change interventions for reducing sodium intake in adults: a systematic review and meta-analysis

The effects of technology-supported behavior change interventions for reducing sodium intake on health outcomes in adults are inconclusive. Effective intervention characteristics associated with sodium reduction have yet to be identified. A systematic review and meta-analysis were conducted, searching randomized controlled trials (RCTs) published between January 2000 and April 2023 across 5 databases (PROSPERO: CRD42022357905). Meta-analyses using random-effects models were performed on 24-h urinary sodium (24HUNa), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Subgroup analysis and meta-regression of 24HUNa were performed to identify effective intervention characteristics. Eighteen RCTs involving 3505 participants (51.5% female, mean age 51.6 years) were included. Technology-supported behavior change interventions for reducing sodium intake significantly reduced 24HUNa (mean difference [MD] -0.39 gm/24 h, 95% confidence interval [CI] -0.50 to -0.27; I2 = 24%), SBP (MD -2.67 mmHg, 95% CI -4.06 to -1.29; I2 = 40%), and DBP (MD -1.39 mmHg, 95% CI -2.31 to -0.48; I2 = 31%), compared to control conditions. Interventions delivered more frequently (≤weekly) were associated with a significantly larger effect size in 24HUNa reduction compared to less frequent interventions (>weekly). Other intervention characteristics, such as intervention delivery via instant messaging and participant-family dyad involvement, were associated with larger, albeit non-significant, effect sizes in 24HUNa reduction when compared to other subgroups. Technology-supported behavior change interventions aimed at reducing sodium intake were effective in reducing 24HUNa, SBP, and DBP at post-intervention. Effective intervention characteristics identified in this review should be considered to develop sodium intake reduction interventions and tested in future trials, particularly for its long-term effects.

Bringing down barriers to children's healthy eating: a critical review of opportunities, within a complex food system

This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.

Effectiveness of a targeted primary preventive intervention in a high-risk group identified using an efficiency score from data envelopment analysis: a randomised controlled trial of local residents in Japan

OBJECTIVE

To determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents hypertension.

DESIGN

Randomised controlled trial.

SETTING

Takahata town (Yamagata, Japan).

PARTICIPANTS

Residents aged 40-74 years belonged to the information provision group for specific health guidance. Participants with a blood pressure ≥140/90 mm Hg, those taking antihypertensive medication, or those with a history of cardiac diseases were excluded. Participants were consecutively assigned based on their health check-up visit at a single centre from September 2019 to November 2020 and were followed up at the check-up in the following year, until 3 December 2021.

INTERVENTION

A targeted approach using minimal intervention. Target was identified using DEA and 50% of participants with higher risk were targeted. The intervention was notifying the results of their risk of hypertension according to the efficiency score obtained by the DEA.

PRIMARY OUTCOME MEASURES

A reduction in the proportion of participants who developed hypertension (≥140/90 mm Hg or taking antihypertensive medication).

RESULTS

A total of 495 eligible participants were randomised, and follow-up data were available for 218 and 227 participants in the intervention and control groups, respectively. The risk difference for the primary outcome was 0.2% (95% CI -7.3 to 6.9) with 38/218 (17.4%) and 40/227 (17.6%) events in the intervention and control group, respectively (Pearson's χ² test, p=0.880). The adjusted OR of the effect of the intervention was 0.95 (95% CI 0.56 to 1.61, p=0.843), and that of the efficiency score (10-rank increase) was 0.81 (95% CI 0.74 to 0.89, p<0.0001).

CONCLUSIONS

Minimal intervention to a high-risk population stratified by DEA was not effective in reducing the onset of hypertension in 1 year. The efficiency score could predict the risk of hypertension.

TRIAL REGISTRATION NUMBER

UMIN000037883.

Consumer perception of salt-reduced bread with the addition of brown seaweed evaluated under blinded and informed conditions

BACKGROUND

Many consumers have a high salt intake and bread is a primary source because of its high rate of consumption. The inclusion of seaweeds has been proposed as an ingredient that could help reduce the salt content of food products. As such, the present study aimed to evaluate whether the amount of salt in bread could be reduced and the change in sensory properties be mitigated by the inclusion of brown seaweed. There were two different sensory trials conducted. In the first trial, participants (n = 102) evaluated bread made with brown seaweed (4% substitution for flour) with reduced amounts of salt (10%, 20%, 30%, 40% and 50%). The second trial asked participants (n = 98) to evaluate the control bread and the 20% salt-reduced bread in blinded and informed conditions. In both sensory trials, the breads samples were assessed using hedonic scales, just-about-right scales, and check-all-that-apply.

RESULTS

The results showed that the 10% and 20% salt-reduced breads were acceptable and associated with being soft, chewy and having no aftertaste. The other breads were associated with a dense, dry and strong aftertaste, along with not being salty enough for the consumers. When the breads were evaluated in informed conditions, the salt reduction label had a negative impact on the consumers' liking.

