Infants' and Children's Salt Taste Perception and Liking: A Review

Encouraging online consumers into making better food choices: The power of nature exposure on healthy food choices

BACKGROUND

online environments can influence food desire and choices. We tested if online calming nature and stressful street environments can affect desire for healthy and unhealthy foods.

METHOD

we asked 238 participants (40 ± 14 yrs) to rate their desire (100 mm VAS) for 7 low calorie nutrient rich foods (Healthy) and 7 high calorie nutrient poor foods (Unhealthy), and perceived stress (state anxiety in STAI), before and after imagining themselves in a control, nature park, or busy street condition.

RESULTS

participants who imagined themselves being in a nature park had a significant higher desire for Healthy foods, than participants in the busy street condition (p < 0.05). Participants in the busy street condition decreased their desire for Healthy foods after they imagined themselves in a busy street (p < 0.05)). However, perceived stress did not impact the association between condition and desire for low calorie foods nor high calorie foods.

CONCLUSION

this study suggests that online environments can have an impact on healthy food desires, which could be of importance for the increased number of food choices which are made in online environments.

Salt Intake of Children and Adolescents: Influence of Socio-Environmental Factors and School Education

(1) Background: The aim of this study was to investigate the salt consumption by children and adolescents from the Silesian Province (Poland), taking into account the region's dietary traditions and the age of the students+. (2) Methods: 300 students aged 10-18 from different types of schools were enrolled in the study and divided into groups in terms of school, sex, and the state of their nutrition. A survey questionnaire about dietary habits, including the frequency and serving size with respect to 12 salty products, was used. On the basis of the frequency and the amount of consumed products, as well as the data on salt content, the amount of total daily intake of salt was estimated. (3) Results: The mean daily intake of salt by children and adolescents was 1.083 g (0.433 g of sodium); children aged 10-12 consumed the highest amount of salt (1.296 g/day) compared to pupils aged 13-15 (1.131 g of sodium) and adolescents aged 16-18 (0.863 g/day). (4) Conclusions: With age, as a result of various factors, the consumption of salt declines. The parents' impact and the familial socio-environmental factors begin to wane, and other factors start to have influence, e.g., school education of a healthy lifestyle and health behavior of peers.

Evidence that carbohydrate-to-fat ratio and taste, but not energy density or NOVA level of processing, are determinants of food liking and food reward

This virtual (online) study tested the common but largely untested assumptions that food energy density, level of processing (NOVA categories), and carbohydrate-to-fat (CF) ratio are key determinants of food reward. Individual participants (224 women and men, mean age 35 y, 53% with healthy weight, 43% with overweight or obesity) were randomised to one of three, within-subjects, study arms: energy density (32 foods), or level of processing (24 foods), or CF ratio (24 foods). They rated the foods for taste pleasantness (liking), desire to eat (food reward), and sweetness, saltiness, and flavour intensity (for analysis averaged as taste intensity). Against our hypotheses, there was not a positive relationship between liking or food reward and either energy density or level of processing. As hypothesised, foods combining more equal energy amounts of carbohydrate and fat (combo foods), and foods tasting more intense, scored higher on both liking and food reward. Further results were that CF ratio, taste intensity, and food fibre content (negatively), independent of energy density, accounted for 56% and 43% of the variance in liking and food reward, respectively. We interpret the results for CF ratio and fibre in terms of food energy-to-satiety ratio (ESR), where ESR for combo foods is high, and ESR for high-fibre foods is low. We suggest that the metric of ESR should be considered when designing future studies of effects of food composition on food reward, preference, and intake.

Accumbal μ-opioid receptors and salt taste-elicited hedonic responses in a rodent model of prenatal adversity, and their correlates using human functional genomics

Prenatal adversity is associated with behavioral obesogenic features such as preference for palatable foods. Salt appetite may play a role in the development of adiposity and its consequences in individuals exposed to prenatal adversity, and sodium consumption involves individual differences in accumbal µ-opioid receptors function. We investigated the hedonic responses to salt and the levels of µ-opioid receptors and tyrosine hydroxylase in the nucleus accumbens (Nacc) of pups from an animal model of prenatal dietary restriction. In children, we evaluated the interaction between fetal growth and the genetic background associated with the accumbal µ-opioid receptor gene (OPRM1) expression on sodium consumption during a snack test. Sprague-Dawley dams were randomly allocated from pregnancy day 10 to receive an ad libitum (Adlib) or a 50% restricted (FR) diet. The pups' hedonic responses to a salt solution (NaCl 2%) or water were evaluated on the first day of life. FR and Adlib pups differ in their hedonic responses to salt, and there were decreased levels of accumbal µ-opioid and p-µ-opioid receptors in FR pups. In humans, a test meal and genotyping from buccal epithelial cells were performed in 270 children (38 intrauterine growth restricted-IUGR) at 4 years old from a Canadian prospective cohort (MAVAN). The OPRM1 genetic score predicted the sodium intake in IUGR children, but not in controls. The identification of mechanisms involved in the brain response to prenatal adversity and its consequences in behavioral phenotypes and risk for chronic diseases later in life is important for preventive and therapeutic purposes.

Benchmarking the nutrient composition and labelling practices of commercially produced ready-to-eat purées and meals for older infants and young children across seven Southeast Asian countries

Commercially produced complementary foods (CPCF), including ready-to-eat CPCF purées and meals, are gaining popularity among caregivers of older infants and young children (IYC) as a convenient alternative to home-prepared foods in low and middle-income countries. However, there is growing concern regarding the suitability of these products for older IYC, as they can contain high levels of sugar and/or sodium. Given the rapidly evolving market in Southeast Asia, it is crucial to monitor the appropriate composition and promotion of CPCF in the region. This study examined the nutrient composition and labelling practices of CPCF purées and meals sold in 2021 in the capital cities of seven Southeast Asian countries: Phnom Penh (Cambodia), Jakarta (Indonesia), Manila (Philippines), Bangkok (Thailand), Vientiane (Lao PDR), Hanoi (Viet Nam), Kuala Lumpur (Malaysia). The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older IYC. The proportion of CPCF purées and meals that would require a high sugar front-of-pack warning based on the percentage energy from total sugar was also determined. Of the 459 CPCF purées/meals assessed, only 37.7% of the products met all nutrient composition requirements and none met all labelling requirements. In addition, most CPCF purées and meals were identified as having high total sugar content. To ensure that older IYC consume appropriate CPCF products, Southeast Asian countries need to implement and enforce regulations concerning the nutrient composition and labelling practices of CPCF purées and meals.

