02 TR Saltmeter

2018
SALT METER FOR FOOD
HEALTH TECHNOLOGY ASSESSMENT SECTION (MaHTAS)

MEDICAL DEVELOPMENT DIVISION
MINISTRY OF HEALTH MALAYSIA
002/2018
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.
Please contact: htamalaysia@moh.gov.my, if you would like further information.
Health Technology Assessment Section (MaHTAS)

Medical Development Division
Ministry of Health Malaysia
Level 4, Block E1, Precinct 1
Government Office Complex
62590 Putrajaya
Tel: 603 88831246
Fax: 603 8883 1230
Available at the following website: http://www.moh.gov.my
ii
Prepared by:
Dr Erni Zurina Romli
Senior Principal Assistant Director
Reviewed by:
Dr Junainah Sabirin
(Public Health Physician)
Deputy Director
External reviewers:
Professor Dr Aminah bt Abdullah

Food Science and Nutrition
Universiti Islam Malaysia
Associate Professor Dr Hamid Jan Bin Jan Mohamed

Programme Chairman of Nutrition & Dietetics
School of Health Sciences
Universiti Sains Malaysia
Ms Gui Shir Ley

Science Officer (Nutrition)
Nutrition Division
Ministry of Health
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
Change in lifestyle, rapid urbanisation and more production of processed foods

have led to an increase in world salt consumption. According to the updated report
by WHO in 2016, the average population salt intake in most countries has risen to
9-12g/day. Most adult population in Asian countries have average salt intake more
than 11.7g/day (more than 4.6g/day sodium). The excessive consumption of salt
or dietary sodium is associated with hypertension and progression of renal
disease. 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. Globally, one billion people suffer from
hypertension, which leads to heart attacks and strokes. For the past few decades,
cardiovascular disease (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.
According to National Health and Morbidity Survey (NHMS) report in 2015, the
overall prevalence of hypertension (known and undiagnosed) among Malaysian
adults aged 18 years and above was 30.3% (6.1 million adults).
Salt reduction health strategy in population by World Health Organisation (WHO)

and United Nations (UN) has been recognised as one of the most cost-effective
health strategy in prevention of CVD. In 2015, Malaysian Ministry of Health
developed the 10-year National Strategic Plan for Non-Communicable Diseases
(NSP-NCD) 2016-2025 based on WHO mandates to strengthen NCD prevention
and control in Malaysia. Among the implemented action plans are National Plan of
Action for Nutrition of Malaysia (NPANM) III 2016-2025 and Salt Reduction
Strategy to Prevent and Control NCD For Malaysia 2015-2020. The Malaysia Salt
Reduction Initiatives are aimed to promote, educate and collaborate with all related
stakeholders to reduce salt intake among the Malaysian population, working
towards achieving the 30% reduction of the average salt intake of the adult
population by year 2025, in line with WHO recommendations. The establishment
of Healthy Cafeteria is one of the strategies to address food and nutrition
challenges in the country, by creating supportive environment for healthy eating
habits. One of the key components in assessing the food preparation for Healthy
Cafeteria is to monitor salt/sodium content of foods. Currently, the assessment of
salt/sodium content of foods is conducted by measuring the degree of saltiness of
foods based on taste perception of the assessor. It is a very subjective
measurement as taste perception is influenced by range of genetic, physiological
and metabolic variables.
iv
Laboratory analyses provide a more consistent and reliable method of monitoring
however, are resource intensive, expensive and lack of feasibility. The use of
saltmeter can potentially be a promising alternative method to deliver a reliable,
accurate and reproducible measurement of salt/sodium content. It is cheaper than
laboratory analyses and can provide a rapid, easy measurement of salt/sodium
level in the foods. This technology review was requested by Nutrition Division,
Ministry of Health, Malaysia to assess the applicability and feasibility of using
saltmeter as a monitoring device for salt/sodium content in foods.
Objective/Aim
The objective of this systematic review was to assess the efficacy/effectiveness,

safety and economic implication of saltmeter as a measuring device for monitoring
salt/sodium content in foods.
Results and conclusions
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
Kindstedt P.S et al. Florence E Ehling S et al. Ploegaerts G et al.

STUDY
(2016) (2014) (2010) (2015)
1. Cheeses Tomato ketchup sauces
Finished food products with
TYPE OF FOOD 2. Butters - supermarket ketchup
Cheeses low sodium content
ANALYSED 3. Finished salted food - low sodium ketchup
(≤140mg/ reference amount)
products - homemade spiked ketchup
1. Dispersion in water
TYPE OF PREPARATION Dispersion in water Dispersion in water Dispersion in water 2. Wet digestion
3. Dry ashing
Method A: AAS
1. ICP/MS 1. AAS
REFERENCE METHOD AAS 2. FAES
Method B:
2. AAS 3. ICP-AES
Volhard Titration Method
INTERVENTIONS / OUTCOMES
Accuracy: Accuracy: Accuracy
Ion selective electrode - Correlation of ISE Cheeses Spike recovery:
(ISE) with AAS, r = 0.99 - r = 0.996 with AAS Liquid foods – 99 -126%
- Comparative results - spike recovery =97-102% Dry foods – 89-101%
of the 2 methods Nuts -75-92%
differed by Butters Butter – 79.2%
0.06 ± 0.04% Na. - Comparative results : 9%
and 7% higher than the Precision
Precision: reference method A and Median within-day and
- RSD ≤ 0.02% sodium B results, respectively interday RSD were 5.6% and
- Coefficient variation (sodium ion in oil) 6.2% respectively. (Ref
(CV) = 0.006-0.024 method : median RSDs of
Finished salted food 2.7% and 3.5%)
Sensitivity: products
Standard additions: Comparative results: good
0.5mg-2.5 mg sodium, agreement between 3
was excellent for all methods for all foods.
cheeses.
Accuracy
- Calculated chloride to
Na ratios were widely
variable, ranging from 0.3
in cookies to 30 in pasta.
- Food with very low
concentration of chloride
Potentiometric
ions (below the LOQ,
Titration
about 35 mg/g), chloride-
Chloride Ion
to-Na ratio could not be
determined.
Automated
Precision
Method
Within-day and interday RSD
Titration
values were 0.12–3.1% and
0.3–4.4%, respectively
Accuracy
- spiked recovery = 99-101%
Precision: RSD = 1%
Thermometric
endpoint
Limit of detection(LOD)
titrimetry (TET)
= 0.1g Na 100g-1
Limit of quantification (LOQ)

