**Background:** Salt (NaCl) and dietary sodium are essential for human health but excessive consumption is a major global public health challenge, contributing to hypertension, cardiovascular disease, and kidney disease. The World Health Organization (WHO) recommends a maximum of 5 g of salt per day, yet the current mean intake in WHO member states is nearly double this value. Despite a global agreement to reduce salt intake by 30% by 2025, progress has been insufficient, particularly in low- and middle-income countries. The authors argue that existing approaches to salt reduction are fragmented across disciplines and fail to account for the complex, context-dependent nature of salt consumption. They propose an 'eater-oriented' knowledge framework that integrates nutritional, socio-economic, cultural, material, and socio-psychological determinants to build more effective public health interventions.
**Methods:** The authors conducted an exploratory scoping review following PRISMA-ScR guidelines. The search strategy targeted articles articulating salt consumption and public health across disciplines including health and epidemiology, behavioral and social sciences, nutrition, and public health management. Searches were limited to English and French language articles published between 2000 and 2022, using search engines including Google Scholar, ScienceDirect, NCBI PMC, PubMed, Persée, CAIRN, JStore, and ISIDORE. Search terms included combinations of 'Salt*', 'Sodium', 'Consumption', 'Home', 'Table', 'Cook*', 'Discretionary salt', 'Health', and 'Nutrition'. After initial screening by two researchers and discussion within a larger scientific consortium, three researchers reviewed full texts. Eligibility criteria included original data from scientific or credible sources (e.g., national cohort reports), significant sampling size, and articulation of salt consumption with public health. Reports from public agencies, book chapters, and non-peer-reviewed articles were excluded, though institutional reports based on French nutritional epidemiological surveys were retained. A total of 71 published peer-reviewed articles were retained, plus 12 older articles marking emergence of key themes. The categorization process involved creating a descriptive form for each article, then enriching it with two ad-hoc columns identifying 'relational features' (how salt becomes an object of study) and links with nutritional recommendations. Through iterative discussion and consensus, the authors synthesized six knowledge fields, ten links with nutritional recommendations, nine relational features, and four thematic categories.
**Key Results:** The 71 retained articles came from 29 sources and covered North America (US n=18; Canada n=3), South America (n=6), Europe (n=23), Asia (n=11), Africa (n=8), Nordic countries (n=3), and Oceania (n=10). Most studies focused on a single country (n=64), while five took a comparative perspective. Five sources of salt intake were identified: salt in raw or processed food (SF), table salt (TS), cooking salt (CS), controlled added salt (CAS), and global sodium consumption. Nine non-exclusive relational features were extracted: Intake, Knowledge, Awareness, Beliefs, Attitudes, Behaviors/social practices, Liking/Preference, Taste perception, and Consumer practices. Four thematic categories were developed: (1) Socio-demographic and cultural descriptors of salt consumers (18 works); (2) Knowledge, attitudes, and beliefs on nutritional norms (21 works); (3) Salt practices associated with dietary or medical regimes (8 works); and (4) Salt materialities: interactions and contexts (24 works). Six knowledge fields articulating salt consumption and health were identified: Food Science and Nutrition; Nutrition and Public Health; Medical and Behavioral Studies; Behavioral Research and Social Science; Social Science; and Interdisciplinary. Ten strategic approaches to excessive sodium consumption were identified, with 'Sodium reduction' (n=15) and 'Socio-cultural determinants' (n=12) being the most common. The review found that most studies relied on declarative data (dietary recalls, questionnaires) or objective measures (24-h urine collection), with very few employing qualitative methods. Only one study (Blanco-Metzler et al.) used ethnography and ethnology to understand salt-related practices from participants' perspectives.
**Clinical Implications:** The authors argue that current nutritional databases and public health interventions are insufficient because they treat salt consumption as a purely nutritional or biomedical issue, ignoring the social, cultural, psychological, and material contexts in which eating occurs. They propose that flexible, eater-oriented databases—categorizing data around practices and relations rather than disciplinary questions—could improve the effectiveness of salt reduction campaigns. Such databases would integrate knowledge about salt's interaction with humans (liking, perception, body effects), its material dimensions (compositions, formats, presentation), socio-economic issues (population groups most at risk), cultural influences (recipes, traditions, beliefs), common practices and routines, and knowledge about food manufacturing and nutritional messages. The authors suggest that their categorization system can serve as a framework for conducting qualitative interviews and observations, and that the documentary base (Supplementary Table 1) can guide future research. They emphasize that taking salt materialities and interactions seriously is important for understanding compensation strategies during salt reduction programs and for coherent coexistence of different public health initiatives (e.g., iodized salt programs for iodine deficiency prevention). The review concludes that achieving the WHO goal of 30% reduction in dietary sodium by 2025 requires interdisciplinary collaboration and eater-centered knowledge production.