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Salt reduction is a public health priority for the Japanese population. We focused on the effect of salt reduction by changing eating utensils to reduce salt consumption. As a test meal, we used ramen, which is commonly eaten by Japanese individuals and has a high salt content. In this randomized crossover study, we hypothesized that eating ramen with a perforated spoon would reduce the quantity of ramen soup and salt consumed compared to using a regular spoon without holes. Soup intake, after-meal fullness, and deliciousness were compared between eating with chopsticks and a regular spoon, and with chopsticks and a perforated spoon. In total, 36 male university students (mean age, 20.7 [standard deviation, 1.8] years) were included in the analyses. The median salt intake (25th and 75th percentiles) was significantly lower with perforated spoons (1.8 [1.5, 4.3] g) than with regular spoons (2.4 [1.8, 4.8] g; p = 0.019). There were no significant differences in after-meal fullness or deliciousness for both spoon conditions (p > 0.05). For young men, the soup intake when eating ramen with a perforated spoon was lower than that with a regular spoon; this suggests a reduction in salt intake.

The salt‐reducing pickling method has been applied to the industrial production of zhacai. In order to reveal the succession of the microbial community structure and flavor components during the pickling process, this study used PacBio Sequel to sequence the full length of 16S rRNA (bacteria, 1400 bp) and ITS (fungi, 1200 bp) genes, and detected flavor components simultaneously, including organic acids, volatile flavor components (VFC), monosaccharides, and amino acids. Eleven phyla and 148 genera were identified in the bacterial community, and 2 phyla and 60 genera in the fungal community. During the four stages of pickling, the dominant bacterial genera were Leuconostoc, Lactobacillus, Leuconostoc, and Lactobacillus, while the dominant fungal genera were Aspergillus, Kazachstania, Debaryomyces, and Debaryomyces, respectively. There were 32 main flavor components (5 organic acids, 19 VFCs, 3 monosaccharides, and 5 amino acids). Correlation heat mapping and bidirectional orthogonal partial least squares (O2PLS) analysis showed that the flora having close relation to flavor components included 14 genera of bacteria (Leuconostoc, Clostridium, Devosia, Lactococcus, Pectobacterium, Sphingobacterium, Serratia, Stenotrophomonas, Halanaerobium, Tetragenococcus, Chromohalobacter, Klebsiella, Acidovorax, and Acinetobacter) and 3 genera of fungi (Filobasidium, Malassezia, and Aspergillus). This study provides detailed data regarding the microbial community and flavor components during the salt‐reducing pickling process of zhacai, which can be used as a reference for the development and improvement of salt‐reducing pickling methods. This study investigated a whole process of the salt‐reducing pickling of zhacai. The microbial community structure during the four stages was analyzed by using the PacBio Sequel platform to sequence full‐length 16S rRNA and ITS genes, the flavor components were measured (organic acids, VFCs, monosaccharides and amino acids), the correlations between microbial communities and flavor components were analyzed using correlation heat mapping and O2PLS modeling, the core functional flora were inferred through integrated correlation analysis, and the predicted functions of the microbial communities after using PICRUSt2 analysis were highlighted.

Sodium is a necessary nutrient for regulating extracellular fluid and transferring molecules around cell membranes with essential functions. However, the prevalence of some diseases is related to unnecessary sodium intake. As a result, a particular problem for the food industry remains a matter of sodium content in foods. It is considered that customer acceptance is associated with salt perception dynamics related to the evolution of food production. It is a significant challenge and technique to minimize the salt content of various foods and provide replacement products with substantial reductions in salt levels. This review summarizes salt reduction strategies related to health problems based on traditional review methodology, with practical and methodological screening performed to determine the appropriate reference sources. Various technological (salt replacement, food reformulation, size and structural modifications, alternative processing, and crossmodal odor interaction) and behavioral strategies (memory process, gradual salt reduction, and swap) are identified in this work, including a deeper understanding of the principles for reducing sodium content in foods and their effect on food characteristics and potential opportunities for the food industry. Thereby, the food industry needs to find the proper combination of each strategy’s advantages and disadvantages to reduce salt consumption while maintaining product quality.