= 0.3g Na 100g-1
Conductivity meter No retrievable evidence
Refractometer No retrievable evidence
AAS - Atomic Absorption Spectrometry, FAES - Flame Atomic Emission Spectrometry
ICP/MS - Inductively coupled plasma/MS, ICP-AES - Inductively Coupled Plasma-Atomic Emission Spectrometry
vi
There was limited retrievable evidence to demonstrate the efficacy of ion selective
electrode and titration methods in measuring salt/sodium content in food :
Ion selective electrode (ISE)

• In measuring sodium content in cheese
- Correlation between ISE with reference atomic absorption
was 0.99 and comparative results of the two methods differed
by an average of 0.06 ± 0.04% sodium.
- The procedure was rapid with analysis time in laboratory of
seven to eight minutes per sample, including time required to
calibrate the instrument, weigh and analyse the sample.
• 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 (<100µg/g).
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.
b.Thermometric endpoint titrimetry (TET)

• The analytical sensitivity of the TET was very low in comparison with
those obtained for spectrometric techniques [(flame atomic
absorption spectrometry (FAAS), flame atomic emission
spectrometry (FAES) and inductively coupled plasma-atomic
emission spectrometry (ICP-AES)].
• Limit of detection and LOQ values of TET were very high.
• Relative standard deviation of the thermometric titration was
comparable to those of the spectrometric techniques.
• Thermometric endpoint titrimetry could not determine sodium
content at traces level (<0.1 g Na 100g-1)
• Dispersion preparation of the food sample was the preferred method
with TET.
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
There was no retrievable scientific evidence on the cost-effectiveness of salt

meter.
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 Old English, it is referred as sealt. In plain English, it is known as salt, a

combination of Latin word, sal and Greek word, hals.1 Since ancient time, salt has
a significant impact on human’s live. It has became a valuable trading commodity
throughout history. Wars had been waged for ownership and control of its water. It
also has revolutionised our food development and we as human, have a biological
dependency to it for its role as our body’s essential nutrient.1 Salt is present in
almost all the foods we eat either naturally or often added in as food preservative
and flavouring.2 It also can be used for fermentation control (in baking, pickle and
cheese making), as colour developer (for processed meats) and as binding agent
(sausage making).2 Salt is the main source of sodium in foods. Chemically, salt is
an ionic compound sodium chloride (NaCl), comprises 40% elemental sodium and
60% elemental chloride on a weight basis.3 Hence, for every gram of salt contains
approximately 400mg of sodium. One teaspoon of salt is equivalent to
approximately 5g of salt with sodium content of 2000mg.3 Sodium is an essential
mineral for human body to function. It regulates fluid in the body, maintains acid-
base balance, plays a major role in transmission of nerve impulses and ensures
normal cell function.3 The body’s physiological requirement for sodium is between
230 to 460mg/day (0.58 to 1.17 g/day salt).4
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
Salt reduction health strategy in population by World Health Organization (WHO)

and United Nations (UN) has been recognised as one of the most cost-effective
health strategy in prevention of CVD.16 It is also a cost-saving strategy with the
potential of improvement in hypertension control rates, reduction in the need for
pharmacological treatment and subsequently to control associated health care
costs.17, 18 Asaria et al. demonstrated the salt reduction programmes in low and
middle-income countries were more cost-effective or at least as effective as
tobacco control in reducing the incidence of CVD.19 WHO recommends the
population average salt intake should be less than 5g/day (2g/day sodium).5 WHO
Member States have agreed on global target for 30% reduction in mean
population’s salt intake by 2025.5
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
Condition / Claim Sodium content
High sodium >0.48g/100g
Moderate sodium 0.12g-0.48g/100g
Low sodium <0.12g/100g
Very low sodium <0.04g/100g
Free of sodium <0.005g/100g
Guide to Nutrition Labelling and Claims 2010, MOH
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
In 2015, Malaysian Ministry of Health developed the 10-year National Strategic

Plan for Non-Communicable Diseases (NSP-NCD) 2016-2025 based on WHO
mandates to strengthen NCD prevention and control in Malaysia. Among the
implemented action plans are National Plan of Action for Nutrition of Malaysia
(NPANM) III 2016-2025 and Salt Reduction Strategy to Prevent and Control NCD
For Malaysia 2015-2020.27 The Malaysia Salt Reduction Initiatives are aimed to
promote, educate and collaborate with all related stakeholders to reduce salt intake
among the Malaysian population, working towards achieving the 30% reduction of
the average salt intake of the adult population by year 2025, in line with WHO
recommendations.27 The establishment of Healthy Cafeteria is one of the
strategies to address food and nutrition challenges in the country, by creating
supportive environment for healthy eating habits.28 The recognition of Healthy
Cafeteria is given to food premises based on three criterias which include the
preparation of nutritious foods based on the Malaysian Dietary Guidelines and
Recommended Nutrient Intake (RNI), compliance to food safety and quality
standards based on Food Hygiene Regulations 2009 and the provision of smoke-
free premises. 28, 29 One of the key components in assessing the food preparation
for Healthy Cafeteria is to monitor salt/sodium content of foods. Currently, the
assessment of salt/sodium content of foods is conducted by measuring the degree
of saltiness of foods based on taste perception of the assessor. It is a very
subjective measurement as taste perception is influenced by range of genetic,
physiological and metabolic variables.30 Laboratory analyses provide a more
consistent and reliable method of monitoring however, are resource intensive,
expensive and lack of feasibility.20 The use of saltmeter can potentially be a
promising alternative method to deliver a reliable, accurate and reproducible
measurement of salt/sodium content. It is cheaper than laboratory analyses and
can provide a rapid, easy measurement of salt/sodium level in the foods.
This technology review was requested by Nutrition Division, Ministry of Health,

