Effect of sodium reduction during lunch on consumer acceptance and on sodium intake

In the Dutch population, current estimations show an individual consumption of
nine to ten grams of salt (sodium chloride) per day, whereas the Dutch health
council recommends to lower sodium consumption to a maximum of six grams of
salt per day. Sodium intake is for 75-80% determined by processed food.
Reducing the sodium content in processed foods might be an effective strategy
to reduce sodium intake on population basis.
However, reduced sodium contents are associated with an impaired palatability.
Consumers might respond to sodium reduced foods by rejecting the foods or
increase their use of table salt or intake of salted foods later during the
day.
Little is known about a reduced salt level in relation to food choice
behaviour. Hence, there is a need to determine the consumer*s acceptance and
consumption of sodium reduced foods, with and without being informed on the
reduced salt content, in relation to daily dietary sodium intake.


This study examines the effect of salt reduction of lunch products, with and
without information, on food choice behaviour and salt intake.

The main objective is to gain insight in the impact of sodium reduced flavor
compensated (reformulated) foods on the consumer*s acceptance and consumption,
so industrial producers will be better motivated to reduce sodium in processed
foods, which helps the consumer to make the healthy choice the easy choice.

Primary objectives are to study:
1.The effects of offering a variety of lunch foods with a reduction of 30-60%
in sodium on food consumption, caloric and sodium intake and liking during
lunch.
2.Whether expected reduced sodium intakes during lunch extents towards a
reduced daily sodium intake measured via excreted sodium in 24-hr urines.

Secondary objectives are to study:
1.The effects of providing information about sodium reductions during lunch on
food consumption, caloric and sodium intake and liking.
2.The effects of providing information about sodium reductions on daily sodium
excretion.
3.The effects of offering a variety of 30-60% sodium reduced lunch foods on use
of table salt and other seasonings used during lunch.

The study consists of a parallel within-subjects study design, in which the
participants are blinded for the treatment for 7 weeks.
Participants in the control and intervention group can choose freely food
products to consume for lunch from the allocated lunch buffet and don*t have to
pay for their lunch.
After a control period of 2 weeks with regular foods for both groups, foods in
the buffet of the intervention group are exchanged for sodium reduced flavor
compensated foods, during 3 weeks. No information on sodium reduction is
provided.
In the last 2 weeks of the study, both groups are offered sodium reduced foods
but now with information on the sodium reduction.

In week 2, 5 and 7 participants of both the control and the intervention group
will have to collect 24-hr urine, for a urinary total sodium measurement.

After the run-in period, sodium reduced lunch products are offered to the
intervention group and to the control group regular products are offered during
3 weeks. Then all participants are offered sodium reduced lunch products for 2
more weeks, with information about the salt reduction.

Participants will participate in thirty-two free lunches in the Restaurant of
the Future that each last about 30 minutes. There are no risk associated with
this set up. The burden is minimal, people have to consume come for lunch 32
times and have to fill in 3 questionnaires (and 1 inclusion questionnaire)

For collection of 24-hr urine (3 separate days) para-aminobenzoic acid (PABA)
is given (tablets) to verify if all samples have been provided. Low doses of
PABA, as given in methodological studies, have rarely caused any side effects
and are therefore regarded as safe.

The study provides knowledge on reduction of sodium contents in diets, which
can contribute to healthier food choices, with reduced sodium intake. This an
contribute to a reduction of the occurrence of cardiovascular diseases. In our
opinion, in the light of the minimal burden and the large challenge on sodium
reduction in diets, the expected benefits justify this set up.