Abstract
Background: To reduce morbidity and mortality associated with cardiovascular disease, the World Health Organization recommends adults consume <2000 mg sodium per day. On average, New Zealanders consume one-and-a-half times this amount. Previous studies have suggested it is difficult to achieve this target intake, and barriers and facilitators to adherence are unknown.
Objective: This was a feasibility study for a randomised controlled trial examining the effects of diets that align with the World Health Organization recommendations for sodium intake. This study aimed to examine adherence to a four-week low sodium diet in a sample of healthy New Zealand adults and identify barriers and facilitators to adherence. It also addressed whether following a low sodium diet was accompanied by changes in intakes of other nutrients that influence cardiovascular risk.
Design: Eleven healthy adults in Dunedin were recruited via flyers and social networks. They provided dietary intake data (a 24-hour urine collection, 2-day weighed diet record and 24-hour recall) at baseline. They then received nutritional advice, incorporating label reading, low sodium recipes and recommendations to use a label-reading smartphone app and salt substitute. Participants undertook a low sodium diet (<2000 mg/day) for four weeks and met with the candidate weekly for advice and support. At the end of the four-week period, participants provided follow-up dietary intake data. They also completed a semi-structured interview that elicited participants’ opinions on barriers and facilitators to following a low sodium diet and addressed other changes in dietary habits.
Outcomes: Mean sodium intake lowered between baseline and follow-up and the majority of participants met the WHO recommendation for sodium intake at follow-up.