An essential component of Health Canada's sodium reduction activities is research, with a focus on identifying and filling knowledge gaps and establishing research priorities that would engage partners and the research community in generating data to support sodium reduction.
Three domains of research questions have been identified:
- Health aspects of sodium, including:
- exposure to sodium in childhood or in utero as a predisposing factor for hypertension and cardiovascular diseases;
- the vulnerability of at-risk populations to the effects of sodium, including Aboriginal people, people of South Asian and African origin, infants, children and the elderly;
- the influence of sodium reduction in the population, including long-term benefits and risks other than cardiovascular endpoints, such as asthma, osteoporosis, gastrointestinal cancers, etc.
- Food science aspects of sodium, including:
- the role of sodium in microbial food safety;
- limits to lowering sodium in food while maintaining the functional aspects for which sodium is added;
- role of sodium in taste physiology;
- alternatives to sodium, considering safety and functionality, and including technological innovations and alternative food processing strategies.
- Knowledge-to-action aspects of sodium, including:
- the impact of regulation and policy, including questions such as how package labelling affects food choices and an examination of "natural experiments," based on policy approaches used in different countries;
- the effectiveness of taking action, including understanding the barriers to going from knowledge to action with respect to sodium, differences according to segments within the general population and implications for developing enabling tools.
In January 2010, The Institute of Nutrition, Metabolism, and Diabetes (INMD) and the Institute of Circulatory and Respiratory Health (ICRH) of the Canadian Institutes of Health Research organized a workshop called Developing a Research Agenda to Support Sodium Reduction in Canada, with the objectives of identifying:
- strengths, gaps, and opportunities in research capacity in Canada for sodium reduction in the thematic areas of health, food science, knowledge-to-action, and in evaluation and monitoring;
- a research agenda for sodium reduction in Canada;
- opportunities for international and global collaborations for the Canadian research community in the context of Chronic Disease Prevention and Control;
- potential research funders to support the identified research agenda for sodium reduction in Canada.
The workshop focussed on the identification of research questions in the following four thematic areas:
- Health and human physiology
- Food science and food technology
- Evaluation and monitoring
The diverse range of stakeholders participating in the workshop identified key knowledge gaps and developed priorities for research and action plans in each of three streams: health, food science and food technology, and knowledge to action.
The Natural Sciences and Engineering Research Council of Canada (NSERC) and the Canadian Institutes for Health Research (CIHR) Institute of Nutrition, Metabolism and Diabetes Funding Initiative for Sodium Reduction in the Canadian Food Supply.
Applications are accepted in the following research areas:
- Investigating alternative processes or technologies to meet the microbial food safety and food technology needs at a lower level of sodium, without unduly increasing cost;
- Determining the microbial food safety consequences of decreasing the sodium concentration in foods, and how to manage them effectively;
- Investigating the effectiveness, potential risks and benefits of alternatives to salt and sodium-based food ingredients in foods from a technology and/or food safety perspective;
- Determining the physiological mechanisms of taste perception affected by sodium, including the modifying effects of different food matrices.
Applicants are required to partner with a Canadian-based industrial organization (a single firm, industrial association or a producer group). NSERC and the CIHR-INMD encourage small and medium-sized enterprises to be involved in this initiative. Industry partners must contribute to the direct project costs in an amount at least equal to the amount requested from NSERC and they must be in a position to apply successful research results. The food industry have been encouraged to consider research conducted in this area as a non-competitive issue to allow greater sharing of techniques and technologies for meeting the sodium reduction targets, thus promoting the health of all Canadians.
- Dickhout, Jeffrey G. Role of endoplasmic reticulum (ER) stress in the development of kidney disease. McMaster University.
- Jhamandas, Jack. Role of RFamide peptides in CNS cardiovascular regulation. University of Alberta.
- L'Abbé, Mary. Evaluating the impact of Canada's Sodium Reduction Strategy on dietary intakes of sodium, the overall nutritional quality of the food supply, changes in food labelling, and consumer knowledge and attitudes towards sodium. University of Toronto.
- McLaren, Lindsay. Population-level prevention and implications for socioeconomic inequities in health: Dietary sodium as a case example. University of Calgary.
Government Publications Related to Sodium
Canadians continue to consume too much sodium and not enough potassium
CM Tanase; KG Koski; PJ Laffey; MJ Cooper; KA Cockell. Canadian Journal of Public Health, 102(3): 164-8.