CONCLUSION

The research emphasizes that salt-reduced labels influence consumers' sensory perception. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Behavioural Nudges, Physico-Chemical Solutions, and Sensory Strategies to Reduce People’s Salt Consumption

This narrative historical review examines the wide range of approaches that has been trialled/suggested in order to reduce the consumption of salt. While sodium is an essential micronutrient, there is widespread evidence that high levels of consumption are leading to various negative health outcomes. This review summarises the evidence relating to the various approaches that have been put forward to date to help reduce salt consumption over the years, while also highlighting a number of important questions that remains for future research. Solutions to reducing salt consumption include everything from the gradual reduction in salt in foods through to the reduction in the number/size of holes in saltshakers (what one might consider a behavioural nudge). Physico-chemical solutions have included salt replacers, such as monosodium glutamate (MSG) through to the asymmetric distribution of salt in processed (e.g., layered) foods. A wide range of sensory approaches to modulating expected and perceived saltiness have also been suggested, including the use of salty aromas, as well as suggesting the use of colour cues, sonic seasoning, and even textural primes. It is currently unclear whether different salty aromas can be combined to increase odour-induced taste enhancement (OITE) effectiveness. In the years ahead, it will be interesting to assess how long such solutions remain effective, as well as whether different solutions can be combined to help reduce salt consumption without having to compromise on taste/flavour

The association of knowledge, attitudes and behaviors related to salt with 24-h urinary sodium, potassium excretion and hypertensive status

To understand the association between sodium and potassium consumption levels, hypertension and knowledge, attitudes and behaviors (KAB) toward salt and the commitment to effective sodium reduction and potassium supplementation to achieve the purpose of suppressing hypertension. A stratified multistage random sampling method was used to obtain a representative provincial sample of 7512 residents aged 18-69 years through a cross-sectional survey by the Salt Reduction and Hypertension Prevention Project (SRHPP) in Zhejiang Province of China in 2017-2018. A screening including demographic, anthropometric, salt-related KAB and physical measurements was implemented, and 24-h urine of approximately 1/5 of the participants was collected and tested. The mean age was 44.8 years, 50.1% were women, 44.0% lived in urban areas, and hypertension or prehypertension accounted for approximately 35.0%. The mean 24-h urinary sodium and potassium excretion were 3848.5 (1661.1) mg/d and 1491.1 (710.9) mg/d, respectively. KAB in urban areas was generally more favorable than in rural areas, women were better than men, and the optimal blood pressure group was better than the other two groups (P < 0.05). However, the awareness and correct use rate of salt-restricted spoons, low-sodium salt and nutrition labeling were lower. A multivariable linear regression model indicated that KAB had a smaller effect on sodium (two indicators effective for promoting sodium reduction) and a greater effect on potassium (six indicators effective for promoting potassium supplementation) and mainly focused on knowledge and behavior indicators. A multivariable logistic regression model indicated that mastering more knowledge and taking active measures could effectively reduce the transition to hypertension, even if the individual was already in prehypertension. There is much room for improvement of salt-related KAB in the Chinese population. A clear association indicates that KAB can help to reduce sodium and supplement potassium, especially potassium, and help to suppress the development of hypertension. The role of beliefs in KAB should be fully valued and improved, similar to knowledge and behaviors. This study provides important evidence and insight into China's efforts to meet the targets of salt reduction and hypertension prevention.

Reduction of sodium chloride: a review

Sodium chloride (NaCl) is an enjoyable condiment. However, evidence is accumulating to indicate that an excessive intake of Na⁺ in food may lead to an increased risk of cardiovascular and cerebrovascular diseases. Previous systematic reviews have focused on replacing NaCl with other metal salts (e.g. KCl). However, new salty flavor enhancers (yeast extract, taste peptides, and odor compounds) have yet to be reviewed. This systematic review evaluates the methods for, and feasibility, of NaCl reduction. It defines NaCl reduction and considers the methods used for this purpose, especially the use of flavor enhancers (yeast extract, taste peptides, and odor compounds). © 2022 Society of Chemical Industry.

The Effect of Sea Salt with Low Sodium Content on Dough Rheological Properties and Bread Quality

The aim of this study was to analyze the effects of the addition of sea salt with low sodium content (SS) in a refined wheat flour at the levels of 0.3%, 0.6%, 0.9% 1.2% and 1.5% on the rheological properties of the dough during mixing, extension, pasting and fermentation and the bread quality in terms of bread physical properties, crumb and crust color, texture and sensory characteristics. According to the data we obtained, the SS presented a strengthening effect on the dough network by increasing its stability, dough development time, energy and resistance. Moreover, the SS addition resulted in an increase in dough extensibility, to a delay of the gelatinization process and an increase of the falling number value. The bakery products obtained with the SS were of a higher quality compared to the control sample, presenting better physical and textural characteristics, a darker color and being more appreciated by consumers with the increased level of SS addition in the wheat flour. According to the sodium content from the bread recipe, the bread samples obtained may be classified as products with a very low sodium content of up to a 0.6% SS addition in the wheat flour or with a low sodium content if at least 0.9% SS is contained in the bread recipe.