Malaysia to assess the applicability and feasibility of using saltmeter as a
monitoring device for salt/sodium content in foods.
4
2. OBJECTIVE / AIM
The objective of this systematic review was to assess the efficacy/effectiveness,

safety and economic implication of saltmeter as a measuring device for monitoring
salt/sodium content in foods.
3. TECHNICAL FEATURES
3.1 Methods of sodium analysis
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
The conductivity method works on the principle of conductivity in liquid. It is a

measure of the solution’s ability to pass an electrical current. Ions allow the flow
of electricity through solution. Solution with more ions present will conduct more
electrical current. Salt dissociates as two ions in solution: sodium and chloride.
Since ions are charged particles, electricity is conducted more easily.32 As a result,
an electrical conductivity (EC) meter can be used to estimate the amount of salt
dissolved in solution. Once an EC measurement is obtained, a conversion factor
specific to salt must be applied in order to get the amount of salt in a solution. This
calculation is built-in the EC meter.31
Figure 1 : Basic illustration of conductivity meter. A conductivity meter can

be considered as an ‘amp meter’. Two plates made of inert metal are
positioned in the sample. An alternating current of around 1000 cycles per
second is applied across them and the current is measured.
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
Figure 2: Amperometric probe
Potentiometric conductivity sensors use four ring electrodes. Two of these

electrodes are sensing electrodes; the other two are drive electrodes. The drive
electrodes apply an alternating voltage that induces current in the solution. The
sensing electrodes measure the voltage drop and the measurement is converted
to electrical conductivity. Potentiometric conductivity sensors have wide measuring
range and can cover virtually all food samples. However, these probes generally
require more sample for the electrodes to be fully submerged due to the space
required for all four-ring probes. These probes also tend to be more expensive,
partially due to the platinum required for their manufacture.31
6
Figure 3: Potentiometric probe
Table 2: Examples of conductivity method salt meters available on the market
Product Product Image Description

Model/Supplier
Digital Salt-Meter, - Ideal for measuring dilute solution of samples,

Model ES-421, such as soy sauce, ketchup, mayonnaise,
ATAGO, Supplier: Worcester sauce, and pickle juice.
ATAGO USA INC33 - Measurement range : 0.00 to 10.0% (g/100g)
- Accuracy: ± 0.05%
- Relative precision: ± ≤ 5% (for salt
concentration of 1.00 to 10.0%)
Digital Handheld - Portable salt-conductivity meter; only for

‘Pocket’ Salt-Meter NaCl in water
PAL-SALT 4250, - Cannot measure total salt content of a mixed
Supplier: ATAGO substance, but can provide salt-conductivity
USA INC33 of a Total Dissolved Solids sample.
- Measurement range, accuracy and
precision: similar to ES-421
Digital Hand-held - Ideal for checking salt level in deli meats,

“Pocket” Salt-meter fish roe, cheese and other highly-salted
PAL-SALT PROBE foods.
4222, Supplier: - Measurement range: 0.00 to 7.0% (g/100g)
ATAGO USA INC33 of salt concentration
- Accuracy: ± 0.01%
- Relative precision ±10% (5.1 to 7.0%)
7
Model/Supplier
Electronic Salinity - Ideal for measuring salt concentration in

Tester Salt liquid food analysis of daily diet.
Measuring Meter - 7 red LED indicate salt concentrations:
Detector (White), 0.3% - 0.6% (medium), 0.8% - 1%
Supplier: VAKIND34 (high), 1.3% - 2% (normal)
- This meter is designed to measure the salt

content in semi-solid food products such as
meat, cold cuts, cheese, salads.
Food Salt Meter
SSX-210, Supplier:
- The SSX-210 cannot measure pure oil, as it
PCE Instrument 35
does not contain water or pure fat, because it
is an electrical insulator unlike water. Also,
CE marked
vinegar and acids will affect the salt
measurement by increasing electrical
conductivity.
LAQUATWIN Salt - It has the ability to be immersed in liquids,

11 Meter, Supplier: while solids or powders can be placed
Horiba Instruments directly on the sensor.
36
- Provides several flexible measurement

CE marked techniques (drops of sample, immersion,
scoops, wiping with sampling sheet)
Sample Application
Solid Powder Paper & Textiles
- Minimum sample volume: 0.12ml

- Measurement range: 0.1 to 10%
- Accuracy:
±2% of full scale (0.0 to 9.9 g/L)
±4% of full scale (10 to 100.0 g/L)
* g/L is equivalent to parts per thousand (ppt)
8
ii. Ion-selective electrode37
An ISE is a chemical sensor used to determine the concentration of a specific ion

in a solution. In sodium ISEs, the tip is a sodium-sensitive glass bulb. A glass ion
selective electrode develops a voltage due to the ion exchange that occurs
between the solution and the sensing membrane. It correlates a millivolt (mV)
reading to a concentration value. The selective glass membrane blown on the tip
of the sensor exchanges ions with the solution being measured. The charge
imbalance between the membrane surface and internal cell of the sensor produces
a voltage that changes in response to the sample’s ion activity. When the ionic
strength of the solution is fixed by the addition of ionic strength adjuster (ISA), the
voltage is proportional to the concentration of free ions in solution. Ion selective
electrodes require care to ensure accurate measurements. The sodium sensitive
membrane should be conditioned before performing a calibration. The conditioning
of the electrode is a two-step process in which the glass is etched then rehydrated.
The first step is etching. This is a process of using strong acid to remove a thin
layer of sensitive glass from the sodium membrane, exposing a sodium-containing
fresh surface. The second step is rehydration in which the probe is placed in
storage solution to rehydrate the glass membrane. Allowing the glass to rehydrate
after etching provides optimum conditions for the exchange of sodium ions
between the membrane and solution. The ISE must be calibrated daily in order to
ensure accurate measurements. Calibration standards should bracket the
expected concentration of the sodium content of the food. For example, one
calibration standard should have a higher concentration than the expected value,
and the other a lower concentration. Ionic strength adjuster must also be added in
a fixed ratio to both calibration standards and samples for accurate readings. The
sodium ISA is important for two reasons. One is that the ISA buffers the pH of the
standard and sample to above pH 9.8. This removes any interference from
hydrogen ions that occur at lower pH’s. The second purpose of the ISA is to ensure
that the activity coefficient is constant so the concentration of free sodium ions can
be measured. Having solutions with a constant ionic strength reduces the margin
of error between measurements of different samples at different concentrations.
Electrode response is affected by ion concentration and ion activity. The ISA
standardises ion activity between calibration standards and samples, ensuring that
changes in the electrode response are based on changes in ion concentration.
Once calibration is complete, measurements of liquid or solid samples can be
performed. Solid samples require pre-treatment in order to make a slurry that can
then be measured with the probe. Sodium ISEs are specific to sodium
measurement and are prone to little interference. The startup cost to measure
sodium with an ISE is moderate. A pH meter with an ISE concentration readout or
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
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
HI931102 - Measures the sodium content of a solution

FOODCARE NaCl/°C and report it as g/L NaCl or percent NaCl
(ISE) Meter with FC - Able to auto-range from sample to sample
300B combination over an extremely broad range without the
sodium electrode, need for recalibration.
Supplier: Hanna - Measurement range: 0.150 g/L to 300 g/L
Instruments, Inc 39 - Accuracy: ±5% of actual reading
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.
Courtesy of Hanna Instruments, Inc 40

