Chile

Salt Action Summary

April 2012

Chile has performed the first assessment of the voluntary agreements with bread producers: The average salt content dropped from >800 mg/100 gr to 480 mg/100 gr of dry bread (marraquetas- the most commonly used bread in Chile).

February 2012

Chile is progressing with it's first salt reduction program through:  

  • Raising awareness on level of consumption of salt in the population; the national nutrition strategy is shifting from obesity prevention to promotion of healthy diet where over consumption of salt makes part of it. 
    • The Ministry of Health website has a web page with particular focus on consumers, food producers and professionals on elements of Chilean Strategy for Reduction of Intake of Salt/Sodium. 
    • National program 'Elije Vivir Sano' (Choose living healthy) addresses over consumption of salt  as one of leading health issues for Chile.
  • The reduction of salt in food: The results of the compliance of voluntary agreement made between Government and bakers industry on reducing the content of sodium to 600mg/100g of bread by end of 2011, are to be publically announced 
  • National government and Organization that secures school complementary food program (JUNAEB) for school children from deprived environment has included the requirement on sodium levels in it’s standards.  
  • Linkage of research to decision-making: it is expected that during the year 2012 a group of experts of the academy carry out a proposal of updating of the current Nutritional Guidelines.   One of the principal foci of this review will be to underscore the importance of the sodium reduction in the diet.  

October 2010 

Chilean chapter of WASH launched

March 2009

Dr Vanessa Garcia-Larsen, our first Chilean WASH member, has informed us that hypertension affects 33.7% of Chilean adults. Whilst there is no accurate data on salt intake at a national level, estimates suggest average consumption is around 10g/day. The Chilean Ministry of Health launched limited salt reduction guidelines in 2005 in the Educative Guidelines for a Healthy Life. The Ministry of Health’s Advisory Committee on Diet & Nutrition is developing strategic liaisons with the food industry to create healthier food options.

July 2007

Comment in BMJ in response to Francesco P Cappuccio’s paper: Salt and cardiovascular disease. BMJ 2007; 334: 859-860

Salt intake and hypertension in Chile: the need for health interventions

Vanessa Garcia-Larsen,
Post-Doctoral Research Associate
NHLI, Imperial College London, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, UK

Victor Zarate, Jorge Jimenez de la Jara (Departamento de Salud Publica, Pontificia Universidad Catolica de Chile)

Send response to journal:
Re: Salt intake and hypertension in Chile: the need for health interventions

Hypertension affects 33.7% of Chileans above 17 years old and increases to 53.7 % in those aged 45 to 64 years old [1]. Over half of the population presents some level of overweight. The same proportion has two or more risk factors for cardiovascular diseases, the leading cause of death in Chile (28% of all deaths in 2004) [2].

As Cappuccio points out in his editorial [3], it is estimated that only 20% of salt intake in developed countries comes from discretionary use. At present there are no accurate data on salt intake at a national level in Chile, but estimations suggest that the average consumption is around 10g/d [4]. Although Chile is still a developing country, its nutritional and epidemiological profiles are comparable to most European countries. Consumption of processed foods, carbohydrates and saturated fats accounts for a large percentage of the total daily energy intake, and it is likely that purchased foods and meals may account for over 70% of the daily intake of salt.

The efforts of the Chilean Ministry of Health to reduce consumption of salt have been mirrored in the Educative Guidelines for a Health Life launched in 2005 [5]. Through this initiative the population is encouraged to reduce the amount of salt used in their meals and to check the labels of the foods before buying them. However, this has limitations, as salt- reduction recommendations alone are unlikely to have an impact in the population. In addition, lack of information on the labelling of foods remains a main hindrance, and many individuals choose foods unaware of their high content of sodium.

Keeping in line with one of Cappuccio’s proposals, Finland and Norway have introduced a number of legal initiatives to protect consumers (e.g. legal taxation/subsidising of foods with high and low content of salt, respectively, and declaration of salt content in foods). The British Foods Standards Agency has started a campaign in the UK to reduce salt intake to 6g/day. Several large food manufacturers and public health organisations are participating, aiming at reducing salt levels in 85 food categories that contribute most to the amount of salt in the British diet. At present, there are commitments to cut the content of salt in bread and soups by 30%.

In Chile, the Ministry of Health’s Advisory Committee on Diet and Nutrition has recently acknowledged the need for a strategic liaison with the food industry to create healthier food options [6]. Taking on board the current figures of cardiovascular diseases, and the high economic and social cost they involve for the country, it seems urgent to introduce measures to lower the current consumption of salt in the general population. A joint campaign with the collaboration of food manufacturers would be a good start.

In addition, the introduction of a public health policy by which certain foods should not have more than a set amount of salt seems advisable. In August 2006, the burden of diet-related non communicable chronic diseases, including hypertension and high intake of salt and was addressed in the Chilean Senate [4]. The need for actions was widely acknowledged by the members of the Parliament and the Minister of Health welcomed the idea of a better legislation to protect the consumers, including the labelling of foods. Due to the magnitude and impact that hypertension has in the population, it seems appropriate to endeavour a legislation on this matter.

References

[1] Ministry of Health, Chile. Report on the First Chilean National Health Survey 2003. Available on: http://epi.minsal.cl/epi/html/invest/ENS/InformeFinalENS.pdf

[2] Ministry of Health, Chile. Mortality for cardiovascular diseases in males and females 1990-2004. Accessed on 02/06/2007 http://deis.minsal.cl/deis/salidas06/mortalidad.asp?temp=CARDIO_9004.htm

[3] Cappuccio FP. Salt and cardiovascular disease. BMJ 2007; 334: 859 -60.

[4] Uauy R. The problem of obesity in Chile. Special session in the Parliament. 2006. http://www.senado.cl/prontus_senado/site/extra/sesiones/pags/fset/diar/21060811182410.html

[5] Ministry of Health, Chile. Commission “Life Chile”. Educative guidelines for a healthy life. Guidelines on food intake, physical activity and tobaco 2005. Report No 76

[6] Araya H, Atalah E, Benavides M, et al. Food and nutrition interventions priorities in Chile. Rev Chil Nutr 2006; 33: 458-63

See: www.bmj.com/cgi/eletters/334/7599/859