Excessive sodium (Na) intakes and insufficient potassium (K) intakes are known contributors to hypertension. Na and K content based on recently analyzed food composite samples from the Canadian marketplace were matched with over 35,000 dietary recalls from the Canadian Community Health Survey (CCHS 2.2). The majority of Canadians exceeded the Tolerable Upper Intake Level (UL) for Na for their age and sex group, including infants, children, adolescents and adults. In sharp contrast, few had Adequate Intakes (AI) of K. Canadians of all ages need to decrease Na intakes below the UL. At the same time, increased consumption of dairy products, fruits and vegetables must be promoted to increase K intakes to current recommendations. Both dietary interventions are required to help lower hypertension in the Canadian population. We provide the first report based on direct analysis of Canadian foods, confirming the high Na and low K intakes of the Canadian population. With its annual sampling program of foods commonly consumed in Canada, the Total Diet Study provides an important sentinel system for monitoring these dietary risk factors for hypertension.
Dietary sodium intake among Canadian adults with and without hypertension
Y. Shi; M. de Groh; H. Morrison; C. Robinson; L. Vardy. Chronic Diseases in Canada. 31(2).
To understand how much sodium is consumed by people with hypertension, we examined and compared average daily sodium intake between people with hypertension and without, after controlling for key potential confounding factors.
Sodium and potassium in composite food samples from the Canadian Total Diet Study
Corina M. Tanase; Philip Griffin; Kristine G. Koski; Marcia J. Cooper; Kevin A. Cockell. Journal of Food Composition and Analysis , 24(2): 237-43.
Sodium (Na) and potassium (K) are essential nutrients. Like people in many Western societies, Canadians consume too much Na and not enough K, both of which contribute to hypertension. We analysed the Na and K content of 154 food composites, broadly representative of the foods most commonly consumed in Canada, from the Canadian Total Diet Study collection of 2007. With a few exceptions, foods high in Na were lower in K, and vice versa. Through judicious food selection it may be possible for consumers to decrease Na intake while increasing K, with associated health benefits. Such choices would be consistent with common nutrition advice to decrease consumption of processed foods, while increasing intakes of fresh fruits and vegetables.
Canadians' and Health Care Professionals' Views on Sodium
Prepared for the Public Health Agency by Decima Research, Inc
The Public Health Agency of Canada commissioned public opinion research to inform the Working Group about Canadians' current awareness about sodium.
Sodium Food Sources in the Canadian Diet
Peter W.F Fischer; Michel Vigneault; Rong Huang; Konstantinia Arvaniti; Paula Roach. Applied Physiology, Nutrition, and Metabolism, 34(5): 884-92.
The purpose of this study was to provide information on the current sources of dietary sodium in the Canadian food supply, to identify where sodium reduction efforts should be focussed, and to establish a platform for measuring the effectiveness of strategies to reduce salt consumption. Such strategies are being developed by a Health Canada-led multi-stakeholder Working Group. Data from the 2004 Canadian Community Health Survey (CCHS) 2.2, Nutrition, was used to determine the leading food group contributors of sodium in the Canadian diet.
DROPPING THE SALT : Practical steps countries are taking to prevent chronic non-communicable diseases through population-wide dietary salt reduction
Prepared for the Public Health Agency of Canada by Sheila Penney.
This paper was prepared at the request of the Public Health Agency of Canada (PHAC) as a background document for participants at the January 2009 PHAC/PAHO meeting on Mobilizing for Dietary Salt Reduction in the Americas.
Executive Summary of the 2009 Canadian Food Industry Survey on Progress, Challenges and Business Impact of Reducing Sodium in Processed Food Products
Agriculture and Agri-Food Canada commissioned a small qualitative survey to increase their understanding of the priority level of sodium reduction for the industry, issues faced by the food industry as it reduced sodium levels of processed foods, the ways in which the industry was trying to reduce sodium, and of how sodium reduction efforts were impacting business. Respondent data for this survey was collected in February and March of 2009.
Sodium Consumption at all Ages
Canadians consume a large amount of sodium. Although some sodium is needed to control blood volume and to help cells function properly, most Canadians consume far more than is necessary, or recommended. Results from the 2004 Canadian Community Health Survey indicate that, among people aged 19 to 70, over 85% of men and 60% of women had sodium intakes exceeding the recommended upper limit beyond which health risks increase.
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