Decreasing Salt in Hospital Meals Reduced Energy Intake in Elderly Japanese Inpatients

Dietary assessment methods for measurement of oral intake in acute care and critically ill hospitalised patients: a scoping review

Quantification of oral intake within the hospital setting is required to guide nutrition care. Multiple dietary assessment methods are available, yet details regarding their application in the acute care setting are scarce. This scoping review, conducted in accordance with JBI methodology, describes dietary assessment methods used to measure oral intake in acute and critical care hospital patients. The search was run across four databases to identify primary research conducted in adult acute or critical care settings from 1st of January 2000-15th March 2023 which quantified oral diet with any dietary assessment method. In total, 155 articles were included, predominantly from the acute care setting (n = 153, 99%). Studies were mainly single-centre (n = 138, 88%) and of observational design (n = 135, 87%). Estimated plate waste (n = 59, 38%) and food records (n = 43, 28%) were the most frequent assessment methods with energy and protein the main nutrients quantified (n = 81, 52%). Validation was completed in 23 (15%) studies, with the majority of these using a reference method reliant on estimation (n = 17, 74%). A quarter of studies (n = 39) quantified completion (either as complete versus incomplete or degree of completeness) and four studies (2.5%) explored factors influencing completion. Findings indicate a lack of high-quality evidence to guide selection and application of existing dietary assessment methods to quantify oral intake with a particular absence of evidence in the critical care setting. Further validation of existing tools and identification of factors influencing completion is needed to guide the optimal approach to quantification of oral intake in both research and clinical contexts.

Salt Contents in Fermented Dairy Products: A Strategic Blueprint for Healthier Intake

This study aimed to estimate the quantity and trends of salt intake from industrial fermented dairy products, develop strategies to reduce salt content, and inform policymakers on promoting public health through healthier dairy options. A cross-sectional study was conducted on fermented dairy products. Seventy-nine random samples were selected, and the salt (NaCl %) content was determined by potentiometric titration after sample preparation and homogenization; also samples were analyzed for their moisture (oven drying method). Data analysis involved descriptive statistics and one-sample t-test. A comprehensive literature review on salt reduction strategies was also performed proposing a model for an optimized low-salt fermented dairy product. This study found high salt content in many fermented dairy products. Brined cheese had the highest salt level (7.57 g/100 g), while pizza processed cheese had the lowest (1.03 g/100 g). Probiotic yogurts contained less salt (0.29 g/100 g) than regular ones. Other products like doogh (1.04 g/100 g), kefir (0.63 g/100 g), and kashk (2.78 g/100 g) also contributed significantly to salt intake. Most products exceeded recommended salt limits. Consuming just one serving of these products often accounted for a substantial portion of the daily recommended salt intake (WHO: 5 g/day). This research emphasizes the need for reducing salt in fermented dairy products to improve public health. This study highlights the excessive salt content in many fermented dairy products, surpassing recommended daily intake levels. Therefore, to address this public health concern, a multi-faceted approach is necessary. For this purpose, Policymakers should implement stringent monitoring, enforce food labeling, and develop legislation to reduce salt content. Furthermore, the food industry must innovate to reduce salt while maintaining product quality and taste. On the other hand, consumer education and awareness campaigns are crucial for informed choices. Additionally, further research is needed to understand consumer perceptions and the long-term impact of salt-sustainable reduction strategies on dietary habits and public health.

Stress Condition on a Restricted Sodium Diet Using Umami Substance (L-Glutamate) in a Pilot Randomized Cross-Over Study

Hypertensive patients who adopt a sodium-restricted diet have difficulty maintaining this change, and this could increase stress. On the other hand, soup rich in umami substances (dashi) was reported to reduce indexes of anxiety and stress. The objective of this study was to measure mood and physiological stress indexes during administration of a sodium-restricted diet with and without an umami substance (free L-glutamate) by a cross-over randomized, single-blind, placebo-controlled trial in Japanese female university students. The baseline was measured for 5 days followed by a sodium-restricted diet intervention phase that lasted for 10 days. The Profile of Mood States questionnaire was administered, a stress marker in saliva (chromogranin-A) was measured, and the amount of sodium intake was confirmed from 24 h urine collection samples. Results showed that the sodium reduction was verified by 24 h urine excretion. The percentage of change in the stress marker from the baseline showed that the stress level in group without the umami substance was significantly higher than that in the group with the umami substance (p = 0.013) after receiving a sodium-reduced diet for 6 or more days, indicating that stress was alleviated. This study suggested that umami substances might help to ameliorate stress during a sodium-reduced diet, especially in the initial phase.