Effects of a behavioral intervention that emphasizes spices & herbs on adherence to recommended sodium intake

Anderson CAM, Cobb LK, Miller ER, Woodward M, Hottenstein A, Chang AR, Mongraw-Chaffin M, Charleston J, Tanaka T, Thomas L, and Appel LJ

Overview

This study examined the effects of a behavioral intervention, which emphasized spices and herbs, on the maintenance of sodium intake at the recommended intake of 1500 mg/d in individuals to whom the US Dietary Guidelines for Americans apply.

Methods

A 2-phase study was conducted that included adults >18 y of age for whom Dietary Guidelines for Americans recommends 1500 mg Na/d. In phase 1, 55 individuals consumed a low-sodium diet for 4 wk. Participants were provided all foods, snacks, and calorie-containing drinks. In phase 2, 40 participants from phase 1 were randomly assigned to either a behavioral intervention to reduce sodium intake (n = 20) or a self-directed control group (n = 20) for 20 wk. The primary study outcome was the change in mean 24-h urinary sodium excretion during phase 2. Linear regression analyses were used to determine intervention effects on urinary sodium excretion.

Results/Conclusions

At the end of phase 2, mean 24-h sodium excretion was lower in the behavioral intervention than in the self-directed group (mean difference: 2956.8 mg/d; 95% CI: 21538.7, 2374.9 mg/d) after sodium intake at screening was controlled for (P = 0.002). These findings persisted in sensitivity analyses that excluded potentially incomplete urine collections [Mage’s equation mean difference: 21090 mg/d (P = 0.001); Joosens’ equation mean difference: 2796 mg/d (P = 0.04)].

A multifactorial behavioral intervention emphasizing spices and herbs significantly reduced sodium intake. Because of the ubiquity of sodium in the US food supply, multilevel strategies addressing individual behaviors and the food supply are needed to improve adherence to recommendations.