To understand the factors influencing the implementation of salt reduction interventions in low- and middle-income countries (LMIC). Retrospective policy analysis based on desk reviews of existing reports and semi-structured stakeholder interviews in four countries, using Walt and Gilson's 'Health Policy Triangle' to assess the role of context, content, process and actors on the implementation of salt policy. Argentina, Mongolia, South Africa and Vietnam. Representatives from government, non-government, health, research and food industry organisations with the potential to influence salt reduction programmes. Global targets and regional consultations were viewed as important drivers of salt reduction interventions in Mongolia and Vietnam in contrast to local research and advocacy, and support from international experts, in Argentina and South Africa. All countries had population-level targets and written strategies with multiple interventions to reduce salt consumption. Engaging industry to reduce salt in foods was a priority in all countries: Mongolia and Vietnam were establishing voluntary programs, while Argentina and South Africa opted for legislation on salt levels in foods. Ministries of Health, the WHO and researchers were identified as critical players in all countries. Lack of funding and technical capacity/support, absence of reliable local data and changes in leadership were identified as barriers to effective implementation. No country had a comprehensive approach to surveillance or regulation for labelling, and mixed views were expressed about the potential benefits of low sodium salts. Effective scale-up of salt reduction programs in LMIC requires: (1) reliable local data about the main sources of salt; (2) collaborative multi-sectoral implementation; (3) stronger government leadership and regulatory processes and (4) adequate resources for implementation and monitoring.

To explore the perspectives, barriers and enablers on salt reduction in out-of-home sectors in Malaysia among street food vendors, caterers and consumers. A qualitative study involving twenty-two focus group discussions and six in-depth interviews was conducted, recorded and transcribed verbatim. An inductive thematic analysis approach was employed to analyse the data. Two in-depth interviews and twenty-two focus group discussions were conducted face-to-face. Four in-depth interviews were conducted online. Focus group discussions were conducted among twenty-three street food vendors, twenty-one caterers and seventy-six consumers of various eateries. In-depth interviews were conducted among two street food vendors and four caterers, individually. Consumers and food operators perceived a high-salt intake within Malaysia's out-of-home food sectors. Food operators emphasised the necessity for a comprehensive salt reduction policy in the out-of-home sector involving all stakeholders. Consumers faced limited awareness and knowledge, counterproductive practices among food operators and challenges in accessing affordable low-Na food products, whereas food operators faced the lack of standardised guidelines and effective enforcement mechanisms and uncooperative consumer practices. Both groups expressed that food quality and price of salt were also the barriers, and they advocated for awareness promotion, enhanced regulation of manufactured food products and stricter enforcement targeting vendors. Consumers also suggested promoting and recognising health-conscious food premises, whereas food operators suggested on knowledge enhancement tailored to them, strategies for gaining consumers acceptance and maintaining food quality. These findings provide valuable insights that serve as foundational evidence for developing and implementing salt reduction policies within Malaysia's out-of-home sectors.

The United Kingdom has successfully implemented a salt reduction programme. We carried out a comprehensive analysis of the programme with an aim of providing a step-by-step guide of developing and implementing a national salt reduction strategy, which other countries could follow. The key components include (1) setting up an action group with strong leadership and scientific credibility; (2) determining salt intake by measuring 24-h urinary sodium, identifying the sources of salt by dietary record; (3) setting a target for population salt intake and developing a salt reduction strategy; (4) setting progressively lower salt targets for different categories of food, with a clear time frame for the industry to achieve; (5) working with the industry to reformulate food with less salt; (6) engaging and recruiting of ministerial support and potential threat of regulation by the Department of Health (DH); (7) clear nutritional labelling; (8) consumer awareness campaign; and (9) monitoring progress by (a) frequent surveys and media publicity of salt content in food, including naming and shaming, (b) repeated 24-h urinary sodium at 3–5 year intervals. Since the salt reduction programme started in 2003/2004, significant progress has been made as demonstrated by the reductions in salt content in many processed food and a 15% reduction in 24-h urinary sodium over 7 years (from 9.5 to 8.1 g per day, P <0.05). The UK salt reduction programme reduced the population’s salt intake by gradual reformulation on a voluntary basis. Several countries are following the United Kingdom’s lead. The challenge now is to engage other countries with appropriate local modifications. A reduction in salt intake worldwide will result in major public health improvements and cost savings.