Application of a salt substitute in bitter taste suppression and toward better acceptance of cruciferous vegetables in diet

The addition of table salt has been reported to enable better acceptance when consuming the least preferred vegetables belonging to the Cruciferae family. Considering the adverse effect of excessive table salt intake on incidence of hypertension and cardiovascular diseases, it is essential to explore an alternative healthier option for better acceptance and to encourage consumption of these vegetables. In this study, 261 adult participants were evaluated for their preferences toward basic tastes and food as well as sensory evaluation of a meal prepared from cruciferous vegetables with the addition of two different salts, sodium chloride and salt substitute containing a blend of potassium and sodium salts. A general questionnaire was used to assess taste and food preferences, while the Cruciferous Vegetable Food Frequency Questionnaire (CVFFQ) was used for vegetable intake assessment. The Labeled Magnitude Scale (LMS), Just About Right (JAR) scale, and several hedonic scales were used to determine taster status and sensory evaluation. The results show that a low concentration of the salt substitute did not impact bitterness suppression but did result in higher preference of the cruciferous vegetable meal. Although, subjects self-reported to have salty taste preferences were more sensitive to bitter taste, they did not perceive samples as less salty and less acceptable than subjects with lower sensitivity. The results show the necessity for further examination of the effectiveness of different concentrations of the assessed salt substitute in suppressing perceived bitterness of cruciferous vegetables and regarding their overall acceptance for inclusion in diets.

Sodium Reduction in Bouillon: Targeting a Food Staple to Reduce Hypertension in Sub-saharan Africa

Bouillon cubes are a staple ingredient used in Sub-saharan African countries providing flavor enhancement to savory foods. Bouillon has been identified as a vehicle for fortification to overcome micronutrient deficiencies in Sub-saharan Africa. However, bouillon has a high sodium content (and in addition with other foods) contributes to dietary sodium intake above recommended guidelines. High dietary sodium intake is a key risk factor for hypertension and cardiovascular disease (CVD). Africa has the highest rates of hypertension and CVD globally with nearly half the adult population above 25 years affected. This review presents current state of research on sodium reduction strategies in bouillon. The key challenge is to reduce sodium levels while maintaining optimal flavor at the lowest possible production cost to ensure bouillon continues to be affordable in Sub-saharan Africa. To produce lower sodium bouillon with acceptable flavor at low cost will likely involve multiple sodium reduction strategies; direct reduction in sodium, sodium replacement and saltiness boosting flavor technologies. Efforts to reduce the sodium content of bouillon in Sub-saharan Africa is a worthwhile strategy to: (i) lower the overall sodium consumption across the population, and (ii) deliver population-wide health benefits in a region with high rates of hypertension and CVD.

Impact of salt concentration on bacterial diversity and changes in biogenic amines during fermentation of farmhouse soybean paste in Northeast China

Farmhouse soybean paste in Northeast China is a traditional fermented product made from soybean, and more than 11% (w/w) salt is usually added during production to control the fermentation process. In this study, the variations in bacterial diversity, biogenic amines(BAs) and physicochemical properties during the natural fermentation of soybean paste with different salt concentrations (8%, 9%, 10%, 11%, and 12%) were studied. The results show that at 0 days (0 d) of fermentation in soybean paste, the dominant genera included Staphylococcus, unidentified Clostridiales, and Sporolactobacillus. During fermentation from 30 d to 90 d, the dominant genera were Tetragenococcus and Staphylococcus. However, the proportions of the dominant genera were different depending on the salt concentration. Putrescine(Put), tryptamine(Try), β-phenethylamine(Phe), cadaverine(Cad), histamine(His), and tyramine(Tyr) showed negative correlations with salt concentration. The amino type nitrogen(ANN), titratable acidity(TTA) and total number of colonies were also negatively correlated with salt concentration. Analysis of the correlation between genera and BAs showed that 12 genera were positively correlated with BAs, and 4 genera were negatively correlated with BAs. The results of this study indicated that salt has a significant impact on bacterial diversity during the fermentation of soybean paste, which in turn affects the changes in bacterial metabolites. From the perspective of food safety, the amount of salt added in the soybean paste can be reduced to 10% under the existing fermentation conditions.

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The effect of salt concentration on soybean paste was studied.

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Salt concentration affected the bacterial diversity and BAs in soybean paste.

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There was a species succession process in the initial 30 days of fermentation.

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There was correlation between the BAs and some bacteria in soybean paste.

Applying Customer Journey Mapping in Social Marketing to Understand Salt-Related Behaviors in Cooking. A Case Study

Worldwide, salt consumption exceeds the World Health Organization’s recommendation of a daily intake of 5 g. Customer journey mapping is a research method used in market research to understand customer behaviors and experiences and could be useful in social marketing as well. This study aimed to explore the potential of customer journey mapping to better understand salt-related behaviors performed during the preparation of household cooking. We tracked the journey of four women in their kitchens for approximately two hours to observe the preparation of lunch. Individual journey maps were created, one for each woman, that were composited into a single journey map. We found that customer journey mapping was a suitable research method to understand how food preparers made decisions around adding salt and artificial seasonings at each stage of the journey. In contrast to the interviewee’ responses, it was observed that the four women added salt and artificial seasonings consistently and incrementally with little control and without any standard measure. In this study, we demonstrate the utility of customer journey mapping in a novel context and nudge social marketers to include this tool in their repertory of research methods to understand human behavior.