Benchmarking the nutrient composition and labelling practices of finger foods and snacks for older infants and young children across seven Southeast Asian countries

Ensuring consumption of nutrient-dense, safe and appropriate complementary foods among older infants and young children (IYC) 6-36 months of age is critical for enabling optimal growth and development. The ubiquitous availability of and high demand for commercially packaged snack foods has culminated in a growing trend of snack food products specifically produced and promoted for older IYC. Commercially produced complementary foods (CPCF) that are finger foods/snacks often contain added sugars, excessive sodium content and high total sugar content, making them inappropriate for this young population. This study benchmarked the nutrient composition and labelling practices of CPCF finger foods/snacks available for purchase in seven countries in Southeast Asia. The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older IYC. Of the total 606 products identified, 8.2% were automatically categorized as not suitable because they were confectionery items. Of the remaining 556 products assessed, over 85% failed to meet all nutrient composition requirements, with the presence of added sugars/sweeteners and excessive sodium and total sugar contents the primary reasons for failure. Products also demonstrated concerning labelling practices, with all of the products (98.6%) displaying an inappropriate claim on the label. These findings reveal major concerns with the nutrient composition and labelling practices of CPCF finger foods/snacks in the SEA region and should serve as an alarm bell for regulatory action. National binding legal measures, such as mandatory standards for composition and labelling are urgently needed.

Benchmarking the nutrient composition and labelling practices of dry or instant cereals for older infants and young children across seven Southeast Asian countries

In Southeast Asia, the increasing availability of commercially produced complementary foods (CPCF), including dry or instant cereals (CPCF cereals), has been noted, however, concerns exist around their nutrient profile and labelling practices. This 2021 study assessed the nutrient composition, labelling practices, and micronutrient content of CPCF cereals sold in the capital cities of seven Southeast Asian countries: Phnom Penh (Cambodia), Jakarta (Indonesia), Manila (Philippines), Bangkok (Thailand), Vientiane (Lao PDR), Hanoi (Vietnam), and Kuala Lumpur (Malaysia). The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older infants and young children. Micronutrient content of fortified CPCF cereals was assessed against fortification levels specified in the Codex Alimentarius guideline for formulated complementary foods. Of the 484 products assessed, 184 (38.0%) met all nutrient composition requirements. Around one-third of CPCF cereals contained added sugars and/or sweeteners (37.2%) and high levels of sodium (28.9%). None of the CPCF cereals met all labelling requirements, primarily due to the presence of inappropriate claims on the labels. Most fortified CPCF cereals contained adequate amounts of critical micronutrients, such as calcium, iron, zinc, vitamin A, and vitamin D. However, rates of fortification varied across the seven countries, and almost a third (30.8%) of CPCF cereals were not fortified with any micronutrients. To support the appropriate promotion of CPCF in the region, Southeast Asian countries need to strengthen and enforce national binding legal measures, including national standards for the composition, labelling, and fortification of CPCF cereals.

Avoidance of added salt for 6-12-month-old infants: A narrative review

Most nutrition guidelines recommend avoiding foods with added salt for infants aged 6-12 months. However, the reason for no added salt lacks enough and reliable evidence. We re-searched and re-studied the relevant evidence. We searched PubMed and the Cochrane database for English-language studies published from 1904 through 2021. We also searched the databases of the websites of different national institutions. Randomized clinical trials (RCTs), systematic reviews, observational studies, and dietary guidelines were included in this review. The kidneys of infants aged 6-12 months have adequate sodium excretion capacity. There is insufficient evidence that high salt (sodium) intake early in life might lead to hypertension or salty diet preference in adults. Infants aged 6-12 months might be at risk of low sodium intake of only 150-300 mg of sodium/day, which may not meet the body's needs, if their supplementary food is not adequately salted.

Effect of Marinating in Dairy-Fermented Products and Sous-Vide Cooking on the Protein Profile and Sensory Quality of Pork Longissimus Muscle

The aim of the study was to evaluate the effect of marinating (3 or 6 days) in kefir (KE), yogurt (YO) and buttermilk (BM) and sous-vide cooking (SV) at 60 or 80 °C on changes in the protein profile of pork in relation to its sensory quality. In the marinated raw meat, an increased share of some fractions of myofibrillar and cytoskeletal proteins and calpains were found. The greatest degradation of proteins, regardless of time, was caused by marinating in YO and KE and cooking SV at 80 °C. The lowest processing losses were in samples marinated in KE and YO and cooked SV at 60 °C, with marinating time having no significant effect. The odor, flavor, tenderness and juiciness of meat marinated in BM was better than in KE and YO. Meat marinated and cooked SV at 60 °C was rated better by the panelists. Changes in proteins significantly affect the formation of meat texture, tenderness and juiciness, which confirms the correlations. This is also reflected in the sensory evaluation. During the process of marinating and cooking meat, protein degradation should be taken into account, which can be a good tool for shaping the sensory quality of cooked pork.

Initiatives to Reduce the Content of Sodium in Food Products and Meals and Improve the Population's Health

Table salt is the main source of sodium (Na) in the human diet. Excessive supply of Na in a diet is strongly linked to many non-communicable human diseases, such as hypertension, obesity and stomach cancer. The World Health Organization recommends that daily intake of salt in adult diets should be kept below 5 g/person/day, which corresponds to 2 g Na/person/day. However, on average, adults consume about 9-10 g/person/day, and children and young people about 7-8 g/person/day. Initiatives to reduce salt intake include modifications of food composition in collaboration with the food industry, education of consumers, salt marking on foodstuff labels and taxation of salt. A need also exists to educate society so that they choose low-sodium products. In view of the food technology and amount of salt intake, the most important and the easiest change to make is to reduce the content of salt in baked goods. This paper analyses the results of surveys regarding strategies to reduce salt content in food products and considers multifaceted initiatives to reduce salt intake as a possible efficient method of improving the population's health status.

The gut-brain axis and sodium appetite: Can inflammation-related signaling influence the control of sodium intake?

Sodium is the main cation present in the extracellular fluid. Sodium and water content in the body are responsible for volume and osmotic homeostasis through mechanisms involving sodium and water excretion and intake. When body sodium content decreases below the homeostatic threshold, a condition termed sodium deficiency, highly motivated sodium seeking, and intake occurs. This is termed sodium appetite. Classically, sodium and water intakes are controlled by a number of neuroendocrine mechanisms that include signaling molecules from the renin-angiotensin-aldosterone system acting in the central nervous system (CNS). However, recent findings have shown that sodium and water intakes can also be influenced by inflammatory agents and mediators acting in the CNS. For instance, central infusion of IL-1β or TNF-α can directly affect sodium and water consumption in animal models. Some dietary conditions, such as high salt intake, have been shown to change the intestinal microbiome composition, stimulating the immune branch of the gut-brain axis through the production of inflammatory cytokines, such as IL-17, which can stimulate the brain immune system. In this review, we address the latest findings supporting the hypothesis that immune signaling in the brain could produce a reduction in thirst and sodium appetite and, therefore, contribute to sodium intake control.

