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Sodium reduction is a perennial interest area for policymakers and public health advocates. It’s a cornerstone of U.S. nutrition policy, addressed in proposed rules to update the “healthy” claim and school meals regulations, the Food and Drug Administration’s short- and (planned) long-term voluntary reduction targets, and throughout the National Strategy on Hunger, Nutrition, and Health. Almost all nutrient profiling-based policies include a sodium threshold or reduction goal.
Sodium reduction also is a priority of the World Health Organization (WHO), which recommends that adults consume less than 2,000 milligrams of sodium (or 5 grams of salt) per day, to reduce blood pressure and risk of cardiovascular disease, stroke and coronary heart disease. Global intakes continuously exceed these levels, motivating calls for stronger policy action.
To this effect, the WHO published a new report in March that measures global sodium reduction progress and issues first-ever country scores. The report’s goal is to show which countries have adopted sodium reduction policies (and to what extent), and to encourage bolder actions that will help reduce diet-related deaths.
Results from the report are worth reviewing. The highest-scoring countries likely will drive local and regional nutrition policy action on sodium and complementary health and wellness priorities. Lower-scoring countries will be encouraged to learn from these experiences and follow suit, and may feel pressure to do more. WHO will directly support countries in improving their scores, and plans to establish a “mechanism to monitor the implementation of commitments of food operators.”
Select Findings: WHO Global Report on Sodium Intake Reduction
Countries (WHO Member States) are scored on a scale from 1 (lowest score) to 4 (highest score), based on their progress towards implementing “best buy” policies, with a preference for mandatory implementation. These policies include:
- Food reformulation
- Front-of-pack (FOP) and other interpretive labeling
- Mass media campaigns to change consumer behavior
- Public food procurement and service requirements
- Marketing restrictions
- Fiscal strategies
Scores
- Score of 4: 9 countries (5% of Member States) have implemented at least two mandatory policies or measures. Includes Brazil, Chile, Mexico, Uruguay, Saudi Arabia, Czechia, Lithuania, Spain, and Malaysia.
- Score of 3: 43 countries (22%) have implemented at least one mandatory policy or measure. Includes the United States, Argentina, United Kingdom, Seychelles, Thailand, and Philippines, among others.
- Score of 2: 64 countries (33%) have implemented at least 1 voluntary policy or measure. Includes Canada, Australia, New Zealand, Singapore, South Africa, Russian Federation, China, Japan, and India, among others.
- Score of 1: 56 countries (29%) have made a policy commitment towards sodium reduction. Includes most countries in the African region, several countries in the Central American and Western Pacific regions, and a limited number of countries in the European region.
Policy Details
- The policies implemented most often include mass media campaigns, reformulation, and public procurement.
- Mandatory policy implementation is most common in public procurement policies, reformulation, and marketing restrictions.
- A positive relationship exists between income level and number of policies implemented (mandatory and/or voluntary).
- The most active regions, by type of policy, include:
- Reformulation: European, Eastern Mediterranean, Western Pacific
- Procurement (most often schools-based): European, Americas, Western Pacific
- FOP and interpretive labeling (of labeling types, warning signs and traffic lights are most often mandatory vs. voluntary): European, Southeast Asian, Americas, Western Pacific
- Media campaigns: European, Southeast Asian, Western Pacific
- Marketing restrictions: Americas (all mandatory, based on activity primarily in Latin America), European, Western Pacific
Implications
Sodium reduction is a complex issue. Anticipated public health benefits need to be considered alongside food formulation realities, as sodium is critical for taste, food safety, and function. And, meaningful progress may only be achieved via strategies that address the holistic food environment, including sodium use at the household, retail, and foodservice levels.
Nutrition policies to reduce sodium in foods are here to stay. Actively managing sodium reduction within your organization is important, whether that includes reformulation to reduce or replace sodium, ingredient innovation, consumer and stakeholder education on sodium’s role in food and health, and/or communicating your progress effectively. Reach out to Global Food IQ to explore opportunities.
Recommended Read: Progress on Front-of-Pack Labeling in the U.S.
