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02 TR Saltmeter
02 TR Saltmeter
02 TR Saltmeter
i
DISCLAIMER
Technology review is a brief report, prepared on an urgent basis, which draws on
restricted reviews from analysis of pertinent literature, on expert opinion and / or
regulatory status where appropriate. It has been subjected to an external review
process. While effort has been made to do so, this document may not fully reflect
all scientific research available. Additionally, other relevant scientific findings may
have been reported since completion of this review.
ii
Prepared by:
Dr Erni Zurina Romli
Senior Principal Assistant Director
Health Technology Assessment Section (MaHTAS)
Ministry of Health Malaysia
Reviewed by:
Dr Junainah Sabirin
(Public Health Physician)
Deputy Director
Health Technology Assessment Section (MaHTAS)
Ministry of Health Malaysia
External reviewers:
DISCLOSURE
The author of this report has no competing interest in this subject and the
preparation of this report is totally funded by the Ministry of Health, Malaysia.
iii
EXECUTIVE SUMMARY
Background
Objective/Aim
A total of 59 titles were identified through the Ovid interface and PubMed. After
removal of 53 irrelevant or duplicate articles, six titles were screened. Of these,
four relevant abstracts were retrieved in full text. After reading, appraising and
applying the inclusion and exclusion criteria to the four full text articles, all the
articles were included, which comprised of experimental laboratory studies.
Efficacy
There were four included studies on the efficacy of the salt meter which comprised
of two studies on ion selective electrode (ISE) method, one study on thermometric
endpoint titrimetry (TET) and one study on ISE and potentiometric titration of
chloride ion. No retrievable evidence was found for the efficacy of conductivity
method and refractometry method. (Table 1)
v
Table 1 : Summary of evidence on the efficacy of salt measurement by different methods
Precision: RSD = 1%
Thermometric
endpoint
Limit of detection(LOD)
titrimetry (TET)
= 0.1g Na 100g-1
vi
There was limited retrievable evidence to demonstrate the efficacy of ion selective
electrode and titration methods in measuring salt/sodium content in food :
Titration
a. Automated Potentiometric Titration Chloride Ion
• Analysis of chloride content did not produce reliable sodium
estimates in low-sodium foods (<100µg/g).
• In certain starchy, high-fat matrices, such as cookies, granola,
peanuts, and potato chips, incomplete extraction of chloride ions led
to slow response of the electrode.
• Sample preparation with dispersion and blending with water was
considered adequate.
vii
Safety
There was no evidence retrieved from the studies on the safety of salt meter in
measuring salt/sodium content in food.
Cost /cost-effectiveness
Methods
Electronic databases were searched through the Ovid interface: Ovid MEDLINE®
In-process and other Non-indexed citations and Ovid MEDLINE® 1946 to present,
EBM Reviews - Cochrane Central Register of Controlled Trials - February 2018,
EBM Reviews - Cochrane Database of Systematic Reviews - 2005 to March 2018,
EBM Reviews - Health Technology Assessment – 4th Quarter 2016, EBM Reviews
– NHS Economic Evaluation Database 1st Quarter 2016. Searches were also run
in PubMed. Google was used to search for additional web-based materials and
information. No limits were applied. Additional articles were identified from
reviewing the references of retrieved articles. Last search was conducted on
15 March 2018.
viii
SALT METER FOR FOOD
1. BACKGROUND
In the past few millennia, there was a shift in dietary pattern around the world with
an increase in consumption of highly salted processed food. The change in
lifestyle, rapid urbanisation and more production of processed food which makes it
more available and affordable are among the reasons for the high consumption of
processed food. According to the updated report by WHO in 2016, the average
population salt intake in most countries has risen to 9-12g/day.5 Most adult
population in Asian countries have average salt intake more than 11.7g/day (more
than 4.6g/day sodium).6 The excessive consumption of salt or dietary sodium is
associated with hypertension and progression of renal disease.7, 8 Hypertension
or raised blood pressure is major risk factor for cardiovascular disease (CVD).
Many scientific studies including animal studies, genetic studies, epidemiologic
studies and interventional studies have provided a robust and long term evidence
for a causal relationship between salt intake and CVD.9-12
Globally, one billion people suffer from hypertension, which leads to heart attacks
and strokes. Currently, raised blood pressure kills an estimated nine million people
every year.13 Systolic blood pressure of 140mmHg or higher has been associated
with 58.3% haemorrhagic stroke related death (2.0 million [95% CI, 1.6-2.3
1
million]), 50.0% ischaemic stroke related death (1.5 million [95% CI, 1.2-1.8
million]) and 54.5% ischaemic heart disease related death (4.9 million [95% CI, 4.0-
5.7 million]).14 The financial toll of hypertension on the families, communities and
countries are related to premature death, disability, personal and family disruption,
loss of income and healthcare expenditure.13 The latest published data on global
healthcare expenditure reported that the annual cost of hypertension is
approximately USD370 billion (10% of global healthcare spending) which include
the cost of health care services, medications to treat high blood pressure and
missed days of work.15 Addressing risk factors for raised blood pressure effectively
and in timely manner has significant benefit in preventing the adverse health
consequences as well as health and economic gains. A study on the impact of
population-wide lifestyle modification suggested that a reduction of 2mmHg
diastolic blood pressure in the mean population distribution with modest salt
reduction would decrease the prevalence of hypertension by 17%, the risk of
coronary artery disease by 6% and the risk of stroke by 15%.12
A good understanding and management of dietary salt is vital for reduction of salt
intake. Monitoring the nutrient content and other characteristics (for example
serving size) of foods may help the development of strategies to reduce dietary salt
consumption. The sodium content of processed and manufactured foods can be
monitored through the Nutrition Facts label on packaged foods and the availability
of public and private databases containing this information.20
2
The table below shows a guideline of sodium content in food and conditions for
nutrient content / claims ‘low in’ or ‘free of’.21, 22
Malaysia has a very rich and diverse dietary culture with extensive use of salt and
spices. My Salt study in 2015 reported the average salt intake among 1027 health
staff in Malaysia was 7.15g/day (2.86g/day sodium).23 Sauces/seasonings
specifically light soy sauce was the main contributor to the highest salt/sodium
consumption. Among the popular foods with high salt/sodium content consumed
by participants were sambal belacan, salted fish, local kuih-muih, fried noodle, fried
rice, nasi lemak, roti canai, fast foods and meat products.23 A cohort study in 2016
involving 794 adolescents aged 13 years old from 15 public schools in Central
(Kuala Lumpur and Selangor) and Northern (Perak) Regions of Peninsular
Malaysia, had shown that the level of salt intake from a seven days historical
assessment of habitual food intakes was 5.73g/day (2.29g/day sodium) which
exceeded the recommendation by WHO.24 As Malaysia experiences rapid
urbanisation, economic development and the emergence of a middle class, the
Malaysian food lifestyle are changing from traditional way of eating habits to a new
stylisation of food consumption patterns. More and more Malaysians are
developing a taste for eating out. Many young families prefer outside foods as they
are easily available and more convenient. Additionally, the growing number of
working parents means that there is less time for home cooking. Malaysian Food
Barometer study, conducted by Taylor’s University in 2013 was able to capture the
changes in food consumption at the local national level whereby 64.1% of
Malaysians eat at least one meal per day outside of home.25
For the past few decades, CVD has become a leading cause of death in Malaysia
concurrent with the rapid growth of the economy and associated change in the
socio-demography with adoption of new lifestyles, food habits and dietary pattern.
