La ingesta de sal y el consumo de pan. Una visión amplia de la situación en España
DOI:
https://doi.org/10.14306/renhyd.17.2.12Palabras clave:
Sal, pan, sodio, potasioResumen
El objetivo de este trabajo ha sido realizar una revisión de la ingesta de sal en España (9,6 g/día) y los problemas de salud que se derivan de su excesivo consumo. Por otra parte, valorar el papel del pan relacionado con dicha ingesta y su posible reducción y/o corrección desde diferentes enfoques. Finalmente, evidenciar las consecuencias favorables de dicha corrección por medio de un cálculo teórico en un pan tipo baguette.
El pan es el alimento que aporta generalmente una mayor cantidad de sal en la dieta (19%), por lo que es uno de los objetivos clave en una política de reducción de su consumo. Se ha comprobado que es posible una disminución escalonada de sal en el pan, sobre todo cuando se parte de valores altos, aunque otra alternativa es su sustitución parcial por otras sales, principalmente potásicas, que tienen además un efecto que contrarresta al sodio (disminución de la relación Na/K). Esta sustitución debe hacerse con criterios de mantenimiento del perfil sensorial y se ve favorecida en panes con un sabor potenciado, ya sea por ingredientes o procesos, dado que ello facilita la reducción del contenido de sal. Por otra parte, la legislación europea en alegaciones nutricionales y de salud permite destacar los aspectos positivos de esta reducción y/o sustitución. La reducción de un 30% de sal en el pan, viable desde un punto de vista tecnológico, implicaría una reducción de la ingesta diaria de sal de 0,6 g.
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Haaland R. Porridge and pot, bread and oven: Food ways and symbolism in Africa and Near Est from the Neolithic to the present. Cambridge Arch J 2007;17:167-83.
Brown IJ, Tzoulaki I, Candeias V, Elliott P. Salt intakes around the world: implications for public health. Int J Epidemiol 2009;38(3):791-813. PubMed PMID: 19351697.
He FJ, MacGregor GA. A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens 2009;23(6):363-84. PubMed PMID: 19110538.
Lindeberg S. Modern human physiology with respect to evolutionary adaptations that relate to diet in the past. In: The evolution of hominin diets. Hublin JJ, Richards MP, editors. Germany: Springer; 2009. p. 33-57.
Eaton SB, Eaton SB (3rd) . Paleolithic vs. modern diets--selected pathophysiological implications. Eur J Nutr 2000;39(2):67-70. PubMed PMID: 10918987.
Eaton SB, Eaton SB (3rd), , Konner MJ. Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications. Eur J Clin Nutr 1997;51(4):207-16. PubMed PMID: 9104571.
Lev-Ran A, Porta M. Salt and hypertension: a phylogenetic perspective. Diabetes Metab Res Rev 2005;21(2):118-31. PubMed PMID: 15759281.
Frassetto L, Morris RC (Jr) , Sellmeyer DE, Todd K, Sebastian A. Diet, evolution and aging--the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr 2001;40(5):200-13. PubMed PMID: 11842945.
Adeva MM, Souto G. Diet-induced metabolic acidosis. Clin Nutr 2011;30(4):416-21. PubMed PMID: 21481501.
Grassi G. Sympathetic neural activity in hypertension and related diseases. Am J Hypertens 2010;23(10):1052-60. PubMed PMID: 20651696.
Duprez DA. Role of the renin-angiotensin-aldosterone system in vascular remodeling and inflammation: a clinical review. J Hypertens 2006;24(6):983-91. PubMed PMID: 16685192.
Ortega RM, López-Sobaler AM, Ballesteros JM, Pérez-Farinós N, Rodríguez-Rodríguez E, Aparicio A, et al. Estimation of salt intake by 24 h urinary sodium excretion in a representative sample of Spanish adults. Br J Nutr 2011;105(5):787-94. PubMed PMID: 20969815.
Quilez J, Salas-Salvado J. Salt in bread in Europe: potential benefits of reduction. Nutr Rev 2012;70(11):666-78. PubMed PMID: 23110645.
Meneton P, Jeunemaitre X, de Wardener HE, MacGregor GA. Links between dietary salt intake, renal salt handling, blood pressure, and cardiovascular diseases. Physiol Rev 2005;85(2):679-715. PubMed PMID: 15788708.
