Consumer acceptance of reformulated food products: A systematic review and meta-analysis of salt-reduced foods

Effects of different curing concentrations and drying times on the microbial community structure and metabolites of dried Spanish mackerel

Cured Spanish mackerel has a promising market owing to its nutritious nature as well as ease of transportation and preservation. However, the nutritional and flavor formation mechanism of Spanish mackerel after curing and drying is unclear. To overcome this problem, the effects of different processing conditions on the free amino acid, microbial community, and flavor of Spanish mackerel were explored. Staphylococcus and Cobetia are the main microorganisms in cured mackerel and are closely associated with the formation of their quality. Compared with fresh mackerel, cured mackerel contains increased levels of protein, fat, and chloride, contributing to its distinctive flavor. The contents of free amino acids in the BA64 group were substantially higher than those in other groups, particularly the contents of threonine, glycine, and tyrosine. These findings will contribute to the development of high-quality cured Spanish mackerel products and cured aquatic products.

Knowledge mobilization between the food industry and public health nutrition scientists: findings from a case study

BACKGROUND

Improving the nutritional quality of the food supply increases access to nutritious foods, which improves dietary habits and population health. Yet, knowledge mobilization initiatives between public health nutrition researchers and food industries are often not adequately considered and understood. This study explored what elements related to this specific context need to be recognized so that researchers can better mobilize nutrition science knowledge with the food industry to promote the nutritional improvement of food products.

METHOD

A case study qualitative approach was selected to answer the research question, using semi-structured interviews as the data collection technique. Québec baking industry actors were shown a mock-up of an online mobilization platform sharing the results of the Food Quality Observatory that describes the nutritional quality of breads offered in Québec, Canada. They were asked to think aloud as they explored the web platform and were interviewed. Two coders analyzed the data using an inductive approach and thematic content analysis, starting with individual open coding, and then put forward their analyses and drafted the final themes.

RESULTS

The final data consisted of 10 semi-structured interviews conducted between October 2019 and August 2020. Four main themes were identified: the industry's context, the knowledge mobilization initiative, the product-related matters stemming from the information shared and the motivation within the industry. Within each theme, sub-themes were highlighted and related to the industries' motivation to improve their products' nutritional quality. This study also specified key considerations for changes to the sodium and fiber content in bread.

CONCLUSION

Other steps beyond using simple language and a website format could be taken to better mobilize scientific knowledge with food industries, such as providing more consumer information, using an integrated knowledge mobilization approach that includes a consideration of ethics, working with communication professionals, collaborating with food science experts, and providing resources to act on shared information. Legislation such as the front-of-pack regulations could accelerate the pace of collaboration between researchers and industry. Overall, establishing a prior relationship with industries could help gain a better understanding of the themes highlighted in this study. Future research could build on this case study to provide more insights and solidify these findings.

CLASSIFICATION CODES

Public Health, Public Private, Policy Making, Research Institutions, Use of Knowledge.

Manufacture of Low-Na White Soft Brined Cheese: Effect of NaCl Substitution with a Combination of Na-K Salts on Proximate Composition, Mineral Content, Microstructure, and Sensory Acceptance

All over the world, especially in Western societies, table salt intake that is inordinately higher than the acceptable level has been observed. An excess of Na in the human diet, mostly from processed foods, is becoming the "number one killer", leading to increased blood pressure. Therefore, the food industry is faced with a need to reduce Na in human nutrition in an effort to raise public health protection to a higher level. In this study, a commercially available combination of Na/K salts (COMB) at different concentrations was used as a NaCl substitute in the production of a modified, healthier, Na-reduced cheese. Samples of the modified low-Na white soft-brined cheese (WSBC) were produced by adding four different concentrations of COMB to production lots PL-1 to PL-4, and the control (CON) samples were prepared by salting with the usual, non-reduced concentration of NaCl. The effects of NaCl replacement on the physical-chemical parameters, major- and micro-elements, and microstructural and sensory properties of the WSBC were investigated. The obtained results indicated that there was no significant influence on the ash content, pH, and aw. The Na and K levels differed among treatments (p < 0.001). The lowest Na level in this study was recorded in PL-4 (only COMB was added) and was 334.80 ± 24.60 mg/100 g. According to the Na content, WSBC PL4 can be labeled with the nutrient claim "reduced amount of Na". A significant difference (p < 0.05) was noticed in overall acceptance between the CON and PL-4, with no statistically significant difference found amongst other WSBC production lots. The replacement of NaCl resulted in a slightly greater firmness of the WSBC. The results confirm the possibility of producing low-Na WSBC when optimal amounts of a suitable mineral salt are used as a substitute for NaCl, thus reducing the risk of high Na intake in the human body through the consumption of evaluated cheese.

High-pressure processing enhances saltiness perception and sensory acceptability of raw but not of cooked cured pork loins-leveraging salty and umami taste

The salt (NaCl) content in processed meats must be reduced because of its adverse effects on cardiovascular health. However, reducing salt in meat products typically leads to a lower taste intensity and, thus, consumer acceptability. Industry interventions must reduce salt content while maintaining taste, quality, and consumer acceptability. In this context, high-pressure processing (HPP) has been proposed to enhance saltiness perception, though there are contradictory reports to date. The present work aimed to conduct a targeted experiment to ascertain the influence of HPP (300/600 MPa) and cooking (71°C) on saltiness perception and sensory acceptability of meat products. HPP treatment (300/600 MPa) did enhance those two sensory attributes (approx. +1 on a 9-point hedonic scale) in raw (uncooked) cured pork loins but did not in their cooked counterparts. Further, the partition coefficient of sodium (PNa+), as an estimate of Na+ binding strength to the meat matrix, and the content of umami-taste nucleotides were investigated as potential causes. No effect of cooking (71°C) and HPP (300/600 MPa) could be observed on the PNa+ at equilibrium. However, HPP treatment at 300 MPa increased the inosine-5'-monophosphate (IMP) content in raw cured pork loins. Finally, hypothetical HPP effects on taste-mediating molecular mechanisms are outlined and discussed in light of boosting the sensory perception of raw meat products as a strategy to achieve effective salt reductions while keeping consumer acceptability.