10
Digital refractometers utilise an internal light source at a fixed wavelength. This
internal light passes through a prism and into the sample and an internal light
detector identifies the critical angle. Digital refractometers remove the subjectivity
of determining the shadow line manually and have improved temperature
compensation due to the use of pre-programmed algorithms; they can also perform
measurements over wider temperature ranges at a low-moderate price investment.
Refractometers are attractive due to their low startup cost and that they use no
chemical reagents. A small sample is all that is needed. This makes them ideal for
quantitative use in simple solutions, such as a salt brine solution. However, this
method is not specific to salt. Other substances present in the sample will alter the
refractive index. These substances include fats, sugars, and minerals. Variations
in temperature will affect the accuracy of refractometry readings, so the use of
temperature compensation is highly recommended for reliable results. Many of
refractometers nowdays, contain a built-in temperature sensor and is programmed
with temperature compensation algorithms in accordance with internationally
recognized references which vary based on the parameter being measured.
Table 4: Examples of refractometer available on the market

Model/Supplier
HI96821 Digital -Ideal for the analysis of salad

Refractometer for dressings, cheeses, condiments,
Measuring Sodium canned and jarred foods, soups, brines
Chloride in Food. and whey.
Supplier: Hanna -Minimum sample size: 2 metric drops
Instruments, Inc 40 (100 μl)
-Measurement range: 0 to 85% brix
CE marked range
-Accuracy : ± 0.2%
Reichert™ Salt-Chek - 3 measurement scales in one model

Digital Handheld - Measure the concentration of NaCl
Refractometer. from 0.0 to 25.8%, measure the
Supplier: Reichert™ 41 Specific Gravity (SG) of NaCl from
1.000 to 1.197, and measure NaCl
CE marked Parts per Thousand from 0 to 258 PPT.
- Accuracy: ± 0.75% NaCl, ±0.002 sp.
gr. NaCl, ±1.5ppt NaCl
Atago 2483 MASTER- - For measuring the concentration of

S28M Hand-Held salt in water.
Salinity Refractometer For example: Preparation and Storage
Supplier: ATAGO USA of seafood, Brining solutions &
INC42 Concentration of salt used in cooking.
- Measurement range: Brix 0.0 to

28.0%
- Accuracy: ± 0.2%
11
Model/Supplier
Atago 3276 Automatic - 30 kind of user scales can be input

Digital Refractometer, according to sample.
RX-5000i. Supplier: - USB flash drive
ATAGO USA INC43 - require AC power supply
- pre-programmed with 22 of the most
commonly used concentration scales.
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
Solution being titrated (Analyte)

*THE SOLUTION OF UNKNOWN
CONCENTRATION BUT OF KNOWN VOLUME
+
A few drops of colour indicator
Start
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.
b. Manual Titration: Volhard’s Method44

This method uses a back titration with potassium thiocynate to determine the
concentration of chloride ions in a solution. A back titration is a titration method
where the concentration of an analyte is determined by reacting it with a known
amount of excess reagent. The remaining excess reagent is then tritrated with
another second reagent. An excess volume of a silver nitrate solution is added to
the solution containing chloride ions, forming a precipitate of silver chloride. The
moles of silver nitrate added are known to exceed the moles of sodium chloride
present in the samples so that all the chloride ions present will react. The indicator
Fe3+ (ferric ion) is then added and the solution is titrated with the potassium
thiocyanate solution. The titrate remains pale yellow as the excess silver ions react
with the thiocyanate ions to form a silver thiocyanate precipitate. Once all the silver
ions have reacted, the slightest excess of thiocyanate reacts with Fe3+ to form a
dark red complex. The concentration of chloride ions is determined by substracting
the titration findings of the moles of silver ions that reacted with the thiocyanate
from the total moles of silver nitrate added to the solution. This method is used
when the pH of the solution, after the sample has been prepared, is acidic. If the
pH is neutral or basic, Mohr’s method or the gravimetric method should be used.
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
Recovery = (Amount of NaCl in spike sample – Amount of NaCl in sample) x 100

Amount of NaCl added
c. Automated Titration: Potentiometric Method37

Titration with silver nitrate can be automated with a potentiometric titration system.
A titration system for salt analysis is equipped with an ISE sensitive to the
concentration of either chloride or silver ions. The ISE is used to monitor the
solution for a change in the mV potential as a result of chloride ions being
consumed or the silver ions being in excess. Potentiometric titration systems
automatically control titrant dosing and endpoint detection. Automatic endpoint
detection increases titration precision and accuracy by eliminating the human
subjectivity that is associated with a titration using a visual indicator. Instead of
monitoring for a colour, the titrator determines the endpoint by measuring changes
in mV potential. It is important to note that there is no calibration of an ISE with
potentiometric titration since it is an abrupt mV change that is important. The
automated dosing system of a potentiometric titrator also increases precision due
to the ability to dispense and measure finite amounts of titrant.
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.
d. Automated Titration : Thermometric Titrimetry45

Thermometric titration is a form of titration using either the heat of enthalpy
produced by a chemical reaction to determine its endpoint. This method of titration
is free from the electrochemical and solvent effects that are present in many types
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.
Table 5: Examples of titrators available on the market

Product Model/Supplier Product Image Description
Sodium Analyzer Easy Method : Standard Addition

Plus Na 30060051. Technique (Potentiometric
Supplier: METTLER Method)
TOLEDO 46
Certifications: UL listed
and CSA certified. IEC and
EN certified.
Method: Potentiometric Titration

Automatic Potentiometric
(pH/mV/ISE) Titration
System - HI902C.
Supplier Hanna
Instruments, Inc47
Method: Thermometric Titration

859 Titrotherm. Supplier:
Metrohm AG 45, 48
FDA certificate MQV

70.10-01
15
3.2. Validation of Analytical Methods49
Selection of the suitable sodium analysis methods or tools should be based on

fitness for purpose concept, which referring to the performance characteristics of
selected method or tool must be adequate to meet the needs of the user as
appropriate. Accuracy, precision and reproducibility are important components
when considering reliable measurements.49 The principle parameters in method
validation are
§ Selectivity and Specificity

§ Accuracy
§ Precision (within batch and between batches)
§ Range and linearity
§ Limit of detection (LOD) and Limit of Quantification (LOQ)
§ Robustness
§ Uncertainty of Measurement
3.2.1. Selectivity and Specificity49
Selectivity is the ability of the method to discriminate between analyte to be

determined and other matrix components in analysed matrices (other materials in
the test sample). Matrix effect is the effect on an analytical method caused by all
other components of the sample except the specific compound to be quantified.
Matrix effects and selectivity issues have long been associated with bioanalytical
techniques. The negative matrix effect values indicates suppression, while positive
value is a sign of matrix enhancement.
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.
3.2.2. Accuracy and Precision49
Accuracy by definition is a measure of the closeness

of the experimental value to the actual amount of the
substance in the matrix.
Precision measures of how close individual

measurements are to each other.
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.
3.2.3. Range and linearity49