3
According to National Health and Morbidity Survey (NHMS) report in 2015, the
overall prevalence of hypertension (known and undiagnosed) among adults aged
18 years and above was 30.3% (6.1 million adults).26 The survey also reported an
increase in prevalence with age from 6.7% in the 18-19 years age group, reaching
a peak of 75.4% among the 70-74 years age group.26 Data from Malaysian Burden
of Disease Study in 2014 had shown that high blood pressure contributed to 42.2%
of deaths and 21.6% of disability-adjusted life years (DALY), the largest contributor
for both men and women.27
4
2. OBJECTIVE / AIM
3. TECHNICAL FEATURES
There are variety of methods available for determining sodium (salt) content in
food. Selection of suitable method largely depends on the accuracy desired,
equipment cost and the experience level of the person performing the test. The
most common methods for measuring sodium content are ;
i. Conductivity method
ii. Ion-selective electrode (ISE)
iii. Refractometry
iv. Titration method
i. Conductivity method31, 32
5
The meter is equipped with probe to measure conductivity in foods. There are two
main types of probes used for the measurement; amperometric probes and
potentiometric probes. Amperometric probes are made from two electrodes
spaced a known distance from each other. This distance is called the cell constant.
A voltage is then applied to the two electrodes and current is measured between
them. Eventually, the resistance can be determined, which can be used to calculate
the conductivity. Amperometric conductivity probes have the advantage of
requiring a low sample size and are generally less expensive than other
conductivity technologies. However, different ranges of salt require different cell
constants using amperometric sensors. This means that multiple sensors are
required for different ranges.31
6
Figure 3: Potentiometric probe
7
Product Product Image Description
Model/Supplier
Sample Application
8
ii. Ion-selective electrode37
9
a dedicated sodium ISE meter is needed along with the ISE, ISA and calibration
standards.
Table 3: Examples of ISE meters available on the market
Product Product Image Description
Model/Supplier
- Flat sensor allows measurement of viscous
LAQUATWIN Na-11 liquids, solids and powder samples
Sodium Ion Meter, - Ion measurement can be affected by non-
Supplier: Horiba target ions (see the glossary for details).
Instruments38 - Detection of ion in water only; electrolytes in
oils cannot be measured.
CE marked - Minimum sample volume: 0.3ml (0.05ml with
sampling sheet)
- Measurement range: 2 to 9900 ppm (mg/L)
0.1 to 430 mmol/L
- Accuracy: ± 10% of actual value
CE marked
iii. Refractometry37
This method determines the salt content of a substance based on refractive index.
The refractive index is determined by passing a light through a prism into a sample
and measuring how the light bends. Refractometers determine the critical angle of
a sample. The critical angle is the angle at which no light is refracted and all light
is internally reflected. Each refractometer is based on the effect of density and
temperature on the refractive index for a specific measured parameter. The
refractive index is converted to a measurement unit such as % Brix (soluble solids
as sucrose) or % salt.
iv. Titration37
Titration is the most common method of salt analysis by a food manufacturer with
an in-house laboratory. A titration method is referenced by organisations such as
the Association of the Official Analytical Chemists (AOAC) for a variety of food
matrices including cheeses, meats and vegetables. A titration is a procedure where
a solution of a known concentration (titrant) is used to determine the concentration
of an unknown solution (analyte). Results are calculated based on the amount of
titrant used to reach an endpoint. An endpoint can correspond to a colour change
with the use of a chemical indicator or detection with a potentiometric sensor, such
as a chloride or silver ISE.
Burrete
*USED TO ACCURATELY MEASURE THE
AMOUNT OF STANDARD SOLUTION
THAT IS BEING DISPENSED INTO THE
SOLUTION OF UNKNOWN Vinitial
CONCENTRATION
Volume
titrant used
Vf – Vi
Vfinal
Standard Solution (Titrant)
*THE SOLUTION OF KNOWN CONCENTRATION
12
a. Manual Titration: Mohr Method37
One way to determine salt content by titration is by the Mohr method. Historically,
the Mohr method is a manual titration method using silver nitrate as a titrant and
potassium chromate as a colour indicator. In this titration, a volumetric burette is
used to manually add silver nitrate titrant to a sample that has chloride analyte as
the indicator. The reaction between the silver and chloride ions produces an
insoluble silver chloride (AgCl) precipitate. The silver nitrate is added until all of the
chloride ions have reacted with the silver nitrate. At this point, any additional silver
nitrate will be in excess resulting in the presence of silver ions. The silver ions will
then bind to the potassium chromate color indicator to produce a red color in
solution. This signals the endpoint of the titration. The chloride concentration is
then calculated from the volume of silver nitrate that was added and then used to
infer sodium or sodium chloride content. Manual titration relies on subjective
interpretation of the colour indicator change. For this reason, this method is prone
to overestimating the salt content. An additional challenge with a manual titration
is the accurate measurement of the titrant that is used. The investment to perform
a manual titration with silver nitrate titrant, colour indicator, volumetric burette and
other necessary glassware is very low.
