Salt intake in children 10–12 years old and its modification by active working practices in a school garden

Cotter, Jorge; Cotter, Maria J.; Oliveira, Pedro; Cunha, Pedro; Polónia, Jorge

doi:10.1097/hjh.0b013e328363572f

Cited by 34 publications

(52 citation statements)

References 32 publications

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“…Three school-based interventions (one of good quality;[40] one of fair quality;[57] one of poor quality [58]) and three worksite-based studies (all of fair quality) were included. [59–61] No modelling studies were identified for this section.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy?

et al. 2017

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BackgroundNon-communicable disease (NCD) prevention strategies now prioritise four major risk factors: food, tobacco, alcohol and physical activity. Dietary salt intake remains much higher than recommended, increasing blood pressure, cardiovascular disease and stomach cancer. Substantial reductions in salt intake are therefore urgently needed. However, the debate continues about the most effective approaches. To inform future prevention programmes, we systematically reviewed the evidence on the effectiveness of possible salt reduction interventions. We further compared “downstream, agentic” approaches targeting individuals with “upstream, structural” policy-based population strategies.MethodsWe searched six electronic databases (CDSR, CRD, MEDLINE, SCI, SCOPUS and the Campbell Library) using a pre-piloted search strategy focussing on the effectiveness of population interventions to reduce salt intake. Retrieved papers were independently screened, appraised and graded for quality by two researchers. To facilitate comparisons between the interventions, the extracted data were categorised using nine stages along the agentic/structural continuum, from “downstream”: dietary counselling (for individuals, worksites or communities), through media campaigns, nutrition labelling, voluntary and mandatory reformulation, to the most “upstream” regulatory and fiscal interventions, and comprehensive strategies involving multiple components.ResultsAfter screening 2,526 candidate papers, 70 were included in this systematic review (49 empirical studies and 21 modelling studies). Some papers described several interventions. Quality was variable. Multi-component strategies involving both upstream and downstream interventions, generally achieved the biggest reductions in salt consumption across an entire population, most notably 4g/day in Finland and Japan, 3g/day in Turkey and 1.3g/day recently in the UK. Mandatory reformulation alone could achieve a reduction of approximately 1.45g/day (three separate studies), followed by voluntary reformulation (-0.8g/day), school interventions (-0.7g/day), short term dietary advice (-0.6g/day) and nutrition labelling (-0.4g/day), but each with a wide range. Tax and community based counselling could, each typically reduce salt intake by 0.3g/day, whilst even smaller population benefits were derived from health education media campaigns (-0.1g/day). Worksite interventions achieved an increase in intake (+0.5g/day), however, with a very wide range. Long term dietary advice could achieve a -2g/day reduction under optimal research trial conditions; however, smaller reductions might be anticipated in unselected individuals.ConclusionsComprehensive strategies involving multiple components (reformulation, food labelling and media campaigns) and “upstream” population-wide policies such as mandatory reformulation generally appear to achieve larger reductions in population-wide salt consumption than “downstream”, individually focussed interventions. This ‘effectiveness hierarchy’ might deserve greater emph...

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Section: Resultsmentioning

confidence: 99%

“…[58] In the second school based RCT, the practical intervention group achieved a significant net reduction of 0.7g/day compared with the control group. [57] In a cluster RCT in China, education and training significantly reduced salt intake by a mean of −1.9 g/day in 279 school children (and −2.9 g/day in adult family members). [40]…”

Section: Resultsmentioning

confidence: 99%

Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy?

et al. 2017

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“…At this point, we cannot offer an explanation for the influence on these results of early-life determinants or other proposed contributors to accelerated vascular aging as (short-term) BP variability [44] or salt consumption (recent studies in Portugal have reported the average individual salt consumption as reaching 10.7 g/day in adults, and 7.8 g/day in 10-12-year-old children [45,46]). …”

Section: Early Vascular Agingmentioning

confidence: 94%

Pulse wave velocity distribution in a cohort study

Cunha

Cotter²,

Oliveira³

et al. 2015

Journal of Hypertension

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“…19 In 10-to 12-year-old Portuguese children, 24-hour urinary sodium excretion showed an average salt intake of 7.8 g/d. 20 Similarly, a study in Australian private school children aged 5 to 13 years, which also collected 24-hour urine samples, showed an average salt intake of 6.0 g/d. 21 A review by Brown et al 22 of 41 reports from 20 countries that had included salt intake as an outcome measure showed that in all age groups, in both sexes, in different countries throughout the world salt intake in children is high.…”

Section: Discussion Dietary Salt Intakementioning

confidence: 99%