Nutritional Content of Sliced Bread Available in Quebec, Canada: Focus on Sodium and Fibre Content

Bread is a highly consumed food and an important source of nutrients in the diet of Canadians, underlining the need to improve its nutritional quality. The Food Quality Observatory (Observatory) aimed to evaluate the nutritional value of the sliced bread products available in Quebec (Canada), according to their grain type and main flour. Analyses included comparing the bread’s sodium content to Health Canada’s daily values (DV) and sodium voluntary targets, comparing the bread’s fibre content thresholds with the source of fibre mentioned, and assessing whether the main flour was associated with the nutrient content. The nutritional values of 294 sliced breads available in Quebec were merged with sales data (from October 2016 to October 2017), with 262 products successfully cross-referenced. The results showed that 64% of the breads purchased were ‘low’ in fibre (i.e., below 2 g per two slices), while 47% were ‘high’ in sodium (i.e., above 15% DV per two slices). Attention should be paid to 100% refined grain bread and to bread with refined flour as the main flour, since they are great sellers, while showing a less favourable nutrient content. This study shows that there is room for improvement in the nutritional content of Quebec’s bread offer, particularly regarding sodium and fibre content.

Taste of Modern Diets: The Impact of Food Processing on Nutrient Sensing and Dietary Energy Intake

BACKGROUND

Both fresh and processed foods are available in the modern food environment where taste can signal presence of nutrients. However, whether these taste-nutrient relationships are maintained across different degrees of food processing is not well understood, and less is known about the relative contribution of different taste qualities to population energy intakes.

OBJECTIVES

To investigate the association between perceived intensity of 6 taste modalities and a food's nutrient content in the context of food processing and to further examine the relative contribution of different taste clusters to total energy intakes, stratified by weight status.

METHODS

Diet and lifestyle data from the Singapore Multi-Ethnic Cohort Phase 2 (N = 7011; aged 21-75 y) were collected through interviewer-administrated questionnaires. Taste and nutrient profiles for each of the 269 Singaporean foods were derived using a published taste database and food composition table. Each food was then categorized into the NOVA food-processing classification (unprocessed, processed, ultra-processed) to compare the strength of taste-nutrient relationships. Multivariable-adjusted models were used to examine associations between relative consumption of foods from different taste clusters and processing categories, energy intake, and BMI (in kg/m2) within a population cohort.

RESULTS

Sweet taste and mono- and disaccharide content of foods were significantly associated across all processing categories, although this association was weaker among ultra-processed foods (UPFs) (r = 0.42) than among unprocessed foods (r = 0.72). In contrast, associations between fat sensation and fat content (r = 0.74), as well as salt taste and sodium content (r = 0.84), were stronger for UPFs. Individuals who had higher energy intakes or were overweight (BMI >23) derived significantly greater percentage of energy from processed foods rather than UPFs, and this energy was higher from "savory-fatty" and lower from "neutral" tasting foods than those with lower energy intakes and normal weight (all P < 0.001). Eighty percent of individuals' dietary energy was from both "savory-fatty" and "neutral" foods, independent of differences in total energy intake and weight status.

CONCLUSIONS

Taste-nutrient relationships are maintained across different degrees of food processing. Greater consumption of foods that have a high "savory-fatty" taste was associated with increased energy intakes and overweight in the Asian population.

Current Knowledge and Behavior towards Salt Reduction among Hong Kong Citizens: A Cross-Sectional Survey

Excessive dietary salt intake is prevalent in the Hong Kong community. Over the last decade, the Hong Kong Special Administrative Region Government has been actively promoting community participation to reduce salt intake. The aim of this study was to investigate the current knowledge levels and behaviors relating to dietary salt intake among Hong Kong adults. This cross-sectional survey involved 426 adults in Hong Kong. The findings of this study identified areas of knowledge deficit in the recommended upper limit of daily salt intake for an adult set by World Health Organization (n = 295, 69.2%) indicated a lack of awareness that the overconsumption of salt could cause coronary heart disease (n = 233, 54.7%). Disengagement with salt reduction behavior, such as rarely/never checking the sodium or salt content listed on the food label (n = 252, 59.2%) and rarely/never purchasing food labelled with low salt or no salt content (n = 292, 68.9%), was reported. Excessive salt intake in dietary habits remains an under-recognized non-communicable disease threat by Hong Kong citizens, indicating ineffective responsive risk communication. There is a need to refine existing salt reduction initiatives to aid in making appropriate decisions regarding dietary salt intake among Hong Kong citizens.

A Review Study of a Green Diet and Healthy Ageing

Nowadays people are living longer, and there has been a substantial growth in the global elderly population in the past decades. While life expectancy is increasing, there are growing concerns towards the heavy financial and social burdens related to chronic diseases among the elderly. These have been critical health care issues, and healthy ageing is considered a top priority in public health. Diet and eating habits are crucial factors contributing to healthy ageing. These important aspects have attracted much attention in health research, particularly in consideration of the causes and management of chronic conditions which affect most elder adults in the world. Recently, a growing number of investigations have reported significant findings on the association of reduction in the risks of chronic non-communicable diseases with plant-based diets. Meanwhile, there have been worldwide initiatives and programmes implemented for reduction of salt intake. A green diet, which emphasises the consumption of a diet rich in plant foods with minimal portions of red or processed meat and reduced salt intake, is advocated with due consideration to the importance of sustainable environment and healthy ageing. This paper highlights a brief review of the recent advance of knowledge in diet and health, its effects on the elderly and the significance of a green diet on healthy ageing. Implications for a green diet and recommendations for future research are also discussed.