Consumers frequently associate low-salt foods with reduced taste. The present study aimed to address this issue by conducting a suite of sensory analyses to determine the effects of current salt reduction strategies on the sensory acceptability of a reduced salt ready-meal. Initial sensory trials investigated the effect of gradually lowering salt levels in a chilli con carne ready-meal over an extended period of time. Reduced salt commercial chilli con carne ready-meals, formulated to contain salt levels ranging from 0.4 to 1.5%, were compared with ready-meals containing standard commercial levels of salt (~1.0%). Paired comparison and triangle tests indicated that gradually removing salt up to a level of 40% was achievable, without panellist's detecting a difference in taste. A range of commercially available salt substitutes and flavour enhancers were subsequently sourced and incorporated into the lowest salt meal at a level of 0.5%. Sensory analyses, including triangle, paired comparison and preference tests, revealed that chilli con carne ready-meals containing 0.5% of a commercial nucleotide yeast extract were comparable with ready-meals containing standard commercial levels of salt (~1.0%), a result which was further reinforced by the fact that consumers found no significant difference in hedonic acceptability scores between this low-salt meal and control ready-meals. Addition of salt substitutes allowed for salt reduction well in excess of 50% to be achieved.

To describe the UK Food Standards Agency's (FSA) salt reduction programme undertaken between 2003 and 2010 and to discuss its effectiveness. Relevant scientific papers, campaign materials and evaluations and consultation responses to the FSA's salt reduction programme were used. Adult salt intakes, monitored using urinary Na data collected from UK-wide surveys, indicate a statistically significant reduction in the population's average salt intake from 9·5 g/d in 2000-2001 to 8·6 g/d in 2008, which is likely to have health benefits. Reducing salt intake will have an impact on blood pressure; an estimated 6 % of deaths from CHD in the UK can be avoided if the number of people with high blood pressure is reduced by 50 %. Salt levels in food, monitored using commercial label data and information collected through an industry self-reporting framework, indicated that substantial reductions of up to 70 % in some foods had been achieved. The FSA's consumer campaign evaluation showed increased awareness of the benefits of reducing salt intake on health, with 43 % of adults in 2009 claiming to have made a special effort to reduce salt in their diet compared with 34 % of adults in 2004, before the campaign commenced. The UK's salt reduction programme successfully reduced the average salt intake of the population and increased consumers' awareness. Significant challenges remain in achieving the population average salt intake of 6 g/d recommended by the UK's Scientific Advisory Committee on Nutrition. However, the UK has demonstrated the success of its programme and this approach is now being implemented elsewhere in the world.

To understand the extent to which national salt reduction strategies in Malaysia and Mongolia were implemented and achieving their intended outcomes. Multiple methods process evaluations conducted at the mid-point of strategy implementation, guided by theoretical frameworks. Malaysia (2018-2019) and Mongolia (2020-2021). Desk-based reviews of related documents, interviews with key stakeholders ( 12 Malaysia, 10 Mongolia), focus group discussions with health professionals in Malaysia ( 43) and health provider surveys in Mongolia ( 12). Both countries generated high-quality local evidence about salt intake and levels in foods and culturally specific education resources. In Malaysia, education and reformulation activities were delivered with moderate dose (quantity) but reach among the population was low. Within 5 years, Mongolia implemented education among schools, health professionals and food producers on salt reduction with high reach, but with moderate dose (quantity) and reach among the general population. Both countries faced challenges in implementing legislative interventions (mandatory salt labelling and salt limits in packaged foods) and both could improve the scaling up of their reformulation and education activities. In the first half of Malaysia's and Mongolia's strategies, both countries generated necessary evidence and education materials, mobilised health professionals to deliver salt reduction education and achieved small-scale reformulation in foods. Both subsequently should focus on implementing regulatory policies and achieving population-wide reach and impact. Process evaluations of existing salt reduction strategies can help strengthen intervention delivery, aiding achievement of WHO's 30 % reduction in salt intake by 2025 target.