Setting sodium targets for pre-packaged foods in China - an exploratory study

Introduction

Setting sodium targets for pre-packaged food has been a priority strategy for reducing population sodium intake. This study aims to explore the attitudes and considerations of researchers and key stakeholders toward implementing such policy in China.

Methods

An exploratory study comprising a survey and a focus group discussion was conducted among 27 purposively selected participants including 12 researchers, 5 consumers, 4 administrators, 3 industry association representatives and 3 food producers. The survey/discussion covered the key questions considered when developing/promoting sodium targets. Free-text responses were manually classified and summarized using thematic analysis.

Results

Two-thirds of the participants supported target-setting policy. Researchers and administrators were most supportive, and food producers and associations were least supportive. Adapted WHO food categorization framework was well accepted to underpin target-setting to ensure international comparability and applicability for Chinese products. Maximum values were the most agreed target type. The WHO benchmarks were thought to be too ambitious to be feasible given the current food supply in China but can be regarded as long-term goals. Initially, a reduction of sodium content by 20% was mostly accepted to guide the development of maximum targets. Other recommendations included implementing a comprehensive strategy, strengthening research, engaging social resources, establishing a systematic monitoring/incentive system, maintaining a fair competitive environment, and developing a supportive information system. Target-setting policy was acceptable by most stakeholders and should be implemented alongside strategies to reduce discretionary salt use.

Discussion

Our findings provide detailed guidance for the Chinese government when developing a target-setting strategy. The methods and results of this study also provide meaningful references for other countries to set sodium targets for pre-packaged foods and implement other salt reduction strategies simultaneously.

Pertinence of Salt-Related Knowledge and Reported Behaviour on Salt Intake in Adults: A Cross-Sectional Study

The association between salt-related knowledge, attitude, behaviour (KAB) and actual salt consumption in Greek adults is uncertain. This study investigates the correlation between salt intake, gauged by 24-h urinary sodium excretion, with salt-related KAB. It further explores how socio-demographic factors influence these behaviors. Salt consumption was evaluated using a 24-h urinary sodium test, and compared to self-reported KAB data. Knowledge and behavior scores related to salt were computed. An overall cohort-adjusted model examined the relationship between daily salt consumption, knowledge and behavior scores, and certain covariates. Through the stratification by the cohort random effect, two models were established (Cohort I Adults; Cohort II Students) examining the same relationships of the overall cohort model. 463 Greek adults participated. The average salt intake was 9.54 g/day, nearly double the WHO recommendation. Significant differences in knowledge scores were noted based on sex, age, education, and BMI. A trend suggesting lower discretionary salt use with increased salt intake was observed (p = 0.06). However, comprehensive analysis revealed no direct correlation between salt intake and either knowledge (p = 0.562) or behavior scores (p = 0.210). The results emphasize the need for food product reforms by industry stakeholders and accelerated efforts towards reducing salt intake.

Effective and Scalable Interventions to Reduce Sodium Intake: a Systematic Review and Meta-Analysis

PURPOSE OF REVIEW

High-sodium intake is a main risk factor for increased blood pressure and cardiovascular disease, the leading cause of death worldwide. Reducing sodium intake at the population level is one of the most cost-effective strategies to address this. The aim of the present systematic review and meta-analysis are to examine data from recent studies that measure the effectiveness and scalability of interventions aimed at reducing sodium intake at both the population and individual level.

RECENT FINDINGS

Worldwide, sodium intake is higher than the World Health Organization recommendations. Structural interventions such as mandatory reformulation of foods, food labeling, taxes or subsidies, and communication campaigns have shown to be the most effective in reducing the population's sodium consumption. Interventions in education, particularly those that use a social marketing framework with short duration, food reformulation, and combined strategies, have the potential to decrease sodium intake.

Perspective: Challenges and Strategies to Reduce the Sodium Content of Foods by the Food Service Industry

Most Americans have dietary sodium intakes that exceed the recommended limits, which is a risk factor for hypertension and CVD. The share of total food expenditures for foods prepared and consumed away from home (FAFH) is ∼55%. These foods are consumed at various venues, including restaurants, workplaces, schools and universities, military installations, and assisted living/long-term care facilities. The food service industry has dealt with and continues to deal with various challenges in its attempt to reduce the sodium content in the foods that they prepare and sell. Despite these challenges, there have been various successful strategies used to reduce the sodium content in FAFH. This perspective article provides an overview of the challenges and strategies that have been used by the food service industry to reduce sodium in FAFH, as well as future sodium reduction strategies. Because of the widespread consumption of FAFH, implementing such future strategies could have a profound impact on the sodium content of the American diet.

Global nutritional challenges of reformulated food: A review

Food reformulation, the process of redesigning processed food products to make them healthier, is considered a crucial step in the fight against noncommunicable diseases. The reasons for reformulating food vary, with a common focus on reducing the levels of harmful substances, such as fats, sugars, and salts. Although this topic is broad, this review aims to shed light on the current challenges faced in the reformulation of food and to explore different approaches that can be taken to overcome these challenges. The review highlights the perception of consumer risk, the reasons for reformulating food, and the challenges involved. The review also emphasizes the importance of fortifying artisanal food processing and modifying microbial fermentation in order to meet the nutrient requirements of people in developing countries. The literature suggests that while the traditional reductionist approach remains relevant and yields quicker results, the food matrix approach, which involves engineering food microstructure, is a more complex process that may take longer to implement in developing economies. The findings of the review indicate that food reformulation policies are more likely to succeed if the private sector collaborates with or responds to the government regulatory process, and further research is conducted to establish newly developed reformulation concepts from different countries. In conclusion, food reformulation holds great promise in reducing the burden of noncommunicable diseases and improving the health of people around the world.

Increasing saltiness of salts (NaCl) using mid-infrared radiation to reduce the health hazards

Table salt, rock salt, and iodized salts (composed principally of NaCl) are commonly used in many areas, such as medicine, cooking, industry, or personal care. Common fried, salty, and spicy foods contain an excess of added salt, which has detrimental health effects, especially on the kidneys. Our research aims to enhance the inherent saltiness of these three salts, which would reduce intake and thereby minimize salt's health hazards. We invented a water-based 2-6 μm of Mid-Infrared Generating Atomizer (MIRGA), which, when applied to salts, caused changes in the salts' chemistry and enhanced saltiness, thus allowing the reduction of salt intake by 25%-30%. This easy-to-use technology did not show any side effects. MIRGA was found to have enhanced the saltiness, thus allowing the reduction of salt intake by 25%-30%. MIRGA is safe, portable, highly economical, unique in the mid-IR laser technology, and possesses vast research scope in other areas of food science.