Nutrient profiles of commercially produced complementary foods available in Cambodia, Indonesia and the Philippines

OBJECTIVE

To assess the nutritional suitability of commercially produced complementary foods (CPCF) marketed in three South-East Asian contexts.

DESIGN

Based on label information declared on the products, nutrient composition and content of CPCF were assessed against the WHO Europe nutrient profile model (NPM). The proportion of CPCF that would require a 'high sugar' warning was also determined.

SETTING

Khsach Kandal district, Cambodia; Bandung City, Indonesia; and National Capital Region, Philippines.

PARTICIPANTS

CPCF products purchased in Cambodia (n 68) and Philippines (n 211) in 2020, and Indonesia (n 211) in 2017.

RESULTS

Only 4·4 % of products in Cambodia, 10·0 % of products in Indonesia and 37·0 % of products in the Philippines fully complied with relevant WHO Europe NPM nutrient composition requirements. Sixteen per cent of CPCF in Cambodia, 27·0 % in Indonesia and 58·8 % in the Philippines contained total sugar content levels that would require a 'high sugar' warning.

CONCLUSIONS

Most of the analysed CPCF were not nutritionally suitable to be promoted for older infants and young children based on their nutrient profiles, with many containing high levels of sugar and sodium. Therefore, it is crucial to introduce new policies, regulations and standards to limit the promotion of inappropriate CPCF in the South-East Asia region.

Characterizing Adolescents' Dietary Intake by Taste: Results From the UK National Diet and Nutrition Survey

The taste of foods is a key factor for adolescents' food choices and intakes, yet, exploring taste characteristics of adolescents' diet is limited. Using food records for 284 adolescents (10–19 years old) from the National Diet and Nutrition Survey (NDNS), year 9 (2016–2017), we classified diets according to taste. Tastes for each food consumed were generated from a previous survey that asked participants to allocate one main taste to each food. Responses from that survey were processed and included in a Hierarchical Cluster Analysis (HCA) to identify taste clusters. The resulting tastes were then applied to the adolescents' food records in the NDNS. For each individual, the total weight of food per day for each taste was calculated. A linear regression model was used to explore dietary intakes from each taste. Findings reveal that adolescents' daily energy intake was highest (34%) from foods that taste sweet. Sweet foods were the main calorie contributors at breakfast and daytime snacking, while energy intake from neutral-tasting foods was higher at lunch and dinner. Sweet food intake was significantly positively associated with higher energy, sugar, and fat intakes. For each percentage increase in sweet foods, energy increased by 10 kcal/d (95% CI 6, 15; P &lt; 0.01). Savory food intake was lower in carbohydrates and sugars; with neutral food consumption inversely associated with energy, carbohydrate, sugars, saturated and total fat. Higher salty food intake was linked to higher saturated fat as well as sodium consumption. Sweet and neutral foods dominate the UK adolescent diet, followed by savory tastes. Balancing the contributions of different tasting foods could assist in improving adolescent diet quality.

Development and validation of an instrument to assess Brazilians' knowledge, perceptions, and behaviors toward salt and sodium

This study aimed to develop and validate an instrument to assess Brazilian adults' knowledge, perceptions, and behaviors (KPB) toward salt and sodium. Based on a PAHO/WHO questionnaire, a new instrument was developed and evaluated by 11 experts, generating item and scale-level content validity indexes (I-CVI and S-CVI, respectively). Face validity was verified through a focus group with eight participants, followed by an operational test with 36 interviewees. Exploratory factor analysis (EFA) was used to determine the construct validity, and Cronbach's α coefficient was calculated to analyze instrument's reliability, using data collected via telephone from a probabilistic sample of 422 adults. The generated solutions were analyzed from theoretical and statistical significance perspectives, which supported the determination of the best model. Remaining items were scored, with higher scores related to healthier practices. A descriptive analysis was performed considering the data from the 422-adult sample. I-CVIs (0.73-1), S-CVIs (0.93; 0.97) and the interviewees' analysis indicated that items are representative and clear, in addition to being suitable for application to the target audience. Tests confirmed sample adequacy to perform the EFA (KMO = 0.82; Bartlett's sphericity test, p < .001). The final validated model, with 16 items, sufficiently explained the variance and presented good reliability (Cronbach's α = 0.81; 95% CI 0.79 - 0.84). Women, older individuals, and with higher education had significantly higher scores, regardless of chronic diseases diagnosis (p < .001). This instrument is ready to be applied and easily reproduced, contributing to the assessment of KPB toward salt and sodium in Brazil.

Usual Nutrient Intake Distribution and Prevalence of Inadequacy among Australian Children 0-24 Months: Findings from the Australian Feeding Infants and Toddlers Study (OzFITS) 2021

(1) Background: Breastmilk provides all the nutrition an infant requires between 0−6 months. After that, complementary foods are needed to meet the child’s increasing energy and nutrient requirements. Inadequate energy and nutrient intake may lead to growth faltering, impaired neurodevelopment, and increased disease risk. While the importance of early life nutrition is well recognized, there are few investigations assessing the nutritional adequacy of Australian children <24 months. Here, we describe usual energy and nutrient intake distributions, including the prevalence of inadequate intakes and exceeding the upper limit (UL), in a national sample of Australian children 6− 24 months and infants < six months who had commenced solids and/or formula. (2) Methods: Dietary intakes were assessed using a one-day food record for 976 children with a repeat one-day record in a random subset. (3) Results: Based on the Nutrient Reference Values for Australia and New Zealand, children’s intakes were above the Adequate Intake or Estimated Average Requirement for most nutrients. Exceptions were iron and zinc where the prevalence of inadequacy was estimated to be 90% and 20%, respectively, for infants aged 6−11.9 months. Low iron intake was also observed in one quarter of toddlers 12−24 months. On average, children consumed 10% more energy than predicted based on Estimated Energy Requirements, and ~10% were classified as overweight based on their weight for length. One third of toddlers exceeded the tolerable upper limit for sodium and consumed > 1000 mg/day. Of the children under six months, 18% and 43% exceeded the UL for vitamin A (retinol) and zinc. (4) Conclusions: Compared to nutrient reference values, diets were sufficient for most nutrients; however, iron was a limiting nutrient for infants aged 6−11.9 months and toddlers 12−24 months potentially putting them at risk for iron deficiency. Excessive sodium intake among toddlers is a concern as this may increase the risk for hypertension.

Investigating New Sensory Methods Related to Taste Sensitivity, Preferences and Diet of Mother-Infant Pairs and its Relationship to Body Composition and Biomarkers: Protocol for an Explorative Study (Preprint)

Background

Early experiences with different flavors play an important role in infant development, including food and taste acceptance. Flavors are already perceived in utero with the development of the taste and olfactory system and are passed on to the child through breast and bottle feeding. Therefore, the first 1000 days of life are considered a critical window for infant developmental programming.