13
Amount of NaCl in sample % = (V2-V1) x N x 5.844
W
Where, W = weight of sample
V2 = Titer volume of blank (mL)
V1 = Titer volume of sample (mL)
1mL of 0.1 N KSCN is equivalent to 5.844mg of NaCl
Many titration systems feature the ability to dynamically dose a titrant. Dynamic
dosing allows the meter to control how much titrant is dosed based on the progress
of the titration. Larger doses are dispensed in the beginning of the titration, with
progressively smaller doses being dispensed as the endpoint is approached. This
saves time and reduces the likelihood of overshooting the endpoint. Automatic
titrators will also perform all of the necessary calculations and display the results
in the concentration units desired. The other benefits of an automatic titration
system include the ability to generate reports for traceability and the option to
perform other titrations including acidity.
14
of titration making them difficult to adapt to some food matrices. It is a method of
testing the true amount of sodium directly. Thermometric titrations are readily
automated, and share with other automated titration techniques the use of a sensor
to detect the endpoint of the titration reaction. In the case of thermometric titrimetry,
the sensor is a thermometer. The temperature sensing element is a thermistor, a
solid-state device which exhibits relatively large changes in its resistance as a
function of temperature. The thermistor forms one arm of Wheatstone bridge
(bridge circuit) and the analogue output is converted to a digital signal and
transferred by an electronic interface to a computer for processing. The actual
temperature of the solution is immaterial, as the sensor is only required to detect
the change in solution temperature at the endpoint. For this reason, there is no
need to calibrate the sensor. Further, sensor maintenance is minimal, and it is
normally stored dry between titrations.
Certifications: UL listed
and CSA certified. IEC and
EN certified.
15
3.2. Validation of Analytical Methods49
Specificity is the ability of the method to assess unequivocally, the analyte in the
presence of components that may be expected to be present in the matrix or
sample such as degradation products and impurities.
16
a) Accuracy
The most common technique for determining accuracy is the spike recovery
method, in which the amount of a target compound is determined as a
percentage of the theoretical amount present in the matrix (recovery value in %).
The theoretical recovery of the target analyte from the spiked material is the sum
of the amount of added analyte and the amount of naturally occurring analyte
(as determined in the parallel analysis of unspiked material). The difference
between the theoretical amount and the amount analytically determined in the
spiked matrix provides an estimate of accuracy. Other ways of evaluating
accuracy are by the use of certified reference material as controls and the use
of a standard/reference method with little or no systematic error.
b) Precision
The overall concept of precision is divided into three components: repeatability,
intermediate precision, and reproducibility.
- Repeatability is a measure of the within-laboratory uncertainty
(combination of within batch and between batches variability). The
guidance recommends that a validation package include analysis for
minimum ten times of known material singly or in replicate that produce
a relative standard deviation (RSD) of less than one percent. Relative
standard deviation, also known as the coefficient of variation (CV) is
defined as a standardised measure of dispersion of a probability
distribution or frequency distribution and often expressed as a
percentage.
- Intermediate precision is a measure of the ruggedness of the method,
i.e., reliability when performed in different environments. Demonstration
of intermediate precision requires that the method be run on multiple days
by different analysts and on different instruments. At a minimum, such
studies should be run on at least two separate occasions.
- Reproducibility is an indication of the precision that can be achieved
between different laboratories and is evaluated using multi-laboratory
collaborative studies.
17
be the one whose applicability range within range found in the samples. Samples
also can be diluted to fit the range.
3.2.5. Robustness49
Robustness experiments measure a method’s ability to remain unaffected by small
but deliberate variations in method parameters. Examples of potentially sensitive
processes include extraction time, extraction temperature and extraction process.
4. METHODS
4.1. Searching
Electronic databases were searched through the Ovid interface: Ovid MEDLINE®
In-process and other Non-indexed citations and Ovid MEDLINE® 1946 to present,
EBM Reviews - Cochrane Central Register of Controlled Trials - February 2018,
EBM Reviews - Cochrane Database of Systematic Reviews - 2005 to March 2018,
EBM Reviews - Health Technology Assessment – 4th Quarter 2016, EBM Reviews
– NHS Economic Evaluation Database 1st Quarter 2016. Searches were also run
in PubMed. Google was used to search for additional web-based materials and
information. No limits were applied. Additional articles were identified from
reviewing the references of retrieved articles. Last search was conducted on 15
March 2018.
18
4.2. Selection
A reviewer screened the titles and abstracts against the inclusion and exclusion
criteria and then evaluated the selected full text articles for final article selection.
Inclusion criteria
Interventions Saltmeter
No comparator or taste perception or standard
laboratory analysis [ie spectroscopic techniques
Comparators such as flame photometry, inductively-coupled
plasma spectroscopy (ICP) and atomic absorption
spectroscopy (AAS)]
i. Efficacy/effectiveness (measuring salt/sodium
content in food)
Outcomes
ii. Safety (adverse events, complication)
iii. Economic implication (cost, cost-effectiveness)
Exclusion criteria
Data were extracted from the full text articles and summarised in evidence table as in
Appendix 2.
19
5. RESULTS AND DISCUSSION
A total of 59 titles were identified through the Ovid interface and PubMed. After
removal of 53 irrelevant or duplicate articles, six titles were screened. Of these,
four relevant abstracts were retrieved in full text. After reading and applying the
inclusion and exclusion criteria to the four full text articles, all the articles were
included which comprised of experimental laboratory studies. The selection of
studies is as shown on Figure 4.
Number of records
Number of records excluded (n=2)
screened (n=6)
20
5.1. EFFICACY
5.1.1. There were four included studies on the efficacy of the salt meter which comprised
of two studies on ISE method, one study on TET and one study on ISE and
potentiometric titration of chloride ion. There was no retrievable evidence on the
efficacy of conductivity method and refractometry method.