Formation of process contaminants in commercial and homemade deep-fried breadcrumbs

Breading is a culinary technique widespread throughout the world. Deep-frying breaded foods forms a palatable crust but also promotes the formation of compounds of toxicological relevance. The influence of the composition of breadcrumbs on the risk associated with the formation of acrylamide, hydroxymethylfurfural (HMF), and furfural was investigated in a deep-fried breadcrumb coating model. Commercial (CBC) and homemade (HBC) wheat-based breadcrumbs were characterized by the reducing sugars and the asparagine content among other parameters (moisture, pH, and CIELab color). The formation of process contaminants in fried breadcrumbs were not influenced by their initial content, but they were affected by the precursors level. The HMF content was significantly higher (1.4 times) in fried HBC (172 mg/kg) than in CBC (120 mg/kg). By contrast, the acrylamide content was 3 times higher in fried CBC (332 µg/kg) than in HBC (111 µg/kg). Multivariate analysis shows that asparagine is the limiting factor for acrylamide formation, and the reducing sugar content is the main determinant for the formation of furanic compounds. A signal value of 463 µg/kg is proposed for the acrylamide content in the coating of deep-fried breaded foods. The reducing sugars and asparagine content in breadcrumb coatings should be considered when designing breaded foods, thereby reducing the formation and consequently the dietary exposure to these potentially harmful compounds.

Eater-oriented knowledge framework for reducing salt and dietary sodium intake (scoping review)

Salt and dietary sodium are ubiquitously present in daily food practices and, at the same time, reducing salt intake presents an important public health issue. Given such an ambivalent position of salt in human diet, we argue that public health guidelines toward dietary sodium reduction require an eater-oriented knowledge framework. In this article we are making the first steps toward a flexible interdisciplinary database which would include nutritional, socio-economic, cultural, material, and socio-psychological determinants of salt consumption for comprehensive public health campaigns. We employ an explorative scoping review of academic articles and reports, limiting our review to the original data on salt or sodium consumption published in English or French between 2000 and 2022. We describe salt consumption as research object, identifying its representation in different research fields, data sources, methodologies, samples, and links with nutritional recommendations. We synthesize existing approaches via four eater-oriented categories: Socio-demographic and cultural descriptors of salt consumers; Knowledge, attitudes, and beliefs on nutritional norms; Salt practices associated with dietary or medical regimes; Salt materialities: interactions and contexts. In each category, we identify the dominant relational features, i.e., what kind of 'eater-salt' relation is being put forward. We thus build an interdisciplinary documentary base of dietary sodium consumption factors. We discuss the results, suggesting that comprehensive nutritional policies for global salt reduction require interdisciplinary eater-oriented data frameworks.

Advancing Health Research Impact through a Systemic Multi-Sectoral Approach: A Protocol for Introducing Reduced-Sodium Salts and Salty Condiments in Vietnam

Better alignment between health research organisations with the needs (and interests) of key stakeholders in the health policy and research system is critical to improving research impact. The George Institute for Global Health's 'Healthier Societies' program focuses on harnessing the power of governments, markets, and communities to improve population level health equity outcomes and maximise research impact. This protocol outlines a systemic multi-sectoral approach to advance health research impact globally applied to a project to reduce population salt intake in Vietnam by introducing reduced-sodium salts and salty condiments. We defined a systemic multi-sectoral approach to be a strategy that involves engaging with government, market and communities in a deliberate and joined-up way to solve a problem in which they all have a role to play. The project objectives are to: (i) produce reduced-sodium fish sauce products and test consumer acceptability; (ii) investigate the market feasibility of introducing reduced-sodium foods (salt, bot canh and fish sauce) into the Vietnamese market; (iii) estimate the cost-effectiveness of three different government strategies to support the implementation of reduced-sodium products; and (iv) develop an advocacy roadmap to maximise potential research impact. Methods will include standard quality and safety assessments, consumer sensory testing for the locally produced reduced-sodium fish sauces, market feasibility assessment (including collating market data and semi-structured interviews with stakeholders), cost-effectiveness modelling (Markov cohort model), multi-sector stakeholder engagement, and the development of a coordinated advocacy strategy using the Kotter Plus framework. Health research organisations are increasingly seeking ways to achieve greater impact with their research. Through the application of a systemic multi-sectoral approach with governments, markets and communities, this protocol provides an example of how health research projects can achieve such impact.

Modeling the health impact of legislation to limit the salt content of bread in Portugal: A macro simulation study

Background

Excessive salt consumption-associated with a range of adverse health outcomes-is very high in Portugal, and bread is the second largest source. Current Portuguese legislation sets a maximum limit of 1.4 g salt per 100 g bread, but imported and traditional breads are exempted. In 2017 the Ministry of Health proposed reducing the salt threshold to 1.0/100 g by 2022, however the legislation was vetoed by the European Commission on free-trade grounds.

Aims

To estimate the health impact of subjecting imported and traditional breads to the current 1.4 g threshold, and to model the potential health impact of implementing the proposed 1.0 g threshold.

Methods

We gathered bread sales, salt consumption, and epidemiological data from robust publicly available data sources. We used the open source WHO PRIME modeling tool to estimate the number of salt-related deaths that would have been averted in 2016 (the latest year for which all data were available) from; (1) Extending the 1.4 g threshold to all types of bread, and (2) Applying the 1.0 g threshold to all bread sold in Portugal. We used Monte Carlo simulations to generate confidence intervals.

Results

Applying the current 1.4 g threshold to imported and traditional bread would have averted 107 deaths in 2016 (95% CI: 43-172). Lowering the current threshold from 1.4 to 1.0 g and applying it to all bread products would reduce daily salt consumption by 3.6 tons per day, saving an estimated 286 lives a year (95% CI: 123-454).

Conclusions

Salt is an important risk factor in Portugal and bread is a major source. Lowering maximum permissible levels and removing exemptions would save lives. The European Commission should revisit its decision on the basis of this new evidence.

