Project description:The objective of this periodic review was to identify, summarize, and appraise studies relating to the implementation of salt reduction strategies that were retrieved between November 2015 and February 2016. From the established MEDLINE search, 56 studies were identified as relevant to the implementation of salt reduction initiatives. Detailed appraisal was performed on seven studies that evaluated the impact of salt reduction interventions. While study quality varied, all had one or more risks related to bias. There was consistent evidence, from three studies, demonstrating that setting-based structural interventions to improve the nutritional composition of foods were effective in reducing salt but mixed evidence in relation to the effectiveness of behavioral interventions. The development of an evaluation guidance framework that supports scientific rigor and external validity would aid future design and interpretation of studies evaluating salt reduction interventions, particularly for low-resource countries.
Project description:This review aims to identify, summarize, and appraise studies reporting on the implementation of salt reduction interventions that were published between March and August 2016. Overall, 40 studies were included: four studies evaluated the impact of salt reduction interventions, while 36 studies were identified as relevant to the design, assessment, and implementation of salt reduction strategies. Detailed appraisal and commentary were undertaken on the four studies that measured the impact of the interventions. Among them, different evaluation approaches were adopted; however, all demonstrated positive health outcomes relating to dietary salt reduction. Three of the four studies measured sodium in breads and provided consistent evidence that sodium reduction in breads is feasible and different intervention options are available. None of the studies were conducted in low- or lower middle-income countries, which stresses the need for more resources and research support for the implementation of salt reduction interventions in these countries.
Project description:This periodic review aims to identify, summarize, and appraise studies relating to the implementation of salt reduction strategies that were published between September 2016 and February 2017. A total of 41 studies were included as relevant to the design, assessment, and implementation of salt reduction strategies, and a detailed appraisal was conducted on the seven studies that evaluated the impact of salt reduction strategies. Of these, three were national studies or included large populations and four were conducted in communities with small participant sample sizes. Each study used a different strategy for reducing salt intake varying from category-specific sodium targets for packaged food to use of a low-sodium salt substitute to behavior change interventions. Four studies found statistically significant decreases in dietary salt intake and one study showed statistically significant decreases in mean sodium density of packaged food products. Four of the seven studies used either spot or 24-hour urine samples to measure dietary salt intake and five were conducted in East or Southeast Asia-two of which were in low- and middle-income countries. Study quality varied among the seven studies and all except one had one or more risks related to bias.
Project description:The Science of Salt reviews identify, summarize, and critically appraise published studies on dietary salt and health outcomes according to pre-specified methods. This review covers the period April 3 to October 30, 2018. Here, nineteen studies that fit pre-specified criteria for review and summary are included. Three of these, one prospective cohort study, one randomized controlled trial, and a post hoc analysis of the Dietary Approaches to Stop Hypertension (DASH) sodium trial fulfilled the quality criteria for detailed critical appraisal, including risk of bias assessment, and commentary. Two trials demonstrated a positive association between salt intake and blood pressure. In a cohort of older Italians, increased risk of total mortality was observed with salt intake less than ~16 g/d (6300 mg sodium/d) at baseline; no association existed for incident cardiovascular disease (CVD) or CVD mortality. The paucity of published studies which met our criteria for methodological quality is of concern.
Project description:The purpose of this review was to identify, summarize, and critically appraise studies on dietary salt relating to health outcomes that were published from December 2015 to March 2016. The search strategy was adapted from a previous systematic review on dietary salt and health. Overall, 13 studies were included in the review: one study assessed cardiovascular events, nine studies assessed prevalence or incidence of blood pressure or hypertension, one study assessed kidney disease, and two studies assessed other health outcomes (obesity and nonalcoholic fatty liver disease). Four studies were selected for detailed appraisal and commentary. One study met the minimum methodologic criteria and found an increased risk associated with lower sodium intake in patients with heart failure. All other studies identified in this review demonstrated positive associations between dietary salt and adverse health outcomes.
