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Zata Vickers - One of the best experts on this subject based on the ideXlab platform.
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A longitudinal comparison of two salt reduction strategies: Acceptability of a Low Sodium Food depends on the consumer
Food Quality and Preference, 2015Co-Authors: Nuala Bobowski, Aaron Rendahl, Zata VickersAbstract:In their 2010 publication, Strategies to Reduce Sodium Intake in the United States, the Institute of Medicine suggested the FDA mandate salt reduction at the Food industry level via a strategy of gradual, step-wise decline. The objective of this study was to compare the acceptability trajectories of a gradual to an abrupt salt reduction strategy of a high Sodium Food, and to determine if these trajectories were impacted by an individual's hedonic sensitivity to salt and/or motivation to reduce dietary salt intake. Eighty-three subjects participated in a three-part study: an initial taste test, a 16-week longitudinal study, and a final taste test. At the initial and final taste tests, subjects indicated liking of tomato juice at four salt concentrations ranging from 136. mg Sodium/serving (Low Sodium) to 640. mg Sodium/serving (comparable to a commercially available product). To create two groups for the 16-week study, subjects were balanced for 6-n-propylthiouracil sensitivity, motivation to reduce dietary salt intake, and hedonic sensitivity to salt (the difference in liking between the highest and Lowest salt concentrations in tomato juice served at the initial taste test). One group received juice abruptly reduced in salt at week 4 to a target Low Sodium level; the second group received juice gradually reduced in salt via difference threshold steps determined in a preliminary study (cumulating reductions of 12% each), to reach the target at week 14. We observed no overall difference in liking for Low Sodium juice at the end of the study as a result of salt reduction strategy; however, the trajectory of liking ratings over time differed between groups. Gradual salt reduction was more effective than the abrupt salt reduction because the abrupt reduction was accompanied by a large immediate drop in liking whereas the gradual reduction better maintained acceptability throughout the process. Subjects with Low hedonic sensitivity responded favorably to both salt reduction strategies and would likely have no difficulty in adjusting to the taste of reduced salt Foods. However, subjects with high hedonic sensitivity disliked reduced salt juice at some point during the study, regardless of strategy, and would likely have difficulty in adjusting to the taste of reduced salt Foods.
Nuala Bobowski - One of the best experts on this subject based on the ideXlab platform.
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A longitudinal comparison of two salt reduction strategies: Acceptability of a Low Sodium Food depends on the consumer
Food Quality and Preference, 2015Co-Authors: Nuala Bobowski, Aaron Rendahl, Zata VickersAbstract:In their 2010 publication, Strategies to Reduce Sodium Intake in the United States, the Institute of Medicine suggested the FDA mandate salt reduction at the Food industry level via a strategy of gradual, step-wise decline. The objective of this study was to compare the acceptability trajectories of a gradual to an abrupt salt reduction strategy of a high Sodium Food, and to determine if these trajectories were impacted by an individual's hedonic sensitivity to salt and/or motivation to reduce dietary salt intake. Eighty-three subjects participated in a three-part study: an initial taste test, a 16-week longitudinal study, and a final taste test. At the initial and final taste tests, subjects indicated liking of tomato juice at four salt concentrations ranging from 136. mg Sodium/serving (Low Sodium) to 640. mg Sodium/serving (comparable to a commercially available product). To create two groups for the 16-week study, subjects were balanced for 6-n-propylthiouracil sensitivity, motivation to reduce dietary salt intake, and hedonic sensitivity to salt (the difference in liking between the highest and Lowest salt concentrations in tomato juice served at the initial taste test). One group received juice abruptly reduced in salt at week 4 to a target Low Sodium level; the second group received juice gradually reduced in salt via difference threshold steps determined in a preliminary study (cumulating reductions of 12% each), to reach the target at week 14. We observed no overall difference in liking for Low Sodium juice at the end of the study as a result of salt reduction strategy; however, the trajectory of liking ratings over time differed between groups. Gradual salt reduction was more effective than the abrupt salt reduction because the abrupt reduction was accompanied by a large immediate drop in liking whereas the gradual reduction better maintained acceptability throughout the process. Subjects with Low hedonic sensitivity responded favorably to both salt reduction strategies and would likely have no difficulty in adjusting to the taste of reduced salt Foods. However, subjects with high hedonic sensitivity disliked reduced salt juice at some point during the study, regardless of strategy, and would likely have difficulty in adjusting to the taste of reduced salt Foods.
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A longitudinal comparison of two salt reduction strategies and acceptability of a Low Sodium Food
2013Co-Authors: Nuala BobowskiAbstract:University of Minnesota Ph.D. dissertation. July 2013. Major: Food science. Advisor: Zata Vickers. 1 computer file (PDF); ix, 186 pages, appendices A-G.
Debra K. Moser - One of the best experts on this subject based on the ideXlab platform.