21
Table 6: Comparison of sodium ion selective electrode (ISE) and atomic absorption (AA)
methods for determination of sodium in eight cheese
Average % Sodium
Cheese Sample Difference
ISE AA
A 1.53 1.65 0.12
Blue
B 1.87 1.72 0.15
A 0.79 0.86 0.07
Camembert
B 0.79 0.74 0.05
Repeatability of the ISE method was evaluated on ten replicates for each cheese.
Variability within each set of ten replicates is shown in Table 7. Standard deviations
were ≤ 0.02% sodium for all cheeses and coefficients of variation (CV) ranged from
0.006 for blue cheese to 0.024 for Parmesan and Camembert. 50
% Sodium
Cheese CV
Mean SD
Blue 1.60 0.01 0.006
Camembert 0.84 0.02 0.024
Cheddar 0.60 0.01 0.017
Mozzarella 0.85 0.01 0.012
Parmesan 0.84 0.02 0.024
Process Cheddar 1.55 0.02 0.013
Salt-free Gauda 0.04 0.0007 0.018
Swiss 0.23 0.004 0.017
CV – coefficients of variation
SD – standard deviation
22
Sensitivity of the sodium ISE method to small differences of sodium contents
among samples, as determined by standard additions of 0.5 mg to 2.5 mg sodium,
was excellent for all cheeses. Recovery of total sodium by the ISE method, shown
in Table 8, approached the ideal recovery of 100% in most cases. Data in Table 8
indicate that the sodium ISE was sensitive to small differences in cheese sodium
content. The authors concluded that sodium ISE method could be applied
successfully to cheese. The procedure was simple, required only a modest
investment in equipment, and was relatively rapid. Analysis time was seven to eight
minutes per sample, including time required to calibrate the instrument, weigh and
analyse the sample.50
23
Florence E conducted an experimental laboratory study to investigate the use of
the sodium ISE as a rapid, reliable and inexpensive method for the determination
of sodium in salted foods.51 The study analysed the sodium content in nine types
of cheese, 12 varieties of butter and a selection of salted foods which included all-
bran, custard powder, self-raising flour, gravy powder, Oxo and salad cream. Two
reference methods were used for comparison with ISE. Reference method A were
dry-ashed and hydrochloric acid extracts analysed for sodium by atomic absorption
spectrometry. Reference method B were analysed for salt content by Volhard
titration according to the British Standards. Tests were carried out with various
concentration of sodium added to Cheddar cheese in order to determine the
recovery of sodium added to cheese. The results given in Table 9, showed that the
recovery of sodium added to cheese was good over the concentration range used
(10-100 p.p.m of sodium). Test samples of nine types of cheeses (in six replicates
of each sample) were analysed by the proposed ISE method and reference method
A. There was a good agreement between the results for all cheeses with a high
correlation coefficient (r=0.996) as shown in Table 10.
Table 10: Determination of sodium in cheese: comparison of ion-selective electrode (ISE) with AAS
24
time for butter was not as definitive as for cheese and it was difficult to elect a point
of stability. This was associated with enhanced activity of the free sodium ion in
presence of oil. It was proven by measuring sodium in total butter mixtures and in
oil-free filtrates.
Table 11: Determination of sodium in butter: comparison of ion-selective electrode (ISE) with
reference methods A (AAS) and B (British Standard, BS)
Sodium/mg per 100g
Butter sample No
ISE AAS BS
1 766 722 731
2 440 413 428
3 684 627 652
4 782 711 715
5 935 824 857
6 943 865 896
7 959 890 892
8 896 800 849
9 519 450 452
10 582 545 534
11 880 799 833
12 1089 1023 1053
Over all mean 790 722 741
Table 12: Comparison of methods for the determination of sodium in other salted foods
A selection of salted foods was analysed by the proposed ISE method and by
reference methods A and B. The results are given in Table 12. There was a good
agreement between the results of the three methods for all foods, with the
exception of the result for the analysis of all-bran by reference method A (AAS),
which is 25% higher than that found by ISE measurement. The reason for the
significantly higher value produced by ISE measurement was not explained by the
author. The authors concluded that the sodium ISE was a rapid and inexpensive
method for the determination of sodium in cheese, butter and other salted foods.
The total time of analysis was ≤10 minutes. Good precision was achieved for a
variety of cheese and other salted foods with reference to a standard method. For
butter a positive bias was found (≤9%) for measurements made with the ion-
selective electrode over those using the reference method.51
25
5.1.3. Titration method with thermometric endpoint titrimetry
Table 14: Estimated limit of detection (LOD) and limit of quantification (LOQ)
in sample in (g Na 100g-1) for each technique
* FAAS: Flame atomic absorption spectrometry ; FAES: Flame atomic emission spectrometry; ICP:
Inductively coupled plasma atomic emission spectrometry ; TET: thermometric endopoint titrimetry
26
Table 15: Concentration of sodium in supermarket ketchup sauce (g Na.100g-1)
FAAS* FAES* ICP* TET*
(mean±CI) † (mean±CI)† (mean±CI)† (mean±CI)†
Digestion 1.11 ± 0.02 0.88 ± 0.03 1.01 ± 0.05 1.05 ± 0.03
Dry ashing 1.09 ± 0.04 0.96 ± 0.04 0.95 ± 0.04 1.04 ± 0.01
*FAAS: Flame atomic absorption spectrometry ; FAES: Flame atomic emission spectrometry; ICP: Inductively coupled plasma
atomic emission spectrometry ; TET: thermometric endpoint titrimetry.
† mean and confidence interval (CI) have been calculated from the commodities of each series (10 replicates) at 95% of
confidence.
Table 16 displayed the results of the analysis of low sodium ketchup sauce by
different methods. As its LOD was around 0.1g Na 100g-1 (Table 14), TET was
not able to determine a 0.07g Na 100g-1 sample. In order to evaluate the accuracy
of the results, a recovery rate was calculated from the differences between
synthetic concentration enhancements and the average values. The analysed
concentration of the low sodium content sauce was taken into account as well as
the added quantity of sodium for determination of the concentration of synthetic
solution. Table 17 shows the low sodium ketchup sauce sample doped with a
known quantity of sodium and Table 18 shows the recovery rates. The calculated
theoretical concentration in the doped sample was 1.02 ± 0.01g Na 100g-1.