Objective

The objective of our study is to investigate, both in the prenatal and postnatal period, taste sensitivity, preferences, and dietary diversity of mother-infant pairs. The explorative study design will also report on the impact of these variables on body composition (BC) and biomarkers. In contrast to conventional methods, this study involves long-term follow-up data collection from mother-infant pairs; moreover, the integration of audiovisual tools for recording infants' expressions pertaining to taste stimuli is a novelty of this study. Considering these new methodological approaches, the study aims to assess taste-related data in conjunction with BC parameters like fat-free mass or fat mass, biomarkers, and nutritional intake in infants and children.

Methods

Healthy pregnant women aged between 18 and 50 years (BMI≥18.5 kg/m² to ≤30 kg/m²; <28 weeks of gestation) were recruited from January 2014 to October 2014. The explorative design implies 2 center visits during pregnancy (24-28 weeks of gestation and 32-34 weeks of gestation) and 2 center visits after delivery (6-8 weeks postpartum and 14-16 weeks postpartum) as well as follow-up visits at 1, 3-3.5, and 6 years after delivery. Data collection encompasses anthropometric and biochemical measurements as well as BC analyses with air displacement plethysmography, taste perception assessments, and multicomponent questionnaires on demographics, feeding practices, and nutritional and lifestyle behaviors. Audiovisual data from infants’ reactions to sensory stimuli are collected and coded by trained staff using Baby Facial Action Coding and the Body Action Posture System. Birth outcomes and weight development are obtained from medical records, and additional qualitative data are gathered from 24 semistructured interviews.

Results

Our cohort represents a homogenous group of healthy women with stringent exclusion criteria. A total of 54 women met the eligibility criteria, whereas 47 mother-child pairs completed data collection at 4 center visits during and after pregnancy. Follow-up phases, data analyses, and dissemination of the findings are scheduled for the end of 2023. The study was approved by the ethics committee of the Medical University of Graz (EC No 26–066 ex 13/14), and all participants provided informed consent.

Conclusions

The results of this study could be useful for elucidating the connections between maternal and infant statuses regarding diet, taste, biomarkers, and prenatal and postnatal weight development. This study may also be relevant to the establishment of further diagnostic and interventional strategies targeting childhood obesity and early body fat development.

International Registered Report Identifier (IRRID)

DERR1-10.2196/37279

Infant and Toddler Responses to Bitter-Tasting Novel Vegetables: Findings from the Good Tastes Study

BACKGROUND

Infants are born with the biological predisposition to reject bitterness. Dark green vegetables contain essential nutrients but also bitter compounds, making them more difficult to like.

OBJECTIVE

The Good Tastes Study was designed to determine whether reducing bitterness by adding small amounts of sugar or salt would alter infant acceptance of kale purées.

METHODS

Caregivers (n = 106, 94% mothers, 82% Non-Hispanic White) and children (53% male, aged 6-24 mo) participated in a videorecorded laboratory visit during which infants were offered 4 versions of puréed kale: plain, 1.2% or 1.8% added sugar, or 0.2% added salt. Caregivers rated their children's liking for each kale version. Videos were coded for the number of tastes accepted and for children's behaviors and acceptance of each kale version. A multilevel ordered logistic model was fit for the number of accepted tastes and caregiver ratings of child liking of kale versions with age, breastfeeding history, order effects, and kale version as predictors.

RESULTS

Infants 6 to <12 mo accepted more tastes (b = 2.911, P < 0.001) and were rated by caregivers as liking the kale more than older toddlers (≥18 mo; b = 1.874, P = 0.014). The plain kale was more likely to be accepted (P < 0.001); also, the first version offered was more likely to be rejected (b = -0.586, P < 0.007). Older infants (≥18 mo) exhibited more avoidant behaviors (b = 1.279, P < 0.001), more playing (b = 2.918, P < 0.001), and more self-feeding (b = 1.786, P = 0.005) than younger infants (6 to <12 mo). Children who were reported to have been breastfed more in the last 7 d were more likely to self-feed (b = 0.246, P < 0.001) and play with food (b = 0.207, P < 0.005).

CONCLUSIONS

Our findings support that there may be a sensitive period, during the early phase of complementary feeding, to improve success of introducing a novel, bitter, more difficult-to-like food. When low levels of sugar or salt were added, no advantage of bitterness reduction was observed. This study has been registered with ClinicalTrials.gov as NCT04549233.

Association between childhood obesity and familial salt intake: analysis of data from Korean National Health and Nutrition Examination Survey, 2014-2017

High salt intake is known as a risk factor of childhood obesity. As family members share not only genes but also their diet habit, parents' salt intake may affect to their children's obesity. In this study, we investigated correlations between childhood obesity and parents' or children's sodium intakes based on a nationwide survey data. From the Korean National Health and Nutrition Examination Survey data from 2014 to 2017, 802 boys and 657 girls aged 10-18 years, and their parents were included. BMI z-score and 24-hour urinary sodium excretion, which is estimated through Tanaka's equation, were used to examine associations between obesity and sodium intakes. The BMI status and the prevalence of obesity between children and their parents showed strong positive correlations in both sexes (all p < 0.001). The urinary sodium excretion between children and their parents showed positive correlations in both sexes (all p < 0.05). Children with higher urinary sodium excretion showed higher BMI (in both sexes, p < 0.001) and higher parental obesity compared to those with lower urinary sodium excretion, however, statistical significances of the latter relationship were varied by sex. In conclusion, our study suggests close relationship between childhood obesity and their sodium intakes, which also correlate well with parental BMIs and diet behavior. Therefore, parental education and active participation could be crucial in regulating childhood obesity.

Does Responsiveness to Basic Tastes Influence Preadolescents' Food Liking? Investigating Taste Responsiveness Segment on Bitter-Sour-Sweet and Salty-Umami Model Food Samples

The objective of this study was to investigate the relationships between taste responsiveness and food liking in preadolescents. Model food samples of grapefruit juice (GF) and vegetable broth (VB) modified with four additions of sucrose and sodium chloride, respectively, were employed. Intensity perception for sweetness, sourness, and bitterness were measured in GF while saltiness and umami were measured in VB. The children (N = 148) also completed food choice, familiarity, stated liking and neophobia questionnaires. The test was conducted at school, with instructions provided remotely via video call. Four segments were defined differing in basic taste responsiveness. Segments and sucrose concentrations significantly affected liking for GF, while no significant effect of segments and sodium chloride concentrations occurred on liking for VB. An increasing sucrose concentration was positively associated with liking for GF only in the segment with low responsiveness to bitter and sour tastes. No significant differences across segments were found for food choice, familiarity, stated liking, and neophobia. Conclusively, relationships between taste responsiveness and liking are product and basic taste-dependent in addition to being subject-dependent. Strategies to improve acceptance by using sucrose as a suppressor for warning sensations of bitterness and sourness can be more or less effective depending on individual responsiveness to the basic tastes.

