Table 2. Dietary counselling (individuals).
Study | Study type | Geographical scope | Aim and main outcomes | Policies analysed | Relevant results | Quality assessment |
---|---|---|---|---|---|---|
Hooper et al. (2002)45 | SR and meta-analysis of RCTs | US, Australia, New Zealand, UK | Aim: to assess the long term effects of advice to restrict dietary sodium in adults with and without hypertension. Outcomes: salt intake as measured by urinary sodium excretion | Dietary advice |
Meta-analysis (11 studies included). They found reductions in salt intake at both intermediate, <12 months (2.8g/day) and late follow up, 13–60 months (2.0g/day). |
Good |
Appel et al. (2003)46 | Randomised trial | US |
Aim: to determine the effect on BP of 2 multicomponent, behavioral interventions Outcomes: salt intake as measured by urinary sodium excretion |
Dietary advice | Only the reduction in the established group differed significantly from that of advice only group. 24-hour dietary recall data indicated both behavioral interventions significantly reduced sodium intake in comparison with advice only group (P value = 0.01). Advice group • Baseline = 10.0g/day • 6 months = 8.8g/day • Mean difference = -1.2g/day Intervention group • Established: mean difference = -1.82 g/day • Established + DASH: mean difference = -1.83 g/day |
Good |
Brunner et al. (1997)47 | Meta-analysis of RCTs | UK, US, Netherlands and Australia | Aim: to evaluate the effectiveness of dietary advice in primary prevention of chronic disease. Outcomes: salt intake | Dietary advice | Overall mean net reduction of 1.8g/day which is a 20% reduction in salt intake. The heterogeneity test was highly significant (P < .0005) for the 3- to 6-month trials, with a net reduction of 3.4 (95% CI = 45, 72) g/day. Summary effect of the two trials with SE was somewhat larger at 9–18 months than at 3–6 months. | Fair |
Francis & Taylor (2009)48 | Randomised control group study | US | Aim: to implement a health-healthy diet-education programme. Outcomes: salt intake | Dietary counselling | Intervention salt consumption decreased significantly (P0.020) from record 1 to record 3. The reduction in control group participants’ sodium intake was not significant Intervention: (Mean ± SEM (g/day); P-value) • Record 1: 7.0 ± 0.5; 0.020e • Record 2: 5.9 ± 0.3; 0.067 • Record 3: 5.9 ± 0.4; 0.937 Control (Mean ± SEM (g/day), P-value) • Record 1: 6.2 ± 0.5; 0.323 • Record 2: 6.1 ± 0.4; 0.880 • Record 3: 5.7 ± 0.4; 0.284 Mean effect size:- 0.6g/day |
Fair |
Parekh et al. (2012)49 | RCT | Australia | Aim: to evaluate the effectiveness of a minimal intervention on multiple lifestyle factors including diet using computer tailored feedback. Outcomes: salt intake (%) | Health promotion–computer tailored advice | Salt (%) Intervention +5.43 net change. Control +1.23 net change. Significant changes between groups were observed for reduced salt intake (OR 1.19, CI 1.05–1.38). The intervention group were 20% more likely to reduce salt intake | Fair |
Petersen et al. (2013)50 | RCT | Australia | Aim: to investigate whether urinary sodium excretion can be reduced by educating people with T2DM to read food labels and choose low sodium products. Outcomes: salt intake | Nutrition education | Baseline reported salt intake: 6.8 ± 3.2 g/day Intervention • Baseline: 10.0 ± 0.7 • 3 months: 10.1 ± 0.7 • Change: +0.06 ± 0.9 Control • Baseline: 9.6 ± 0.9 • 3 months: 9.3 ± 0.7 • Change: -0.3 ± 0.8 There was no between group difference (p > 0.05) |
Fair |
Kokanović et al. (2014)51 | Before and after study | Croatia |
Aim: to assess eating habits of adolescent population diagnosed with one or more cardiovascular risks before and after two months of individual dietary intervention Outcomes: salt intake |
Nutrition education | Difference in intake on initial and control examination statistically significant for intake of sodium p = 0.013. Salt intake g/day. Initial examination: 18.9d/day; Control examination: 15.4g/day; Difference: -3.5g/day (= -18.8%) |
Fair |
Heino et al. (2000)52 | Prospective randomized trial | Finland | Aim: to examine sodium intake of 1-5-y-old children in a CHD prevention trial, focused on dietary fat modification. Outcomes: salt intake | Dietary counselling | Intervention children (+1.5g/day) • 13 months: 4.1 ± 1.2 • 3 years: 4.9 ± 1.2 • 5 years: 5.6 ± 1.3 Control children (+1.6g/day) • 13 months: 3.9 ± 1.4 • 3 years: 4.7 ± 1.3 • 5 years: 5.5 ± 1.4 No significant differences between the intervention and control group found |
Poor |
Wang et al. (2013)53 | RCT | US |
Aim: one year dietary intervention study to examine patterns and amount of daily sodium intake among participants with metabolic syndrome Outcomes: salt intake |
Dietary counselling | Intervention arm at one year follow-up found participants who consumed sodium greater than 5.8g/day declined from 75% at baseline to 59%. Those consumed higher than 3.8g/day declined from 96% (at baseline) to 85%. Average salt intake decreased from 7.5 g/day at baseline to 6.4 g/day at one-year (P<0.001). At one-year visit, salt intake was consistently reduced; significant difference only observed between males (7.6± 0.4 g/day) and females (6.0 ± 0.2 g/day; p < 0.001) | Poor |