In a validated method, the detector response should be linear over the anticipated
range of analyte concentrations. All methods have an upper and lower boundary
of applicability and may not be linear over all concentrations. Linearity is
determined by creating a minimum five level calibration curve using the analyte(s)
of interest. The resulting plot of detector response versus analyte concentration
should have a regression coefficient of at least 0.999. The chosen method should
17
be the one whose applicability range within range found in the samples. Samples
also can be diluted to fit the range.
3.2.4. Limit of detection (LOD) and Limit of Quantification (LOQ) 49

The Limit of Detection is defined as the smallest amount or concentration of an
analyte that can be reliably detected, but not necessarily quantified in a given type
of sample or medium by a specific measurement process.
The Limit of Quantification is the amount of substance that can reliably be

assigned a quantitative value. This limit is usually defined as 10% RSD or standard
deviation used to calculate the detection limit.
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.
Appendix 1 showed the detailed search strategies.
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.
The inclusion and exclusion criteria were:
Inclusion criteria
Population/Problem Salt/Sodium content in food
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)
Health Technology Assessment (HTA), Systematic

Review, Randomised Controlled Trial (RCT), Non-
Study design randomised controlled trial, Economic evaluation
study, Cohort study, pre- and post-intervention
study, cross sectional study, case series
English full text articles
Exclusion criteria
Studies conducted in animals, narrative reviews or case

Study design
report
Non English full text articles
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 identified

Number of additional records
through electronic databases
identified from other sources (n=0)
searching (n= 59)
Number of records after duplicates and irrelevant articles removed (n=6)
Number of records
Number of records excluded (n=2)
screened (n=6)
Number of full-text Number of full-text

articles assessed articles excluded
for eligibility (n=4) (n=0) with reasons
Number of full-text articles

included in qualitative
synthesis (n=4)
Figure 4: Flow chart of study selection
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.
5.1.2. Ion-selective electrode (ISE)
Kindstedt P.S et al. conducted an experimental laboratory study to evaluate the

accuracy, repeatability and sensitivity of sodium ISE method for measuring sodium
in cheese.50 Sodium in blue, Camembert, Cheddar, processed Cheddar,
Parmesan, Mozzarella, salt-free Gouda, and Swiss cheeses in duplicate (two
samples of each cheese type, sample A and sample B) was measured by ion
analyser with a selective sodium ion electrode and atomic absorption method (AA).
In preparation of homogenous samples, 1 g of cheese was blended in an ionic
strength adjustment buffer and filtered through cheese cloth to remove foam.
Sodium was measured directly on the filtrate by the sodium ISE. Results of two
methods, shown as the average of duplicates, are compared in Table 5. A
correlation of the sodium ISE method with atomic absorption was 0.992.
Correlation coefficient, denoted by r, is a measure of the strength of the straight-
line or linear relationship between two methods. The correlation takes on values
ranging between +1 and -1, where a perfect correlation is ±1 and 0 is the absence
of correlation. Values of r between 0 and 1 reflect a partial correlation, which can
be significant or not. A r of 0.992 indicated that the measurement result of sodium
ISE was related to atomic absorption at 99%. Comparative results of the two
methods differed by an average of 0.06 ± 0.04% sodium (Table 6).50
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
A 0.63 0.63 0.00

Cheddar
B 0.55 0.49 0.06
A 0.81 0.91 0.10
Mozzarella
B 0.76 0.71 0.05
A 0.80 0.83 0.03
Parmesan
B 0.65 0.75 0.10
A 1.61 1.67 0.06
Process Cheddar
B 1.52 1.46 0.06
A 0.04 0.06 0.02
Salt-free Gauda
B 0.03 0.05 0.02
A 0.23 0.24 0.01
Swiss
B 0.27 0.27 0.00
Mean (overall) r = 0.992 0.805 0.815 0.060
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
Table 7: Repeatability of the sodium ion selective electrode

for determination of sodium in eight cheeses
% 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
Table 8: Recovery of sodium in eight cheese by sodium ion electrode method
Sodium added (mg)

Cheese Sodium
0 0.5 1.0 1.5 2.0 2.5
Expected, mg ... 1.68 17.3 17.8 18.3 18.8
Blue Found, mg 16.3 16.6 17.2 17.8 18.5 19.0
%Recovery ... 98.8 99.4 100 101.5 101.1
Expected, mg ... 8.95 9.45 9.95 10.45 10.95
Camembert Found, mg 8.45 9.05 9.20 9.80 10.25 10.70
%Recovery ... 101.1 97.4 98.5 98.1 97.7
Expected, mg ... 6.45 6.95 7.45 7.95 8.45

Cheddar Found, mg 5.95 6.35 6.75 7.40 7.80 8.40
%Recovery ... 98.5 97.1 99.3 98.1 99.4
Expected, mg ... 8.45 8.95 9.45 9.95 10.45
Mozzarella Found, mg 7.95 8.50 9.05 9.50 10.10 10.60
%Recovery ... 100.6 101.1 100.6 101.5 101.4
Expected, mg ... 6.90 7.40 7.90 8.40 8.90
Parmesan Found, mg 6.40 6.90 7.60 8.00 8.30 9.20
%Recovery ... 100 102.7 101.3 98.8 103.4
Expected, mg ... 16.7 17.2 17.7 18.2 18.7
Process Cheddar Found, mg 16.2 16.7 17.2 17.7 18.0 18.5
%Recovery ... 100 98.8 100 98.9 98.9
Expected, mg ... 1.65 2.15 2.65 3.15 3.65
Salt-free Gauda Found, mg 1.15 1.70 2.15 2.63 3.20 3.70
%Recovery ... 103 100 99.2 101.6 101.4
Expected, mg ... 3.12 3.62 4.12 4.62 5.12
Swiss Found, mg 2.62 3.05 3.56 3.90 4.60 5.00
%Recovery ... 97.8 98.3 94.7 99.6 97.7
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 9: Recovery of sodium added to cheese as determined with the ISE

Sodium Meter read-out, p.p.m
Recovery, %
added/mg Expected Found
0 - 50.0 -
1.0 55.0 54.5 99.1
2.5 61.2 62.5 102.1
5.0 75.0 72.8 97.1
Table 10: Determination of sodium in cheese: comparison of ion-selective electrode (ISE) with AAS
Sodium/mg per 100g

