Only 5% of 194 WHO member states are protected by mandatory and comprehensive sodium reduction policies; 73% lack full range of implementing such policies
Two million deaths can be prevented by 2025 and seven million by 2030 if policies recommended by the World Health Organization to reduce sodium intake are implemented, according to the WHO Global Report on Sodium Intake Reduction.
But the world is off-track to achieve its global target of reducing sodium intake by 30 per cent in the next two years (by 2025), according to the report released March 9, 2023.
Reducing salt intake has been identified as one of the most cost-effective measures countries can take to improve population health outcomes. Key salt reduction measures will generate an extra year of healthy life for a cost that falls below the average annual income or gross domestic product per person.
Reduction of sodium is also an important component of action to achieve the Sustainable Development Goal target of reducing deaths from noncommunicable disease.
The report allocated a sodium country score from 1 (the lowest level) to 4 (the highest level) to each member state based on the level of implementation of sodium reduction policies and other measures. This is a first-of-its kind step.
The sodium country score is used to estimate the impact of policy progress on population dietary sodium intake and cardiovascular disease.
Of the 194 WHO member states, 56 remain in score 1 in the sodium country score card, without further measures implemented in the WHO African Region and among low-income countries. Ninety-eight implemented either voluntary, or mandatory policies and other measures, and scored higher.
“Just under half of these member states had already made a sodium reduction policy commitment by 2013, the year of the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases and the global sodium reduction target,” the report said.
Only nine countries (Brazil, Chile, Czech Republic, Lithuania, Malaysia, Mexico, Saudi Arabia, Spain and Uruguay) have a comprehensive package of recommended policies to reduce sodium intake.
Of the 194 WHO member states, 55 per cent have implemented sodium reduction policies and other measures through mandatory and voluntary approaches.
Some 79 per cent have a policy commitment towards sodium reduction. Even though there is little variation across WHO regions, low income countries less frequently have stated sodium reduction commitments.
The most common setting in which public food procurement and service policies are applied is schools.
Forty-three member states have set standards for foods and beverages offered during school lunches, other meals or snacks, while 31 member states have set standards for foods and beverages sold in school cafeterias, tuckshops, snack bars or vending machines.
Five member states (Cabo Verde, Kiribati, Mongolia, Republic of Korea and Seychelles) have set sodium-specific standards for food sold around the school perimeter.
The most implemented sodium reduction measure is voluntary media campaigns (49 per cent), followed by reformulation (34 per cent) and public food procurement and service policies that are both mandatory and voluntary.
The variation of sodium content in manufactured food offers an important opportunity for sodium reduction through reformulation and showed that reducing sodium in processed food is possible.
Bread and bread products are the most targeted food category for sodium reduction across the implemented reformulation policies in member states. This was followed by meat, poultry, game or fish, ready made and convenience foods and composite dishes and savoury snacks.
The South African government introduced a mandatory maximum limit for sodium content in 2013 and it was set for products in 13 food categories — including bread, breakfast cereals, margarines, meat products, snack foods and soup mixes. Food companies were given a period of three years to ensure that their products were compliant.
The regulation came into effect in June 2016 and further reduction was expected three years later in 2019. Evidence from the WHO Study on global Ageing and adult health suggests a reduction of 400 mg/day sodium (1.15 g/day salt) between 2015 and 2019.
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