Effect of reducing sodium chloride based on the sensory properties of meat products and the improvement strategies employed: a review

Many consumers are concerned about the high levels of salt intake owing to the accompanied risk of chronic diseases. Due to this dietary concern, the food industry has recommended the reduction of salt content in many products. However, the addition of salt to meat products improves their quality and sensory properties, including saltiness, color, juiciness, and texture. Because quality deteriorations could induce decreased sensory scores owing to salt reductions, the challenges involved in improving the quality of reduced-salt meat products have been addressed. During the development of low-salt meat products, it is important to reduce sodium content and address the problems that arise with this reduction. Modified salt, organic acids, amino acids, nucleotides, hydrocolloids, high-pressure, ultrasound, electric pulsed field, and irradiation have been suggested as strategies to replace or reduce sodium content, and sensory scores could be improved by these strategies. Therefore, when developing a low-salt meat product, several perspectives must be considered and the latest technologies that could resolve this problem should be adopted.

Perinatal High-Salt Diet Induces Gut Microbiota Dysbiosis, Bile Acid Homeostasis Disbalance, and NAFLD in Weanling Mice Offspring

A perinatal high-salt (HS) diet was reported to elevate plasma triglycerides. This study aimed to investigate the hypothesis that a perinatal HS diet predisposed offspring to non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of abnormal lipid metabolism, and the possible mechanism. Female C57BL/6 mice were fed a control diet (0.5% NaCl) or HS diet (4% NaCl) during pregnancy and lactation and their offspring were sacrificed at weaning. The perinatal HS diet induced greater variation in fecal microbial beta-diversity (β-diversity) and increased bacteria abundance of Proteobacteria and Bacteroides. The gut microbiota dysbiosis promoted bile acid homeostasis disbalance, characterized by the accumulation of lithocholic acid (LCA) and deoxycholic acid (DCA) in feces. These alterations disturbed gut barrier by increasing the expression of tight junction protein (Tjp) and occludin (Ocln), and increased systemic lipopolysaccharide (LPS) levels and hepatic inflammatory cytokine secretion (TNF-α and IL-6) in the liver. The perinatal HS diet also inhibited hepatic expression of hepatic FXR signaling (CYP7A1 and FXR), thus triggering increased hepatic expression of pro-inflammatory cytokines (TNF-α and IL-6) and hepatic lipid metabolism-associated genes (SREBP-1c, FAS, ACC), leading to unique characteristics of NAFLD. In conclusion, a perinatal HS diet induced NAFLD in weanling mice offspring; the possible mechanism was related to increased bacteria abundance of Proteobacteria and Bacteroides, increased levels of LCA and DCA in feces, and increased expressions of hepatic FXR signaling.

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.

Almli V. Investigating the Relationships between Basic Tastes Sensitivities, Fattiness Sensitivity, and Food Liking in 11-Year-Old Children

This study investigates the relationships between basic tastes and fattiness sensitivity and food liking in 11-year-old children. The basic taste sensitivity of 106 children was measured using different methods, namely detection (DT) and recognition (RT) thresholds, and taste responsiveness. Caffeine and quinine (bitter), sucrose (sweet), citric acid (sour), sodium chloride (salty), and monosodium glutamate (umami) were investigated for DT and RT at five concentrations in water solutions. In addition, taste responsiveness and liking were collected for the high-intensity concentrations. PROP (6-n-propylthiouracil) responsiveness was tested on paper strips. Fattiness sensitivity was measured by a paired comparison method using milk samples with varying fat content. Liking for 30 food items was recorded using a food-list questionnaire. The test was completed in a gamified “taste detective” approach. The results show that DT correlates with RT for all tastes while responsiveness to PROP correlates with overall taste responsiveness. Caffeine and quinine differ in bitterness responsiveness and liking. Girls have significantly lower DTs than boys for bitterness and sweetness. Food liking is driven by taste and fattiness properties, while fatty food liking is significantly influenced by fattiness sensitivity. These results contribute to a better holistic understanding of taste and fattiness sensitivity in connection to food liking in preadolescents.

Sodium-not harmful?

BACKGROUND

The temporality between the mandated reduction of salt in processed food and the decrease of death from stroke and ischemic heart disease, the association of hypertension, and cardiovascular disease led many public health organizations to recommend reducing dietary sodium to a maximum of 2300 mg per day. It turns out that some nuances can be brought about to this universally shared belief.

METHODS & RESULTS

Indeed, consideration of health outcomes instead of only blood pressure as a surrogate marker of cardiovascular disease and prognosis gave contradictory results whereas low sodium intake is associated to an excess of death and cardiovascular events.

CONCLUSIONS

Accordingly, sodium intake should be adapted to individual risk factors, and evidence is still clearly lacking to support indiscriminate recommendations in healthy people. By contrast, a restricted sodium diet is certainly useful in patients with chronic kidney disease exposed to salt retention, and by reciprocity, low sodium diet must be absolutely avoided in all patients presenting renal or extra renal sodium wasting where sodium depletion is a life-threatening condition.

The Use of Added Salt and Sugar in the Diet of Polish and Austrian Toddlers. Associated Factors and Dietary Patterns, Feeding and Maternal Practices

Children aged <2 years should not be given meals with the addition of salt and sugar due to health risks and to promote healthier dietary habits. The aims of this study were: to assess the prevalence of the use of added salt (AS), sugar (ASu) and both salt and sugar (AS&Su) in the diets of Polish and Austrian toddlers aged 12-24 and 25-36 months; to explore the sociodemographic and early nutritional factors associated with the use of AS and ASu; to investigate the difference in dietary habits and maternal concerns about toddlers' eating regarding the use of AS and ASu in toddlers' diet. This cross-sectional anonymous study was conducted in 5893 mothers of children aged 12-36 months, recruited through social media in 2017-2019. The questionnaire consisted of questions about sociodemographics, early feeding practices and current children's nutrition (e.g., use of AS and ASu, food frequency questionnaire). Multivariate logistic regression and cluster analyses were applied. Austrian mothers more often used AS than mothers from Poland (at 2 years old: 74.8% vs. 52.8%; at 3 years old 87.4% vs. 74.4%, p ≤ 0.001), however Polish mothers were more prone to use ASu (at 2 years old: 34.7% vs. 27.7%; at 3 years old: 59.0% vs. 45.8%, p ≤ 0.001). In younger toddlers (12-24 months), the odds of using of AS, ASu, and AS&Su increased with toddlers' age, when the mother was a multipara, was not currently breastfeeding, or had exclusively breastfed for 4-5 months. This risk decreased when older toddlers (25-36 months) were introduced to solids by baby-led weaning (BLW). Toddlers from both countries who consumed meals with AS or ASu more often a followed Western-like dietary pattern. Our study emphasizes the need for parental nutritional education when beginning to introduce solid foods.