Hoffmann IS, Cubeddu LX. Salt and the metabolic syndrome. Nutr Metab Cardiovasc Dis 2009;19(2):123-8. PubMed PMID: 18556187.
He FJ, Marrero NM, MacGregor GA. Salt intake is related to soft drink consumption in children and adolescents: a link to obesity?. Hypertension 2008;51(3):629-34. PubMed PMID: 18287345.
US Department of Agriculture (USDA) , US Department of Health and Human Services (USDHHS) . Dietary guidelines for Americans 2010. United States: US Department of Agriculture and US Department of Health and Human Services; 2010. doi: Disponible en: http://health.gov/ dietaryguidelines/dga2010/DietaryGuidelines2010.pdf.
Reglamento (EC) 1169/2011 del Parlamento Europeo y del Consejo de 25 de Octubre 2011 sobre la información alimentaria facilitada al consumidor. Diario Oficial de la Unión Europea, L304, (22/11/2011). .
Colhoun HM, Hemingway H, Poulter NR. Socio-economic status and blood pressure: an overview analysis. J Hum Hypertens 1998;12(2):91-110. PubMed PMID: 9504351.
Saint-Elie DT, Patel PV, Healy KA, Solomon T, Pattaras JG, Qian J, et al. The impact of income and education on dietary habits in stone formers. Urology 2010;76(2):307-13. PubMed PMID: 20138338.
Purdy J, Armstrong G, McIlveen H. The influence of socio-economic status on salt consumption in Northern Ireland. Int J Consumer Studies 2002;26:71-80.
Murakami K, Sasaki S, Takahashi Y, Uenishi K, Japan Dietetic Students' Study For Nutrition and Biomarkers Group. . Neighborhood socioeconomic disadvantage is associated with higher ratio of 24-hour urinary sodium to potassium in young Japanese women. J Am Diet Assoc 2009;109(9):1606-11. PubMed PMID: 19699842.
Strazzullo P, D' Elia L, Kandala NB, Cappuccio FP. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ 2009 Nov;339:45-67. PubMed PMID: 19934192.
de la Sierra A , Lluch MM, Coca A, Aguilera MT, Sánchez M, Sierra C, et al. Assessment of salt sensitivity in essential hypertension by 24-h ambulatory blood pressure monitoring. Am J Hypertens 1995;8(10):970-7. PubMed PMID: 8845078.
Sanders PW. Dietary salt intake, salt sensitivity, and cardiovascular health. Hypertension 2009;53(3):442-5. PubMed PMID: 19153264.
Karppanen H. Minerals and blood pressure. Ann Med 1991;23(3):299-305. PubMed PMID: 1930921.
D' Elia L, Barba G, Cappuccio FP, Strazzullo P. Potassium intake, stroke, and cardiovascular disease a meta-analysis of prospective studies. J Am Coll Cardiol 2011 Mar;57(10):1210-9. PubMed PMID: 21371638.
Vaskonen T. Dietary minerals and modification of cardiovascular risk factors. J Nutr Biochem 2003;14(9):492-506. PubMed PMID: 14505811.
He FJ, Marciniak M, Carney C, Markandu ND, Anand V, Fraser WD, et al. Effects of potassium chloride and potassium bicarbonate on endothelial function, cardiovascular risk factors, and bone turnover in mild hypertensives. Hypertension 2010;55(3):681-8. PubMed PMID: 20083724.
Berry SE, Mulla UZ, Chowienczyk PJ, Sanders TA. Increased potassium intake from fruit and vegetables or supplements does not lower blood pressure or improve vascular function in UK men and women with early hypertension: a randomised controlled trial. Br J Nutr 2010;104(12):1839-47. PubMed PMID: 20673378.
Kotchen TA. Contributions of sodium and chloride to NaCl-induced hypertension. Hypertension 2005;45(5):849-50. PubMed PMID: 15837830.
Luft FC, Zemel MB, Sowers JA, Fineberg NS, Weinberger MH. Sodium bicarbonate and sodium chloride: effects on blood pressure and electrolyte homeostasis in normal and hypertensive man. J Hypertens 1990;8(7):663-70. PubMed PMID: 2168457.