An overall framework for the E. coli γ-glutamyltransferase-catalyzed transpeptidation reactions

γ-Glutamyl derivatives of proteinogenic or modified amino acids raise considerable interest as flavor enhancers or biologically active compounds. However, their supply, on a large scale and at reasonable costs, remains challenging. Enzymatic synthesis has been recognized as a possible affordable alternative with respect to both isolation procedures from natural sources, burdened by low-yield and by the requirement of massive amount of starting material, and chemical synthesis, inconvenient because of the need of protection/deprotection steps. The E. coli γ-glutamyltransferase (Ec-GGT) has already been proposed as a biocatalyst for the synthesis of various γ-glutamyl derivatives. However, enzymatic syntheses using this enzyme usually provide the desired products in limited yield. Hydrolysis and autotranspeptidation of the donor substrate have been identified as the side reactions affecting the final yield of the catalytic process. In addition, experimental conditions need to be specifically adjusted for each acceptor substrate. Substrate specificity and the fine characterization of the activities exerted by the enzyme over time has so far escaped rationalization. In this work, reactions catalyzed by Ec-GGT between the γ-glutamyl donor glutamine and several representative acceptor amino acids have been finely analyzed with the identification of single reaction products over time. This approach allowed to rationalize the effect of donor/acceptor molar ratio on the outcome of the transpeptidation reaction and on the distribution of the different byproducts, inferring a general scheme for Ec-GGT-catalyzed reactions. The propensity to react of the different acceptor substrates is in agreement with recent findings obtained using model substrates and further supported by x-ray crystallography and will contribute to characterize the still elusive acceptor binding site of the enzyme.

Strategies for Reducing Sodium Intake in Bakery Products, a Review

Nowadays, the dietary sodium chloride intake is higher than the daily recommended levels, especially due to its prominent presence in food products. This may cause an increase of high blood pressure leading to cardiovascular diseases. Cereal products, and in particular bread, are the main source of salt in human diet. However, salt is a critical ingredient in bread making, and its reduction can have a negative impact on bread quality. This review focuses on physiological role of sodium chloride, its effect on the human body and legislative recommendations on its consumption. Moreover, it presents sodium chloride effects on the bread making from the technological and sensory point of view and presents different options for salt reduction in foods focusing on bakery products. It may be concluded that salt reduction in bread making while maintaining dough rheological properties, yeast fermentation rate, bread quality through its loaf volume, color, textural properties, sensory characteristics is difficult to be achieved due to sodium chloride’s multifunctional role in the bread-making process. Several strategies have been discussed, focusing on sodium chloride replacement with other type of salts, dry sourdough and flavor enhancers.

The role of sodium chloride in the sensory and physico-chemical properties of sweet biscuits

Salt is included in many foods which consumers do not regard as salty. This "hidden-salt" may offer functional benefits but is often overlooked in sodium reduction strategies. This study investigated its role in shortbread-like sweet biscuits (1.05 g NaCl/100 g). Sensory tests revealed significant flavour and texture differences after a salt reduction of 33% (0.86 g/ 100 g). This was explained by differences in the partitioning of hydrophobic aroma compounds into the headspace and a significant impact on structure. Texture analysis and X-ray-µCT measurements revealed a reduced hardness with larger and more air cells in salt-reduced biscuits. It is suggested that salt impacts on cereal proteins by altering their aggregation around flour particles and at bubble walls and that slower water loss occurs in salted matrices during baking. Hence, this study revealed the key properties significantly affected by salt reduction and proposes an explanation which will help to develop a targeted "hidden-salt" reduction strategy.

Strategies for Reducing Salt and Sugar Intakes in Individuals at Increased Cardiometabolic Risk

Non-communicable diseases (NCDs) are the first causes of death worldwide. Reduction in the dietary intake of salt and sugars is important lifestyle advice that is useful for NCD prevention. However, the simple recommendations of reducing salt and sugars by healthcare professionals are often ineffective; innovative strategies are therefore necessary. This review aimed at describing the current knowledge about the strategies to reduce dietary salt and sugar intake, including both strategies for the food industry to reduce the salt or sugar of its products and recommendations for health professionals in a clinical context, such as the replacement with substitutes in foods, the gradual reduction to allow a progressive consumer adaptation towards less intense taste, and the different spatial distribution of tastants within the food matrix with taste intensity enhancement. In addition, the cross-modal interaction between two or more different sensory modalities as an innovative strategy for enhancing sweetness and saltiness perception was described. Finally, the dietary tips for salt and sugar reduction were summarized in order to create a comprehensive guide of dietary advices for healthcare professionals for optimizing the management of patients at increased cardiometabolic risk.