Cheese ISE AAS
Mean*S.d. Mean*S.d. Difference
Cheddar 720 6 722 2 2
Cheshire 526 4 530 7 4
Leicester 498 5 528 10 30
Double Gloucester 515 11 516 4 1
Caerphilly 632 10 610 14 22
Lancashire 544 7 522 13 22
Wensleydale 570 12 570 9 0
Derby sage 725 8 721 17 4
Blue Stilton 1144 28 1200 33 56
Over all mean 653 - 658 - 16
r = 0.996
*Mean of six determination
The analysis of 12 varieties of butter by sodium ISE and by reference methods A

and B as shown in Table 11, revealed that the ISE results were 9% and 7% higher
than the reference method A and B results, respectively. The electrode response
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
Sodium/g per 100g

Food
ISE AAS BS
All-bran 1.08 1.35 1.10
Custard powder 0.35 0.36 0.34
Self-raising flour 0.52 0.58 0.24
Gravy powder 9.09 8.85 9.67
Oxo 9.98 10.26 9.80
Salad cream 1.02 1.04 1.08
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
An experimental labarotary study was conducted by Ploegaerts G et al. to evaluate

the accuracy and precision of different preparation methods and assay technique
to determine sodium content in food.52 Four analytical techniques [thermometric
endpoint titrimetry (TET), flame atomic absorption spectrometry (FAAS), flame
atomic emission spectrometry (FAES) and inductively coupled plasma-atomic
emission spectrometry (ICP-AES)] and three preparation methods (dispersion in
water, wet digestion and dry ashing). Twelve protocols resulting from the three
common recipes for the sample preparation combined with four analytical
techniques (three “traditional” based on atomic spectroscopy and TET) were
compared on ketchup tomato sauces. There were three types of tomato ketchup
samples [ketchup sauce from supermarket(Table 15), low sodium ketchup
sauce(Table 16) and doped homemade ketchup sauce(Table 17)]. As shown in
Table 13, the analytical sensitivity of the TET was very low in comparison with
those obtained for spectrometric techniques. As all volumetric techniques, the
biggest challenge for TET was the high values of the LOD and LOQ. Even if more
diluted titrant solution is used, the LOD/LOQ ranges of spectrometric techniques
will not be reached. On the other hand, if the concentration was high enough (like
in the classic ketchup sauce), this technique did not require any further dilution of
the sample, all benefit in the preparation time. Two hundred fold dilution factor was
necessary when using spectroscopic techniques. The result also showed that RSD
of TET was comparable to those of the spectrometric techniques.52
Table 13: Merits of the different techniques
FAAS* FAES* ICP* TET*

Analytical sensitivity (L
55 36 45 2
mg-1)
RSD† (%) 1.0 1.9 0.8 1.0
LOD† (mg L- 1) 0.01 0.03 0.01 90
LOQ† (mg L-1) 0.03 0.1 0.02 180
FAAS: Flame atomic absorption spectrometry ; FAES: Flame atomic emission spectrometry; ICP: Inductively coupled plasma
atomic emission spectrometry ; TET: thermometric endopoint titrimetry.
† LOD: limit of detection ; LOQ: limit of quantification ; RSD: relative standard deviation
Table 14: Estimated limit of detection (LOD) and limit of quantification (LOQ)
in sample in (g Na 100g-1) for each technique
LOD 0.003 0.008 0.002 0.1

LOQ 0.01 0.03 0.006 0.3
* 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)
(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
Dispersion 0.96 ± 0.01 0.95 ± 0.03 0.98 ± 0.01 1.08 ± 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
Table 16: Concentration of sodium in low sodium ketchup sauce (g Na.100g-1)

Digestion 0.071 ± 0.002 0.047 ± 0.002 0.070 ± 0.002 < 0.1
Dry ashing 0.071 ± 0.003 0.064 ± 0.003 0.068 ± 0.003 < 0.1
Dispersion 0.069 ± 0.002 0.064 ± 0.001 0.066 ± 0.001 < 0.1

confidence.
27
Table 17: Concentration of sodium in doped sauce (g Na.100g-1)
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 1.03 ± 0.01 1.01 ± 0.01 1.00 ± 0.01 1.01 ± 0.01

*FAAS: Flame atomic absorption spectrometry ; FAES: Flame atomic emission spectrometry; ICP: Inductively coupled
plasma atomic emission spectrometry ; TET: thermometric endpoint titrimetry.
confidence.
Table 18: Recovery rates of sodium in doped sauce in (%)

Digestion 101 ± 1 95 ± 3 98 ± 1 101 ± 2
Dry ashing 103 ± 1 100 ± 2 99 ± 2 100 ± 1
Dispersion 102 ± 1 99 ± 1 99 ± 1 99 ± 1
confidence.
5.1.4. Ion selective electrode and potentiometric titration of chloride ion
An experimental laboratory study was conducted by Ehling S et al. to evaluate

within-laboratory performance of ion-selective electrode (ISE), potentiometric
titration of chloride ion, inductively coupled plasma/MS (ICP/MS) and flame atomic
absorption spectrophotometry (FAAS) in 17 low-sodium foods.53 Seventeen food
products containing 140mg or less Na per serving [qualifying for “low sodium”
according to U.S. Food and Drug Administration (FDA) nutrition labeling
regulations)]. These included the following: almond butter; apple juice; baby food
dinner (beef, carrots, and corn); cereal (flax); cheese (soft, from skim milk); chicken
broth; cookies (arrowroot); granola (fruit and nut); green beans; pasta (whole
wheat); peanuts; potato chips; sardines (in spring water); sweet peas; tomato
sauce; vegetable broth; and yogurt (nonfat). 53
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
Letters (A, B, C) indicate within-day or interday means
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
Potentiometric titration of chloride ion was performed on all 17 low-sodium foods

in order to evaluate the chloride to Na ratios and the possibility of indirectly
estimating Na concentrations. Results are presented in Table 21. Calculated ratios
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
Table 21 : Results of chloride ion analysis by potentiometric titration in 17 low-sodium foods