Schorr U, Distler A, Sharma AM. Effect of sodium chloride- and sodium bicarbonate-rich mineral water on blood pressure and metabolic parameters in elderly normotensive individuals: a randomized double-blind crossover trial. J Hypertens 1996;14(1):131-5. PubMed PMID: 12013486.
Overlack A, Maus B, Ruppert M, Lennarz M, Kolloch R, Stumpe KO. Potassium citrate versus potassium chloride in essential hypertension. Effects on hemodynamic, hormonal and metabolic parameters. Dtsch Med Wochenschr 1995 May;120(18):631-5. PubMed PMID: 7750429.
He FJ, Markandu ND, Coltart R, Barron J, MacGregor GA. Effect of short-term supplementation of potassium chloride and potassium citrate on blood pressure in hypertensives. Hypertension 2005;45(4):571-4. PubMed PMID: 15723964.
Braschi A, Naismith DJ. The effect of a dietary supplement of potassium chloride or potassium citrate on blood pressure in predominantly normotensive volunteers. Br J Nutr 2008;99(6):1284-92. PubMed PMID: 18053306.
Sellmeyer DE, Schloetter M, Sebastian A. Potassium citrate prevents increased urine calcium excretion and bone resorption induced by a high sodium chloride diet. J Clin Endocrinol Metab 2002;87(5):2008-12. PubMed PMID: 11994333.
Demigné C, Sabboh H, Rémésy C, Meneton P. Protective effects of high dietary potassium: nutritional and metabolic aspects. J Nutr 2004;134(11):2903-6. PubMed PMID: 15514249.
Jehle S, Zanetti A, Muser J, Hulter HN, Krapf R. Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia. J Am Soc Nephrol 2006;17(11):3213-22. PubMed PMID: 17035614.
Graudal NA, Galløe AM, Garred P. Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride: a meta-analysis. JAMA 1998 May;279(17):1383-91. PubMed PMID: 9582047.
He FJ, MacGregor GA. How far should salt intake be reduced. Hypertension 2003;42(6):1093-9. PubMed PMID: 14610100.
Selmer RM, Kristiansen IS, Haglerod A, Graff-Iversen S, Larsen HK, Meyer HE, et al. Cost and health consequences of reducing the population intake of salt. J Epidemiol Community Health 2000;54(9):697-702. PubMed PMID: 10942450.
Bibbins-Domingo K, Chertow GM, Coxson PG, Moran A, Lightwood JM, Pletcher MJ, et al. Projected effect of dietary salt reductions on future cardiovascular disease. N Engl J Med 2010 Feb;362(7):590-9. PubMed PMID: 20089957.
Geleijnse JM, Kok FJ, Grobbee DE. Blood pressure response to changes in sodium and potassium intake: a metaregression analysis of randomised trials. J Hum Hypertens 2003;17(7):471-80. PubMed PMID: 12821954.
Cook NR, Obarzanek E, Cutler JA, Buring JE, Rexrode KM, Kumanyika SK, et al. Joint effects of sodium and potassium intake on subsequent cardiovascular disease: the Trials of Hypertension Prevention follow-up study. Arch Intern Med 2009 Jan;169(1):32-40. PubMed PMID: 19139321.
Karppanen H, Mervaala E. Sodium intake and hypertension. Prog Cardiovasc Dis 2006;49(2):59-75. PubMed PMID: 17046432.
American Heart Association Nutrition Committee (AHA), , Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 2006 Jul;114(1):82-96. PubMed PMID: 16785338.
Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007;25(6):1105-87. PubMed PMID: 17563527.
Karppanen H, Karppanen P, Mervaala E. Why and how to implement sodium, potassium, calcium, and magnesium changes in food items and diets?. J Hum Hypertens 2005;19(Suppl 3):10-9. PubMed PMID: 16302005.
Dewettinck K, Bockstaele, F. Van , Kühne B, Walle, D. Van de , Courtens TM, Gellynck X. Nutritional value of bread: influence on processing, food interaction and consumer perception. J Cereal Sci 2008;48:243-57.
