Need for coordinated programs to improve global health by optimizing salt and iodine intake

Campbell, Norm R.C.; Dary, Omar; Cappuccio, Francesco P.; Neufeld, Lynnette M.; Harding, Kimberly; Zimmermann, Michael

doi:10.1590/s1020-49892012001000006

Cited by 27 publications

(23 citation statements)

References 20 publications

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“…Considering the importance of integrative approaches to monitor salt and iodine consumption for effective salt iodisation programs, the validated INTERSALT equations (a) and (b) to estimate 24-h urinary sodium excretion in young adults were applied [12,13]. This approach was evaluated by comparing our results with recent data from a 24-h urine excretion in a similar Portuguese population [14].…”

Section: Methodsmentioning

confidence: 99%

Iodine Status and Iodised Salt Consumption in Portuguese School-Aged Children: The Iogeneration Study

et al. 2017

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The World Health Organization promotes salt iodisation to control iodine deficiency. In Portugal, the use of iodised salt in school canteens has been mandatory since 2013. The present study aimed to evaluate iodine status in school-aged children (6–12 years) and to monitor the use of iodised salt in school canteens. A total of 2018 participants were randomly selected to participate in a cross-sectional survey in northern Portugal. Children’s urine and salt samples from households and school canteens were collected. A lifestyle questionnaire was completed by parents to assess children’s eating frequency of iodine food sources. Urinary iodine concentration (UIC) was measured by inductively coupled plasma-mass spectrometry. The median UIC was 129 µg/L which indicates the adequacy of iodine status and 32% of the children had UIC < 100 µg/L. No school canteen implemented the iodised salt policy and only 2% of the households were using iodised salt. Lower consumption of milk, but not fish, was associated with a higher risk of iodine deficiency. Estimation of sodium intake from spot urine samples could be an opportunity for adequate monitoring of population means. Implementation of iodine deficiency control policies should include a monitoring program aligned with the commitment of reducing the population salt intake.

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Section: Methodsmentioning

confidence: 99%

Iodine Status and Iodised Salt Consumption in Portuguese School-Aged Children: The Iogeneration Study

et al. 2017

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“…Countries are also recognizing the need to balance longstanding programs to prevent iodine deficiency that rely on iodized table salt with initiatives to reduce salt intake. The WHO and PAHO have prepared technical documents that can be consulted for guidance in this regard …”

Section: Discussionmentioning

confidence: 99%

“…The WHO and PAHO have prepared technical documents that can be consulted for guidance in this regard. 5,8,[35][36][37][38]…”

Section: Challengesmentioning

confidence: 99%

Targets and Timelines for Reducing Salt in Processed Food in the Americas

Campbell

Legowski

Legetić

et al. 2014

J of Clinical Hypertension

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Reducing dietary salt is one of the most effective interventions to lessen the burden of premature death and disability. In high‐income countries and those in nutrition transition, processed foods are a significant if not the main source of dietary salt. Reformulating these products to reduce their salt content is recommended as a best buy to prevent chronic diseases across populations. In the Americas, there are targets and timelines for reduced salt content of processed foods in 8 countries—Argentina, Brazil, Canada, Chile, Ecuador, Mexico, and the National Salt Reduction Initiative in the United States and Paraguay. While there are common elements across the countries, there are notable differences in their approaches: 4 countries have exclusively voluntary targets, 2 countries have combined voluntary and regulated components, and 1 country has only regulations. The countries have set different types of targets and in some cases combined them: averages, sales‐weighted averages, upper limits, and percentage reductions. The foods to which the targets apply vary from single categories to comprehensive categories accounting for all processed products. The most accessible and transparent targets are upper limits per food category. Most likely to have a substantive and sustained impact on salt intake across whole populations is the combination of sales‐weighted averages and upper limits. To assist all countries with policies to improve the overall nutritional value of processed foods, the authors call for food companies to supply food composition data and product sales volume data to transparent and open‐access platforms and for global companies to supply the products that meet the strictest targets to all markets. Countries participating in common markets at the subregional level can consider harmonizing targets, nutrition labels, and warning labels.

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“…In parallel to the global roll out of salt reduction efforts there is a need to ensure that actions to control the impact of iodine deficiency are not adversely impacted [37]. Iodisation of salt is the preferred method for iodine deficiency disorder elimination [38] and there is a theoretical risk that a highly effective salt reduction program could reduce the effectiveness of this strategy.…”

Section: Discussionmentioning

confidence: 99%

Protocol for the implementation and evaluation of a community-based intervention seeking to reduce dietary salt intake in Lithgow, Australia

et al. 2014

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BackgroundExcess dietary salt is a leading risk for health. Multiple health, government, industry and community organisations have identified the need to reduce consumption of dietary salt. This project seeks to implement and evaluate a community-based salt reduction intervention.MethodsThe study comprises a baseline assessment followed by a targeted intervention and then an evaluation of efficacy. The study location is Lithgow, a regional town in New South Wales, Australia. The salt reduction intervention is based upon the Communication for Behavioural Impact framework which utilises an integrated communication model to enact community advocacy and impact by providing tools that enable the translation of knowledge into behavioural change. The duration of the intervention will be between 6 and 12 months. The primary evaluation will be through measurement of 24-hr urinary sodium excretion in independent population samples aged > 20 years, drawn before and after the intervention period. The study is designed to detect a difference in mean sodium excretion of 0.7 grams per day or greater with 80% power and p = 0.05.DiscussionThis study will provide a robust evaluation of the effectiveness of a community-based intervention seeking to reduce dietary salt intake using the Communication for Behavioural Impact framework. The results will provide important new evidence to inform the design and implementation of current and future salt reduction policies in Australia. The results will also have important international implications because, following the recent World Health Organization recommendations for the control of non-communicable diseases, many countries are now seeking to achieve a reduction in average population salt consumption.Trial registrationClinicalTrials.gov, NCT02105727

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Need for coordinated programs to improve global health by optimizing salt and iodine intake

Cited by 27 publications

References 20 publications

Iodine Status and Iodised Salt Consumption in Portuguese School-Aged Children: The Iogeneration Study

Iodine Status and Iodised Salt Consumption in Portuguese School-Aged Children: The Iogeneration Study

Targets and Timelines for Reducing Salt in Processed Food in the Americas

Protocol for the implementation and evaluation of a community-based intervention seeking to reduce dietary salt intake in Lithgow, Australia

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