Population-based Cardiovascular Disease Prevention Measures Aimed at Reducing Salt Intake: Analysis of International Strategies and Prospects for Implementation in the Russian Federation

High salt intake is an important risk factor for cardiovascular diseases (CVD), closely related to the level of blood pressure in the population. The purpose of the review: to study population-based interventions for CVD prevention, aimed at reducing salt intake; to assess the potential for their implementation in the Russian Federation. We presented population-based strategies for dietary salt intake reduction used in different countries. The main components of strategies aimed to correct this risk factor in the Russian Federation were identified. The main components of the population-based approach to reducing salt intake are: determining population salt consumption, identifying sources of salt in the diet, monitoring of salt content in products, engaging with the food industry, consumer awareness campaigns, changes in product labeling, tax measures. An integrated approach to the problem is the most successful. Measures which were highly effective have not yet been fully implemented in the Russian Federation. At the moment, taxation of high-salt foods and tax subsidies for healthy food are not applied. Food manufacturers are not sufficiently involved - there are no legislatively introduced measures to reduce salt through food reformulation. Firstly it has to be applied to diet-forming products that are consumed daily, such as bakery and dairy products, and meat products.

The Effect of Sea Salt, Dry Sourdough and Fermented Sugar as Sodium Chloride Replacers on Rheological Behavior of Wheat Flour Dough

The aim of this study was to investigate the effects of formulation factors, sea salt (SS), dry sourdough (SD) and fermented sugar (FS) as sodium chloride replacers in wheat flour on dough mixing, extension, pasting and fermentation rheological properties, evaluated by Farinograph, Extensograph, Amylograph and Rheofermentometer devices. With regard to mixing and extension properties, SS and FS presented a strengthening effect, whereas SD presented a weakening one. SS and FS presented a positive effect on dough stability, energy and resistance, whereas SD presented a negative one. On the Amylograph, peak viscosity increased by SS and FS addition and decreased when SD was incorporated in the dough recipe. During fermentation, dough development and gas production in the dough system increased after SS and SD addition, whereas they decreased after FS addition. Response surface methodology (RSM) was used to investigate the effect of independent variables on the rheological properties of the dough. Mathematical models between the independent variables, SS, SD and FS, and the dependent variables, represented by the rheological values of the dough, were obtained. The best formulation obtained was of 0.30 g/100 g SS, 0.50 g/100 g SD and 1.02 mL/100 g FS addition with a 0.618 desirability value, following Derringer's desirability function approach. For this formulation, bread quality characteristics were better appreciated than for those obtained for the control sample, in which 1.5% NaCl was incorporated in wheat flour.

Is a Consumer Perception of Salt Modification a Sensory or a Behavioural Phenomenon? Insights from a Bread Study

Salt plays a major role in food manufacturing and affects the technological and sensory properties of foods. At the same time, high dietary salt intake increases the risk of cardiovascular diseases and represents a considerable public health concern. In many populations, bread is a major contributor to salt intake and is therefore targeted by health policies recommending salt reduction reformulations. However, producers are often reluctant to reduce salt content due to fears of potential negative effects on consumer acceptability and drops in sales. The present work aims to assess the effect of salt content on consumers’ hedonic liking and perception of saltiness intensity, as well as the interaction of these two. The study was conducted using two market-leading bread types (white and multigrain) and bread samples with the national average (reference), reduced (−15%) and increased (+10%) salt levels. A sensory evaluation study (n = 200) was done including a questionnaire on attitudes and behaviour regarding bread and salt, enabling the exploration of individual differences in reactions to modified levels of salt content. The latter only affected hedonic liking for the multigrain sample with 15% salt reduction but not for others, which discloses the importance of the bread matrix; and it did not affect the perception of saltiness intensity. Penalty analysis revealed that perceived non-optimal saltiness results in significantly penalised hedonic liking scores. Segmentation based on perceived saltiness disclosed the explanatory importance of underlying consumer behaviour dimensions which should be considered in designing bread reformulations.

Sodium concentration of pre-packaged foods sold in Hong Kong

OBJECTIVE

To describe the Na concentration of pre-packaged foods available in Hong Kong.

DESIGN

The Na concentrations (mg/100 g or mg/100 ml or per serving) of all pre-packaged foods available for sale in major supermarket chains in Hong Kong were obtained from the 2017 Hong Kong FoodSwitch database. Median and interquartile range (IQR) of Na concentration for different food groups and the proportion of foods and beverages considered low and high Na (<120 mg/100 g or mg/100 ml and >600 mg/100 g or mg/100 ml, respectively) were determined.

SETTING

Hong Kong.

PARTICIPANTS

Not applicable.

RESULTS

We analysed 11 518 pre-packaged products. 'Fruit and vegetables (including table salt)' had the highest variability in Na concentration ranging from 0 to 39 000 mg/100 g, followed by 'sauces, dressings, spreads and dips' ranging from 0 to 34 130. The latter also had the highest median Na concentration (mg/100 g or mg/100 ml) at 1180 (IQR 446-3520), followed by meat and meat products (median 800, IQR 632-1068) and snack foods (median 650, IQR 453-926). Fish and fish products (median 531, 364-791) and meat and meat products (median 444, IQR 351-593) had the highest Na concentration per serving. Overall, 46·7 and 26·7 % of products were low and high in Na, respectively.

CONCLUSIONS

Our results can serve as a baseline for food supply interventions in Hong Kong. We have identified several food groups as priority areas for reformulation, demonstrating the potential of such initiatives to improve the healthiness of the food supply in Hong Kong.