Ministerio de Agricultura Alimentación y Medio Ambiente . El consumo de alimentos en España. Madrid: Ministerio de Agricultura Alimentación y Medio Ambiente; 2010.
James WP, Ralph A, Sanchez-Castillo CP. The dominance of salt in manufactured food in the sodium intake of affluent societies. Lancet 1987 Feb;1(8530):426-9. PubMed PMID: 2880223.
Mattes RD, Donnelly D. Relative contributions of dietary sodium sources. J Am Coll Nutr 1991;10(4):383-93. PubMed PMID: 1910064.
Joossens JV, Sasaki S, Kesteloot H. Bread as a source of salt: an international comparison. J Am Coll Nutr 1994;13(2):179-83. PubMed PMID: 8006300.
Agencia Española de seguridad Alimentaria y Nutrición (AESAN). Agencia Española de seguridad Alimentaria y Nutrición (2009) Plan de reducción de sal. Jornadas de debate. Disponible en: Http://www.naos.aesan.msps.es/ naos/ficheros/estrategia/Memoria_Plan_de_reduccion_del_consumo_de_sal_-_Jornadas_de_debate.pdf. [Consultado en: 25 de Octubre 2011]. .
Booth DA, Thompson A, Shahedian B. A robust, brief measure of an individual's most preferred level of salt in an ordinary foodstuff. Appetite 1983;4(4):301-12. PubMed PMID: 6670860.
Conner MT, Booth DA, Clifton VJ, Griffiths RP. Individualized optimization of the salt content of white bread for acceptability. J Food Sci 1988;53:549-54.
Sosa M, Flores A, Hough G, Apro N, Ferreyra V, Orbea MM. Optimum level of salt in French-type bread. Influence of income status, salt level in daily bread consumption, and test location. J Food Sci 2008;73(8):392-7. PubMed PMID: 19019126.
Egan MB, Fragodt A, Raats MM, Hodgkins C, Lumbers M. The importance of harmonizing food composition data across Europe. Eur J Clin Nutr 2007;61(7):813-21. PubMed PMID: 17554245.
Bertino M, Beauchamp GK, Engelman K. Long-term reduction in dietary sodium alters the taste of salt. Am J Clin Nutr 1982;36(6):1134-44. PubMed PMID: 7148734.
Girgis S, Neal B, Prescott J, Prendergast J, Dumbrell S, Turner C, et al. A one-quarter reduction in the salt content of bread can be made without detection. Eur J Clin Nutr 2003;57(4):616-20. PubMed PMID: 12700625.
Janssen AM, Koeman FT. Effect of stepwise reduction of salt content in bread on consumer’s food choice during breakfast. Proc 4th European Conference on Sensory and Consumer Research. Vitoria (Spain) 2010. Disponible en: Http://elsevier.conference-services.net/resources/247/1894/pdf/SENS2010_0388.pdf.. .
Miller RA, Hoseney RC. Role of salt in baking. CFW 2008;53:4-6.
Quilez J, Ruiz JA, Romero MP. Relationships between sensory flavor evaluation and volatile and nonvolatile compounds in commercial wheat bread type baguette. J Food Sci 2006;71:423-427.
Lynch EJ, Dal Bello F, , Sheenan EM, Cashman KD, Arendt EK. Fundamental studies on the reduction of salt on dough and bread characteristics. Food Res Int 2009;42:885-91.
Belz MC, Ryan LA, Arendt EK. The impact of salt reduction in bread: a review. Crit Rev Food Sci Nutr 2012;52(6):514-24. PubMed PMID: 22452731.
Salovaara H. Effect of partial sodium chloride replacement by other salts on wheat dough reology and breadmaking. Cer Chem 1982;59:422-6.
Kaur A, Bala R, Singh B, Rehal J. Effect of replacement of sodium chloride with mineral salts on rheological characteristics of wheat flour. Am J Food Tech 2011;6:674-84.
Jane Wyatt C, , Ronan K. Evaluation of potassium chloride as salt substitute in bread. J Food Sci 1982;47:672-3.
Salovaara H. Sensory limitations to replacement of sodium with potassium and magnesium in bread. Cer Chem 1982;59:427-30.