Recoveries were very close to the target (almost 100%) and all of the values were
very close to each other (global RSD of only 2%).The authors concluded that
despite the worse LOD whereby TET could not determine sodium content at traces
level, TET seems to be potentially as efficient as the traditional atomic
spectrometric techniques.52
Dry ashing 0.071 ± 0.003 0.064 ± 0.003 0.068 ± 0.003 < 0.1
27
Table 17: Concentration of sodium in doped sauce (g Na.100g-1)
FAAS* FAES* ICP* TET*
(mean±CI) † (mean±CI)† (mean±CI)† (mean±CI)†
Digestion 1.03 ± 0.01 0.97 ± 0.03 1.00 ± 0.01 1.03 ± 0.02
Dry ashing 1.05 ± 0.01 1.02 ± 0.02 1.01 ± 0.02 1.02 ± 0.01
Dispersion 102 ± 1 99 ± 1 99 ± 1 99 ± 1
*FAAS: Flame atomic absorption spectrometry ; FAES: Flame atomic emission spectrometry; ICP: Inductively coupled plasma
atomic emission spectrometry ; TET: thermometric endpoint titrimetry.
† mean and confidence interval (CI) have been calculated from the commodities of each series (10 replicates) at 95% of
confidence.
Table 19 shows results of sodium analysis by ICP/MS, FAAS and ISE in 17 low-
sodium food types. All samples were analysed in triplicate (within-day and interday)
by each method. Matrix effects were evaluated by carrying out spiking experiments
in triplicate at two different spiking levels by each method. Results, calculated as
total recovery (native Na + spiked Na) are given in Table 19. There was a good
agreement between the results by all three methods for chicken broth, cereal,
granola and potato chips. Results by ISE were significantly lower than both ICP/MS
28
and FAAS in almond butter, cookies, and vegetable broth. In case of almond butter,
this was explained by the strong negative matrix effects by ISE and positive matrix
effects by FAAS. Results by ISE in cookies were 15–20% lower than by either
ICP/MS or FAAS, likely because of incomplete extraction of Na from the matrix.
Incomplete aqueous extraction of Na had also been reported in bread, where the
bread to water ratio determined the extraction yield. Results by ISE were
significantly higher than by both ICP/MS and FAAS in green beans (within-day
only) and higher than ICP/MS in apple juice (interday only). These differences
could be explained by the high K to Na ratio in these matrixes. The within-day and
interday repeatability precision of all three methods, expressed as the RSD, as
shown in Table 18. By comparing the median RSDs among all 17 matrices, it
appeared that overall ICP/MS and FAAS offered comparable within-day precision
(median RSDs of 2.7% and 3.5%, respectively), while the ISE was somewhat less
precise (median RSD of 5.6%). Flame atomic absorption spectrophotometry offers
the best interday precision (median RSD of 3.2%), while both ICP/MS and ISE
have lower interday precision (median RSDs of 6.1% and 6.2%, respectively). 53
Table 19 : Results of sodium analysis by ICP/MS, FAAS, and ISE in 17 low-sodium food
sample
29
Overall the fewest matrix effects (defined as mean spike recoveries outside the
90–110% range) were found with ICP/MS (seven), followed by FAAS and ISE (12
and 13, respectively; Table 20). In certain foods (e.g., almond butter, granola,
pasta, and peanuts), matrix effects were found with more than one method. In other
foods, matrix effects were observed by one method and not by the others.53
Table 20: Total recovery of sodium from 17 low-sodium food samples analysed by ICP/MS,
FAAS and ISE
30
were compared against the theoretical ratio of 1.542 (in NaCl). Chloride to Na ratios
were closed to 1.542 in almond butter, baby food dinner, cereal, chicken broth, and
vegetable broth (five out of 17 samples). In all other samples, calculated chloride
to Na ratios were widely variable, ranging from 0.3 in cookies to 30 in pasta. The
very low ratio in cookies was due to the use of sodium hydrogen carbonate in the
product’s recipe. Remarkably, the chloride to Na ratio in cheese was significantly
higher than 1.542, even though the product contains added NaCl. The chloride-to-
Na ratio in apple juice could not be determined due to the very low concentration
of chloride ions (below the LOQ, about 35 µg/g). Overall, it could be concluded that
chloride levels do not allow the reliable estimation of Na levels in low-sodium foods,
even when added NaCl was present. With the exception of almond butter and
peanuts containing <100 µg/g of chloride, and baby food dinner containing about
230 µg/g chloride, within-day and interday RSD values were 0.12–3.1% and 0.3–
4.4%, respectively, comparable to those reported by others. The authors
concluded that while the ISE performed satisfactorily in certain types of samples,
it showed negative matrix effects in fatty foods and positive matrix effects at very
low Na concentrations (<100 µg/g). Even though the analysis of chloride ions could
give a reasonable estimation of Na concentration in certain particular types of foods
with low levels of Na, it could not be endorsed overall, even when such foods
contain added NaCl. 53
31
5.2. SAFETY
There was no evidence retrieved from the studies on the safety of salt meter in
measuring salt/sodium content in food. Food Salt Meter SSX-210 by PCE
Instrument, LAQUATWIN Salt EC and LAQUATWIN Na-11 Sodium ISE Meter by
Horiba Instruments, HI931102 FOODCARE NaCl/°C (ISE) Meter with FC 300B
combination sodium electrode and HI96821 Digital Refractometer by Hanna
Instruments and Salt-Chek Digital Handheld Refractometer by Reichert are in
compliance with the CE Directives (CE marked). 35, 36, 38, 39, 40, 41 Thermometric Titrator
Metrohm AG is FDA approved. 45, 48
5.4. LIMITATIONS
This technology review has several limitations. The selection of studies was done
by one reviewer. Only English full text articles were included in this review. Level
of evidence and risk of bias in the included studies could not be assessed as the
study design for these studies was experimental laboratory study.