Project description:The purpose of this review was to systematically identify, summarize, and critically appraise studies on dietary salt relating to health outcomes that were published from August to November 2015. The search strategy was adapted from a previous systematic review on dietary salt and health. Overall, 15 studies were included in the review: one study assessed cardiovascular events, five studies assessed blood pressure or hypertension incidence, six studies assessed surrogate outcomes for cardiovascular or kidney diseases, and three studies assessed other outcomes (age-related cataracts, rheumatoid arthritis, and bone mineral density, respectively). Four studies were selected for detailed appraisal and commentary.
Project description:Studies identified from an updated systematic review (from June 2014 to May 2015) on the impact of dietary salt intake on clinical and population health are reviewed. Randomized controlled trials, cohort studies, and meta-analyses of these study types on the effect of sodium intake on blood pressure, or any substantive adverse health outcomes were identified from MEDLINE searches and quality indicators were used to select studies that were relevant to clinical and public health. From 6920 studies identified in the literature search, 144 studies were selected for review, of which only three (n=233,680) met inclusion criteria. Between them, the three studies demonstrated a harmful association between excess dietary salt and all-cause mortality, noncardiovascular and cardiovascular disease mortality, and headache. None of the included studies found harm from lowering dietary salt. The findings of this systematic review are consistent with the large body of research supportive of efforts to reduce population salt intake and congruent with our last annual review from June 2013 to May 2014.
Project description:Background:Zika virus (ZIKV) is an emerging mosquito-borne disease that can cause severe birth defects if contracted congenitally. Since late 2015, there has been a large increase in the number of travel-related cases of Zika virus infection in Canada. Objective:The objective of this study was to describe the epidemiology of travel-related Zika cases in Canada from October 2015 to June 2017 and review them in the context of the international outbreak in the Americas. Methods:Zika virus infections were confirmed by polymerase chain reaction (PCR) detection of viral RNA and/or the serological identification of ZIKV-specific antibodies in serum. Cases of ZIKV infection were identified by provincial and territorial health authorities, and reported on a regular basis to the Public Health Agency of Canada (PHAC). Case information requested included date of illness onset, age category, sex, pregnancy status, and location(s) and dates of travel. Estimates for the monthly number of Canadians travelling outside of Canada to other countries in the Americas were obtained from Statistics Canada and the International Air Transport Association (IATA). Data to produce the epidemic curves of autochthonous cases for each region of the Americas were extracted from country-specific epidemic curves on the Pan American Health Organization website. Results:As of June 7, 2017, 513 laboratory confirmed cases and two Zika-related birth/fetal anomalies were reported across all 10 provinces. Illness in Canadian travellers generally coincided with outbreak intensity in the country of exposure rather than travel volume. There has been no evidence of autochthonous (local) transmission in Canada. Currently, cases are on the decline both in Canada and internationally. Conclusion:The surge in Canadian ZIKV infections in 2016 was directly related to the incursion and spread of ZIKV into the Americas. Although cases are now on the decline worldwide, it remains to be seen whether a resurgence of cases in previously affected or new areas will occur. Both outbreak intensity and seasonality of ZIKV transmission should be monitored over time in order to inform the timing of public health education campaigns, as some may turn out to be more effective in the off-peak travel season when the risk of disease transmission may be higher. Ongoing education and awareness among travellers, particularly for pregnant women and those planning pregnancies, is still indicated.
Project description:The World Hypertension League Science of Salt health outcomes review series highlights high-quality publications relating to salt intake and health outcomes. This review uses a standardised method, outlined in previous reviews and based on methods developed by WHO, to identify and critically appraise published articles on dietary salt intake and health outcomes. We identified 41 articles published between September 2019 to December 2020. Amongst these, two studies met the pre-specified methodological quality criteria for critical appraisal. They were prospective cohort studies and examined physical performance and composite renal outcomes as health outcomes. Both found an association between increased/higher sodium intake and poorer health outcomes. Few studies meet criteria for high-quality methods. This review adds further evidence that dietary salt reduction has health benefits and strengthens evidence relating to health outcomes other than blood pressure and cardiovascular disease. We observe that most studies on dietary sodium do not have adequate methodology to reliably assess sodium intake and its association with health outcomes.