Salovaara H, Helleman U, Kurkela R. Effect of salt on bread flavour. Lebbensm Wiss Technol 1982;15:270-4.
Charlton KE, MacGregor E, Vorster NH, Levitt NS, Steyn K. Partial replacement of NaCl can be achieved with potassium, magnesium and calcium salts in brown bread. Int J Food Sci Nutr 2007;58(7):508-21. PubMed PMID: 17852502.
Braschi A, Gill L, Naismith DJ. Partial substitution of sodium with potassium in white bread: feasibility and bioavailability. Int J Food Sci Nutr 2009;60(6):507-21. PubMed PMID: 18608540.
Council of the European Union. Council conclusions on action to reduce population salt intake for better health. Geneva: European Union; 2010. Disponible en: http://www.consilium.europa.eu/uedocs/cms_data/docs/pressdata/en/lsa/114998.pdf. .
Laatikainen T, Pietinen P, Valsta L, Sundvall J, Reinivuo H, Tuomilehto J. Sodium in the Finnish diet: 20-year trends in urinary sodium excretion among the adult population. Eur J Clin Nutr 2006;60(8):965-70. PubMed PMID: 16482074.
Henderson L, Irving K, Gregory J, Bates CJ, Prentice A, Perks J, Swan G, Farron M. National Diet and Nutrition Survey: Adults aged 19 to 64 years. Vitamin and mineral intake and urinary analytes. TSO 2003. Disponible en: http://www.food.gov.uk/multimedia/pdfs/ndnsv3.pdf. .
Food Standards Agency (FSA). 2010-2012 Salt reduction targets. Food Standards Agency; 2009. Disponible en: Http://www.food.gov.uk/news/newsarchive/2009/may/salttargets. .
National Center for Social Research (NCSR). An assessment of dietary sodium levels among adults (aged 19-64) in the UK general population in 2008, based on analysis of dietary sodium in 24 hour urine samples. Food Standards Agency; 2008. Disponible en: Http://www.food.gov.uk/multimedia/pdfs/08sodiumreport.pdf. .
Ballesteros JM, Dal-Re M, Perez-Farinos N, Villar C. La estrategia para la nutrición, actividad física y prevención de la obesidad (estrategia NAOS). Rev Esp Salud Publica 2007;81:443-9.
Reglamento (CE) 1924/2006 del Parlamento Europeo y del Consejo de 20 de diciembre de 2006, relativo a las declaraciones nutricionales y de propiedades saludables de los alimentos. Diario Oficial de la Unión Europea, L404/9 (30/12/2006). .
Reglamento (EC) 1925/2006 del Parlamento Europeo y del Consejo de 20 de diciembre de 2006, sobre la adición de vitaminas, minerales y otras sustancias determinadas a los alimentos. Diario Oficial de la Unión Europea, L404/26 (30/12/2006). .
Directiva 2008/100/CE de la Comisión de 28 de octubre de 2008, por la que se modifica la Directiva 90/496/CEE del Consejo, relativa al etiquetado sobre propiedades nutritivas de los productos alimenticios, en lo que respecta a las cantidades diarias recomendadas, los factores de conversión de la energía y las definiciones. Diario Oficial de la Unión Europea, L285/9 (29/10/2008). .
Reglamento (UE) 432/2012 de la Comisión de 16 de mayo de 2012, por el que se establece una lista de declaraciones autorizadas de propiedades saludables de los alimentos distintas de las relativas a la reducción del riesgo de enfermedad y al desarrollo y la salud de los niños. Diario Oficial de la Unión Europea, L136/1 (25/05/2012). .
European Food Safety Authority (EFSA) . Opinion of the scientific panel on dietetic products, nutrition and allergies on a request from the Commission related to the tolerable upper intake level of chloride. EFSA Journal 2005;193:1-9.
Suggs LS, McIntyre C. European Union public opinion on policy measures to address childhood overweight and obesity. J Public Health Policy 2011;32(1):91-103. PubMed PMID: 21150940.
FoodDrink Europe (FDE). FoodDrink Europe (FDE) rebukes discriminatory tax on soft drinks in France; 2011. Disponible en: Http://www.fooddrinkeurope.eu/news/statement/fooddrinkeurope-rebukes-discriminatory-tax-on-soft-drinks-in-france-aimed-a/. .
