Dietary Sources of Salt in Low- and Middle-Income Countries: A Systematic Literature Review

Abstract

Rapid urbanization in low- and middle-income countries (LMICs) is transforming dietary patterns from reliance on traditional staples to increased consumption of energy-dense foods high in saturated fats, trans fats, sugars, and salt. A systematic literature review was conducted to determine major food sources of salt in LMICs that could be targeted in strategies to lower population salt intake. Articles were sourced using Medline, Web of Science, Scopus, and grey literature. Inclusion criteria were: reported dietary intake of Na/salt using dietary assessment methods and food composition tables and/or laboratory analysis of salt content of specific foods in populations in countries defined as low or middle income (LMIC) according to World Bank criteria. Of the 3207 records retrieved, 15 studies conducted in 12 LMICs from diverse geographical regions met the eligibility criteria. The major sources of dietary salt were breads, meat and meat products, bakery products, instant noodles, salted preserved foods, milk and dairy products, and condiments. Identification of foods that contribute to salt intake in LMICs allows for development of multi-faceted approaches to salt reduction that include consumer education, accompanied by product reformulation.

Sodium and Salt Consumption in Latin America and the Caribbean: A Systematic-Review and Meta-Analysis of Population-Based Studies and Surveys

“…The results only show that any estimate provided for South America is larger than the result for the Caribbean; this is consistent with the findings by Powel and colleagues [7]. Different dietary sources could potentially explain the differences [30]; for example, meat and bakery seem to be relevant sodium sources in low-and middle-income countries [30] and we could argue that these, particularly meat, are more often consumed in South America. Gender and age distributions in the selected reports were largely similar across the countries, which may imply that these variables do not greatly explain the results.…”

Salt and potassium intake among adult Ghanaians: WHO-SAGE Ghana Wave 3

“…Further, Ghana's national salt iodization programme, along with accompanying major public health campaigns on iodine consumption [47][48][49][50] may partially be responsible for an increase in discretionary salt intake. However, lack of information on sources of salt provided from discretionary and non-discretionary Despite the current study not including a dietary assessment component, a recent systematic review of dietary sources of salt in LMICs identified that bread, meat and meat products, bakery products, instant noodles, salted preserved foods, milk and dairy products, and condiments were major sources thereof [51]. In some LMICs, bread alone may contain as much as 1.36 g salt per 100 g bread [52].…”

Harmful Compounds and Willingness to Buy for Reduced-Additives Salami. An Outlook on Italian Consumers

“…Such innovation has been directed towards the manufacture of productions that are more health-beneficial, and two different strategies have gradually been developed. The first strategy addresses the reduction of unhealthy compounds and ingredients, such as additives, fat, and salt [6,7]. The second is directed to enhance the nutritional contents of food, by adding compounds with health benefits, such as natural antioxidants like spices, omega 3 fatty acids, probiotics, etc.…”