The impact of the reduction of sodium content in processed foods in salt intake in Brazil

Burden of non-communicable diseases attributable to dietary risks in Brazil, 1990-2019: an analysis of the Global Burden of Disease Study 2019

INTRODUCTION

An unhealthy diet is a modifiable risk factor for non-communicable diseases (NCDs), one of the most important public health problems in Brazil. This study aimed to analyze the burden of NCDs attributable to dietary risks in Brazil between 1990-2019.

METHODS

Secondary data from the Global Burden of Disease Study were used to estimate the burden attributable to fifteen dietary risks in Brazil. The main sources of data for Brazil were national surveys and international databases. A comparative risk assessment was used to obtain the population attributable fraction. We described the intake of each dietary risk and the distribution of number and rates of deaths and Disability-adjusted life years (DALYs) attributable to diet by sex, age, state, and year from 1990-2019.

RESULTS

Cardiovascular diseases, diabetes mellitus, and neoplasms were the main NCDs attributable to an unhealthy diet. Age-standardized mortality and DALYs rates attributable to unhealthy diet decreased between 1990-2019 (-51.5% and -48.8, respectively). Diet high in red meat and sodium, and low in whole grains were the three main risk factors contributing to the burden of NCDs both in 1990 and 2019. The burden of NCDs was higher among males in the middle-aged population (around 50 years), as well as in the states of Maranhão, Rio de Janeiro, and Alagoas.

CONCLUSIONS

The present study found a suboptimum diet among the Brazilian population. The major contributors to this burden were diet high in red meat and sodium and low in whole grains. This study supports priorities in public policies on food and nutrition to reduce the burden of NCDs.

Can Meals Outside Homes Impact Sodium Intake?

BACKGROUND

The WHO currently recommends a daily sodium intake of 2 g and has established the goal of a 30% reduction in mean salt intake by 2025.

OBJECTIVE

We sought to estimate sodium intake in study participants according to the locations of where they consumed meals and their demographic and socioeconomic characteristics and practices related to salt consumption.

METHODS

A population-based, cross-sectional study was conducted with a sample of 2574 individuals aged ≥10 y who answered the 2015 Campinas-Brazil Nutrition Survey. Mean sodium intake was estimated using a 24-h recall log and associations with the independent variables were tested using generalized regression analysis stratified by age group.

RESULTS

Sodium intake was higher in male participants as well as adolescents and adults who reported eating ≥1 meal outside the home (6.07% and 7.06% increase, respectively). Per meal, sodium was consumed more outside the home at breakfast, during an afternoon snack, and at dinner among adolescents. No significant differences were found in the analysis by type of meal among the adults and seniors.

CONCLUSIONS

Sodium intake exceeded the WHO recommendation in all age groups analyzed. Having ≥1 meal outside the home was associated with greater sodium intake among adolescents and adults. Measures to regulate the food industry and dietary/nutritional education strategies targeting consumers are important to reducing the sodium intake of the population.

Analysis of the intake of sodium with cereal products by the population of Poland

The study aimed to analyse the intake of Na with cereal products by the population of Poland. In addition, based on available literature, changes in the content of Na in bread sold in the Polish market from 2009 to 2018 were analysed with regard to Na intake reduction campaigns held in Poland since 2009 popularising information about the adverse effect of sodium on the human cardiovascular system. The results led to the conclusion that the analysed products contained 3.042 ± 3.4 g of Na per 1 kg of fresh product. The content of Na in the analysed products was bread > bread rolls > grains > pasta > rice. Cereal products provide 48.3 % of an adult's intake of Na, where as much as 48.2 % is covered by bread, with only 0.04 % by grains, 0.04 % by pasta, and 0.01 % by rice. According to information available in reference literature from 2009-2017 the content of Na in baked goods has not been subject to significant modifications. In Poland, with regard to an excessive consumption of Na, efficient strategies must be developed to increase the awareness of consumers and to reduce the use of table salt in the most popular products, and in particular in baked goods. One of the ways to reduce the intake of Na would be consumers' selection of an adequate range of foodstuffs naturally poor in this element or having its content reduced by means of a suitable technology. This can be a significant component of practices preventing the development of hypertension. However, the fact that information about the content of Na in cereal products is often missing from product labels makes consumer choice difficult.

Sodium Reduction in Processed Foods in Brazil: Analysis of Food Categories and Voluntary Targets from 2011 to 2017

Non-communicable diseases, including cardiovascular diseases, are responsible for over 70% of deaths in Brazil. Currently, over 25% of Brazilian adults are diagnosed as hypertensive; overall, current dietary sodium intake in Brazil (4700 mg/person) is over twice the international recommendations, and 70-90% of adolescents and adults consume excessive sodium. National sodium reduction strategies consider the main dietary sources of sodium to be added salt to foods, foods consumed outside of the household, and sodium in processed foods. The national voluntary strategy for sodium reduction in priority food categories has been continuously monitored over a 6-year period (2011-2017) and there was a significant 8-34% reduction in the average sodium content of over half food categories. Different food categories have undergone differing reductions in sodium over time, aiding gradual biannual targets to allow industries to develop new technologies and consumers to adapt to foods with less salt. By 2017, most products of all food categories had met the regional targets proposed by the Pan American Health Organization, showing that voluntary sodium reduction strategies can potentially contribute to food reformulation. Nevertheless, regulatory approaches may still be necessary in the future in order to reach all food producers and to allow stronger enforcement to meet more stringent regional targets.