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The Equity and Effectiveness of Achieving Canada's Voluntary Sodium Reduction Guidance Targets: A Modelling Study Using the 2015 Canadian Community Health Survey-Nutrition.

ABSTRACT: Background: High sodium intake is a leading modifiable risk factor for cardiovascular diseases. This study estimated full compliance to Canada's voluntary sodium reduction guidance (SRG) targets on social inequities and population sodium intake. Methods: We conducted a modeling study using n = 19,645, 24 h dietary recalls (Canadians ≥ 2 years) from the 2015 Canadian Community Health Survey-Nutrition (2015 CCHS-N). Multivariable linear regressions were used to estimate mean sodium intake in measured (in the 2015 CCHS-N) and modelled (achieving SRG targets) scenarios across education, income and food security. The percentage of Canadians with sodium intakes above chronic disease risk reduction (CDRR) thresholds was estimated using the US National Cancer Institute (NCI) method. Results: In children aged 2-8, achieving SRG targets reduced mean sodium intake differences between food secure and insecure households from 271 mg/day (95%CI: 75,468) to 83 mg/day (95%CI: -45,212); a finding consistent across education and income. Mean sodium intake inequities between low and high education households were eliminated for females aged 9-18 (96 mg/day, 95%CI: -149,341) and adults aged 19 and older (males: 148 mg/day, 95%CI: -30,327; female: -45 mg/day, 95%CI: -141,51). Despite these declines (after achieving the SRG targets) the majority of Canadians' are above the CDRR thresholds. Conclusion: Achieving SRG targets would eliminate social inequities in sodium intake and reduce population sodium intake overall; however, additional interventions are required to reach recommended sodium levels.

SUBMITTER: Smith BT

PROVIDER: S-EPMC7997239 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundHybrid methods of dietary patterns analysis have emerged as a unique and informative way to study diet-disease relationships in nutritional epidemiology research.ObjectiveTo identify an obesogenic dietary pattern using weighted partial least squares (wPLS) in nationally representative Canadian survey data, and to identify key foods and/or beverages associated with the defined dietary pattern.DesignData from one 24-hr dietary recall data from the cross-sectional Canadian Community Health Survey-Nutrition (CCHS) 2015 (n = 12,049) were used. wPLS was used to identify an obesogenic dietary pattern from 40 standardized food and beverage categories using the variables energy density, fibre density, and total fat as outcomes. The association between the derived dietary pattern and likelihood of obesity was examined using weighted multivariate logistic regression. Key dietary components highly associated with the derived pattern were identified.ResultsCompared to quartile one (i.e. those least adherent to an obesogenic dietary pattern), those in quartile four had 2.40-fold increased odds of being obese (OR = 2.40, 95% CI = 1.91, 3.02, P-trend< 0.0001) with a monotonically increasing trend. Using a factor loading significance cut-off of ≥|0.17|, three food/beverage categories loaded positively for the derived obesogenic dietary pattern: fast food (+0.32), carbonated drinks (including energy drinks, sports drinks and vitamin water) (+0.30), and salty snacks (+0.19). Seven categories loaded negatively (i.e. in the protective direction): whole fruits (-0.40), orange vegetables (-0.32), "other" vegetables (-0.32), whole grains (-0.26), dark green vegetables (-0.22), legumes and soy (-0.18) and pasta and rice (-0.17).ConclusionThis is the first study to apply weighted partial least squares to CCHS 2015 data to derive a dietary pattern associated with obesity. The results from this study pinpoint key dietary components that are associated with obesity and consumed among a nationally representative sample of Canadians adults.

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The Equity and Effectiveness of Achieving Canada's Voluntary Sodium Reduction Guidance Targets: A Modelling Study Using the 2015 Canadian Community Health Survey-Nutrition.

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