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World Action on Salt. Sugar & Health

The World’s Taking Action to Reduce Salt Intake

by Corinna Hawkes, WCRF

Corinna Hawkes is Head of Policy and Public Affairs at World Cancer Research Fund International. She is a specialist in food policy who has worked for the World Health Organisation, and is an Honorary Fellow at the Centre for Food Policy, City University, London.

This week is World Salt Awareness Week. You might wonder why that matters to an organisation focused on cancer prevention. Well, it matters because the global scientific research analysed by us shows that salt increases the risk of developing stomach cancer. There is an association between stomach cancer and total salt intake as well as consumption of salty and salted foods. There is also a convincing link between bowel cancer and processed meat, which frequently contains salt.

So this week we’re reiterating our recommendation that the population’s average consumption of salt from all sources should be just under a teaspoonful a day.

Excessive salt intake is also linked with other illnesses, notably heart diseases; salt contains sodium and higher sodium intake is a major risk factor for elevated blood pressure and cardiovascular diseases.

Policy Action Can Help People Reduce Their Salt Intake
The good news is that policy actions can help people choose foods lower in salt. We know that people can and do become accustomed to less salty foods. Indeed, often we don’t even notice that the salt content of our food has been reduced. So governments around the world are working to identify the foods most responsible for high salt intake in their populations - a combination of assessing the level of salt in the food itself and how frequently it is consumed - and then engaging industry to voluntarily reduce salt levels, and/or taking steps to implement legislation.

What Governments Around the World Are Doing to Reduce Salt Intake
For World Salt Awareness Week, we have updated our NOURISHING policy framework so that it includes an up-to-date list of many of the actions being taken by governments around the world to reduce the salt intake of their populations. The information shows that at the moment, more than any other single food, bread is the target of actions to reduce salt levels in foods.  For example, governments in Argentina, Austria, Chile, Croatia, Hungary, Ireland, Italy, Mexico, Spain, and Switzerland have voluntary programmes with the food industry to reduce salt levels in bread.  In 2013, governments in Argentina, Paraguay and South Africa took firmer action, implementing legislation that limits sodium to mandatory maximum levels in bread or flour (Portugal mandated maximum levels in bread in 2009 and Belgium, Finland and Greece have had similar legislation for decades).

Bread is not the only targeted food. Some countries have identified processed meat as a particular culprit (Argentina, Ireland); others include a wide range of foods (South Africa, UK, USA). In many Asian countries, the most significant source of salt is not bread or processed foods, but the salty condiments, like soy sauce and salted foods. Experts suspect this is why stomach cancer rates are so high in countries like South Korea and Japan. The “Less Salt Campaign” in South Korea therefore focuses on kimchi, soy sauce, soybean paste, salted fish and noodles.

There are other approaches being adopted to reduce salt intake too. Finland require warning labels on high salt foods (and have done since the 1970s.) Hungary includes high salt foods in its Public Health Product Tax. Many countries also have public awareness programmes to inform people about the heath risks of excessive salt intake.

These examples show that countries are acting to reduce salt, but that they are tailoring them to their own populations and contexts. And it’s this tailored approach that is most likely to work. But is it working? Well, the country that has been in the business of salt reduction for longest is Finland, and salt levels have steadily declined. In the UK, salt intake fell from 9.5g per adult per day in 2005 - when the government started to take action – to 8.1g in 2011.

Why We Need To Help Lower Income Countries
The actual task of monitoring salt intake is, however, challenging and costly, so health funding agencies and international development donors need to help lower income countries put effective monitoring programmes into place.  We also need to work harder to identify the core elements of policy actions that are most effective. This is why WCRF International is collaborating with the World Health Organization’s Collaborating Centre on Population Sodium Reduction to learn more about the details of the actions countries are taking, and whether they are being monitored. We will keep you posted.

Find out more about our work by following @wcrfint or @CorinnaHawkes

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