Sodium Reduction in Bouillon: Targeting a Food Staple to Reduce Hypertension in Sub-saharan Africa

Abstract

Bouillon cubes are a staple ingredient used in Sub-saharan African countries providing flavor enhancement to savory foods. Bouillon has been identified as a vehicle for fortification to overcome micronutrient deficiencies in Sub-saharan Africa. However, bouillon has a high sodium content (and in addition with other foods) contributes to dietary sodium intake above recommended guidelines. High dietary sodium intake is a key risk factor for hypertension and cardiovascular disease (CVD). Africa has the highest rates of hypertension and CVD globally with nearly half the adult population above 25 years affected. This review presents current state of research on sodium reduction strategies in bouillon. The key challenge is to reduce sodium levels while maintaining optimal flavor at the lowest possible production cost to ensure bouillon continues to be affordable in Sub-saharan Africa. To produce lower sodium bouillon with acceptable flavor at low cost will likely involve multiple sodium reduction strategies; direct reduction in sodium, sodium replacement and saltiness boosting flavor technologies. Efforts to reduce the sodium content of bouillon in Sub-saharan Africa is a worthwhile strategy to: (i) lower the overall sodium consumption across the population, and (ii) deliver population-wide health benefits in a region with high rates of hypertension and CVD.

Is investing in food small and medium enterprises a viable path to improved nutrition in Sub‐Saharan Africa? A multidisciplinary perspective

“…Some modifications to improve the nutritional profile of existing foods, such as fortification with micronutrients, typically result in increases in the cost of these foods. Reformulation to reduce content of food components to limit (e.g., sodium or added sugars) may also increase costs if it requires substituting less expensive ingredients (e.g., salt) with more expensive ingredients or additional research to achieve a desirable product with the target nutritional profile (see Archer et al, 2022). On the other hand, investments that increase availability of nutritious products may help to make these products more affordable which is likely to have a positive impact on nutritional status.…”

The Role of Multiply-Fortified Table Salt and Bouillon in Food Systems Transformation

“…There are three main sources of sodium in the diet: (1) sodium naturally present in food, (2) sodium added to packaged or processed foods, and (3) sodium added during cooking or prior to eating at the table (discretionary/table salt). In high-income countries, the vast majority of sodium is consumed from processed foods; however, in lower-income countries, most sodium comes from salt (or seasoning such as bouillon) that is added during cooking (i.e., discretionary salt) [ 48 ]. Thus, attempts to reduce sodium levels in discretionary salt and bouillon consumed in LMICs hold strong potential for reducing sodium intake and, in turn, making progress toward the WHO’s 2030 goal of reducing premature deaths from NCDs by 25% [ 49 ].…”

“…While LMICs have the highest rates of hypertension and mortality due to CVD compared with high- and middle-income countries, there are fewer salt reduction initiatives in these geographies [ 50 ]. Interventions for population-wide sodium reduction include consumer education to reduce intake of high salt foods (e.g., media campaigns or front of pack labeling), reformulation of foods to contain lower sodium content [ 48 ], and government-led initiatives to set voluntary targets or mandatory maximum levels [ 47 , 50 , 51 ]. Options for reducing sodium intake from discretionary use of salt and bouillon in home cooking include consumer education to reduce the addition of salt to foods while cooking in the home environment [ 52 ] and increasing the use of salt substitutes [ 53 ].…”

“…Partial substitution with other non-sodium salts is an option that is widely used in many foods (e.g., potassium chloride or ammonia); however, these have negative sensory effects when used at higher concentrations. Due to the selective nature of the ion channel(s) associated with the detection of salt taste, there may not be a true substitute that can replace salt [ 48 ]. Optimal methods for sodium reduction in current/future micronutrient vehicles containing high salt levels such as bouillon and other condiments require further research.…”

“…Optimal methods for sodium reduction in current/future micronutrient vehicles containing high salt levels such as bouillon and other condiments require further research. Thus, salt reduction of high-sodium-containing foods such as condiments and bouillon will likely involve multiple strategies for reformulation to enable significant reduction [ 48 ]. In the case of bouillon, additional options include reformulating to exploit cross-modal interactions (taste-taste or taste-aroma) to enhance saltiness and overall flavor while reducing the salt content.…”