Insights into smell and taste sensitivity in normal weight and overweight-obese adolescents

Research examining connections between BMI and smell and taste sensitivity in adolescents has been minimal, methodologically inconsistent, and inconclusive. We sought to address this issue with an exploratory study of smell and taste sensitivity in overweight-obese (high BMI) and normal BMI male and female adolescents (ages 12-16 years), using previously validated chemosensory testing measures (Sniffin' Sticks, Taste Strips, 6-n-propylthiouracil: PROP), and taking pubertal stage into account. Puberty was evaluated with the validated Pubertal Development Scale and participants were then classified as either "early" or "late" pubertal stage. We used the phenylethyl alcohol (PEA) version of the Sniffin' Sticks olfactory threshold test and found that high BMI adolescents had significantly greater olfactory sensitivity than normal BMI adolescents. This observation contradicts previous results in overweight adults tested with the n-butanol version of Sniffin' Sticks. We also found that participants in early puberty had significantly higher olfactory sensitivity than participants in late puberty. No significant findings for taste sensitivity were obtained, though there is a suggestion that puberty may affect salty taste thresholds. Our results illuminate a potentially important difference in sensitivity to pure olfactory versus olfactory-trigeminal stimuli as a function of BMI, which the PEA and n-butanol versions of the Sniffin' Sticks respectively assess; and for the first time demonstrate variation in chemosensory acuity in relation to pubertal stage. These findings have implications for eating behavior during adolescence.

Salt need needs investigation

Expensive and extensive studies on the epidemiology of excessive Na intake and its pathology have been conducted over four decades. The resultant consensus that dietary Na is toxic, as well as the contention that it is less so, ignores the root cause of the attractiveness of salted food. The extant hypotheses are that most Na is infiltrated into our bodies via heavily salted industrialised food without our knowledge and that mere exposure early in life determines lifelong intake. However, these hypotheses are poorly evidenced and are meagre explanations for the comparable salt intake of people worldwide despite their markedly different diets. The love of salt begins at birth for some, vacillates in infancy, climaxes during adolescent growth, settles into separate patterns for men and women in adulthood and, with age, fades for some and persists for others. Salt adds flavour to food. It sustains and protects humans in exertion, may modulate their mood and contributes to their ailments. It may have as yet unknown benefits that may promote its delectability, and it generates controversy. An understanding of the predilection for salt should allow a more evidence-based and effective reduction of the health risks associated with Na surfeit and deficiency. The purpose of this brief review is to show the need for research into the determinants of salt intake by summarising the little we know.

Endurance exercise protects aging Drosophila from high-salt diet (HSD)-induced climbing capacity decline and lifespan decrease by enhancing antioxidant capacity

A high-salt diet (HSD) is a major cause of many chronic and age-related defects such as myocardial hypertrophy, locomotor impairment and mortality. Exercise training can efficiently prevent and treat many chronic and age-related diseases. However, it remains unclear whether endurance exercise can resist HSD-induced impairment of climbing capacity and longevity in aging individuals. In our study, flies were given exercise training and fed a HSD from 1-week old to 5-weeks old. Overexpression or knockdown of salt and dFOXO were built by UAS/Gal4 system. The results showed that a HSD, salt gene overexpression and dFOXO knockdown significantly reduced climbing endurance, climbing index, survival, dFOXO expression and SOD activity level, and increased malondialdehyde level in aging flies. Inversely, in a HSD aging flies, endurance exercise and dFOXO overexpression significantly increased their climbing ability, lifespan and antioxidant capacity, but they did not significantly change the salt gene expression. Overall, current results indicated that a HSD accelerated the age-related decline of climbing capacity and mortality via upregulating salt expression and inhibiting the dFOXO/SOD pathway. Increased dFOXO/SOD pathway activity played a key role in mediating endurance exercise resistance to the low salt tolerance-induced impairment of climbing capacity and longevity in aging DrosophilaThis article has an associated First Person interview with the first author of the paper.

Preference for dietary fat: From detection to disease

Recent advances in the field of taste physiology have clarified the role of different basic taste modalities and their implications in health and disease and proposed emphatically that there might be a distinct cue for oro-sensory detection of dietary long-chain fatty acids (LCFAs). Hence, fat taste can be categorized as a taste modality. During mastication, LCFAs activate tongue lipid sensors like CD36 and GPR120 triggering identical signaling pathways as the basic taste qualities do; however, the physico-chemical perception of fat is not as distinct as sweet or bitter or other taste sensations. The question arises whether "fat taste" is a basic or "alimentary" taste. There is compelling evidence that fat-rich dietary intervention modulates fat taste perception where an increase or a decrease in lipid contents in the diet results, respectively, in downregulation or upregulation of fat taste sensitivity. Evidently, a decrease in oro-sensory detection of LCFAs leads to high fat intake and, consequently, to obesity. In this article, we discuss recent relevant advances made in the field of fat taste physiology with regard to dietary fat preference and lipid sensors that can be the target of anti-obesity strategies.

Do the opinions of pediatricians influence their recommendations on complementary feeding? Preliminary results

Complementary feeding practices are debated among pediatricians, primarily regarding whether nutritional needs or developmental readiness should be prioritized in recommendations for starting complementary feeding. The aim of the present study was to analyze the timing of the start of complementary feeding and the related motivations with an 8-item online survey administered to active members of the Italian Society of Primary Care Pediatricians. The participation rate was 43.3% (350 of 808), and 213 (60.9%) and 137 (39.1%) of the participants chose items related to developmental readiness and nutritional needs, respectively, as the criteria for starting complementary feeding. Approximately 74% of the participants reported that they recommended starting complementary feeding between 5 and 6 months of age, 17% recommended starting before 5 months, and 8% recommended starting after 6 months. Predefined schemes were proposed by 38% of the participants, and a responsive feeding modality was proposed by 13%, while the majority (49%) recommended both modalities depending on family characteristics. Regarding recommendations based on nutritional needs, 89% of pediatricians reported providing indications concerning the quantity of meat consumed during the first year of life, and 91% reported recommending introducing added salt only after 12 months of age. Compared with pediatricians who emphasized developmental readiness, those who prioritized nutritional needs suggested earlier complementary feeding start and a higher use of predefined schemes and were more likely to make recommendations regarding meat quantity and added salt (p < 0.0001).Conclusions: Pediatricians who used a developmental readiness criterion for starting complementary feeding may less frequently provide nutritional advice to parents, even if a trend to harmonize the different positions regarding complementary feeding start time is emerging.What is Known:• Pediatricians make suggestions for introducing complementary feeding based on scientific evidence, local traditions, and personal beliefs.• Either infants' nutritional needs or their developmental readiness currently is used as determinant for the timing of complementary feeding.What is New:• More than 60% of Italian pediatricians consider developmental readiness a priority for introducing complementary feeding.• Pediatricians following the criterion of developmental readiness may less frequently give detailed nutritional advice.

