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Contribution of reformulation, product renewal, and changes in consumer behavior to the reduction of salt intakes in the UK population between 2008/2009 and 2016/2017

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Title: Contribution of reformulation, product renewal, and changes in consumer behavior to the reduction of salt intakes in the UK population between 2008/2009 and 2016/2017
Authors: Gressier, M
Sassi, F
Frost, G
Item Type: Journal Article
Abstract: Background The UK salt reduction program started in 2003, consisting of education campaigns to raise awareness about the risks associated with a high-salt diet and of a reformulation strategy for food manufacturers. This program is often cited as an example of a successful public health program. Objectives This study aimed to assess: 1) the impacts of changes in food composition and changes in consumer behavior on sodium intakes; and 2) whether changes were similar across socioeconomic groups. Methods Food intakes for the UK population were derived from food diaries in the UK National Diet and Nutrition Survey for 2008/09 (year 1; n = 1334) and 2016/17 (year 9; n = 995). Year-specific sodium densities of foods were used to calculate the average sodium density of all food and beverage consumed. Changes in sodium density between the 2 years were explained by changes in food composition (change in sodium density of products) and/or changes in behavior (type and quantity of food consumed) using a decomposition approach. Results The program was linked to a 16% (95% CI: −21% to −12%) decrease in sodium intake between years 1 and 9, while the sodium density of foods consumed decreased by 17% (95% CI: −21% to −12%). This decrease was largely driven by reformulation (−12.0 mg/100 g). Changes in food choices reinforced the effects of the program, but had a smaller impact (−1.6 mg/100 g). These effects were similar across socioeconomic groups, whether stratified by education or income, with a consistent effect of reformulation across groups and no differences between groups in behavioral responses to the program. Conclusions A multi-component sodium reduction strategy deployed in the United Kingdom starting in 2003 corresponded to an important reduction in sodium intakes for the population. This reduction was mostly driven by changes in the food environment (reformulated food products to reduce the sodium density of foods) and, to a smaller extent, by changes in food choices. Impacts were consistent across socioeconomic groups.
Issue Date: 8-May-2021
Date of Acceptance: 30-Mar-2021
URI: http://hdl.handle.net/10044/1/88657
DOI: 10.1093/ajcn/nqab130
ISSN: 0002-9165
Publisher: Oxford University Press (OUP)
Start Page: 1092
End Page: 1099
Journal / Book Title: The American Journal of Clinical Nutrition
Volume: 114
Issue: 3
Copyright Statement: © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor/Funder: Commission of the European Communities
Funder's Grant Number: 77454
Keywords: consumer behavior
food policies
intervention evaluation
public health
Child, Preschool
Choice Behavior
Consumer Behavior
Food Analysis
Food Handling
Middle Aged
Nutrition Policy
Socioeconomic Factors
Sodium Chloride, Dietary
United Kingdom
Young Adult
Nutrition & Dietetics
09 Engineering
11 Medical and Health Sciences
Publication Status: Published
Open Access location: https://academic.oup.com/ajcn/advance-article/doi/10.1093/ajcn/nqab130/6272434
Online Publication Date: 2021-05-08
Appears in Collections:Imperial College Business School
Department of Metabolism, Digestion and Reproduction
Faculty of Medicine

This item is licensed under a Creative Commons License Creative Commons