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the hidden reason for patients nonadherence to Low Sodium diet recommendations
Journal of Cardiac Failure, 2004Co-Authors: Brooke Bentley, Marla Dejong, Debra K. MoserAbstract:Background: Nonadherence to the Low Sodium dietary restriction is a major reason for unnecessary hospitalizations and mortality in patients with heart failure (HF). Despite this fact, little is known about reasons for nonadherence. The purpose of this study was to describe the reasons for nonadherence to Low Sodium diet recommendations. Method: A qualitative descriptive study was conducted using a convenience sample of 21 patients with chronic HF who were recruited from a HF clinic at an academic medical center. One-on-one interviews were conducted, transcribed verbatim, and analyzed using constant comparative analysis to identify themes. Results: All patients reported eating Foods that were inconsistent with a Low Sodium diet. Three primary themes describing reasons for nonadherence to the prescribed Low Sodium diet were evident in the data: 1) lack of knowledge; 2) interference with socialization; and 3) lack of Food selections. Regarding lack of knowledge, participants expressed an unmet need for detailed dietary information and written instructions. They did not understand how to select or prepare Low Sodium Foods or the rationale for this dietary restriction. Patients failed to anticipate that the Low Sodium diet was a life-long endeavor. Diet confusion was noted in those with multiple dietary restrictions. Surprisingly, patients consumed high Sodium Foods even though they linked these Foods to symptoms such as “smothering” and “swelling up.” However, no one expressed concern that these Foods were causing an exacerbation of HF. Regarding the theme of interference with socialization, nearly all participants discussed the difficulties of choosing Low Sodium meals when eating out. Major obstacles to adherence arose when others in the household did not folLow the same Low Sodium diet. Regarding the theme of lack of Food selections, common barriers to adherence included limited Low Sodium Food choices and lack of palatability. Additional dietary restrictions related to other comorbidities confounded the problem of limited Food choices. Conclusion: This is one of the first qualitative studies that directly explored reasons persons with HF find it difficult to adhere to a Low Sodium diet. A major impediment to eating a Low Sodium diet emerged under the theme of lack of knowledge that revealed the real or “hidden” reason patients are nonadherent: patients do not understand the link between increased dietary Sodium and an increase in fluid volume that overwhelms an already failing heart. Targeting this area along with the others identified in this study may improve adherence.
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Low Sodium diet nutritional adequacy and factors limiting adherence
Journal of Cardiac Failure, 2003Co-Authors: Terry A. Lennie, Debra K. Moser, Diane L HabashAbstract:Background: Existing data suggest that nonadherence to Low-Sodium diet (LSD) is the most common cause of rehospitalization among heart failure (HF) patients. Yet, little is known about specific factors that affect patients’ ability to folLow this commonlyprescribed measure. Further, many have expressed concern that patients who folLow a LSD may suffer nutritional deficits that could counterbalance any positive effects of the LSD. Method and Results: The specific aims of this prospective, comparative study were to: a) describe factors that influence the ability of participants to folLow a LSD, b) determine the relationship between self-reported adherence to prescribed LSD and actual Sodium intake, and c) determine the nutritional adequacy of a LSD. Patients recruited from two Midwestern HF clinics filled out a questionnaire that measured perceptions about ability to folLow a LSD and identified factors that limit ability to folLow the diet. Thirty days later, they filled out a 4-day Food diary and completed a 24-hour urine collection to measure urine Sodium. Twelve males and 11 females with a mean age of 65 yrs and NYHA functional class II or III participated in the study. Sodium intake was 3.2 g for those who reported always folLowing a LSD, 2.6 g for those who folLowed it most of the time, and 4.1 g. for those who never folLowed it. Thirty-three percent said it was difficult to folLow the LSD, while 66% reported it was easy. Sodium intake on 4-day Food diary and 24-hour urine Sodium were strongly correlated (r 0.55, p 0.05). The factors reported most to hinder ability to folLow the LSD were: friends/relatives don’t serve Low Sodium Foods; difficult to find appetizing Low Sodium Food, to keep track of total daily Sodium intake, and to identify Low Sodium Foods in restaurants. No relationship between perceived difficulty folLowing the LSD and actual Sodium intake was found. Individual daily caloric intake ranged from a Low of 318 kcal to a high of 3,373 kcal, with a four-day group average intake of 1,548 ( 361) kcal. The percent of calories from fat ranged from 21 percent to 50 percent, with a mean of 34 ( 7) percent. The percent of calories derived from carbohydrate sources ranged from 23 percent to 61 percent, with a mean of 50 ( 10) percent. The percent of calories from protein sources ranged from 9 to 27 percent with a mean of 17 ( 4) percent. The only macronutrient related to Sodium intake was protein (r 0.58, p 0.05). Protein intake of patients with high Sodium intake ( 3g) was significantly greater than those with Low Sodium intake. All diets were deficient in at least one nutrient, regardless of Sodium intake. Themost common nutrient deficiency was magnesium (76%), folLowed by vitamin A (74%), calcium (71%), and vitamin D (65%). Conclusions: Some patients were able to limit Sodium intake, however actual Sodium intake was not related to perceived ability to folLow a LSD nor selfreported adherence. Further, many individuals with HF may have multiple nutritional inadequacies regardless of their level of Sodium intake, although protein deficiencies are prominent in those most closely folLowing a LSD. Modulating the Cost of Prolonged Survival in Heart Failure: Long-Term Benefits of a Nurse-Led, Multidisciplinary, Home-Based Intervention Simon Stewart1—School of Nursing & Midwfery, University of South Australia, Adelaide, South Austrlia, Australia
Aaron Rendahl - One of the best experts on this subject based on the ideXlab platform.
