Interventions to Reduce Sodium Consumption Through a Reduction in Salt Usage in Cooking—A Systematic Review and Meta-analysis

Context Public health experts have identified salt as a primary dietary risk factor, leading many countries worldwide, recognizing its cost-effectiveness, to implement salt-reduction programs to combat cardiovascular disease and other chronic illnesses. Some nations found that a substantial portion of dietary salt comes from cooking practices. Objectives This systematic review aims to describe and assess the effectiveness of interventions aimed at decreasing salt usage in cooking. Data Sources A search across Scopus, PubMed, and Web of Science was conducted to identify interventions from the past decade that target reduced salt usage during cooking, with effectiveness measured through 24-hour urinary sodium excretion. Data Extraction Thirteen studies were ultimately included (comprising 5 intervention study protocols and 8 randomized controlled trials). Data Analysis The interventions primarily focused on adult participants (n = 11). The interventions ranged from educational initiatives, education combined with salt-restricted utensils, warning labels on salt containers, substitution of salt with potassium-enriched low-sodium alternatives to the use of dosing devices for cooking at home. While 3 studies reported a significant reduction in urinary sodium excretion (mainly through educational efforts), others showed decreases without statistically significant differences between groups. The performed meta-analysis with data from 3185 participants indicated that interventions to reduce salt usage during cooking showed a significant trend towards reducing sodium intake (Hedges’ g, -1.06; 95% CI, -1.68 to -0.44; P < .001). Conclusion The findings suggest that interventions targeting reduced salt usage are effective on sodium intake reduction, assessed by 24-hour urinary sodium excretion, particularly among hypertensive individuals. This approach could aid in achieving the World Health Organization’s goal of a 30% reduction in salt intake by 2030. Systematic Review Registration PROSPERO no. CRD42024506312.