The association of parents' behaviors related to salt with 24 h urinary sodium excretion of their children: A Spanish cross-sectional study

BACKGROUND

Sodium intake is excessive among Spanish children, but the salt use behaviors of parents and children are unknown. This study aims to determine behaviors related to salt intake in both schoolchildren and parents and the relationship between parental behaviors and 24 h urinary sodium excretion (UNa-24h) in children.

SUBJECTS AND METHODS

A convenience sample was taken from a cross-sectional analysis. Parents completed a self-reported questionnaire about their behaviors related to salt, and their responses were compared with the UNa-24h of their own children. The median test was used to identify differences in UNa-24h according to behaviors. Logistic regression was used to assess the relationship between the behaviors of parents and high sodium excretion in the children and the risk of children's use of table salt, adjusting for age, sex, and BMI. Multinomial logistic regression models, adjusted by the covariates, were used to study the children's salt preferences.

RESULTS

A total of 329 schoolchildren from different Spanish provinces were included in the study (mean age: 9.0 ± 1.2 years, 157 girls). The majority of families (parents mean age: 42.0 ± 5.2 years) reported adding salt to food during cooking (92%), and 59% of them never looked at the sodium content on food labels. However, none of these behaviors were related to UNa-24h (p > 0.05). The use of iodized salt (53%), the presence of a salt shaker on the table (6%), and the use of table salt by fathers (57%), mothers (52%) or children (17%) increased the odds (p < 0.05) of children having a higher UNa-24h. Checking sodium content on food labels and the use of table salt by the children or father was associated with a lower preference for salty foods (p < 0.05).

CONCLUSIONS

It is important to make parents aware of the relationship between their behaviors regarding the use of discretionary salt and their children's sodium intake. Our data suggest that salt-specific education programs on how to reduce salt both in-home and outside the home should be implemented to improve behavior skills related to salt consumption in parents and children.

The Influence of Taste Liking on the Consumption of Nutrient Rich and Nutrient Poor Foods

Repeated consumption of high-energy nutrient poor foods can lead to undesirable health outcomes such as obesity. Taste plays an important role in food choice, and a better understanding of the links between the taste of foods, individual taste preferences, food choices, and intakes will aid in our understanding of why some people might select and consume unhealthy foods. The present review focuses on three main questions: (1) do nutrient poor and nutrient rich foods significantly differ in taste profile? (2) are humans predisposed toward developing a liking or preference for certain taste profiles? (3) how are individual variations in liking of the basic taste qualities related to long term food intake and adverse health outcomes such as obesity? Results indicated that nutrient poor foods were likely to be sweet, salty and fatty mouthfeel, while the taste profiles of nutrient rich foods were diverse. Although humans are born with a universal liking for sweet and aversion for bitter taste, large individual differences exist in liking of all the basic taste qualities. These individual differences partly explain differences in short term intakes of foods varying in taste profiles. However they fail to sufficiently explain long term food choices and negative health outcomes such as obesity. Future studies should focus on how the full sensory profile of food which includes taste, smell and texture interacts with individual characteristics (e.g., taste or health motivations, taste preferences) to affect consumption of nutrient rich and nutrient poor foods.

Salt Reduction Intervention in Families Investigating Metabolic, Behavioral and Health Effects of Targeted Intake Reductions: Study Protocol for a Four Months Three-Armed, Randomized, Controlled "Real-Life" Trial

Reductions in salt intake have the potential to markedly improve population health at low cost. Real life interventions that explore the feasibility and health effects of a gradual salt reduction lasting at least four weeks are required. The randomized controlled SalT Reduction InterVEntion (STRIVE) trial was developed to investigate the metabolic, behavioral and health effects of four months of consuming gradually salt reduced bread alone or in combination with dietary counselling. This paper describes the rationale and methods of STRIVE. Aiming at 120 healthy families, participants were recruited in February 2018 from the Danish Capital Region and randomly allocated into: (A) Salt reduced bread; (B) Salt reduced bread and dietary counseling; (C) Standard bread. Participants were examined before the intervention and at four months follow-up. Primary outcome is change in salt intake measured by 24 h urine. Secondary outcomes are change in urine measures of potassium and sodium/ potassium ratio, blood pressure, plasma lipids, the renin-angiotensin system, the sympathetic nervous response, dietary intake as well as salt taste sensitivity and preferences. The results will qualify mechanisms affected during a gradual reduction in salt intake in compliance with the current public health recommendations.

Impairment of Bitter Taste Sensor Transient Receptor Potential Channel M5-Mediated Aversion Aggravates High-Salt Intake and Hypertension

Excessive salt consumption leads to cardiovascular diseases. Despite various measures designed to reduce salt intake, daily salt intake remains at a high level. Appropriate salt intake is balanced by salt taste preference triggered by epithelium sodium channel and salt taste aversion evoked by bitter taste sensor, transient receptor potential channel M5 (TRPM5). However, the behavioral mechanism of excessive salt intake remains largely elusive. In this study, wild type and TRPM5^-/- mice were applied to study the influence of high-salt administration on epithelium sodium channel/TRPM5 and the associated behavior to salt consumption. We found that long-term high-salt intake impaired the aversive behavior to high-salt stimulation but did not alter the preference to low salt in mice. The mechanistic evidence demonstrated that high-salt intake blunted the TRPM5-mediated aversive behavior to noxious salt stimulation through inhibiting PKC (protein kinase C) activity and PKC-dependent threonine phosphorylation in the tongue epithelium but did not affect the epithelium sodium channel-dependent salt taste preference. Inhibition of TRPM5 also resulted in an impaired aversive response to high salt, with reduced taste perception in bitter cortical field of mice. TRPM5^-/- mice showed a lowered aversion to high-salt diet and developed salt-induced hypertension. The impaired perception to bitter taste evoked by high-salt intake also existed in hypertensive patients with high-salt consumption. We demonstrate that long-term high-salt consumption impairs aversive response to concentrated salt by downregulating bitter taste sensor TRPM5. It suggests that enhancing TRPM5 function might antagonize excessive salt intake and high salt-induced hypertension.

Repeated Exposure to Low-Sodium Cereal Affects Acceptance but Does not Shift Taste Preferences or Detection Thresholds of Children in a Randomized Clinical Trial

BACKGROUND

Although salt taste preference is malleable in adults, no research to date has focused on children, whose dietary sodium intake exceeds recommended intake and whose salt taste preferences are elevated.

OBJECTIVE

This proof-of-principle trial determined whether 8-wk exposure to low-sodium cereal (LSC) increased children's acceptance of its taste and changed their salty and sweet taste preferences.

