Twenty-four–hour urine collection is the recommended method for estimating sodium intake. To investigate the strengths and limitations of methods used to assess completion of 24-hour urine collection, the authors systematically reviewed the literature on the accuracy and usefulness of methods vs para-aminobenzoic acid (PABA) recovery (referent). The percentage of incomplete collections, based on PABA, was 6% to 47% (n=8 studies). The sensitivity and specificity for identifying incomplete collection using creatinine criteria (n=4 studies) was 6% to 63% and 57% to 99.7%, respectively. The most sensitive method for removing incomplete collections was a creatinine index <0.7. In pooled analysis (≥2 studies), mean urine creatinine excretion and volume were higher among participants with complete collection (P<.05); whereas, self-reported collection time did not differ by completion status. Compared with participants with incomplete collection, mean 24-hour sodium excretion was 19.6 mmol higher (n=1781 specimens, 5 studies) in patients with complete collection. Sodium excretion may be underestimated by inclusion of incomplete 24-hour urine collections. None of the current approaches reliably assess completion of 24-hour urine collection.
Results suggest almost half of adults overall and the vast majority of those receiving health professional advice are taking some action to watch or reduce sodium intake. Although a substantial proportion report using recommended tactics to lower intake, many are not using the most effective tactics. In order to reach the general population, health communication messages could be simpler and focus on the most effective tactics to reduce sodium intake. Furthermore, health professionals can help reduce sodium intake by discussing the benefits of sodium reduction and tactics to do so, regardless of a hypertension diagnosis.
The objective of this study was to compare the sodium content of a regular food and its lower calorie/fat counterpart. Four food categories, among the top 20 contributing the most sodium to the US diet, met the criteria of having the most matches between regular foods and their lower calorie/fat counterparts. A protocol was used to search websites to create a list of “matches”, a regular and comparable lower calorie/fat food(s) under each brand. Nutrient information was recorded and analyzed for matches. In total, 283 matches were identified across four food categories: savory snacks (N = 44), cheese (N = 105), salad dressings (N = 90), and soups (N = 44). As expected, foods modified from their regular versions had significantly reduced average fat (total fat and saturated fat) and caloric profiles. Mean sodium content among modified salad dressings and cheeses was on average 8%–12% higher, while sodium content did not change with modification of savory snacks. Modified soups had significantly lower mean sodium content than their regular versions (28%–38%). Consumers trying to maintain a healthy diet should consider that sodium content may vary in foods modified to be lower in calories/fat.
We examined temporal changes in consumer attitudes toward broad-based actions and environment-specific policies to limit sodium in restaurants, manufactured foods, and school and workplace cafeterias from the 2012 and 2015 SummerStyle surveys. We used two online, national research panel surveys to conduct a cross-sectional analysis of 7845 U.S. adults. Measures included self-reported agreement with broad-based actions and environment-specific policies to limit sodium in restaurants, manufactured foods, school cafeterias, workplace cafeterias, and quick-serve restaurants. Wald Chi-square tests were used to examine the difference between the two survey years and multivariate logistic regression was used to obtain odds ratios. Agreement with broad-based actions to limit sodium in restaurants (45.9% agreed in 2015) and manufactured foods (56.5% agreed in 2015) did not change between 2012 and 2015. From 2012 to 2015, there was a significant increase in respondents that supported environment-specific policies to lower sodium in school cafeterias (80.0% to 84.9%; p < 0.0001), workplace cafeterias (71.2% to 76.6%; p < 0.0001), and quick-serve restaurants (70.8% to 76.7%; p < 0.0001). Results suggest substantial agreement and support for actions to limit sodium in commercially-processed and prepared foods since 2012, with most consumers ready for actions to lower sodium in foods served in schools, workplaces, and quick-serve restaurants.
This education article describes a modular laboratory exercise in which undergraduates use fruit flies to generate novel experimental data while learning to perform advanced molecular techniques.
Dietary data from a nationally representative survey indicate about 80% of US toddlers aged 1–3 years consume too much dietary sodium, which can influence their preference for salty foods in later life. Information on consumer attitudes can inform strategies to reduce sodium in baby and toddler foods. Data were obtained from a 2012 online survey sent to a sample of 11636 US adults aged ≥18 years enrolled in a national probability-based consumer panel; 6378 completed the survey and had nonmissing responses to the question of interest, “It is important for baby and toddler foods to be low in sodium.” Prevalence of agreement was estimated. Logistic regression was used to describe associations of respondent characteristics with agreement. The majority of respondents were non-Hispanic white and had a household income ≥$60,000. About 7 in 10 (68%, 95% CI: 66%–70%) respondents agreed it is important for baby or toddler foods to be low in sodium. More than 6 of 10 respondents in most subgroups agreed. Among parents with a child currently aged <2 years (N = 390), 82% agreed (95% CI: 77% –87%); the highest agreement included parents who thought sodium was very harmful to their own health (92%, 95% CI: 85%–99%) or who were watching/reducing their own sodium intake (95%, 95% CI: 90%–100%). After adjusting for sex, age, race-ethnicity, agreement was most strongly associated with being a parent of a child <2 years, thinking sodium was harmful, and watching/reducing sodium intake (adjusted odds ratios ≥ 2.5, 95% CI’s ≠ 1.0). The majority of respondents including most parents agreed it is important for baby and toddler foods to be low in sodium, suggesting wide consumer support for strategies to lower sodium in these foods.
In recent years, some positive changes were observed in sodium-related knowledge and behaviors; however, the decrease in reported health professional advice to reduce sodium among respondents with hypertension is a concern.
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