Use of Response Surface Methodology to Investigate the Effects of Sodium Chloride Substitution with Potassium Chloride on Dough’s Rheological Properties

Bakery products are one of the main sources of dietary sodium intake of the world’s population. During the last decade, sodium intake has increased worldwide and nowadays the World Health Organization recommends reducing sodium intake by up to 2 g Na/day. KCl is the leading substitute for reducing sodium in bakery products. Therefore, the main purpose of our study was to investigate the impact of sodium reduction on dough’s rheological properties by reformulating the dough recipe using two types of salts, namely NaCl and KCl, with different amounts added to wheat flour. In order to establish their combination for obtaining the optimum rheological properties of dough, the response surface methodology (RSM) by the Design Expert software was used. The effect of combined NaCl and KCl salts were made on mixing, viscometric and fermentation process by using Farinograph, Extensograph, Amylograph and Rheofermentometer devices. On dough’s rheological properties, KCl and NaCl presented a significant effect (p < 0.01) on water absorption, stability, energy, dough resistance to extension, falling number and all Rheofermentometer-analyzed values. Mathematical models were achieved between independent variables, the KCl and NaCl amounts, and the dependent ones, dough rheological values. The optimal values obtained through RSM for the KCl and NaCl salts were of 0.37 g KCl/100 g and 1.31 g NaCl/100 g wheat flour, which leads to a 22% replacement of NaCl in the dough recipe.

The Effect of Sodium Reduction by Sea Salt and Dry Sourdough Addition on the Wheat Flour Dough Rheological Properties

The aim of this research was to investigate a technological approach to decrease the sodium content from bakery products in order to respond to the World Health Organization (WHO)'s recommendation to reduce dietary salt intake. Due to the fact that sodium chloride is one of the main ingredients from baking products that affects dough rheology and therefore the technological process of the bakery products, it is important to evaluate these properties. This study analyzes the effect of sea salt with low sodium content (SS) and dry sourdough from wheat flour (SD) as substitutes for sodium chloride on dough rheological properties and on mixing, extension, pasting, and fermentation process by using Farinograph, Extensograph, Amylograph, Falling Number, and Rheofermentometer devices. The results were analyzed using response surface methodology. SS presented a strengthening effect on the gluten network whereas SD presented a weakening one. On extension properties, SS and SD presented a significant positive effect (p < 0.01) on resistance to extension (R50) and maximum resistance to extension (Rmax) values. For pasting properties, SS increased peak viscosity and falling number values whereas SD decreased them. On fermentation properties, SS decreased the maximum height of gaseous production and total CO2 volume production and increased the retention coefficient whereas SD presented an antagonistic effect on these parameters.

The Effect of an Evaluative Label on Consumer Perception of Cheeses in Hungary

Traditional strategies (such as education, economic incentives or prohibitions) targeted at altering dietary habits only influence health-conscious consumers. Less health-conscious consumers are less capable of self-regulatory behavior, therefore they are more likely to be influenced through perception. The present study aimed to examine how external cues such as labeling affect the consumer's perception of foods. The paper includes a case study based on an experiment. In the experiment the same cheese was tested with four different types of labeling (labeled "conventional", "low salt", "low fat" and "low salt and low fat"). It was found that the health halo effect worked in the case of cheese testing. In spite of all the samples being identical, the healthy samples were associated with considerably less sensory pleasure. The use of labels by the producers resulted in exactly the opposite effect to that intended. The experiment confirmed the efficiency of the application of this type of behavior-oriented nudge.

Can sodium warnings modify preferences? A case study with white bread

Several studies have shown that the inclusion of front of pack nutritional warnings is a potentially effective strategy to encourage consumers to avoid products with high content of nutrients associated with non-communicable diseases. In this context, the present work aimed at exploring consumers' reaction towards sodium reduction in the context of the implementation of warnings in three scenarios: package evaluation, tasting and intention to re-purchase the product after tasting, using white bread as case study. A total of 171 consumers participated in the study that encompassed four parts. Firstly, consumers received two bread samples with different salt content (2.00% and 1.38% salt) under blind conditions and were asked to rate their overall liking and to indicate the one they preferred. Then, they were asked to look at four bread packages differing in graphic design and the presence of warnings. They had to rate their expected liking and to indicate the one they would purchase. Finally, consumers were asked to try the bread they had previously chosen, to assess their overall liking and to indicate their willingness to purchase it again. Salt content significantly affected consumer hedonic reaction towards the breads. Two consumer segments with different preference for the salt content in bread were identified: 58% of consumers preferred the bread with 2.00% salt while 42% preferred breads with 1.38% salt. However, when looking at the packages the majority of consumers in both groups selected bread packages that did not feature warnings. In addition, after having tried the bread, most consumers were willing to buy the bread they had previously chosen again, which is promising in terms of reaching sustainable changes towards lower salt levels. Results from the present work suggest that, in the case of bread, nutritional warnings have potential to shift consumers' preferences to lower sodium content, even after trying the products.