6. CONCLUSION
6.1. Efficacy
There were four included studies on the efficacy of the salt meter which comprised
of two studies on ISE method, one study on TET and one study on ISE and
potentiometric titration of chloride ion. No retrievable evidence was found for the
efficacy of conductivity method and refractometry method.
There was limited retrievable evidence to demonstrate the efficacy of ion selective
electrode and titration methods in measuring salt/sodium content in food :
• Good precision was achieved for a variety of cheese and other salted foods
with reference to a standard methods (atomic absorption spectrometry and
Volhard titration) .
• In measuring sodium content in low sodium foods (food products containing
140mg or less sodium per serving), ISE was less precise (median RSD of
5.6%). Ion selective electrode did not perform well in fatty foods (such as
cookies, peanuts, and almond butter) or at very low sodium concentrations
(<100 µg/g).
Titration
a. Potentiometric Titration Chloride Ion
• Analysis of chloride content did not produce reliable sodium estimates in
low-sodium foods (<100 µg/g).
• In certain starchy, high-fat matrices, such as cookies, granola, peanuts, and
potato chips, incomplete extraction of chloride ions led to slow response of
the electrode.
• Sample preparation with dispersion and blending with water was considered
adequate.
6.2. Safety
There was no evidence retrieved from the studies on the safety of salt meter in
measuring salt/sodium content in food.
33
7. REFERENCES
35
33. Conductivity method salt meters: Scientific Gear; 2018. Available from
http://www.scientificgear.com/salt-testing-conductivity-meters. Accessed on
30.01.18.
34. Electronic Salinity Tester Salt Measuring Meter Detector (White): LAZADA; 2018.
Available from https://www.lazada.com.my/products/electronic-salinity-tester-salt-
measuring-meter-detector-white-i214507939-
s270504677.html?gclid=EAIaIQobChMItoiuqpTD2wIViCQrCh0p_g3VEAQYASA
BEgI38PD_BwE&s_kwcid=AL!3150!3!272448302875!!!g!!&utm_source=google&
utm_m. Accessed on 30.01.18.
35. Food Salt Meter SSX-210. Available from http://www.industrial-
needs.com/technical-data/food-salt-meter-ssx-210.htm. Accessed on 30.01.18.
36. LAQUATWIN SALT 11 METER. QA Supplies. Available from
https://qasupplies.com/laquatwin-salt-11-meter/. Accessed on 30.01.18.
37. Masulli D. Determining Salt in Food. Available from
http://www.foodqualityandsafety.com/article/determining-salt-in-food/. Accessed
on 29.01.18.
38. HORIBA LAQUATWIN NA-11 COMPACT SODIUM ION METER. EnviroSupply
Service Inc. Available from https://envirosupply.net/shop/activated-carbon/grow-
room-odor-control/horiba-laquatwin-na-11-compact-sodium-ion-meter.html.
Accessed on 30.01.18.
39. HI931102 FOODCARE NaCl/°C (ISE) Meter. Hanna Instruments (S) Pte Ltd.
Available from http://shop.hannasingapore.com/applications/food-und-
diary/portable/1416/hi931102-foodcare-nacl/c-ise-meter?c=175. Accessed on
30.01.18.
40. HI96821 Digital Refractometer for Measuring Sodium Chloride in Food. Hanna
Instruments Inc. Available from https://hannainst.com/hi96821-digital-
refractometer-for-sodium-chloride-analysis.html. Accessed on 30.01.18.
41. Reichert™ Salt-Chek Digital Handheld Refractometer. Available from
https://www.fishersci.com/shop/products/reichert-salt-chek-digital-handheld-
refractometer/13940020 - ?keyword=Automatic+Digital+Refractometer+RX-
5000i-Plus. Accessed on 30.01.18.
42. Atago 2483 MASTER-S28M Hand-Held Salinity Refractometer, Manual
Temperature Compensation, Brix 0.0 to 28.0%. Available from:
https://www.amazon.com/Atago-MASTER-S28M-Refractometer-Temperature-
Compensation/dp/B004J4XD3O - feature-bullets-btf. Accessed on 30.01.18.
43. Atago Automatic Digital Refractometer, RX-5000i. Available from
https://www.sciencecompany.com/Atago-Automatic-Digital-Refractometer-RX-
5000i-P16646.aspx. Accessed on 30.01.18.
44. Ganesh S. DETERMINATION OF SODIUM CHLORIDE (SALT) BY VOLHARD'S
METHOD. Available from https://prezi.com/f6chvn3h38rs/determination-of-
sodium-chloride-salt-by-volhards-method/. Accessed on 30.01.18.
45. 859 Titrotherm – Thermometric titration: the ideal complement to potentiometric
titration. Available from https://www.metrohm.com/en-my/products-
overview/titration/titrotherm/. Accessed on 29.01.18.
46. The Easy Na Sodium Analyzer from METTLER TOLEDO determines the sodium
content in food and other products simply and quickly. Available from
36
https://us.vwr.com/store/product/16890335/easy-na-sodium-analyzer-mettler-
toledo. Accessed on 30.01.18.
47. Automatic Potentiometric Titrator - HI901C. Available from
https://hannainst.com/automatic-potentiometric-titration-system-hi901c.html.
Accessed on 30.01.18.
48. 859 Titrotherm by Metrohm AG. Available from
http://www.selectscience.net/products/859-titrotherm/?prodID=20629 - tab-3.
Accessed on 30.01.18.
49. Betz JM, Brown PN, Roman MC. Accuracy, Precision, and Reliability of Chemical
Measurements in Natural Products Research. Fitoterapia. 2011;82(1):44-52.
50. Kindstedt PS, Mattick LR, Kosikowski FV. Simple Selective Sodium Ion Electrode
Measure of Sodium in Cheese. J Dairy Sci. 1983;66(5):988-993.
51. Florence E. Determination of sodium in salted foods using an ion-selective
electrode. Analyst. 1986;111(5):571-573.
52. Ploegaerts G, Desmet C, Van krieken M. Assay of sodium in food: Comparison of
different preparation methods and assay techniques. J Food Compost Anal.
2016;45:66-72.
