Public Health Nutrition by unknow

Author:unknow
Language: eng
Format: epub
ISBN: 9781118660973
Publisher: John Wiley & Sons, Inc.
Published: 2017-06-12T00:00:00+00:00

16.4 Public Health Strategies to Reduce Population-Wide Sodium Intake

The evidence for a beneficial effect of sodium reduction on population health has led the WHO to set a global goal to reduce daily sodium intake to less than 2 g (85 mmol sodium, 5 g salt) per person by 2025. This would result in a shift of the population's blood pressure distribution downwards, leading to worldwide reductions in cardiovascular diseases and premature deaths (Lewington et al., 2002). Reduction in salt consumption will potentially have greater effects in the long term, as reduced intakes would attenuate the rise in blood pressure associated with age.

A public health approach is needed to achieve population-wide reductions in sodium intake. In western countries, because most sodium consumed is added in food manufacturing, population-wide reductions in sodium intakes require action by the food industry to remove added sodium from their products. This can be done in a gradual, stepwise fashion that may go unnoticed by consumers, but which could lead to major public health benefits. This should be accompanied by improvements in food labelling to allow consumers informed choices about the food they eat. Though several countries aim to reduce sodium intakes as per WHO recommendations, only a few countries have currently set specific public health targets. The majority of countries with defined public health strategies focus on increasing public awareness through educational campaigns, food labelling and promotion of foods with reduced salt content. Only a minority of countries have set targeted sodium reduction strategies aimed at the food industry. Moreover, monitoring population sodium intakes and changes over time in the whole population and among subgroups is important to evaluate the effectiveness of public health strategies.

A population-wide strategy to reduce population salt intake was introduced in the UK in 2004. This national strategy comprised a combined approach of voluntary agreements with the food industry to lower salt content in 85 categories of processed foods, improved food labelling and increasing public awareness by media campaigns. Sodium intake was monitored by repeated national surveys using 24 h urine collections. The average sodium intake fell from 3.80 g/day (9.5 g salt) in 2001 to 3.44 g/day (8.6 g salt) in 2008 and to 3.13 g/day (8.0 g salt) in 2014 (Figure 16.4). In 2014, the estimated salt intake of adult men (8.6 g/day) was on average higher than of adult women (6.2 g/day). This public health strategy showed that lowering the sodium content of foods by 5–15% is possible without noticeable changes in flavour, taste or sales. The current UK's salt reduction goals aim for a maximum intake of 6 g/day by 2017 through continued product reformation; intervention studies show that further reduction to 3 g/day salt will have greater effects on blood pressure (He et al., 2013). To encourage the food industry to continue their efforts, Consensus Action on Salt and Health (CASH) monitors and published salt levels in popular household foods as well as in foods eaten out of home and in children's meals of family friendly restaurants. In some Asian country settings (e.

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