Sodium Intake Tracked from Infancy and Salt Taste Preference during Adolescence: Follow-up of a Randomized Controlled Field Trial in Brazil

BACKGROUND: Effective interventions to promote healthy sodium intakes require understanding factors driving liking for salt taste. OBJECTIVES: To examine effects of an early feeding intervention among low-income mothers on their children’s energy and sodium intake and salt taste preferences at 12 years; and to identify age-related changes in dietary sodium sources. METHODS: Secondary analyses were conducted on dietary intake and taste preference data collected from children in a longitudinal trial (NCT00629629). Mothers randomized to the intervention group received counseling on healthy eating practices for 1 year postpartum; the control group received no counseling. Two-day dietary recalls were obtained at 1 year (intervention end) and at 4-, 8-, and 12-year follow-up visits, from which foods were categorized as unprocessed, processed, or ultra-processed. At the 12-year visit, children’s most preferred concentration of salt was measured using a validated, forced-choice, paired-comparison tracking method, and pubertal stage was self-assessed. RESULTS: The intervention group had reduced energy intake compared with controls in all food categories at 1 year (P = 0.04) but not at the other time points. Sodium intake from processed foods increased from 4 to 12 years and from ultra-processed foods from 1 to 4; intake from unprocessed foods decreased from 1 to 8 year (all P < 0.01). At 12 years, children in early stages of puberty (Tanner stages 1–3; P = 0.04) or in the ≥75th percentile of sodium intake (P < 0.01) preferred significantly higher concentrations of salt than the other children. CONCLUSIONS: Both dietary intake of sodium and early puberty were associated with preferences for higher salt concentrations. Childhood and adolescence are important periods for understanding how experience and growth shape diet by changing salt taste. CLINICAL TRIAL REGISTRATION: This manuscript reports secondary analysis of data collected in trial NCT00629629 (2001–3) and follow-up [https://clinicaltrials.gov/ct2/show/NCT00629629?term=NCT00629629&draw=2&rank=1].