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A gradual taste adaption intervention reduced dietary sodium intake among adults with hypertension


 
 
 Type of funding sources: Other. Main funding source(s): University Kentucky College of Nursing Internal Grant
 
 
 
 Despite the recommendations and substantial benefits of reducing dietary sodium intake in adults with hypertension, adherence to a sodium-restricted diet (SRD) remains poor. One of the biobehavioral barriers in following SRD is a poor taste of SRD that leads preference for salty food. We developed a systematic and comprehensive approach of gradual taste adaptation to the SRD (Sodium Watchers Program [SWaP]) to reduce dietary sodium intake by overcoming these sensory barriers. The purpose of this pilot study was to examine the effects of the SWaP-HTN on dietary sodium intake, blood pressure (BP), preference for salty food, and enjoyment of SRD in adults with hypertension.
 
 
 
 A total of 29 adults with hypertension were randomly assigned to the intervention (n=19) and usual care group (n=10) in a 2:1 ratio. The intervention group received a 16-weeks SWAP-HTN intervention via video-conferencing on a tablet. All participants completed collecting 24-h urine specimens and blood pressure baseline and 4-month follow-up. Blood pressure was taken three times at each assessment, and mean BP was calculated. Preference for salty food and enjoyments of SRD were assessed on a 10-point rating scale. Repeated measures ANOVA was used to compare outcomes changes between two groups from pre- to post-intervention.
 
 
 
 Of the 27 participants (mean age = 62.8 years, 55% male), only 3 (11%) were withdrawn. The mean 24-hour urine sodium excretion (24h UNa) was 3,911 mg/day (range 1,563 mg- 8,138 mg) and mean systolic and diastolic blood pressures was 135.7/85.6 mmHg at baseline. The intervention group significantly reduced sodium intake by 1,158 mg/day of sodium, a 30% reduction (TimeX Group P = 0.011: Figure 1), and reported an increase in the enjoyment of SRD at 4-month follow-up (TimeXGroup P = 0.01; Figure 1). Although there was a trend of decreasing mean systolic BP(143.4 mmHg vs. 133.9 mmHg, baseline and 4-month respectively) in the intervention group, it did not reach statistical significance (TimeXGroup, P = 0.061). There was also no significant difference in changes in the preference of salty food and diastolic BP between the two groups.
 
 
 
 Even with a small sample size, we demonstrated that a gradual adaptation strategy to a sodium-restricted diet effectively reduced dietary sodium intake by increasing the hedonic state of SRD. This innovative approach may also have the potential for controlling blood pressure, but this needs to be tested in a large clinical trial.
