Sodium in Store and Restaurant Food Environments - Guam, 2015

Availability and Price of Low-Sodium Condiments and Instant Noodles in the Bangkok Metropolitan Region

INTRODUCTION

Excess sodium consumption can cause hypertension. One component of Thailand's 5-part strategy to reduce sodium intake is reform of the food environment to increase access to low-sodium foods. Our research aimed to describe the availability and price of low-sodium food products in retail stores in the Bangkok Metropolitan Region.

METHODS

In June and July 2021, we used multistage cluster sampling to conduct a cross-sectional study of the availability of low-sodium foods. Availability referred to a retail store offering at least 1 version of low-sodium condiment or instant noodles. We applied the Thai Healthier Choice criteria and World Health Organization (WHO) global benchmark as the low-sodium criteria for these products. We surveyed 248 retail stores in 30 communities in 6 districts in the Bangkok Metropolitan Region. We observed store shelf availability and price by using a survey form and used the Fisher exact test and independent t test to compare availability and price by sodium content and store size.

RESULTS

All subcategories of low-sodium condiments, except black soy sauce in small stores, were less available than regular-sodium condiments. The proportional difference ranged from 11.3% to 90.6% (P < .001). We found no difference in the 4 condiment subcategories, including fish sauce, thin soy sauce, seasoning sauce, and oyster sauce in large stores. Low-sodium versions of instant noodles were unavailable in either large or small stores. The price of low-sodium condiments was 2 to 3 times higher than that of regular-sodium condiments (P < .05).

CONCLUSION

Low-sodium food options are not generally available in the Bangkok Metropolitan Region, and access to them is inequitable because of pricing. Instant noodles, a popular food, were unavailable in low-sodium versions. Their reformulation should be promoted. Government subsidies of the price of commonly used low-sodium condiments could increase their use and reduce sodium consumption overall.

Receiving advice from a health professional and action taken to reduce dietary sodium intake among adults

OBJECTIVE

Population reductions in Na intake could prevent hypertension, and current guidelines recommend that clinicians advise patients to reduce intake. This study aimed to estimate the prevalence of taking action and receiving advice from a health professional to reduce Na intake in ten US jurisdictions, including the first-ever data in New York state and Guam.

DESIGN

Weighted prevalence and 95 % CI overall and by location, demographic group, health status and receipt of provider advice using self-reported data from the 2017 Behavioral Risk Factor Surveillance System optional Na module.

SETTING

Seven states, the District of Columbia, Puerto Rico and Guam.

PARTICIPANTS

Adults aged ≥ 18 years.

RESULTS

Overall, 53·6 % (95 % CI 52·7, 54·5) of adults reported taking action to reduce Na intake, including 54·8 % (95 % CI 52·8, 56·7) in New York and 61·2 % (95 % CI 57·6, 64·7) in Guam. Prevalence varied by demographic and health characteristic and was higher among adults who reported having hypertension (72·5 %; 95 % CI 71·2, 73·7) v. those who did not report having hypertension (43·9 %; 95 % CI 42·7, 45·0). Among those who reported receiving Na reduction advice from a health professional, 82·6 % (95 % CI 81·3, 83·9) reported action v. 44·4 % (95 % CI 43·4, 45·5) among those who did not receive advice. However, only 24·0 % (95 % CI 23·3, 24·7) of adults reported receiving advice from a health professional to reduce Na intake.

CONCLUSIONS

The majority of adults report taking action to reduce Na intake. Results highlight an opportunity to increase Na reduction advice from health professionals during clinical visits to better align with existing guidelines.

The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review

Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review is to synthesize information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries. A structured literature search in two major international databases yielded 139 relevant peer-reviewed articles from nine countries. Most research was conducted in Oceania and North America, and in rural and remote regions. Several convergent issues were identified across global regions including limited grocery store availability/access, heightened exposure to unhealthy food environments, inadequate market food supplies (i.e., high prices, limited availability, and poor quality), and common underlying structural factors including socio-economic inequality and colonialism. A list of actions that can modify the nature and structure of retailing systems to enhance the availability, accessibility, and quality of healthful foods is identified. While continuing to (re)align research with community priorities, international collaboration may foster enhanced opportunities to strengthen the evidence base for policy and practice and contribute to the amelioration of diet quality and health at the population level.

Para I Famagu'on-Ta: Fruit and Vegetable Intake, Food Store Environment, and Childhood Overweight/Obesity in the Children's Healthy Living Program on Guam

This cross-sectional study examined the: (1) association between food store environment (FSE), fruit and vegetable (FV) availability and access, and prevalence of early childhood overweight/obesity (COWOB); and (2) influence of young child actual FV intake on the relationship between the FSE and early COWOB prevalence. Anthropometric and socio-demographic data of children (2 to 8 years; N=466) in baseline communities on Guam participating in the Children's Healthy Living (CHL) Program community trial were included. CDC year 2000 growth charts were used to calculate BMI z-scores and categories. FSE factors (fresh FV scores, store type) were assessed using the CX3 Food Availability and Marketing Survey amended for CHL. ArcGIS maps were constructed with geographic coordinates of participant residences and food stores to calculate food store scores within 1 mile of participant's residences. A sub-sample of participants (n = 355) had Food and Activity Log data to calculate FV and energy intakes. Bivariate correlations and logistic regression evaluated associations. Of 111 stores surveyed, 73% were small markets, 16% were convenience stores, and 11% were large grocery/supermarkets. Supermarkets/large grocery stores averaged the highest FV scores. Most participants did not meet FV intake recommendations while nearly half exceeded energy intake recommendations. Living near a small market was negatively correlated with BMI z-score (r = - 0.129, P < .05) while living near a convenience store was positively correlated with BMI z-score (r = 0.092, P < .05). Logistic regression analysis yielded non-significant associations. The high density of small markets may be an opportunity for FSE intervention but further investigation of Guam's FSE influence on health is needed.