Sensory Evaluation of Common Ice Plant (Mesembryanthemum crystallinum L.) in Response to Sodium Chloride Concentration in Hydroponic Nutrient Solution

Common ice plant (Mesembryanthemum crystallinum L.) is a novel edible plant with a succulent and savory flavor. The plants display prominent epidermal bladder cells (EBCs) on the surface of the leaves that store water and sodium chloride (NaCl). The plants have high nutritional value and are adapted to saline soils. Previous research has determined the impact of NaCl on the growth and mineral content of ice plant, but as NaCl has an impact on a food's sensory properties, an interesting question is whether saline growth media can affect the plant's taste and texture, and if this alters consumers' sensory response to ice plant. The objective of this study was to evaluate the sensory aspects of ice plant, as well as consumer liking in response to increasing NaCl concentration in hydroponic nutrient solution. Four-week-old seedlings of ice plant were transplanted into deep water culture (DWC) hydroponic systems and treated with five NaCl concentrations (0 M [control], 0.05 M, 0.10 M, 0.20 M, and 0.40 M NaCl). Eight-week-old plants (after four weeks of NaCl treatment) were harvested, and the middle leaves of each plant were sampled for consumer testing. A total of 115 participants evaluated various flavor, texture, and appearance aspects of ice plant and provided their liking ratings. The consumers were able to discriminate differences in salt intensity from the plants based on NaCl treatment in the hydroponic nutrient solution. Low NaCl concentrations (0.05-0.10 M) did not have obvious adverse effect on consumer liking, which aligns with the result of previous research that 0.05-0.10 M NaCl could largely stimulate the growth of ice plant. NaCl concentrations higher than 0.20 M are not recommended from both a production and consumer perspective. With increased NaCl level in plant samples, the consumers detected more saltiness, sourness, and fishiness, less green flavor, and similar levels of bitterness and sweetness. NaCl treatment had no effects on leaf appearance and texture, and the consumers' overall liking was mainly determined by flavor. Overall, ice plant presents some unique attributes (salty and juicy) compared to other edible salad greens; however, consumer awareness of ice plant is very low, and purchase intent is relatively low as well. Consumers picture ice plant being used mainly in salads and in restaurants.

Obesity, Diabetes Mellitus, and Vascular Impediment as Consequences of Excess Processed Food Consumption

Regular intake of ready-to-eat meals is related to obesity and several noninfectious illnesses, such as cardiovascular diseases, hypertension, diabetes mellitus (DM), and tumors. Processed foods contain high calories and are often enhanced with excess refined sugar, saturated and trans fat, Na⁺ andphosphate-containing taste enhancers, and preservatives. Studies showed that monosodium glutamate (MSG) induces raised echelons of oxidative stress, and excessive hepatic lipogenesis is concomitant to obesity and type 2 diabetes mellitus (T2DM). Likewise, more than standard salt intake adversely affects the cardiovascular system, renal system, and central nervous system (CNS), especially the brain. Globally, excessive utilization of phosphate-containing preservatives and additives contributes unswervingly to excessive phosphate intake through food. In addition, communities and even health experts, including medical doctors, are not well-informed about the adverse effects of phosphate preservatives on human health. Dietary phosphate excess often leads to phosphate toxicity, ultimately potentiating kidney disease development. The mechanisms involved in phosphate-related adverse effects are not explainable. Study reports suggested that high blood level of phosphate causes vascular ossification through the deposition of Ca²⁺ and substantially alters fibroblast growth factor-23 (FGF23) and calcitriol.

Sodium Content in Cereal-Based Products Sold in Italy: How Far Are We from the Global Benchmarks?

Reformulation of food products is one of the measures needed for reducing salt consumption. Accordingly, the World Health Organization (WHO) recently proposed global sodium benchmarks for different food categories to be used for setting national policies. Therefore, the sodium content of cereal-based products currently sold in Italy was compared with the WHO benchmarks, highlighting those categories primarily needing a reformulation. To this aim, the sodium content and several declarations (i.e., nutrition and health claims, organic or gluten free declaration) were retrieved from 2917 cereal-based products sold on the Italian market. All “minimally processed breakfast cereals” had a sodium content below the benchmark, while “flatbreads” and “leavened bread” had the highest percentage of items above the respective sodium benchmarks. Flatbreads and “crackers/savory biscuits” showed the highest median delta values from the respective benchmarks of 360 and 278 mg/100 g, respectively. Large variability in terms of percentage of products with sodium content above the benchmark was observed within the same categories, as well as among products with different declarations. A large number of food products currently sold on the Italian market have a sodium content above the benchmark. This result suggests the need to reformulate many food products currently on the market to achieve the WHO/United Nations (UN) objective of 30% global reduction in sodium intake by 2025.

Sodium in the New Zealand diet: proposed voluntary food reformulation targets will not meet the WHO goal of a 30% reduction in total sodium intake

PURPOSE

To simulate the potential impact of the HeartSAFE 2020 programme, a food reformulation initiative by the New Zealand (NZ) Heart Foundation, on sodium intake in the NZ adult population.

METHODS

A representative sample of NZ adults aged 15 years and older completed a 24-h diet recall survey, with 25% of participants completing a second diet recall, in the 2008/09 New Zealand Adult Nutrition Survey (n = 4721). These data were used to estimate sodium intakes of participants. The effect of altering the sodium content of 840 foods in 17 categories and 35 sub-categories included in the NZ HeartSAFE 2020 programme was simulated. The simulated sodium intake reductions in each food sub-category for the entire sample were calculated. Using sampling weights, simulated reductions in population sodium intake and by sociodemographic subgroups were also analysed.

RESULTS

Sodium intake from foods included in the HeartSAFE 2020 programme was 1307 mg/day (95% CI 1279, 1336) at baseline. After applying the HeartSAFE 2020 targets, potential sodium intake was 1048 mg/day (95% CI 1024, 1027). The absolute sodium reduction was 260 mg/day (95% CI 252, 268), corresponding to 20% sodium reduction for the foods included in the NZ HeartSAFE programme.

CONCLUSION

Current sodium targets featured in the NZ HeartSAFE programme will not meet the 30% sodium intake reduction set out by the WHO Global Action Plan. A more comprehensive strategy consistent with the WHO SHAKE Technical Package is needed to advance the goal of sodium intake reduction.

