The relationship of health/food literacy and salt awareness to daily sodium and potassium intake among a workplace population in Switzerland.

BACKGROUND AND AIMS: High sodium (Na) and low potassium (K) intake are associated with hypertension and CVD risk. This study explored the associations of health literacy (HL), food literacy (FL), and salt awareness with salt intake, K intake, and Na/K ratio in a workplace intervention trial in Switzerland. METHODS AND RESULTS: The study acquired baseline data from 141 individuals, mean age 44.6 years. Na and K intake were estimated from a single 24-h urine collection. We applied validated instruments to assess HL and FL, and salt awareness. Multiple linear regression was used to investigate the association of explanatory variables with salt intake, K intake, and Na/K. Mean daily salt intake was 8.9 g, K 3.1 g, and Na/K 1.18. Salt intake was associated with sex (p < 0.001), and K intake with sex (p < 0.001), age (p = 0.02), and waist-to-height ratio (p = 0.03), as was Na/K. HL index and FL score were not significantly associated with salt or K intake but the awareness variable "salt content impacts food/menu choice" was associated with salt intake (p = 0.005). CONCLUSION: To achieve the established targets for population Na and K intake, health-related knowledge, abilities, and skills related to Na/salt and K intake need to be promoted through combined educational and structural interventions. Clinical Trials Registry number: DRKS00006790 (23/09/2014).

Twelve-year trends and correlates of dietary salt intakes for the general adult population of Geneva, Switzerland.

BACKGROUND/OBJECTIVES: Investigate dietary salt intake trends by gender, and their associations with risk factors for cardiovascular diseases in Geneva, Switzerland. SUBJECTS/METHODS: Continuous surveillance of the Geneva general adult (35-74 years) population for 12 years (1993-2004) using a validated, semi-quantitative food frequency questionnaire (FFQ) in random, cross-sectional, representative samples (6688 men, 6647 women). Dietary salt intake assessment by FFQ excluded discretionary salt, but was calibrated on total salt intake using an independent validation substudy of 100 volunteers who additionally provided 24-h urine collections. RESULTS: Quartiles (mean) of calibrated dietary salt intake (g per day) were 9.9, 10.5, 11.2 (10.6) in men, and 7.0, 7.8, 8.9 (8.1) in women and were above current recommendations. Quartiles (mean) of salt density (g MJ(-1)) were 0.99, 1.16, 1.39 (1.23) in men, and 0.98, 1.12, 1.30 (1.17) in women. Both measures were stable during the 12-year surveillance period, regardless of hypertension treatment. Salt-density differences between cardiovascular disease risk factor subgroups were moderate. Salt density increased with age and body mass index. The main dietary non-discretionary salt food sources (men/women: 47/48%) were breads (17/17%), cheeses (11/10%), meat and meat products (8/7%), soups (6/9%) and ready-to-eat foods (5/5%). CONCLUSIONS: Salt intakes from all sources for the Geneva, and perhaps the Swiss adult population are above current recommendations. The quantitative and qualitative data provided in this paper could be used to develop and implement strategies for salt-intake reduction in Switzerland.

Obesity and other health determinants across Europe: the EURALIM project.

STUDY OBJECTIVE: EURALIM (EURope ALIMentation), a European collaborative study, aimed to determine and describe the extent to which European data on risk factor distributions from different populations could be pooled and harmonised in a common database for international comparisons. SETTING: Seven independent population-based surveys from six European countries (France, Italy, Northern Ireland/United Kingdom, Spain, Switzerland, the Netherlands). METHODS: Data for 18 381 women and 12 908 men aged 40-59 were pooled in a common database. Central statistical analyses on major cardiovascular risk factors were conducted with careful consideration of methodological issues, including differences in study designs, data assessment tools, and analytic techniques used. MAIN RESULTS: Because of the detected variability among methods used, direct comparisons of risk factor distributions and prevalences between studies were problematic. None the less, comparisons of within population contrasts by sex, age group, and other health determinants were considered to be meaningful and apt, as illustrated here for obesity. Results were targeted and disseminated to both the general public and public health professionals and framed in the context of a European information campaign. CONCLUSIONS: International and national comparisons between existing locally run studies are feasible and useful, but harmonisation methods need improvement. Development of an international risk factor surveillance programme based on decentralised data collection is warranted. In the meantime, risk factor contrasts across populations can be used as a basis for targeting needed public health intervention programmes.

Dietary patterns in six european populations: results from EURALIM, a collaborative European data harmonization and information campaign.