Thow AM, Jan S, Leeder S, Swinburn B. The effect of fiscal policy on diet, obesity and chronic disease: a systematic review. Bull World Health Organ 2010 Aug;88(8):609-14. PubMed PMID: 20680126. doi: 10.2471/BLT.09.070987.
World Health Organization (WHO). Global strategy on diet, physical activity and health. Geneva: WHO; 2004.. .
World Health Organization (WHO). 2008–2013 action plan for the global strategy for the prevention and control of noncommunicable diseases. Geneva: WHO; 2008. .
Caraher M, Cowburn G. Taxing food: implications for public health nutrition. Public Health Nutr 2005;8(8):1242-9. PubMed PMID: 16372919.
Cash SB, Lacanilao RD. Taxing food to improve health: Economic evidence and arguments. Agr Resource Econ Rev 2007;36:174-82.
Nnoaham KE, Sacks G, Rayner M, Mytton O, Gray A. Modelling income group differences in the health and economic impacts of targeted food taxes and subsidies. Int J Epidemiol 2009;38(5):1324-33. PubMed PMID: 19483200. doi: 10.1093/ije/dyp214.
Mytton O, Gray A, Rayner M, Rutter H. Could targeted food taxes improve health?. J Epidemiol Community Health 2007;61(8):689-94. PubMed PMID: 17630367.
Duffey KJ, Gordon-Larsen P, Shikany JM, Guilkey D, Jacobs DR (Jr), , Popkin BM. Food price and diet and health outcomes: 20 years of the CARDIA Study. Arch Intern Med 2010 Mar;170(5):420-6. PubMed PMID: 20212177. doi: 10.1001/archinternmed.2009.545.
Smith-Spangler CM, Juusola JL, Enns EA, Owens DK, Garber AM. Population strategies to decrease sodium intake and the burden of cardiovascular disease: a cost-effectiveness analysis. Ann Intern Med 2010 Apr;152(8):481-7. PubMed PMID: 20194225. doi: 10.1059/0003-4819-152-8-201004200-00212.
Gellynck X, Kühne B, Van-Bockstaele F, Van de Walle D, Dewettinck K . Consumer perception of bread quality. Appetite 2009;53(1):16-23. PubMed PMID: 19447521. doi: 10.1016/j.appet.2009.04.002.
Hellemann U. Perceived taste of NaCl and acid mixtures in water and bread. Int J Food Sci Tech 1992;27:201-11.
Heiniö RL, Urala N, Vainionpää J, Poutanen K, Tourila H. Identity and overall acceptance of two types of sour rye bread. Int J Food Sci Tech 1997;32:169-78.
Agence Française de Sécurité Sanitaire (AFSSA). Report on salt : Evaluation and recommendations. France: AFSA; 2002. Disponible en : http://www.anses.fr/Documents/NUT-Ra-Sel.pdf. .
Verbecke W. Functional foods: Consumer willingness to compromise on taste for health?. Food Qual Pref 2006;17:126-31.
Grunert KG, Wills JM. A review of European research on consumer response to nutrition information on food labels. J Public Health 2007;15:385-99.
Campos S, Doxey J, Hammond D. Nutrition labels on pre-packaged foods: a systematic review. Public Health Nutr 2011;14(8):1496-506. PubMed PMID: 21241532. doi: 10.1017/S1368980010003290.
Cowburn G, Stockley L. Consumer understanding and use of nutrition labelling: a systematic review. Public Health Nutr 2005;8(1):21-8. PubMed PMID: 15705241.
Närhinen M, Nissinen A, Pentillä PL, Simonen O, Cernerud L, Puska P. Salt content labelling of foods in supermarkets in Finland. Agr Food Sci Finland 1998;7:447-53.
Pietinen P, Valsta LM, Hirvonen T, Sinkko H. Labelling the salt content in foods: a useful tool in reducing sodium intake in Finland. Public Health Nutr 2008;11(4):335-40. PubMed PMID: 17605838.
Verbeke W. Impact of communication on consumers' food choices. Proc Nutr Soc 2008;67(3):281-8. PubMed PMID: 18498672. doi: 10.1017/S0029665108007179.