Compendium of sodium reduction strategies in foods: A scoping review

In response to health concerns generated by increased sodium intake, many new approaches have been studied to reduce the sodium content in processed food. It has been suggested that reducing sodium in the food supply may be the most appropriate solution. The aim of this scoping review was to establish what sodium reduction strategies are effective in maintaining acceptable sensory qualities for various food industry applications. Studies that evaluate and report on the effectiveness of a sodium reduction strategy relevant to food and included outcomes detailing how the strategies were received by human subjects using sensory data are included, as well as book chapters, literature reviews, and patents focusing on sodium reduction strategies. Only those published in English and since 1970 were included. Literature was obtained through Scopus, PubMed, EBSCOhost, and ScienceDirect databases, whereas patents were obtained through US Patent Trademark Office, Google Patents, and PATENTSCOPE databases. Two-hundred and seventy-seven primary studies, 27 literature reviews, 10 book chapters, and 143 patents were selected for inclusion. Data extracted included details such as analytical methods, broad and specific treatment categories, significant outcomes, and limitations among other material. Sodium reduction methods were categorized as either salt removal, salt replacement, flavor modification, functional modification, or physical modification. Although salt removal and salt replacement were the majority of included studies, future research would benefit from combining methods from other categories while investigating the impact on sensory characteristics, technological aspects, and consumer perception of the strategy.

Levels of Salt Reduction in Bread, Acceptability and Purchase Intention by Urban Mozambican Consumers

Excess sodium (Na) consumption is implicated in several health problems, particularly hypertension, and bread is an important dietary source. We aimed to analyze perception of salt, acceptability, and purchase intention of low-salt and unsalted white bread by consumers in Mozambique. Sensory evaluation was performed using a triangular test (N = 42) to perceive if differences in saltiness were detected when comparing low-salt and unsalted with salt-reduced white bread. Nine-point hedonic and five-point purchase intention scales were used to measure acceptability and purchase intention, respectively (N = 120). Difference in saltiness was not detected when fresh white bread with 282 mg Na/100 g vs. 231 mg Na/100 g and 279 mg Na/100 g vs. 123 mg Na/100 g were compared. Difference in saltiness was not detected when comparing unsalted vs. 64 mg Na/100 g, while differences were detected when unsalted vs. 105 mg Na/100 g and unsalted vs. 277 mg Na/100 g were compared. Overall acceptability and purchase intention were not affected by reductions of Na in bread. A reduction of up to more than 50% of Na was not perceived and a small level of Na was not distinguished from unsalted bread. Consumers were shown to accept and be willing to buy both unsalted and salt-reduced bread, suggesting that Na can be reduced from current levels.

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.

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.

Cross-sectional comparisons of sodium content in processed meat and fish products among five countries: potential for feasible targets and reformulation

INTRODUCTION

Reducing sodium intake has been identified as a highly cost-effective strategy to prevent and control high blood pressure and reduce cardiovascular mortality. This study aims to compare the sodium content in processed meat and fish products among five countries, which will contribute to the evidence-base for feasible strategies of sodium reduction in such products.

METHODS

Sodium content on product labels of 26 500 prepackaged products, 19 601 meat and 6899 fish, was collected in supermarkets from five countries using the FoodSwitch mobile application from 2012 to 2018. To be specific, it was 1898 products in China, 885 in the UK, 5673 in Australia, 946 in South Africa and 17 098 in the USA. Cross-sectional comparisons of sodium levels and proportions meeting 2017 UK sodium reduction targets were conducted using Kruskal-Wallis H and the χ² test, respectively across the five countries.

RESULTS

The results showed that processed meat and fish products combined in China had the highest sodium level (median 1050 mg/100 g, IQR: 774-1473), followed by the USA, South Africa, Australia, with the lowest levels found in UK (432 mg/100 g, IQR: 236-786) (p<0.001). Similar variations, that is, a twofold to threefold difference of sodium content between the highest and the lowest countries were found among processed meat and fish products separately. Large sodium content variations were also found in certain specific food subcategories across the five countries, as well as across different food subcategories within each country.

CONCLUSION

Processed meat and fish products differ greatly in sodium content across different countries and across different food subcategories. This indicates great potential for food producers to reformulate the products in sodium content, as well as for consumers to select less salted food.

Breakfast Cereals Intended for Children: Opportunities for Reformulation and Potential Impact on Nutrient Intake

Ready-to-eat cereals (RTECs) have become a popular breakfast option claiming to provide important nutrients to children's diets, despite being a source of excess sugar and, therefore, a health concern. Thus, food reformulation constitutes an important public health strategy that could benefit from inputs provided by nutrient profiling. This study aimed to assess the adequacy of the RTECs for children available in Portuguese supermarkets, applying three nutrient profile models (NPMs)-the nutrient profile model of the World Health Organization's Regional Office for Europe (WHO-EURO), the profile of the private-sector EU Pledge (EU-Pledge), and the national model developed by the Directorate-General of Health (NPM-PT)-in order to explore the potential for reformulation of the RTECs identified as not adequate and evaluate the impact of RTECs' reformulation on the nutritional quality of Portuguese children's diets. In total, 78 RTECs intended for children were assessed and two scenarios-current (not considering reformulation) and alternative (considering reformulation to accomplish the nutrient profile requirements)-were considered to assess the impact of reformulation on nutritional quality. Across all RTECs, only 5.1% could be promoted to children according to the considered NPMs. The most common nutrients requiring reformulation were sugar, saturated fatty acids (SFA), salt, and dietary fiber. The scenarios of reformulation considered could reduce the RTECs average content of total sugars, SFA, and salt by 43%, 8.7%, and 1.1%, respectively, and dietary fiber intake could be increased by 34%. Thus, these results support policies to implement reformulation strategies for developing healthier food products to be promoted to children.