53. Ehling S, Tefera S, Earl R et al. Comparison of analytical methods to determine
sodium content of low-sodium foods. J AOAC Int. 2010;93(2):628-637.
9. APPENDIX
37
1. FOOD/
2. food$1.tw.
3. nutrients.tw.
4. MEALS/
5. meal$1.tw.
6. SODIUM, DIETARY/
7. (sodium adj1 dietary).tw.
8. SODIUM CHLORIDE, DIETARY/
9. (sodium chloride adj2 dietary).tw.
10. (table adj1 salt).tw.
11. SALINITY/
12. salinity.tw.
13. (salt adj meter).tw.
14. (sodium adj meter).tw.
15. ELECTRIC CONDUCTIVITY/
16. (electric* adj1 conductivity).tw.
17. salinometer.tw.
18. (salt adj tester).tw.
19. (sodium adj analy#er).tw.
20. (salt adj analy#er).tw.
21. REFRACTOMETRY/
22. refractometry.tw.
23. ION-SELECTIVE ELECTRODES/
24. (electrode$1 adj1 ion-sensitive).tw.
25. TITRIMETRY/
26. titrimetry.tw.
27. 1 or 2 or 3 or 4 or 5
28. 6 or 7 or 8 or 9 or 10 or 11 or 12
29. 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 or 24 or 25 or 26
30. 27 and 28 and 29
38
PubMed
39
Appendix 2
9.2. EVIDENCE TABLE
Number of
Length of
Bibliographic Study patients and Outcome measures/ General
Intervention Comparison follow up (if
citation Type / Methodology patient Effect size comments
applicable)
characteristics
1. Kindstedt Experimental study Sample food: Sodium ion Atomic absorption Results:
PS, Mattick Blue, Camembert, selective spectrometer (Perkin- 1. Samples ranged from 0.05 to
LR, Objective: Cheddar,processed electrode (ISE) Elmer, Model 305B). 1.72% sodium by the reference AA
Kosikowski To evaluate the accuracy, Cheddar, [Ion meter (Orion method and represented a wide
FV. repeatability, and Parmesan, Model 407) with a range of compositional
Simple sensitivity of selective Mozzarella, salt- sodium electrode characteristlcs. Correlation between
Selective sodium ion electrode free Gouda and (Orion, Model 94- ISE and AA methods was 0.992, and
Sodium Ion method for measuring Swiss cheeses 11) in comparative results differed by an
Electrode sodium in cheese combination with average of 0.06 ± 0.04% sodium.
Measure of a single junction
Sodium in Methods reference 2. Repeatability was excellent
Cheese. J Homogeneous samples electrode (Orion, regardless of type of cheese.
Dairy Sci. were prepared by cutting Model 90-01)] Standard deviations for all cheeses
1983;66(5):988- individual cheeses were ≤0.02% sodium, and
93. into small pieces and coefficients of variation ranged from
mixing at high speed in 0.006 for blue cheese to 0.024 for
a Waring blendor. Camembert and Parmesan.
40
Number of
Length of
Bibliographic Study patients and Outcome measures/ General
Intervention Comparison follow up (if
citation Type / Methodology patient Effect size comments
applicable)
characteristics
Sample analysis:
Cheese samples weighing
1.00 + 0.005 g were
blended with 99 ml
deionized distilled water
and 4 ml TISAB at high
speed in a Waring Blendor
for 30 s.
41
Evidence Table: Efficacy
Question: How effective is salt meter as a measuring device for monitoring salt/sodium content of foods?
Analytical technique : Ion selective electrode
Number of
Length of
Bibliographic Study patients and Outcome measures/ General
Intervention Comparison follow up (if
citation Type / Methodology patient Effect size comments
applicable)
characteristics
2. Florence E. Experimental study Sample food: Sodium ion Reference method A Results:
Determination a.Cheese selective Dry-ashed and Cheese
of sodium in Objective: (cheddar, chesire, electrode (ISE) hydrochloric acid - There was good agreement
salted foods To investigate the use of leicester, double extracts analysed for between results for all cheeses
using an ion- the sodium ion-selective goucester, sodium by atomic with a high correlation coefficient
selective electrode as a rapid, caerphilly, absorption (0.996)
electrode. reliable and inexpensive lanchashire, spectrometry
Analyst. 1986; method for the wensleydale, Butter
111(5):571-3. determination of sodium in derby sage, blue Reference method B - There was an obvious bias
salted foods. stilton) Volhard titration where values measured by the
b.Butter according to the electrode method are higher than
Methods c.Other salted food British Standards those found by both reference
The meter was calibrated (all bran, custard methods.
with working standard powder, self-raising - the electrode results are 9% and
solutions for the required flour, gravy powder, 7% higher than the reference
range of concentrations, oxo, salad cream) method A and B results,
i.e., 10-100 or 100-1000 respectively.
ppm. of sodium,
Other salted foods
Calibration was carried out - Good agreement between the
periodically during analysis results of the 3 methods for all
to check for variation in foods, with the exception of the
temperature and electrode result for the analysis of all-bran by
response. reference method A (AAS),
which is 25% higher than that
Cheese found by electrode measurement.
A Cheddar cheese sample
was prepared according to Conclusion:
the British Standard. A 2 g The ISE method was a rapid and
(±50 mg) aliquot of the inexpensive method for the
prepared sample was determination of sodium in cheese,
weighed to the nearest butter and other salted foods.
milligram and placed in the - The total time of analysis is
blender jar together with 8 ≤10 min.
ml of buffer solution and - Good precision was
42
Number of
Length of
Bibliographic Study patients and Outcome measures/ General
Intervention Comparison follow up (if
citation Type / Methodology patient Effect size comments
applicable)
characteristics
198ml of water. The achieved for a variety of cheese
mixture was blended at and other salted foods with
high speed for 1 min. A reference to a standard method.
magnetic PTFE-coated - For butter, a positive bias was
follower was added and found (<9%) for measurements
the beaker placed on a made with the ion- selective
magnetic stirrer. A gentle electrode over those using the
vortex was induced and reference method.
the electrodes plus
thermometer immersed in
the mixture. The direct
read-out of sodium
concentration (p.p.m.) was
taken after 5 min. A
preliminary investigation
determined that the
electrode time response to
reach equilibrium was
between 4 and 5 min
Butter
A sample for analysis was
prepared according to the
British Standard. A 5 g (±
50 mg) aliquot was
weighed to the nearest
milligram and 95ml of
water were added. The
mixture was warmed to
approximately 50 "C to
liquefy the fat completely,
mixed and cooled to
ambient temperature. A 4-
ml aliquot of buffer was
added and mixed in
thoroughly. The mixture
was analysed for sodium
content as for cheese but
with the meter calibrated in
the range 100-1000 p.p.m.
of sodium.
