Nutritional habits of children are formed in the preschool period. This process is influenced by the diet of the family as well as the preschool diet in kindergartens where children usually spend most of the day and eat most of their daily meals. Both genetic predisposition and experiences learned from the environment affect children’s salt preferences. The review study states that although the liking of salty foods started as an unlearned response in early infancy, this liking develops as a result of repeated exposure to salty foods in a short period of time.
Generally speaking, low exposure to salty foods in infancy is associated with a low preference for salty food. No study has suggested that decreasing salt exposure during infancy is associated with an increased desire for salty foods. For this reason, concern about the food quality in the preschool period and the eating habits of children is extremely important for the development and formation of nutritional habits in later life. Children learn by direct eating experience and observing the eating behavior of others.
Many researchers have tried to determine whether children find a food product with a reduced salt content different enough to rate it worse than a regular salt content product. Whether or not a food is liked is an important determinant of food intake, especially among children. Salt adds to the taste of food and makes them more enjoyable. Salt level generally has a positive effect on the intake of target foods. Studies have revealed that 4-month-old babies identify and choose salt water instead of plain water, which indicates their salt taste perception mechanisms.
Six-month-old babies fed salty starchy table food later retained their tendency towards salty foods in childhood. The results of the study showed that children aged 4 and over prefer salty foods to unsalted foods. Various studies have shown that after consuming foods with reduced salt content for a period of time (up to 12 weeks), the preferred salt level in foods drops to a level that is not pleasant for subjects with foods with high salt content. The results of recent studies provide evidence that encouraging sensitive dietary practices can alter the development of eating behavior, sleep patterns and early self-regulation skills, and reduce the risk of early obesity.
A study by Kova examined the responses of kindergarten children to less salty bread and the role of teachers and teachers’ assistants in introducing innovations to children’s nutrition. The aim of the study was to determine the likelihood of an unnoticed decrease in the salt content of bread as a staple food in the diet of preschool children. Children had not been told to pay attention to the salinity of the product before, and they evaluated the product as a whole.
The children expressed emotionally what they thought about the bread they ate. Despite the limitations of hedonic evaluation, the results provided the basic answer. The children liked the reduced salt content of the bread. The results showed that there was no 30% reduction in salt, but a 50% reduction in salt content compared to the original recipe. These findings show that 25% salt reduction can be achieved partially unnoticed. However, the results of the study show that children also accepted breads with a 50% reduction in salt content compared to the original recipe, although the results of some previous studies show that children prefer unsalted foods.
When children step outside their familiar environment, they are attracted to role models. Children look for different role models to help shape their behavior and relationships at school, as well as make food decisions. The effectiveness of a role model in a child’s food choices depends on the relationship between the child and the role model. For many young children, the most important role models are their parents and caregivers, the elderly or celebrities. Children also look after other relatives, teachers and peers.
Peers in kindergarten play an important role in shaping children’s eating habits. The results and qualitative responses of the survey show that educational staff have a significant influence on children’s preferences for a particular product or a particular taste. It can be concluded that the environment in which young children live, particularly those with whom they are in close contact, is important in establishing eating habits and in influencing children’s reduced salt taste acceptance.
High salt intake is the main cause of high blood pressure and therefore leads to cardiovascular diseases. The overall goal of the global salt reduction initiative is a 30% relative reduction in average population salt intake towards the WHO recommended level of less than 5 g per day for adults. The availability and accessibility of low salt products is a crucial part of salt reduction measures. Current reformulation approaches include secretly reducing salt, using salt substitutes, or using flavor enhancers. Especially when preparing food, the most preferred option is the use of fresh or dried spices to flavor the dishes.
Consumer awareness of the need to reduce salt consumption should be increased through effective and correct labeling and marketing of food. Creating a favorable environment for reducing salt and promoting healthy eating and healthy eating habits are the most promising measures, especially in early childhood; at home, in kindergartens and schools. Such an approach can provide a foundation for establishing healthy eating habits that will be of particular importance to their entire lives. WHO stated that reducing salt intake has been described as one of the most cost-effective measures countries can take to improve public health outcomes.
Salt reduction measures will produce an extra year of healthy living at a cost that falls below the average annual per capita income or gross domestic product. If global salt consumption is reduced to the recommended level, an estimated 2.5 million deaths could be avoided each year.
Why Should Salt Be Reduced in Children’s Nutrition?
Salt is the primary source of sodium and is associated with high salt intake, hypertension, and an increased risk of heart disease and stroke. It is well known that high salt intake is the main cause of high blood pressure and, in turn, leads to cardiovascular diseases. Well-conducted cohort studies and several intervention trials have shown that lower salt consumption is associated with a lower risk of cardiovascular events. Studies also show a link between excessive salt intake and stomach cancer and type 1 diabetes.
A modest reduction in salt intake has a significant effect on blood pressure in both people with high blood pressure and those with normal blood pressure. These findings provide additional support for a reduction in the salt intake of the population. Also, the meta-analysis shows a dose-response correlation between the reduction in salt intake and the decrease in blood pressure. Sodium reduction causes a decrease in blood pressure in normotensive; decrease in hypertension; a significant increase in plasma renin, plasma aldosterone level, plasma adrenaline and plasma noradrenaline; It is caused by an increase in LDL cholesterol and an increase in triglycerides.
Systematic study and meta-analysis of prospective studies show that dietary salt intake is directly linked to gastric cancer risk in prospective population studies. So the more salt you consume, the greater the risk of cancer. One review suggests that dietary salt restriction as part of medical nutrition therapy would be beneficial in patients with type 1 diabetes, but the relationship between dietary salt intake and health status in patients with type 2 diabetes is confusing.
Recently, some studies have shown that high salt intake is associated with an increased risk of obesity. One of the reasons for this correlation may be that high salt intake stimulates thirst and increases the consumption of sugar-containing beverages by increasing fluid intake. The link between salt intake and obesity may be partly due to excessive consumption of processed foods that are high in both calories and salt. However, more and more evidence suggests that excessive salt intake is a potential risk factor for obesity independent of energy intake.
It is also recommended to reduce sodium / salt intake in children to control blood pressure. These recommendations recognize that the reduction of salt is in line with salt iodization, which is considered an important public health measure to ensure adequate iodine intake in countries with iodine deficiency. Adequate iodine intake is very important in preventing iodine deficiency disorders such as goiter, neurocognitive disorders, hyperthyroidism and hypothyroidism. Used for cooking and at home, iodized salt remains the main source of iodine in many countries around the world.
The reduction of dietary salt should also be complementary with increasing potassium consumption. Epidemiological studies suggest that the optimal sodium-potassium ratio may be more important than individual sodium and potassium levels for determining the relationship between blood pressure and cardiovascular disease risks. Potassium is often found in a variety of unrefined foods, especially fruits and vegetables. Food processing reduces the amount of potassium in many food products, and a diet high in processed foods and low in fresh fruits and vegetables often lacks potassium. On the other hand, it is important to emphasize that excess potassium intake can be achieved by consuming certain salt substitutes. When consumed in excess, potassium can be harmful for some people with kidney problems.
Author: Ozlem Guvenc Agaoglu