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A longitudinal comparison of two salt reduction strategies: Acceptability of a Low Sodium Food depends on the consumer
Food Quality and Preference, 2015Co-Authors: Nuala Bobowski, Aaron Rendahl, Zata VickersAbstract:In their 2010 publication, Strategies to Reduce Sodium Intake in the United States, the Institute of Medicine suggested the FDA mandate salt reduction at the Food industry level via a strategy of gradual, step-wise decline. The objective of this study was to compare the acceptability trajectories of a gradual to an abrupt salt reduction strategy of a high Sodium Food, and to determine if these trajectories were impacted by an individual's hedonic sensitivity to salt and/or motivation to reduce dietary salt intake. Eighty-three subjects participated in a three-part study: an initial taste test, a 16-week longitudinal study, and a final taste test. At the initial and final taste tests, subjects indicated liking of tomato juice at four salt concentrations ranging from 136. mg Sodium/serving (Low Sodium) to 640. mg Sodium/serving (comparable to a commercially available product). To create two groups for the 16-week study, subjects were balanced for 6-n-propylthiouracil sensitivity, motivation to reduce dietary salt intake, and hedonic sensitivity to salt (the difference in liking between the highest and Lowest salt concentrations in tomato juice served at the initial taste test). One group received juice abruptly reduced in salt at week 4 to a target Low Sodium level; the second group received juice gradually reduced in salt via difference threshold steps determined in a preliminary study (cumulating reductions of 12% each), to reach the target at week 14. We observed no overall difference in liking for Low Sodium juice at the end of the study as a result of salt reduction strategy; however, the trajectory of liking ratings over time differed between groups. Gradual salt reduction was more effective than the abrupt salt reduction because the abrupt reduction was accompanied by a large immediate drop in liking whereas the gradual reduction better maintained acceptability throughout the process. Subjects with Low hedonic sensitivity responded favorably to both salt reduction strategies and would likely have no difficulty in adjusting to the taste of reduced salt Foods. However, subjects with high hedonic sensitivity disliked reduced salt juice at some point during the study, regardless of strategy, and would likely have difficulty in adjusting to the taste of reduced salt Foods.
Brooke Bentley - One of the best experts on this subject based on the ideXlab platform.
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the hidden reason for patients nonadherence to Low Sodium diet recommendations
Journal of Cardiac Failure, 2004Co-Authors: Brooke Bentley, Marla Dejong, Debra K. MoserAbstract:Background: Nonadherence to the Low Sodium dietary restriction is a major reason for unnecessary hospitalizations and mortality in patients with heart failure (HF). Despite this fact, little is known about reasons for nonadherence. The purpose of this study was to describe the reasons for nonadherence to Low Sodium diet recommendations. Method: A qualitative descriptive study was conducted using a convenience sample of 21 patients with chronic HF who were recruited from a HF clinic at an academic medical center. One-on-one interviews were conducted, transcribed verbatim, and analyzed using constant comparative analysis to identify themes. Results: All patients reported eating Foods that were inconsistent with a Low Sodium diet. Three primary themes describing reasons for nonadherence to the prescribed Low Sodium diet were evident in the data: 1) lack of knowledge; 2) interference with socialization; and 3) lack of Food selections. Regarding lack of knowledge, participants expressed an unmet need for detailed dietary information and written instructions. They did not understand how to select or prepare Low Sodium Foods or the rationale for this dietary restriction. Patients failed to anticipate that the Low Sodium diet was a life-long endeavor. Diet confusion was noted in those with multiple dietary restrictions. Surprisingly, patients consumed high Sodium Foods even though they linked these Foods to symptoms such as “smothering” and “swelling up.” However, no one expressed concern that these Foods were causing an exacerbation of HF. Regarding the theme of interference with socialization, nearly all participants discussed the difficulties of choosing Low Sodium meals when eating out. Major obstacles to adherence arose when others in the household did not folLow the same Low Sodium diet. Regarding the theme of lack of Food selections, common barriers to adherence included limited Low Sodium Food choices and lack of palatability. Additional dietary restrictions related to other comorbidities confounded the problem of limited Food choices. Conclusion: This is one of the first qualitative studies that directly explored reasons persons with HF find it difficult to adhere to a Low Sodium diet. A major impediment to eating a Low Sodium diet emerged under the theme of lack of knowledge that revealed the real or “hidden” reason patients are nonadherent: patients do not understand the link between increased dietary Sodium and an increase in fluid volume that overwhelms an already failing heart. Targeting this area along with the others identified in this study may improve adherence.