43
Number of
Length of
Bibliographic Study patients and Outcome measures/ General
Intervention Comparison follow up (if
citation Type / Methodology patient Effect size comments
applicable)
characteristics
Other salted foods
All measurements were
made with the meter
calibrated in the range
100-1000 p.p.m. of
sodium.
44
Evidence Table: Efficacy
Question: How effective is salt meter as a measuring device for monitoring salt/sodium content of foods?
Analytical technique: Titration
Number of
Length of
Bibliographic Study patients and Outcome measures/ General
Intervention Comparison follow up (if
citation Type / Methodology patient Effect size comments
applicable)
characteristics
45
Number of
Length of
Bibliographic Study patients and Outcome measures/ General
Intervention Comparison follow up (if
citation Type / Methodology patient Effect size comments
applicable)
characteristics
- extraction of the sodium
out of the matrix was not
immediate although sample of
ketchup disperse very quickly
into water
2. Precision: analysis of
ketchup sauce
3. Accuracy
a. Recovery rate
- accuracy was achieved
with all the combinations.
b. Standard addition
[the comparison between
values obtained by
calibration curve (CC) and
those obtained by the method
of standard additions
(SA)]
- No significant difference in
the results for all grouped
combinations (all results from
each technique and results from
each preparation method)
46
Evidence Table: Efficacy
Question: How effective is salt meter as a measuring device for monitoring salt/sodium content of foods?
Analytical technique: Ion Selective Electrode and Titration
Number of
Length of
Bibliographic Study patients and Outcome measures/ General
Intervention Comparison follow up (if
citation Type / Methodology patient Effect size comments
applicable)
characteristics
1. Ehling S, Experimental study 17 food products 1. Ion selective 1. Flame atomic Analysis by ICP/MS, FAAS,
Tefera S, containing ≤140mg electrode absorption and ISE
Earl R, Objective: per serving 2. Potentiometric spectrometry - There was a good
Cole S. To evaluate within-laboratory (qualifying for “low titration of (FAAS) agreement between the
Comparison performance of inductively sodium” according chloride ion 2. Inductively results by all three methods
of analytical coupled plasma/MS (ICP/MS), to FDA nutrient coupled for chicken broth, cereal,
methods to flame atomic absorption content claims plasma/MS granola and potato chips.
determine spectrophotometry (FAAS), ion- regulations) (ICP/MS) -Results by ISE were
sodium selective electrode (ISE) and significantly lower than both
content of potentiometric titration of chloride 1.almond butter ICP/MS and FAAS in
low-sodium ion in 17 low sodium foods. 2.apple juice almond butter, cookies, and
foods. J 3.baby food dinner vegetable broth. For
AOAC Int. Methods (beef, carrots, almond butter, this is
2010;93(2):628- - Foods with high water content and corn) explained by the strong
37. were blended in until 4.cereal (flax) negative matrix effects by
homogeneous. 5.cheese (soft, from ISE and positive matrix
- Dry foods were ground in food skim milk) effects by FAAS.
processor until homogeneous. 6.chicken broth -Results by ISE in cookies
Granola was further subjected to 7.cookies were 15–20% lower than by
cryogenic rinding in a freezer mill, (arrowroot) either ICP/MS or FAAS,
chilled with liquid nitrogen, using 8.granola (fruit and likely because of incomplete
three 1.5 min pulsing cycles and a nut) extraction of Na from the
1 min rest between pulsing steps. 9.green beans matrix
- All samples were analyzed in 10.pasta (whole - Precision:
triplicate (within-day and interday) wheat) overall ICP/MS and FAAS
11.peanuts offer comparable within-day
12.potato chips precision (median RSDs of
13. sardines (in 2.7 and 3.5%, respectively),
spring water)
14. sweet peas ISE is somewhat less precise
15. tomato sauce (median RSD of 5.6%).
16.vegetable broth
17.yogurt (nonfat). FAAS offers the best interday
precision (median RSD of
3.2%)
47
Number of
Length of
Bibliographic Study patients and Outcome measures/ General
Intervention Comparison follow up (if
citation Type / Methodology patient Effect size comments
applicable)
characteristics
Potentiometric titration of
chloride ion
-Chloride to Na ratios were
closed to 1.542 in almond
butter, baby food dinner,
cereal, chicken broth,
and vegetable broth (five out
of 17 samples).
-In all other samples,
calculated chloride to Na
ratios were widely variable,
ranging from 0.3 in cookies
to 30 in pasta.
-chloride levels do not allow
the reliable estimation of Na
levels in low-sodium foods,
even when added NaCl was
present.
-In certain starchy, high-fat
matrixes, such as cookies,
granola, peanuts, and
potato chips, the titration
could not be performed
directly on the homogenate
because the slow response
of the electrode precluded
the on-line plotting of the
titration curve.
The homogenate needed to
be centrifuged at cold
temperatures (10°C),
resulted in the separation of
fat and most of the starch.
-With the exception of
almond butter and peanuts
48
Number of
Length of
Bibliographic Study patients and Outcome measures/ General
Intervention Comparison follow up (if
citation Type / Methodology patient Effect size comments
applicable)
characteristics
containing <100µg/g of
chloride, and baby food
dinner containing about 230
µg/g chloride, within-day
and interday RSD values
were 0.12–3.1% and 0.3–
4.4%, respectively,
comparable to those
reported by others.
Conclusion:
ISE showed negative matrix
effects in fatty foods and
positive matrix effects at very
low Na concentrations (<100
µg/g).
49