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Results of a national survey examining Canadians' concern, actions, barriers, and support for dietary sodium reduction interventions.

ABSTRACT: Population-wide dietary sodium reduction is considered a priority intervention to address sodium-related chronic diseases. In 2010, the Canadian government adopted a sodium reduction strategy to lower sodium intakes of Canadians; however, there has been a lack of coordinated action in its implementation. Our objective was to evaluate Canadians' concern, actions, reported barriers, and support for government-led policy interventions aimed at lowering sodium intakes. We conducted a survey among Canadians about sodium knowledge, attitudes, and behaviours. Data were weighted to reflect the 2006 Canadian census. Among 2603 respondents, 67.0% were concerned about dietary sodium and 59.3% were currently taking action to limit sodium intake. Those aged 50-59 years (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.17-2.72) and 60-69 years (OR, 1.63; 95% CI, 1.05-2.55) were more likely to be concerned about sodium vs younger individuals (20-29 years), as were hypertensive patients vs normotensive patients (OR, 4.13; 95% CI, 3.05-5.59). Older age groups and those with hypertension (OR, 3.48; 95% CI, 2.58-4.69) were also more likely to limit sodium consumption. Common barriers to sodium reduction were limited variety of lower sodium processed (55.5%) and restaurant (65.8%) foods. High support for government-led actions was observed, including interventions for lowering sodium levels in processed (86.6%) and restaurant (72.7%-74.3%) foods, and in food served in public institutions (81.8%-82.3%), and also for public education (80.4%-83.1%). There was much less support for financial incentives and disincentives. In conclusion, these concerns, barriers, and high level of support for government action provide further rationale for multi-sectoral interventions to assist Canadians in lowering their sodium intakes.

SUBMITTER: Arcand J

PROVIDER: S-EPMC4870022 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

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Results of a national survey examining Canadians' concern, actions, barriers, and support for dietary sodium reduction interventions.

Arcand Joanne J Mendoza Julio J Qi Ying Y Henson Spencer S Lou Wendy W L'Abbe Mary R MR

The Canadian journal of cardiology 20130313 5

Population-wide dietary sodium reduction is considered a priority intervention to address sodium-related chronic diseases. In 2010, the Canadian government adopted a sodium reduction strategy to lower sodium intakes of Canadians; however, there has been a lack of coordinated action in its implementation. Our objective was to evaluate Canadians' concern, actions, reported barriers, and support for government-led policy interventions aimed at lowering sodium intakes. We conducted a survey among Ca ...[more]

PMID: 23489574

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Project description:BackgroundThe DASH (Dietary Approaches to Stop Hypertension) diets reduced blood pressure (BP) in the DASH and DASH-Sodium trials, but the underlying mechanisms are unclear. We identified metabolites associated with systolic BP or diastolic BP (DBP) changes induced by dietary interventions (DASH versus control arms) in 2 randomized controlled feeding studies-the DASH and DASH-Sodium trials.MethodsMetabolomic profiling was conducted in serum and urine samples collected at the end of diet interventions: DASH (n=219) and DASH-Sodium (n=395). Using multivariable linear regression models, associations were examined between metabolites and change in systolic BP and DBP. Tested for interactions between diet interventions and metabolites were the following comparisons: (1) DASH versus control diets in the DASH trial (serum), (2) DASH high-sodium versus control high-sodium diets in the DASH-Sodium trial (urine), and (3) DASH low-sodium versus control high-sodium diets in the DASH-Sodium trial (urine).ResultsSixty-five significant interactions were identified (DASH trial [serum], 12; DASH high sodium [urine], 35; DASH low sodium [urine], 18) between metabolites and systolic BP or DBP. In the DASH trial, serum tryptophan betaine was associated with reductions in DBP in participants consuming the DASH diets but not control diets (P interaction, 0.023). In the DASH-Sodium trial, urine levels of N-methylglutamate and proline derivatives (eg, stachydrine, 3-hydroxystachydrine, N-methylproline, and N-methylhydroxyproline) were associated with reductions in systolic BP or DBP in participants consuming the DASH diets but not control diets (P interaction, <0.05 for all tests).ConclusionsWe identified metabolites that were associated with BP lowering in response to dietary interventions.RegistrationURL: https://www.Clinicaltrialsgov/ct2/show/NCT03403166; Unique identifier: NCT03403166 (DASH trial). URL: https://www.Clinicaltrialsgov/ct2/show/NCT00000608; Unique identifier: NCT00000608 (DASH-Sodium trial).

Project description:ObjectiveTo summarise evidence describing the cost-effectiveness of population-based interventions targeting sodium reduction.MethodsA systematic search of published and grey literature databases and websites was conducted using specified key words. Characteristics of identified economic evaluations were recorded, and included studies were appraised for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.ResultsTwenty studies met the study inclusion criteria and received a full paper review. Fourteen studies were identified as full economic evaluations in that they included both costs and benefits associated with an intervention measured against a comparator. Most studies were modelling exercises based on scenarios for achieving salt reduction and assumed effects on health outcomes. All 14 studies concluded that their specified intervention(s) targeting reductions in population sodium consumption were cost-effective, and in the majority of cases, were cost saving. Just over half the studies (8/14) were assessed as being of 'excellent' reporting quality, five studies fell into the 'very good' quality category and one into the 'good' category. All of the identified evaluations were based on modelling, whereby inputs for all the key parameters including the effect size were either drawn from published datasets, existing literature or based on expert advice.ConclusionDespite a clear increase in evaluations of salt reduction programs in recent years, this review identified relatively few economic evaluations of population salt reduction interventions. None of the studies were based on actual implementation of intervention(s) and the associated collection of new empirical data. The studies universally showed that population-based salt reduction strategies are likely to be cost effective or cost saving. However, given the reliance on modelling, there is a need for the effectiveness of new interventions to be evaluated in the field using strong study designs and parallel economic evaluations.

Dataset Information

Results of a national survey examining Canadians' concern, actions, barriers, and support for dietary sodium reduction interventions.

Publications

Results of a national survey examining Canadians' concern, actions, barriers, and support for dietary sodium reduction interventions.

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