Within-day repeatability (n=3) Interday repeatability (n=3) Ratio of chloride to Naa
Food type
Mean±SD, µg/g RSD% Mean±SD, µg/g RSD% Mean±SD, µg/g
Almond butter 49.4 ± 3.4 6.8 51.6 ± 6.2 12 1.92 ± 0.26
Apple juice <35 - <35 - >0.74
Baby food dinner 230 ± 12 5.0 223 ± 17 7.5 1.62 ± 0.17
Cereal 2114 ± 25 1.2 2082 ± 19 0.9 1.60 ± 0.14
Cheese 2837 ± 19 0.67 2865 ± 37 1.3 2.208 ± 0.045
Chicken broth 427.5 ± 8.4 0.15 502.5 ± 1.5 0.3 1.437 ± 0.059
Cookies 503.63 ± 0.74 2.0 428.4 ± 9.4 2.2 0.315 ± 0.015
Granola 423.8 ± 2.4 0.57 414.1 ± 6.1 1.5 8.50 ± 0.76
Green beans 332.23 ± 0.71 0.21 330.7 ± 2.2 0.67 8.66 ± 0.28
Pasta 643 ± 20 3.1 655 ± 29 4.4 29.7 ± 3.4
Peanuts 38.13 ± 0.81 2.1 33.6 ± 4.5 13 0.492 ± 0.080
Potato chips 2641 ± 24 0.90 2621 ± 22 0.84 22.35 ± 0.29
Sardines 1521 ± 17 1.1 1526 ± 12 0.80 1.364 ± 0.029
Sweet peas 101.6 ± 2.3 2.2 97.5 ± 2.7 2.8 18.9 ± 1.8
Tomato sauce 618.97 ± 0.72 0.12 617.8 ± 2.1 0.34 8.61 ± 0.82
Vegetable broth 873.1 ± 2.4 0.27 871.3 ± 3.9 0.45 1.606 ± 0.082
Yogurt 1053.3 ± 5.1 0.49 1059.8 ± 4.4 0.42 3.12 ± 0.25
a
Based on interday results for chloride and sodium by ICP/MS
31
5.2. SAFETY
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
5.3. COST / COST-EFFECTIVENESS
There was no retrievable scientific evidence on the cost-effectiveness of salt meter.

The price of the salt meter varies depending on the type, model and characteristics.
The price range for conductivity meter is between USD19.00-USD1,105.0033, 34,
ISE meter is between USD310.00-USD585.0038, 39, refractometer is between
USD180.00-USD11,900.0040, 43 and TET USD3, 000.00-USD16,834.0047, 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 :
Ion selective electrode

• In measuring sodium content in cheese
- Correlation between ISE with reference atomic absorption was 0.99
and comparative results of the two methods differed by an average
of 0.06 ± 0.04% sodium.
32
- The procedure was rapid with analysis time in laboratory of seven to
eight minutes per sample, including time required to calibrate the
instrument, weigh and analyse the sample.
• 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.
b. Thermometric Endpoint Titrimetry

• The analytical sensitivity of the TET was very low in comparison with those
obtained for spectrometric techniques [(flame atomic absorption
spectrometry (FAAS), flame atomic emission spectrometry (FAES) and
inductively coupled plasma-atomic emission spectrometry (ICP-AES)].
• Limit of detection and LOQ values of TET were very high.
• Relative standard deviation of the thermometric titration was comparable to
those of the spectrometric techniques.
• Thermometric endpoint titrimetry could not determine sodium content at
traces level (<0.1 g Na.100g-1)
• Dispersion preparation of the food sample was the preferred method with
TET.
6.2. Safety
measuring salt/sodium content in food.
6.3. Cost /cost-effectiveness

There was no retrievable scientific evidence on the cost-effectiveness of salt meter.
33
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9. APPENDIX
9.1. Appendix 1: LITERATURE SEARCH STRATEGY
Ovid MEDLINE® In-process & other Non-Indexed citations and OvidMEDLINE®

1946 to present
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
EBM Reviews - Cochrane Same MeSH, keywords, limits used as per

Central Register of Controlled MEDLINE search
Trials
EBM Reviews - Cochrane
database of systematic reviews
EBM Reviews - Health
Technology Assessment
EBM Reviews – NHS Economic
Evaluation Database
38
PubMed
((((("food"[MeSH Terms] OR food[Text Word]) OR nutrients[Text Word]) OR

"meals"[MeSH Terms]) OR meal[Text Word]) AND (((("sodium, dietary"[MeSH Terms] OR
sodium dietary[Text Word]) OR "sodium chloride, dietary"[MeSH Terms]) OR sodium
chloride dietary[Text Word]) OR table salt[Text Word])) AND ((((((((((((((("salinity"[MeSH
Terms] OR salinity[Text Word]) OR (("sodium chloride"[MeSH Terms] OR ("sodium"[All
Fields] AND "chloride"[All Fields]) OR "sodium chloride"[All Fields] OR "salt"[All Fields])
AND meter[Text Word])) OR sodium meter[Text Word]) OR "electric conductivity"[MeSH
Terms]) OR electric conductivity[Text Word]) OR salinometer[Text Word]) OR (("sodium
chloride"[MeSH Terms] OR ("sodium"[All Fields] AND "chloride"[All Fields]) OR "sodium
chloride"[All Fields] OR "salt"[All Fields]) AND tester[Text Word])) OR (("sodium,
dietary"[MeSH Terms] OR ("sodium"[All Fields] AND "dietary"[All Fields]) OR "dietary
sodium"[All Fields] OR "sodium"[All Fields] OR "sodium"[MeSH Terms]) AND
analyser[Text Word])) OR (("sodium chloride"[MeSH Terms] OR ("sodium"[All Fields]
AND "chloride"[All Fields]) OR "sodium chloride"[All Fields] OR "salt"[All Fields]) AND
analyser[Text Word])) OR "refractometry"[MeSH Terms]) OR refractometry[Text Word])
OR "ion-selective electrodes"[MeSH Terms]) OR electrode ion-sensitive[Text Word]) OR
"titrimetry"[MeSH Terms]) OR titrimetry[Text Word])
39
Appendix 2
9.2. EVIDENCE TABLE
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
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.
Samples were stored at 3. Recovery of total sodium by the