Dietary Modelling to Explore the Impact of Potassium Chloride Replacement for Sodium in Bread for Adults with Chronic Kidney Disease

Food manufacturers are increasingly substituting potassium chloride (KCl) in food products so as to reduce the sodium chloride content. Bread and bread products are common staple foods in many Western households and are a target for recipe reformulation using KCl. Given that chronic kidney disease (CKD) is a medical condition of global importance that requires dietary potassium restriction in the later stages, we sought to evaluate the impact and safety of varying levels of KCl substitution in bread products. We undertook a secondary analysis of dietary data from the National Nutrition and Physical Activity Survey 2011–2012 for 12,152 participants (154 participants with CKD). The sodium chloride content in bread and bread-based products was substituted with 20%, 30%, and 40% of KCl. The contribution of these alterations in the dietary potassium intake to the total daily potassium intake were then examined. The replacement of sodium in bread with varying amounts of KCl (20%, 30%, and 40%) resulted in one third of people with CKD exceeding the safe limits for dietary potassium consumption (31.8%, 32.6%, and 33%, respectively). KCl substitution in staple foods such as bread and bread products have serious and potentially fatal consequences for people who need to restrict dietary potassium. Improved food labelling is required for consumers to avoid excessive consumption.

Prevalence and concentration of fumonisins in cereal-based foods: a global systematic review and meta-analysis study

Cereal-based foods are utilized as an essential food segment worldwide. Nevertheless, their contamination by mycotoxins, also fumonisins, could pose a critical health risk. The present research provides the first systematic review regarding the prevalence and concentration of fumonisins in cereal-based food with the aid of a meta-analysis. In this regard, some international databases PubMed, Web of Science, Google Scholar, and Scopus were explored during the last 30 years. Among 9729 screened articles, 73 articles (which meet the proposed inclusion criteria), including 11,132 data, were incorporated in the performed meta-analysis. The overall rank order regarding the concentration of fumonisins in cereal-based foods was corn-based foods > wheat-based foods > other cereal foods > barley-based foods > rice-based foods > oat-based foods. Based on the prevalence of fumonisins, the overall rank order was other cereal foods > corn-based foods > rice-based foods > wheat-based foods > oat-based foods > barley-based food. The present meta-analysis results can be a beneficial database for risk assessment model progress, which can help industries and organizations decrease the presence of fumonisins in cereal-based food.

Protein-saliva interactions: a systematic review

Food industries are challenged to reformulate foods and beverages with higher protein contents to lower fat and sugar content. However, increasing protein concentration can reduce sensory acceptability due to astringency perception. Since the properties of food-saliva mixtures govern mouthfeel perception, understanding how saliva and protein interact is key to guide development of future protein-rich reformulations with optimal sensory attributes. Hence, this systematic review investigated protein-saliva interaction using both model and real human saliva, including a quality assessment. A literature search of five databases (Medline, Pubmed, Embase, Scopus and Web of Science) was undertaken covering the last 20 years, yielding 36 604 articles. Using pre-defined criteria, this was reduced to a set of 33 articles with bulk protein solutions (n = 17), protein-stabilized emulsions (n = 13) and protein-rich food systems (n = 4). Interaction of dairy proteins, lysozyme and gelatine with model or human saliva dominated the literature. The pH was shown to have a strong effect on electrostatic interaction of proteins with negatively-charged salivary mucins, with greater interactions occurring below the isoelectric point of proteins. The effect of protein concentration was unclear due to the limited range of concentrations being studied. Most studies employed a 1 : 1 w/w protein : saliva ratio, which is not representative of true oral conditions. The interaction between protein and saliva appears to affect mouthfeel through aggregation and increased friction. The searches identified a gap in research on plant proteins. Accurate simulation of in vivo oral conditions should clarify understanding of protein-saliva interaction and its influence on sensory perception.

Salt and Aroma Compound Distributions Influence Flavour Release and Temporal Perception While Eating Hot-Served Flans

To counteract the negative effect of salt overconsumption on health, strategies have been developed to reduce the salt content in food products. Among them, two promising strategies based on odour-induced saltiness enhancement and the heterogeneous distribution of flavour compounds were combined and assessed in four-layer cream-based snacks. To investigate the relationship between saltiness enhancement, temporal release and perception of flavour compounds in hot snacks with heterogeneous distribution of salt and aroma compounds, complementary techniques were used: nose space PTR-Tof-MS (Proton Transfer Reaction-Time of Flight–Mass Spectrometry) to assess the release of aroma compounds in vivo, and ATI (Alternate Time-Intensity) and TDS Temporal Dominance of Sensations) to evaluate perception as a function of time. The obtained results confirmed that the strategy of concentrating salt in the outer layer of a multilayer product was the optimal solution with respect to taste intensity. Heterogeneous salt distribution decreased aroma compound release and consequently aroma intensity but in different ways according to both salt and added aroma distribution in the food matrix. The salty taste enhancement could be due to the initial strong dominance of the salty sensation at the very beginning of the eating process. The involved mechanisms rely on a combination of physico-chemical and perceptual effects which are not clear yet.

A Successful Pilot Experiment of Salt Reduction in Tunisian Bread: 35% Gradual Decrease of Salt Content without Detection by Consumers

As bread is the most consumed food by the Tunisian population and the major source of salt, a pilot experiment of salt reduction in bread was begun in Bizerte city. Salt analysis in bread collected from Bizerte city was done with the Volhard titration method. A one-way Anova test was carried out to assess salt content changes over time. Application of the salt reduction programme allowed a gradual decrease of salt content in bread by 35% during three years without detection by Tunisian consumers. The salt concentration in bread was then reduced from 1.7 ± 0.2 g/100 g to 1.1 ± 0.1 g/100 g (p < 0.0001). The establishment of an effective salt reduction strategy with lifestyle education is needed to reduce hypertension, which is the primary cause of death in Tunisia.

Evaluating the Antifungal Activity of α-Bisabolol in Association with NaCl on Fusarium oxysporum in Maize Grains

Fusarium infections result in reduced maize grain (Zea mays L.) yields and notable impacts on human and animal health. Research involving natural products to control fungi in food is a promising alternative. Combinations of α-bisabolol (AB) and sodium chloride (NaCl) may suggest the use of lower effective concentrations of the drugs. This study aimed to evaluate the antifungal potential of AB associated with NaCl against Fusarium oxysporum strains isolated from maize. Minimum inhibitory concentrations (MICs) values of AB and NaCl were determined by microdilution, and an association study was performed (checkerboard). Effects on fungal mycelial growth (poisoned substrate technique) and a maize grain contamination model were analyzed. AB presented MIC values ranging from 128 and 1024 μg/mL; NaCl inhibited fungal growth at 16,384 μg/mL. The AB/NaCl association study revealed synergism by decreasing inhibitory concentrations by eight times. In corn kernels, AB and NaCl, whether isolated (at MIC) or in association (at sub-inhibitory concentrations), significantly inhibited in vitro mycelial growth (P < 0.05). Further analysis of liquid from a canned maize sample also revealed the fungistatic effects of the compounds associations (P < 0.05). The results confirm the antifungal potential of AB, whether isolated or in association with NaCl to control F. oxysporum in maize.