The influence of companion foods on sensory attribute perception and liking of regular and sodium-reduced foods

Among major contributors of dietary sodium intake, many foods are consumed together with companion foods, specifically condiments and carriers. This study compared sensory profiles and overall liking between commercially available regular and sodium-reduced foods consumed with or without companion foods; and examined changes in sensory profiles and overall liking when foods are consumed in condiment-carrier pairs. Three distinct consumer panels evaluated one of the three condiment-carrier pairs, salsa-corn chips (n = 98, 63% female), ketchup-tater tots (n = 100, 69% female), and soy sauce-cooked rice (n = 98, 70% female). For each panel, consumers evaluated five samples; including the regular and sodium-reduced carriers/condiments alone, the companion food alone, and the regular and sodium-reduced foods each with its companion food. Samples were rated for overall liking (9-point hedonic scale) and the intensity of defining sensory attributes (3-point Rate-All-That-Apply scale). Consumers perceived sensory attribute differences between regular and sodium-reduced corn chips (salty) and soy sauce (salty, sweet), but not ketchup. The presence of the companion food reduced consumer ability to discriminate sensory attributes between regular and sodium-reduced products and changed sensory profiles and liking of the foods. Additionally, consumer heterogeneity in hedonic response identified three consumer segments in each consumer panel. Consumer segments differed in their sensory attribute perception. PRACTICAL APPLICATION: It is possible for the food industry to reduce sodium in a range of companion foods without changing consumer preference. The selection of companion foods is important to consumer evaluation of foods under the context of food pairing; corn chips-salsa and ketchup-tater tots are appropriate food pairs. Future sensory studies on food reformulation toward sodium reduction should target specific consumer segments of product liking and sensory attribute perception, which may in turn be influenced by food consumption frequency.

Selected Predictors of the Importance Attached to Salt Content Information on the Food Packaging (a Study among Polish Consumers)

This paper aims to identify selected antecedents of the importance attached to salt content information (ISCI) placed on food labels, on the basis of a representative survey of 1051 Polish consumers. The study was conducted with the use of the CAWI (Computer Assisted Web Interviews) method in 2018. Quota sampling was applied with reference to the following five criteria: sex, age, education, place of living (urban and rural areas), and region. In a multiple regression model, ISCI depends on the respondent’s: sex, age, evaluation of the quantity of nutrition claims, importance attached to nutrition claims, willingness to pay a price premium for products with nutrition claims, attention paid to health and nutrition claims, agreeing with the opinion that unreliable nutrition claims are a serious problem, evaluation of healthiness of one’s diet, self-rated knowledge about healthy nutrition, buying organic food, and reading front-of-package (FOP) labels during and after the purchase. The strongest effects on the importance attached to salt content information on the food packaging were displayed by the importance of nutrition claims, attention paid to nutrition and health claims, respondent’s age, FOP label reading at home, and agreeing that the use of unreliable nutrition claims is a serious problem.

A survey of Chinese consumers' knowledge, beliefs and behavioural intentions regarding salt intake and salt reduction

OBJECTIVE

Globally, China is among the 'saltiest' nations. In order to support current nationwide salt reduction initiatives, we investigated Chinese consumers' knowledge, beliefs and behaviours related to salt intake and salt reduction.

DESIGN

A cross-sectional face-to-face survey was carried out, focusing on salt knowledge, beliefs and behaviours related to salt intake and salt reduction, perceptions of salt reduction responsibility and support for different national strategies.

SETTING

The survey was carried out in China mainland.

PARTICIPANTS

Consumers (n 2444) from six of seven major geographical regions in China participated in the survey. After data cleaning, a sample of 2430 was included in the final analysis.

RESULTS

A majority of Chinese consumers believed that salt added during home cooking was the biggest contributor to their salt intake. Knowledge gaps existed in the awareness of salt hidden in certain foods and flavouring products. Chinese consumers in general were interested in lowering their salt intake. They were aware of salt reduction tools, but the adoption level was low. Consumers expressed strong support for promotion of salt-restriction spoons and public education, but not fiscal policies (e.g. salt-related tax or subsidies). In terms of individual differences, education status demonstrated a substantial impact on salt reduction knowledge and behaviour.

CONCLUSIONS

There is still big room to 'shake' Chinese consumers' salt habit. The present study provides important evidence and consumer insights to support China's efforts to meet its salt reduction targets.

Impact of sodium reduction strategies on volatile compounds, sensory properties and consumer perception in commercial wheat bread

The efficacy of two sodium reduction strategies in preserving sensory profile and consumer liking of yeasted wheat bread was tested, by combining sensory data, aroma compounds and consumer investigations. The use of (i) a reduced-sodium salt substitute, Pansalt® (NaCl 57%, other salts and minor ingredients) at 1.5%, and (ii) the heterogeneous NaCl distribution (average level of 1%) leading to enhanced saltiness by taste contrast, were compared with standard (1.5%) and reduced (1.0%) addition of NaCl. The heterogeneous NaCl distribution was effective in preserving saltiness. Salt substitution with Pansalt® was less effective but preserved the overall flavour. Higher amount of Maillard reaction volatile products, associated with more intense toasted odour of the crust, was found in breads with higher NaCl content. The consumer survey highlighted satisfactory results of Pansalt® use for 58% of the respondents (equal or higher liking and purchase intention). Heterogeneous salt distribution was effective for 31% of consumers.