Salt reduction can save many lives at low cost

Eating too much salt raises blood pressure and the risk of cardiovascular disease, which causes nearly 1.89 million deaths around the world each year, primarily in low-income countries. Reducing salt consumption can save lives, with a cost of about $0.40 per person.

Data source: He FJ, Pombo-Rodrigues S, MacGregor GA Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality BMJ Open 2014;4:e004549. doi: 10.1136/bmjopen-2013-004549

The average person’s salt intake is nearly twice the recommended level. In 181 of 187 countries—covering 99% of the world’s population—the average level of salt intake exceeds the World Health Organization’s (WHO) recommendation of 5 grams (or just under one teaspoon) per day.

Our approach

Resolve to Save Lives (RTSL) aims to reduce global salt intake by 30%, based on WHO’s SHAKE technical package

For more information about our technical guidance, toolkits and advocacy materials for sodium reduction, visit LINKScommunity.org.

These strategies target the three areas where salt is most commonly found: packaged food, food consumed outside the home and food consumed at home.

Packaged Food

  • Industry Reformulation*
  • Front of pack warning labels
  • Marketing restrictions
  • Fiscal Policies

Away-from-home food

  • Public food procurement policies*
  • Interventions that address restaurants and vendors

Home

  • Behaviour change campaigns / Mass media*
  • Promotion of potassium-based low-sodium substitutes

* strategies identified as WHO Best Buys

Our Cardiovascular Health team works closely with local, national and global partners to track salt consumption and scale up proven strategies for reducing intake. We have also supported the development of first-of-their-kind global resources, including the RTSL Sodium Reduction Framework, a web-based tool that provides comprehensive guidance on the development, enhancement and evaluation of salt reduction programs. Additionally, we have supported WHO in developing the Sodium Country Score Card, the global sodium benchmarks for different food categories and the Action framework for developing and implementing public food procurement and service policies for a healthy diet.

Establishing a model healthy public food procurement policy in Quezon City, the Philippines

RTSL’s recent work in the Philippines with grantee, ImagineLaw, demonstrates how public food procurement policies are effective in improving national food environments and addressing dietary risk factors on a large scale.

Cardiovascular disease is the leading cause of death in the Philippines, with more than 200,000 lives lost every year. About 81,000 of these deaths are attributed to dietary risk factors, including high sodium intake.

In July 2020, RTSL awarded a grant to ImagineLaw, a non-profit public interest law organization, to help reduce sodium intake and improve diets through public food procurement in Quezon City (QC). ImagineLaw moved quickly to broker a partnership with the QC government, with the goal of developing and implementing a new public food procurement policy.

To initiate policy development, the QC government established a technical working group of government agencies to oversee the development, implementation, monitoring and evaluation of the policy cycle. ImagineLaw worked closely with the technical working group to conduct research, write the initial draft of the nutrition standards and organize workshops and training sessions for developing the policy monitoring instruments. Together, ImagineLaw and the technical working group conducted legal and food environment assessments that informed the draft policy. ImagineLaw’s technical assistance ultimately

On May 12, 2021, the QC Government Executive Committee approved the proposed healthy public food procurement policy. On July 23, 2021, Mayor Josefina Belmonte signed an executive order requiring all food and food suppliers for QC public offices and departments, including city-run hospitals and institutions, to pass QC Nutrition Standards. These guidelines promote a greater consumption nutritionally-balanced foods and whole and fresh foods (instead of processed foods), with an emphasis on fruits and vegetables. They also ban the use of trans fats and place limits on salt and sugar.

Additionally, the policy seeks to strengthen sustainability and food security by promoting local urban farms and sourcing local ingredients and whole foods through programs led by the Small Business and Cooperatives Development Promotions Office, the Sustainable Development Affairs Unit and the Market Development and Administration Department. This collaboration is encouraging local businesses to work with QC institutions to create a healthy and sustainable food environment. It also is influencing barangays—smaller districts in the region that are currently excluded from the executive order—to adopt the same or similar policies in their local food procurement plans and policies.

The QC Health Department will review and update the QC Nutrition Standards, and develop supporting reference tools and materials every three years.

QC Vice Mayor Gian Sotto has recognized the policy as a “giant step towards an institutional and fiscal approach to solving societal concerns caused by lack of nutrition and awareness on the effect of our eating habits to our body.” He said: “The best way to promote healthy eating in our Quezon City families is to lead by example and show that it is not only beneficial to have a nutritious diet, but it is also possible to change our spending habits and embrace a new and more health-conscious lifestyle.”

Quezon City

Resources

The WHO SHAKE Technical Package for Salt Reduction

Resolve to Save Lives Sodium Reduction Framework

Resolve to Save Lives Sodium Reduction Resource Library

Reducing Cardiovascular Disease Through Salt Reduction: Strategies for Success

Annotated Bibliography on Sodium Reduction

Global Sodium Reduction Strategies Course

World Health Organization Sodium Country Score Card

Resolve to Save Lives Advocacy Slide Deck

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