Hedonic thresholds and ideal sodium content reduction of bread loaves

Global public policies have advocated strategies for reducing sodium consumption due to the high incidence of non-communicable chronic diseases (NCDs) worldwide. The objectives of this study were to identify the bread loaves sodium content considered as ideal by the consumers and determine hedonic thresholds. In this descriptive cross-sectional study, 114 consumers evaluated the ideal sodium content in bread loaves by the Just About Right (JAR) test, (first sensorial stage) studying four decreased levels of sodium (10%, 20%, 30%, 40%) from the mean values observed from bread in 11 food composition tables from various regions of the world, and Brazil. This ideal sodium content was used as the control in pairwise acceptance tests with five other reduced-sodium samples of bread loaves (10%, 30%, 50%, 70%, 100% of reduction from the control), and hedonic threshold tests were performed with 156 consumers (a second stage sensorial test of five sessions). The data from the JAR were analyzed by a regression analysis graph and correlated with the consumption of salt and family income range by a Principal Component Analysis with a 5% significance level. In the Hedonic Threshold tests, each paired session was analyzed by Student's t-test (test t), and an adjusted regression graph was built. The Compromised Acceptance Threshold (CAT) was performed, where the calculated t corresponded to the tabulated t. In the Hedonic Rejection Threshold (HRT), the hedonic scale five ("indifferent" term) was considered. The average sodium content of bread marketed in different regions of the world was 457 mg Na/100 g of bread, and the ideal sodium content observed was 395 mg Na/100 g of bread. The gender, age and income family rates as well as attitudes and knowledge regarding the salt consumption of the trial consumers were not directly related to the evaluations of the bread loaves in the JAR test, according to the Principal Components Analysis at p ≤ 0.05. From this ideal content, a 42% reduction was possible according to the CAT test (267 mg Na/100 g of bread), and more reductions were acceptable until an 85% (to 58 mg Na/100 g of bread) reduction, as the samples began to be rejected according to HRT test. These findings demonstrated that this methodology can be applied to sodium reduction product formulations and bread as a food matrix. With this kind of methodology, it is possible to provide to the bakery industry a methodology to know a safe region to work on food reformulations and subsidize the formulation of new products without compromising consumer acceptability, in addition to meeting the demand for safer food.

Building a Resilient, Sustainable, and Healthier Food Supply Through Innovation and Technology

The modern food supply faces many challenges. The global population continues to grow and people are becoming wealthier, so the food production system must respond by creating enough high-quality food to feed everyone with minimal damage to our environment. The number of people suffering or dying from diet-related chronic diseases, such as obesity, diabetes, heart disease, stroke, and cancer, continues to rise, which is partly linked to overconsumption of highly processed foods, especially high-calorie or rapidly digestible foods. After falling for many years, the number of people suffering from starvation or malnutrition is rising, and thishas been exacerbated by the global COVID-19 pandemic. The highly integrated food supply chains that spread around the world are susceptible to disruptions due to policy changes, economic stresses, and natural disasters, as highlighted by the recent pandemic. In this perspective article, written by members of the Editorial Committee of the Annual Review of Food Science and Technology, we highlight some of the major challenges confronting the modern food supply chain as well as how innovations in policy and technology can be used to address them. Pertinent technological innovations include robotics, machine learning, artificial intelligence, advanced diagnostics, nanotechnology, biotechnology, gene editing, vertical farming, and soft matter physics. Many of these technologies are already being employed across the food chain by farmers, distributors, manufacturers, and consumers to improve the quality, nutrition, safety, and sustainability of the food supply. These innovations are required to stimulate the development and implementation of new technologies to ensure a more equitable, resilient, and efficient food production system. Where appropriate, these technologies should be carefully tested before widespread implementation so that proper risk-benefit analyses can be carried out. They can then be employed without causing unforeseen adverse consequences. Finally, it is important to actively engage all stakeholders involved in the food supply chain throughout the development and testing of these new technologies to support their adoption if proven safe and effective.

Implementing the national strategy of salt reduction in Morocco: the baker´s perspective

Introduction

Morocco launched a national salt reduction strategy in 2019. The commitment of bakeries is key in the success of this strategy. However, the evaluation of such a commitment is not yet done. This study aims to examine knowledge of bakers about the national strategy of salt reduction and evaluate their commitment in implementing the specific recommendation related to salt reduction in bread.

Methods

a quantitative exploratory study targeted bakeries (N=432) from all the administrative regions of Morocco. Data was collected using a questionnaire composed of three sections: knowledge of bakers related to national strategy of salt, current contribution of bakers in implementing the national strategy and future commitment towards implementing the national strategy.

Results

about 73% (n=317) bakers lack of knowledge about the recommendations on the progressive reduction of the salt content in bread. Radio and TV were the most used sources to obtain information by bakers (45.2% (n=52) and 35.6% (n=41) respectively). None of the bakers was informed about the process of gradual reduction of salt content in bread, and none of them was committed to it. A total of 60.32% (n=252) of bakeries do not respect the national recommendations of 10g of salt/Kg of flour while 89.6% (n=387) of bakers express their interest in getting committed to the process in the next 2 years.

Conclusion

increasing the knowledge of bakers is highly recommended to guarantee their commitment toward contributing to the strategy of reducing salt in bread. Dissemination of messages via TV and radio could be appropriate.

