Salt Action Summary
A new study has found that consumer knowledge of the relationship between high salt diets and an increased risk of hypertension, cardiovascular disease and kidney disease was high. Furthermore, their knowledge of the sodium content of foods was high.
A further study involving 242 adults from Pohang city found that average salt intake was 9.9g/day, with a range of 5.3g to 14.5g/day. This study utilised 24 hour urinary sodium measurements and indicates that salt intake may be decreasing in South Korea.
Following the establishment of the Korea Center for Less Salt Campaign, 13 food manufacturers are now voluntarily producing low sodium products, or are reformulating their existing products to contain less sodium.
In 2012, the South Korean government established the Korea Center for Less Salt Campaign, following the finding by the Korean Ministry of Health and Welfare that average sodium intake is 4878mg/day, which is equivalent to 12.2g salt per day. The aim of the Korea Center for Less Salt Campaign is to reduce salt intake by 20% by 2017. They will develop low sodium school meals, the Ministry of Education, Science and Technology will hold educational sessions for students and parents, large retailers will need to dedicate areas of their stores to low sodium products and more than 1000 restaurants have pledged to serve low sodium dishes by 2013.
The Korean Food and Drug Administration said that increased sodium intake was responsible for 32% of hypertension cases and 10.9% of diabetes cases in the South Korean population.
Koreans are eating too much salt, experts said. According to a government report on the nutritional condition of Koreans, 13.5 grams of salt per day per person was being consumed, which is 2.7 times more than the World Health Organization (WHO) recommended five grams. It is also higher than Japan's 10.7 grams and the United Kingdom's 11 grams.
A Korean Food and Drug Administration spokesperson said Koreans must watch their salt intake. "As people eat more fast food, spicy food and fatty foods which contain lots of salt, there are possible threats of hypertension, brain and heart disease and even stomach cancer", she said. She warned that even children are being exposed to too much salt.
CASH and WASH member Dr Feng He, Queen Mary University of London, is the principal investigator on a new project which aims to determine salt intake among the Malaysian adult population, the main sources of salt in the diet and knowledge, attitudes and behaviours of the population with regards to salt. The project is funded from January 2017 to January 2019. For more information, please click here.
The Malaysian Ministry of Health delivered a presentation on salt reduction initiatives in the country at a recent seminar. They stated that the average salt intake of the Malaysian population was 8.7g/day and their goal is to reach an intake of 6g/day, or a 30% reduction, by 2025 in line with WHO recommendations. Their first strategy is prevention and promotion of a low salt message, using media, health professionals, consumer education campaigns and NGO/consumer associations advocacy. Their second strategy is clinical management of salt-related complications such as high blood pressure, including timely screening, diagnosis and treatment options. The third strategy is increasing patient compliance with treatments and the fourth is to increase cooperation with government ministries, such as the Ministries of Health and Education, the food industry, universities and research institutes, and NGOs such as the Malaysian Alliance of Salt Reduction Initiatives. Their fifth strategy is monitoring, research and surveillance, which includes establishing baseline data on salt intake through 24-hour urine sampling and new product development as a result of research into new product development. The final strategy is policy and regulatory interventions, which includes requesting mandatory sodium labelling of all products and regulation of sodium in settings such as schools and catering services.
The presentation also detailed the top ten sources of highest sodium consumption, which include soy sauce, fried rice, nasi lemak (a rice dish) and fried meehon (rice vermicelli).
The presentation slides can be viewed here.
In Malaysia, since the early 1980s cardiovascular disease has been the leading cause of mortality. A survey conducted in 1996 showed that 30% of the adult Malaysian population have high blood pressure, and since then this number has probably increased.
Although no dietary survey has been conducted in Malaysia to look at salt intake it is clear from looking at dietary trends that Malaysian’s salt intake is currently at least 10 to 15 g/day. For example, many of the sauces commonly used in Malaysian cooking contain over 2.5g salt/tablespoon. In addition to this, a large number of Malaysians frequently patronise hawker centres. One study in Malaysians adolescents found that 73% of adolescents would have their dinner at hawker centres most days. This will have a substantial effect on salt intake as foods eaten in hawker centres are often high in salt, and a single serving of some of the dishes contribute more than, or close to 1 day’s recommended daily salt intake of 6 grams/day. Also in Malaysia there is currently no legal obligation to label the salt content of processed foods. Therefore it is virtually impossible for the consumer to know how much salt is in a product, consequently they are not aware of how much salt they are eating.
There have been recent reports in the media that would indicate that the Malaysian Minister of Health is encouraging manufacturers to lower the salt content of their food products. It would also appear that The Health Ministry of Malaysia has plans to develop a labelling scheme to help consumers identify healthy food items. The Health Minister has stated that ‘such items would carry a healthy-choice food logo if their sugar, salt and fat content were at healthy levels’.
WASH has approached both Malaysian Ministers of Health with a briefing paper pointing out the need for a reduction in salt intake, the benefits and the evidence that links salt to blood pressure and other harmful effects, and a draft plan of what could be done in these two countries was produced. Action is now being taken in both of these countries in trying to implement some aspects of these plans.