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Background: Population-wide sodium reduction strategies aim to reduce the cardiovascular burden of excess dietary sodium. Lowering sodium in packaged foods, which contribute the most dietary sodium, is an important intervention to lower population intakes. Purpose: To determine sodium levels in Canadian packaged foods and evaluate the proportion of foods meeting sodium benchmark targets set by Health Canada. Methods: A cross-sectional analysis of 7,234 packaged foods available in Canada in 2010−2011. Sodium values were obtained from the Nutrition Facts table. Results: Overall, 51.4% of foods met one of the sodium benchmark levels: 11.5% met Phase 1, 11.1% met Phase 2, and 28.7% met 2016 goal (Phase 3) benchmarks. Food groups with the greatest proportion meeting goal benchmarks were dairy (52.0%) and breakfast cereals (42.2%). Overall, 48.6% of foods did not meet any benchmark level and 25% of all products exceeded maximum levels. Meats (61.2%) and canned vegetables and legumes (29.6%) had the most products exceeding maximum levels. The range of sodium within and between food categories was highly variable. Food categories highest in sodium (mg/serving) were dry, condensed, and ready-to-serve soups (834±256, 754±163, and 636±173, respectively); oriental noodles (783±433); broth (642±239); and frozen appetizers/sides (642±292). Conclusions: These data provide a critical baseline assessment for monitoring sodium levels in Canadian foods. Although some segments of the market are making progress toward sodium reduction, all sectors need encouragement to continue to reduce the amount of sodium added during food processing. [ABSTRACT FROM AUTHOR]

Abstract: Sodium restriction is the primary nutritional strategy in heart failure; however, other diet-related concerns may also occur. We characterized dietary intake among stable patients with heart failure and a non-heart-failure cardiac control group to quantify and determine prevalence of inadequate micronutrient intake. Two 3-day food records were completed by 123 patients with heart failure and 58 controls. A subset of each group provided two 24-hour urine collections. Mean intake of sodium (2,540±1,122 vs 2,596±1,184 mg/day) and potassium (3,190±980 vs 3,114±828 mg/day) was similar between the heart failure and control groups. Prevalence of inadequate potassium intake was 94% among patients with heart failure and 91% among controls. More than 50% in each group had inadequate intakes of calcium, magnesium, folate, and vitamins D and E. In stable patients with heart failure, sodium intake was not excessive. However, we demonstrated widespread dietary inadequacies of other vitamins and minerals. These findings highlight the importance of diet beyond that of sodium restriction. [Copyright &y& Elsevier]

Dietary sodium reduction is commonly used in the treatment of hypertension, heart and liver failure, and chronic kidney disease. Sodium reduction is also an important public health problem since most of the Canadian population consumes sodium in excess of their daily requirements. Lack of awareness about the amount of sodium consumed and the sources of sodium in diet is common, and undoubtedly a major contributor to excess sodium consumption. There are few known tools available to screen and provide personalized information about sodium in the diet. Therefore, we developed a Web-based sodium intake screening tool called the Salt Calculator (), which is publicly available for individuals to assess the amount and sources of sodium in their diet. The Calculator contains 23 questions focusing on restaurant foods, packaged foods, and added salt. Questions were developed using sodium consumption data from the Canadian Community Health Survey cycle 2.2 and up-to-date information on sodium levels in packaged and restaurant food databases from the University of Toronto. The Calculator translates existing knowledge about dietary sodium into a tool that can be accessed by the public as well as integrated into clinical practice to address the high levels of sodium presently in the Canadian diet. [ABSTRACT FROM AUTHOR]

The article discusses a study that quantified the amount of sodium in commonly prescribed hospital patient menus in Ontario and determined if those levels complied with established sodium recommendations. Menus for regular, diabetic and sodium-restricted diet prescriptions at three acute care hospitals between November 2010 and August 2011 were evaluated. The need for sodium-focused food procurement to and better menu-planning policies is also addressed.

Background: Diets high in sodium are a risk factor for cardiovascular disease (CVD). Latin American countries (LAC) consume more than double the recommended sodium levels. Research uptake in dietary sodium reduction policies has been inconsistent in LAC, and the factors impacting research uptake are largely unknown. This study aimed to describe the barriers and facilitators to the uptake of research into sodium reduction policies from a funded research consortium with 5 LAC (Argentina, Brazil, Costa Rica, Paraguay, and Peru). Methods: A qualitative case study included 5 researchers and 4 Ministry of Health officers from the funded consortium. Dimensions from Trostle's framework of actors, content, context, and process and relative advantages from the Diffusion of Innovation informed the semistructured interview guide and analysis. One-on-one interviews were completed from November 2019 to January 2020. The participants validated transcripts, coded, and analyzed using NVivo software. Results: Key barriers to policy advancements included 1) conflicts of interest from the food industry and some government actors; 2) government turnover resulting in policy and personnel changes; 3) a lack of human and financial resources; and 4) and communication gaps among key actors. Key facilitators to policy advancement included: 1) the content and quality of health economic, food supply, and qualitative data; 2) support, technical assistance, and alliances with the government, non-governmental organizations, and international experts; and 3) researchers enhanced skillsets facilitated with communication and dissemination with policymakers. Conclusion: Researchers and policymakers are faced with several barriers and facilitators on research uptake in policies and programs in LAC; these factors should be addressed and leveraged to advance sodium reduction policy development. Future LAC studies can draw from the insights and lessons learned from this case study and apply the results to future efforts on policy nutrition to promote healthy eating and reduce CVD risk. [ABSTRACT FROM AUTHOR]

Highlights: [•] Rasch model was used to measure and rank sodium-reducing dietary recommendations. [•] Level of engagement with recommendations was compared by socioeconomic groups. [•] Engagement is higher for recommendations related to food preparation practices. [•] Engagement is lower for recommendations requiring avoidance of processed foods. [•] Policies at the food supply level needed for lowering sodium in processed food. [Copyright &y& Elsevier]

Dietary modifications are key health behaviour recommendations for the prevention and management of hypertension, a leading contributor of global disease burden. Despite this, few primary care physicians discuss nutrition with their patients. This study describes the barriers and facilitators to the provision of dietary advice for hypertension prevention and management among Canadian physicians. A validated 62-item cross-sectional survey was distributed online to 103 Canadian primary care physicians between 2017 and 2019. Eighty participants were included in the analyses. The majority of participants were based in Ontario (68.7%) and saw 10–24 patients per week (53.5%). Fewer than half (47.5%) of participants were knowledgeable about the recommended sodium level by Hypertension Canada (< 2000 mg/day) and 38.8% felt it was difficult to know which foods are high or low in sodium. Approximately one quarter felt the findings about sodium and hypertension and cardiovascular disease are controversial. Other significant barriers were: not enough time to talk to patients about diet (76.3%), belief that patients are not truthful about their diet (76.3%), patients would not follow their advice (46.8%), and that it was difficult to keep up with so many guidelines (50.0%). Many identified that electronic medical record tools (80.8%), access to dietitians (84.9%), or more nutrition education in medical training (65.8%) would help facilitate advice. Given the importance of diet and the central role of physicians in motivating dietary change among patients, approaches are required to address identified barriers and facilitators to providing dietary advice to reduce the burden of hypertension. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]