Pig feedstuff effect on the physicochemical and sensory properties of low-salt, dry-fermented sausages

This study investigates the effect of the addition of plant-derived extracts (control, garlic extract or a combination of carvacrol, thymol, cinnamic aldehyde and eugenol oils extracts) to pig feedstuff and the reduction in salt content (NaCl or a mixture 60:40 sodium chloride:potassium lactate) on some physicochemical characteristics and consumer acceptability of dry-fermented sausages. Six different batches were formulated. The pH, color, lipid oxidation, and microbial counts were measured, and a consumer home test was performed. Both the use of a plant-derived extract and salt type affected the dry-fermented sausage characteristics. The low-salt batches presented a lower pH and higher microbial counts than the control. The salt reduction affected the color but only in the oil batches, resulting in higher L* and lower a* values. The oil batches presented the highest TBAR values (>1 mg/kg), suggesting that antioxidant compounds present into the meat were not bioavailable on the sausages or were missed during the curing process. The use of plant-derived extracts affected to consumer acceptability, whereas salt replacement did not. Oil batches scored lower than the other. From the current results, the oil extract would not be a recommended additive in pig feedstuff, especially when a low-salt strategy will be employed.

Policy Progress in Reducing Sodium in the American Diet, 2010–2019

Most Americans consume dietary sodium exceeding age-specific government-recommended targets of 1,500–2,300 mg/day per person. The majority (71%) of US dietary sodium comes from restaurant and packaged foods. Excess sodium intake contributes to hypertension and cardiovascular disease, which is the leading cause of death in the United States. This review summarizes evidence for policy progress to reduce sodium in the US food supply and the American diet. We provide a historical overview of US sodium-reduction policy (1969–2010), then examine progress toward implementing the 2010 National Academy of Medicine (NAM) sodium report's recommendations (2010–2019). Results suggest that the US Food and Drug Administration made no progress in setting mandatory sodium-reduction standards, industry made some progress in meeting voluntary targets, and other stakeholders made some progress on sodium-reduction actions. Insights from countries that have significantly reduced population sodium intake offer strategies to accelerate US progress toward implementing the NAM sodium-reduction recommendations in the future.

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.

A Systematic Review of the Sources of Dietary Salt Around the World

Excess salt intake contributes to hypertension and increased cardiovascular disease risk. Efforts to implement effective salt-reduction strategies require accurate data on the sources of salt consumption. We therefore performed a systematic review to identify the sources of dietary salt around the world. We systematically searched peer-reviewed and gray literature databases for studies that quantified discretionary (salt added during cooking or at the table) and nondiscretionary sources of salt and those that provided information about the food groups contributing to dietary salt intake. Exploratory linear regression analysis was also conducted to assess whether the proportion of discretionary salt intake is related to the gross domestic product (GDP) per capita of a country. We identified 80 studies conducted in 34 countries between 1975 and 2018. The majority (n = 44, 55%) collected data on dietary salt sources within the past 10 y and were deemed to have a low or moderate risk of bias (n = 75, 94%). Thirty-two (40%) studies were judged to be nationally representative. Populations in Brazil, China, Costa Rica, Guatemala, India, Japan, Mozambique, and Romania received more than half of their daily salt intake from discretionary sources. A significant inverse correlation between discretionary salt intake and a country's per capita GDP was observed (P < 0.0001), such that for every $10,000 increase in per capita GDP, the amount of salt obtained from discretionary sources was lower by 8.7% (95% CI: 5.1%, 12%). Bread products, cereal and grains, meat products, and dairy products were the major contributors to dietary salt intake in most populations. There is marked variation in discretionary salt use around the world that is highly correlated with the level of economic development. Our findings have important implications for the type of salt-reduction strategy likely to be effective in a country.

The Macronutrient Content of Sodium-Modified Foods Is Unchanged Compared with Regular Counterparts: An Evaluation of Select Categories of Packaged Foods in the United States, 2018

BACKGROUND

Lowering excess sodium in packaged foods is part of a public health strategy to reduce cardiovascular disease risk. Sales of foods with labeled sodium claims increased during the past decade. Yet, it is unclear whether sugars or fats were added during the reformulation of foods that might counter the benefits of sodium reduction.

OBJECTIVE

It was hypothesized that the nutrient content of packaged foods with lower sodium label claims (ie, sodium-modified) would differ from their regular (ie, unmodified) counterparts.

DESIGN

This cross-sectional study compared label data of 153 sodium-modified foods and 141 regular, matched counterparts within four food categories: soups, processed meats, vegetables, and savory snacks. Foods were identified by searching manufacturer websites of the top-10 brands in each category. Sodium, calories, total carbohydrate, sugar, protein, total fat, saturated fat, and potassium (when reported) were compared by labeled serving and per 100 g food.

RESULTS

The average amount in milligrams of sodium per serving in regular foods ranged from 162 mg for savory snacks to 782 mg for soups. Compared with regular foods, the matched lower sodium foods had significantly less sodium per serving (-95 to -387 mg) and per 100 g (-184 to -462 mg) (P<0.01 for all comparisons), except for soups per 100 g (P = 0.166), and were similar to their regular counterparts in calories, total carbohydrate, sugar, protein, total fat, and saturated fat (P>0.05 for all comparisons). Of the soups that reported potassium on the label, potassium was 244 mg/serving (P=0.004) and 139 mg/100 g (P=0.002) higher among matched lower sodium soups.

CONCLUSIONS

The similarity in macronutrient contents on the labels for sodium-modified foods and their regular counterparts suggests that reformulation did not include the addition of significant amounts of sugars, fats, or other macronutrients among major food brands in the selected categories. Potassium content and additional food categories deserve further investigation.

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.

Future foods: a manifesto for research priorities in structural design of foods

A number of major challenges facing modern society are related to the food supply. As the global population grows, it will be critical to feed everyone without damaging the environment. Advances in biotechnology, nanotechnology, structural design, and artificial intelligence are providing farmers and food manufacturers will new tools to address these problems. More and more people are migrating from rural to urban environments, leading to a change in their dietary habits, especially increasing consumption of animal-based products and highly-processed foods. Animal-based foods lead to more greenhouse gas production, land use, water use, and pollution than plant-based ones. Moreover, many animal-based and highly-processed foods have adverse effects on human health and wellbeing. Consumers are therefore being encouraged to consume more plant-based foods, such as fruits, vegetables, cereals, and legumes. Many people, however, do not have the time, money, or inclination to prepare foods from fresh produce. Consequently, there is a need for the food industry to create a new generation of processed foods that are desirable, tasty, inexpensive, and convenient, but that are also healthy and sustainable. This article highlights some of the main food-related challenges faced by modern society and how scientists are developing innovative technologies to address them.