Cross-sectional Comparisons Of Sodium Content In Prepackaged Meat And Fish Products Among Five Countries

Objective: This study aims to compare the sodium content in prepackaged meat and fish products among five countries,which will contribute to the evidence-base for feasible strategies of sodium reduction in such products for China.Methods: Sodium content on product labels of 26500 prepackaged products,19601 meat and 6899 fish,was collected in supermarkets from five countries using the Food Switch mobile application from 2012 to 2018.To be specific,it was 1898 products in China,885 in the United Kingdom(UK),5673 in Australia,946 in South Africa and 17098 in the United States(US).The data were analyzed by Stata/SE 14.2 and SPSS 21.0 software.The Kruskal-Wallis H test was used to compare differences in sodium values of prepackaged meat and fish products across the five countries.The Chi-square tests were used to compare the proportion of products that meet the 2017 UK sodium reduction targets,P<0.05 was considered statistically significant.Results:1.The results showed that prepackaged meat and fish products combined in China had the highest sodium level(median 1050mg/100 g,interquartile range IQR: 774-1473),and the lowest levels found in UK(432mg/100 g,IQR:236-786)(P<0.001).2.Similar variations,i.e.a 2-3-fold difference of sodium content between the highest and the lowest countries were found among prepackaged meat and fish products separately.Large sodium content variations were also found in certain specific food subcategories across the five countries,as well as across different food subcategories within each country.3.In reference to the “Traffic Light” criteria developed by the UK,across the five countries,a large proportion of prepackaged meat and fish products fell into the red and amber categories,with the highest proportion of green light products found in the UK,accounting for 12.66% of all meat and fish products.China had the largest proportion of red light(85.83%)and the smallest proportion of green light products(3.64%)(P<0.001).A similar difference was seen in prepackaged meat products(P<0.001).For prepackaged fish products,the highest proportion of green light products was observed in the US(14.50%),followed by 12.84% in the UK.South Africa had the largest proportion of amber light products(84.73%)and the lowest proportion of red light(8.68%)and green light(6.59%)products among five countries(P<0.001).4.In the 13 categories of prepackaged meat and fish products,the countries with sodium contents reaching 2017 UK sodium reduction targets in descending order were the UK(26.6%),Australia(23.2%),South Africa(22.4%),the US(18.4%)and China(7.1%).Statistically significant differences were observed among countries(P<0.001)for bacon,canned meat,frozen meat,meat burgers,sausage and hot dogs,other meat products and canned fish.5.If 100 g meat and fish products was consumed,the sodium intake would account for 47.2% of the WHO recommended maximum daily intake(2000 mg/d)on average in China,followed by the US(47.1%),South Africa(36.9%),Australia(34.6%)and the UK(27.1%).Conclusions: Prepackaged meat and fish products differ greatly in sodium content across different countries and across different food subcategories,indicating that the products has more room for sodium reduction.The results showed that the UK had the highest proportion of products achieving the targets,followed by Australia,South Africa,US and China.This,to some extent,might be relevant to the implementation of the incremental sodium reduction strategies.The main contributors to sodium intake vary from country to country,suggesting that countries should formulate targeted sodium reduction strategies according to their own national conditions.The main contributors to sodium intake vary from country to country,suggesting that food manufacturers in various countries should pay more attention to food categories that contribute more to sodium intake when reformulating their plans.