METHODS

Children (n = 39; ages 6-14 y; 67% female) were randomly assigned to ingest LSC or regular-sodium cereal (RSC) 4 times/wk for 8 wk. The cereals, similar in sugar (3 g/cup compared with 2 g/cup) and energy content (100 kcal/cup) yet different in sodium content (200 mg sodium/cup compared with 64 mg sodium/cup), were chosen based on taste evaluation by a panel of children. Mothers completed daily logs on children's cereal intake. At baseline and after the exposure period, taste tests determined which cereal children preferred and measured children's most preferred amount of salt (primary outcomes), and most preferred amount of sucrose and salt taste detection thresholds (secondary outcomes). Repeated measures ANOVAs were conducted on primary and secondary outcomes, and generalized estimating equations were conducted on amount of cereal ingested at home over time.

RESULTS

Both treatment groups accepted and ate the assigned cereal throughout the 8-wk exposure. There were no group × time interactions in salt detection thresholds (P = 0.32) or amount of salt (P = 0.30) and sucrose (P = 0.77) most preferred, which were positively correlated (P = 0.001). At baseline and after the exposure, the majority in both groups preferred the taste of the RSC relative to LSC (P > 0.40).

CONCLUSIONS

Children showed no change in salt preference but readily ate the LSC for 8 consecutive weeks. Findings highlight the potential for reducing children's dietary salt intake by incorporating low-sodium foods in the home environment without more preferred higher-salt versions of these foods. This trial was registered at clinicaltrials.gov as NCT02909764.

Early influencing factors on the development of sensory and food preferences

PURPOSE OF REVIEW

The current review focuses on studies investigating the factors related to the development of preferences for foods and sensory inputs (tastes, odours, and food textures) in the first years of life, which constitutes a specific window for food learning.

RECENT FINDINGS

Foetal nutrition, intrauterine growth, and prematurity influence food preferences; this topic warrants more research to broaden our understanding of the 1000 days phenomenon. Although it is less studied than other sensory inputs, food texture acceptance, and the related sensitive period for texture introduction are attracting more attention, as is the impact of fat acceptance. Research should focus not on vegetables alone but on diverse foods whose consumption is encouraged (e.g., fishes and legumes). The role of parental feeding practices, as another major determinant, continues to inspire research exploring the bidirectional influences between children and caregivers. New interventions have confirmed the strong positive influence of repeated exposure to foods through familiarization via taste lessons, cooking, or play activities on acceptance. Interventions that consider individuals traits are necessary.

SUMMARY

Although new evidence is available, it remains a challenge to consider both individual traits and bidirectional influences between parents and children and to investigate this issue worldwide and in all socioeconomic status groups.

Highlighting of Urinary Sodium and Potassium among Indonesian Schoolchildren Aged 9-12 Years: The Contribution of School Food

Background

Sodium (Na) and potassium (K), the essential nutrients, have vital role in promoting cellular growth including growth and development of children. Excessive Na intake and inadequate K consumption, which consequently increases the risk of cardiovascular disease, have been reported. Spot electrolyte urine was highly correlated and validated with gold standard to estimate electrolyte dietary intake. This study aimed at predicting sodium and potassium intake using morning spot urine among Indonesian schoolchildren.

Methods

A cross-sectional study was carried out in 155 healthy elementary students aged 9–12 years. Spot urine samples were collected and analyzed for Na, K, and creatinine. Predicted 24 h Na and K excretions were compared to the Indonesian recommendation dietary allowances. The Na and K contribution from school food was reported by observing directly and the dietary recall method.

Results

A total of 80 boys and 75 girls recruited as samples in this study demonstrated that their estimated urinary Na and K were 105.42 ± 66.05 mmol/day and 16.39 ± 12.57 mmol/day, respectively. Na intake was on average higher than recommended; meanwhile, almost all subjects showed very low compliance of K intake recommendation. Furthermore, food intake at school contributed to those conditions. Na and K content of school food contributed 33% and 29% of the daily intake of each nutrient and contributed 125% and 25% higher than the Na and K school standard, respectively.

Conclusions

Indonesian schoolchildren aged 9–12 years are categorized by excessive Na intake and very deficient K intake. The present study highlights the need for policies in the environmental school setting to reduce Na intake and K intake.

Sources of Dietary Sodium in Food and Beverages Consumed by Spanish Schoolchildren between 7 and 11 Years Old by the Degree of Processing and the Nutritional Profile

Excessive salt intake has negative effects on health and persists as a dietary problem in Spanish children. However, the analysis of dietary sodium sources has not been extensively studied. A group of 321 children between 7 and 11 years old from five Spanish regional communities was studied. A three-day dietary record was used to determine the contribution of food and beverages to dietary sodium intake. The food consumed was classified based on the level of processing (NOVA classification) and the nutritional profile. Boys consumed more dietary sodium and sodium from ultra-processed food (UPF) than girls (p < 0.05). The main sources of dietary sodium from discretionary food were meat and meat products (25.1%), some ready-to-eat and pre-cooked dishes (7.4%) and sugars and sweets (6.3%). More than 4/5 of the total dietary sodium consumed came from processed foods (PF) and UPF. Ready-to-eat and pre-cooked dishes (14.4%), meat and meat products (10.6%), and cereals (10.2%) were the most relevant UPF. These results demonstrate that a key point for Spanish children is a reduction in the sodium content in PF and UPF, whether these foods are for basic or discretionary consumption. Furthermore, a decrease in the frequency and the quantity of discretionary food consumption should be encouraged.

Nutritional quality and reformulation of a selection of children's packaged foods available in Australian supermarkets: Has the Health Star Rating had an impact?

AIM

To examine whether the nutritional quality of children's packaged food products available in Australian supermarkets improved between 2013 and 2016, and whether any change could be detected in product reformulation since the introduction of the Health Star Rating (HSR) labelling scheme.

METHODS

Packaged food products marketed towards children were purchased from three Australian supermarkets in July 2013 (for a previous study) and July 2016. Nutritional quality was assessed using the Food Standards Australian New Zealand Nutrient Profiling Scoring Criterion. Comparisons were made between the nutrient composition and formulation of products (a) available in 2013 and 2016; and (b) with and without HSR graphics.

RESULTS

Of the 252 children's packaged products analysed, 53.6% were classified as 'less healthy'. HSR-labelled products had a significantly higher proportion classified as 'healthy' than those without the HSR (χ² = 26.5; P < 0.0001; 73.8% and 59.0%, respectively). Overall, 28.5% displayed the HSR; the majority (81.5%) having a rating of ≥3.0 stars. Cereal-based products had the greatest uptake of the scheme, with HSR-labelled products having significantly lower mean energy and saturated fat content (P < 0.01) and higher mean protein and fibre content (P < 0.001) than non-HSR products. Reformulation of products that were available in 2013 had occurred in 100% of HSR-labelled products in comparison to 61.3% of non-HSR labelled products.

CONCLUSIONS

Despite the introduction of the HSR, more than half of children's packaged foods sampled are 'less healthy'. However, early indications suggest that the HSR may stimulate healthier product reformulation.