OBJECTIVE: To determine and describe the extent to which European dietary data collected in disparate surveys can be meaningfully compared. DESIGN: Seven independent population-based surveys from six European countries were initially included. Differences in study designs and methodological approaches were examined. Risk factor data for 31,289 adults aged 40-59 y were harmonized and pooled in a common, centralized database. RESULTS: Direct comparisons of dietary measures across studies were not deemed appropriate due to methodological heterogeneity. Nonetheless, comparisons of intra-population contrasts by gender across sites were considered valid. Women consumed fruit and vegetables more often than men. Age-standardized gender differences in the prevalence of low fruit and vegetable consumption ranged from 7 to 18% and 5 to 15%, respectively. Data on energy intake showed good agreement across study populations. The proportion of total energy from macronutrients was similar for women and men. Gender differences for relative intakes of saturated fatty acids (percentage energy) were small and only in France were they significant. Dietary fibre density was significantly higher in women than in men. Overall, the participating Southern European populations from Italy and Spain exhibited more healthful food composition patterns. CONCLUSIONS: Contrasts in dietary patterns by gender across populations may provide the basis for health promotion campaigns. The most favourable patterns observed may serve as attainable goals for other populations. An international risk factor surveillance programme based upon locally run, good quality studies has the potential to provide the needed data. SPONSORSHIP: European Community (DG V), project 96CVVF3-446-0; Swiss Federal Office for Education and Science, OFES 96.0089.

A Swiss population-based assessment of dietary habits before and after the March 1996 'mad cow disease' crisis.

OBJECTIVE: To assess differences in dietary habits in the general population of Geneva, Switzerland, after the 1996 (BSE) crisis. DESIGN: Repeated population-based survey during 1993, 1994, 1995 and 1996. SETTING: The Bus Santé 2000 epidemiological observatory of Geneva, Switzerland. SUBJECTS: A representative sample of 1190 men and 1154 women. MAIN OUTCOME MEASURE: Dietary habits assessed by a semi-quantitative food frequency questionnaire. RESULTS: The proportion of women who reported not having eaten beef was 7.7% in 1993-1995 and went up to 14.6% in 1996 (age-adjusted difference +6.4%, 95% CI +2.4 to +10.4). Among men, the proportion of non-beef-eaters remained constant (5%). There was a sharp increase of women who did not eat liver (+14.7%, +9.1 to +20.3) but less so in men (+2 5.1%, -0.7 to +10.8). Among women who ate meat, the amount of beef intake decreased by 120 g/month (95% CI -208 to -36). While chicken intake increased (+44 g/month, -2 to 88), overall intake of meat (including poultry but not fish) declined by 204 g/month (or 2.7 kg per year). In men the decrease in beef intake was not statistically significant (-48 g/month, -172 to 80), but consumption of chicken increased (+2 56g/month, +8 to +104). Fish intake was stable in both genders. The reduction in intake of animal protein (-3.5 g/day) in women and of retinol intake in both sexes (women -77 micrograms/day; men -56 micrograms/day) was statistically significant. CONCLUSIONS: The BSE crisis coincided with spontaneous differences in food habits, especially in women, that may have nutritional consequences at the population level.

Dietary survey "HEUREKA" 1991: dietary intake of a Swiss collective assessed by a self-administered 24-hour recall questionnaire.

Food consumption (divided into 10 food groups) as well as energy and main nutrient intake of a Swiss collective (n = 3653) aged 7 years and older was studied. The caloric density was much improved for all five age groups considered as compared with findings in former studies. Carbohydrates gained and alcohol lost significance as main energy suppliers. These results indicate a positive trend in the dietary habits of the collective and suggest an improvement in the dietary habits of the Swiss population as a whole.

Validation of a self-administered 24-hour recall questionnaire used in a large-scale dietary survey.

This study investigated the relative validity of a self-administered 24-h recall questionnaire in a dietary survey on 3,653 men and women 7 years of age and older. The validation was carried out in a group of 41 men. An estimated dietary record kept over 3 days served as reference method. Comparison of the questionnaire and the estimated 3-day record showed good agreement. The Wilcoxon matched-pairs ranked signs test (p < 0.05) demonstrated that the only differences were the crude energy and carbohydrate intake and the estimated nutrient density of protein. The estimated proportion of calories from carbohydrate, fat, protein, and alcohol differed by no more than 2.4%. The median percentage differences in crude nutrient intakes and nutrient densities between the two assessment techniques ranged from -9% to 22%. The daily food intake differed significantly in only three of ten food groups. Spearman's correlation coefficients were higher than 0.35 for all density measurements. The highest correlation coefficients of about 0.60 were observed for alcohol and dietary fiber intake. It is concluded that the self-administered 24-hour recall questionnaire is a valid method for estimating the median and mean dietary intake of large groups of subjects.

[Dietary fiber intake of a collective of Swiss population interested in nutrition]. / Nahrungsfaseraufnahme eines ernährungsinteressierten Kollektivs der Schweizer Bevölkerung.

From May to November 1991, a dietary survey in form of a 24-h-recall questionnaire was carried out in Zurich. For the first time, food data from a large, voluntary, undefined, selected collective was acquired (n = 3653). The mean dietary fiber intake of the women was 30 g/day and of the men 33 g/day, which is comparable with various literature data. These values show a positive trend in the eating habits of the population. The dietary fiber intake was also considered in relation to the origin of the fibers.