4°C until analysis. ISE method, approached the ideal
recovery of 100% in most cases.
Ion meter calibration was
according to the Conclusion:
manufacturer's The SIE method can be applied
instructions, using 100 ml successfully to cheese. The
of 100 and 1000 ppm procedure is simple, requires only a
standard sodium solutions modest investment in equipment,
to which 4 ml of a total and is relatively rapid. Analysis time
ionic strength adjustment was 7 to 8 minutes per sample,
buffer (TISAB) was added. including time required to calibrate
the instrument, weigh and analyze
the sample.
40
Number of
Length of
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.
The electrodes was

immersed in the resulting
mixture, allowing the
instrument to achieve
equilibrium (approximately
3mins).
Repeatability of the SIE

method was evaluated by
measuring sodium
contents of 10 identical
samples of each cheese
type.
41
Analytical technique : Ion selective electrode
Number of
Length of
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
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
applicable)
characteristics
Other salted foods
All measurements were
made with the meter
calibrated in the range
100-1000 p.p.m. of
sodium.
For water-soluble foods of

high sodium content, a 2g
aliquot was weighed to the
nearest milligram and
dissolved in 11of water. A
200-ml aliquot of this
solution was treated and
analysed as for cheese.
For water-soluble foods of

lower sodium content a 6-
g aliquot was weighed to
the nearest milligram into
a 200-ml calibrated flask
and dissolved in and made
up to the mark with water.
This solution was treated
and analysed as for
cheese.
For cereal-type foods a 5-

g aliquot was weighed to
the nearest milligram and
blended at high speed for
1 min in 195 ml of water
and 8 ml of buffer solution.
This mixture was analysed
as for cheese.
44
Analytical technique: Titration
Number of
Length of
applicable)
characteristics
1. Ploegaerts, Experimental study Sample food: Thermometric 1. Flame atomic Results:

G., Desmet, Tomato ketchup endpoint titrimetry absorption 1. Merits of the different
C., and Van Objective: sauce (TET) spectrometry techniques
krieken, M. To evaluate the accuracy (FAAS)
Assay of and precision of different 3 types of ketchup 2. Flame atomic The analytical sensitivity of the
sodium in protocols (combination of were analysed emission TET is very low in comparison with
food: sample preparation and a. Classic tomato spectrometry those obtained for spectrometric
comparison analytical technique) to ketchup (FAES) techniques. (Limit of detection and
of different determine sodium content (common one 3. Inductively Limit of quantification values of
preparation in food. found in a coupled TET were very high. However, if
methods supermarket) plasma- the concentration was high enough
and Methods b. low sodium atomic emission (like in the classic ketchup sauce),
assay 12 different ways to ketchup sauce spectrometry TET did not require any further
techniques. determine sodium content c. doped (ICP-AES) dilution of the sample, all benefit in
2016;45: in food with combination of homemade the preparation time.
66-72 4 analytical techniques ketchup sauce
and 3 sample preparation The preparation of the samples
methods. a. Digestion
- the higher quantity of acid in
3 preparation methods the resulting solution has to be
a. dispersion in water neutralized before
(dissolution in water) measurement
b. wet digestion - does not solubilize entirely a
(acid digestion) simple matrix, it will need a
c. dry ashing larger amount of reagents
to achieve satisfactory
Each type of ketchup preparation of other type
sample was prepared by 3 of food like meat or
methods in 10 replicates. cheese
b. Dry ashing
Different internal quality - more efficient but also more
controls (IQCs) were time consuming (8 hours)
applied like calibration, c. Dispersion in water
blanks, mid-range - quick and easy protocol
standard and duplicate. to follow
45
Number of
Length of
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
The good precision obtained with

TET
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)
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.
46
Analytical technique: Ion Selective Electrode and Titration
Number of
Length of
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
applicable)
characteristics
Both ICP/MS and ISE have

lower interday precision
(median RSDs of 6.1 and
6.2%, respectively).
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
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).
Analysis of chloride levels did

not allow the reliable
estimation of Na levels in
low-sodium foods, even
when added NaCl was
present.
49

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2018

SALT METER FOR FOOD

HEALTH TECHNOLOGY ASSESSMENT SECTION (MaHTAS)

Please contact: htamalaysia@moh.gov.my, if you would like further information.

Health Technology Assessment Section (MaHTAS)

Tel: 603 88831246

Fax: 603 8883 1230

Available at the following website: http://www.moh.gov.my

Professor Dr Aminah bt Abdullah

Associate Professor Dr Hamid Jan Bin Jan Mohamed

Ms Gui Shir Ley

Change in lifestyle, rapid urbanisation and more production of processed foods

Salt reduction health strategy in population by World Health Organisation (WHO)

The objective of this systematic review was to assess the efficacy/effectiveness,

Results and conclusions

Kindstedt P.S et al. Florence E Ehling S et al. Ploegaerts G et al.

Limit of quantification (LOQ)

Ion selective electrode (ISE)

b.Thermometric endpoint titrimetry (TET)

There was no retrievable scientific evidence on the cost-effectiveness of salt

In Old English, it is referred as sealt. In plain English, it is known as salt, a

Salt reduction health strategy in population by World Health Organization (WHO)

Condition / Claim Sodium content

High sodium >0.48g/100g

Moderate sodium 0.12g-0.48g/100g

Low sodium <0.12g/100g

Very low sodium <0.04g/100g

Free of sodium <0.005g/100g

Guide to Nutrition Labelling and Claims 2010, MOH

In 2015, Malaysian Ministry of Health developed the 10-year National Strategic

This technology review was requested by Nutrition Division, Ministry of Health,

The objective of this systematic review was to assess the efficacy/effectiveness,

3.1 Methods of sodium analysis

The conductivity method works on the principle of conductivity in liquid. It is a

Figure 1 : Basic illustration of conductivity meter. A conductivity meter can

Figure 2: Amperometric probe

Potentiometric conductivity sensors use four ring electrodes. Two of these

Table 2: Examples of conductivity method salt meters available on the market

Product Product Image Description

Digital Salt-Meter, - Ideal for measuring dilute solution of samples,

Digital Handheld - Portable salt-conductivity meter; only for

Digital Hand-held - Ideal for checking salt level in deli meats,

Electronic Salinity - Ideal for measuring salt concentration in

- This meter is designed to measure the salt

LAQUATWIN Salt - It has the ability to be immersed in liquids,

- Provides several flexible measurement

Solid Powder Paper & Textiles

- Minimum sample volume: 0.12ml

An ISE is a chemical sensor used to determine the concentration of a specific ion

HI931102 - Measures the sodium content of a solution

Courtesy of Hanna Instruments, Inc 40

Table 4: Examples of refractometer available on the market

HI96821 Digital -Ideal for the analysis of salad

Reichert™ Salt-Chek - 3 measurement scales in one model

Atago 2483 MASTER- - For measuring the concentration of

- Measurement range: Brix 0.0 to

Atago 3276 Automatic - 30 kind of user scales can be input

Solution being titrated (Analyte)

b. Manual Titration: Volhard’s Method44

Recovery = (Amount of NaCl in spike sample – Amount of NaCl in sample) x 100

c. Automated Titration: Potentiometric Method37

d. Automated Titration : Thermometric Titrimetry45

Table 5: Examples of titrators available on the market