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. 2015 Jul 22;10(7):e0130247.
doi: 10.1371/journal.pone.0130247. eCollection 2015.

Salt Reduction Initiatives around the World - A Systematic Review of Progress towards the Global Target

Kathy Trieu  1 , Bruce Neal  1 , Corinna Hawkes  2 , Elizabeth Dunford  1 , Norm Campbell  3 , Rodrigo Rodriguez-Fernandez  4 , Branka Legetic  5 , Lindsay McLaren  6 , Amanda Barberio  6 , Jacqui Webster  1
Affiliations

Salt Reduction Initiatives around the World - A Systematic Review of Progress towards the Global Target

Kathy Trieu et al. PLoS One. .

Abstract

Objective: To quantify progress with the initiation of salt reduction strategies around the world in the context of the global target to reduce population salt intake by 30% by 2025.

Methods: A systematic review of the published and grey literature was supplemented by questionnaires sent to country program leaders. Core characteristics of strategies were extracted and categorised according to a pre-defined framework.

Results: A total of 75 countries now have a national salt reduction strategy, more than double the number reported in a similar review done in 2010. The majority of programs are multifaceted and include industry engagement to reformulate products (n = 61), establishment of sodium content targets for foods (39), consumer education (71), front-of-pack labelling schemes (31), taxation on high-salt foods (3) and interventions in public institutions (54). Legislative action related to salt reduction such as mandatory targets, front of pack labelling, food procurement policies and taxation have been implemented in 33 countries. 12 countries have reported reductions in population salt intake, 19 reduced salt content in foods and 6 improvements in consumer knowledge, attitudes or behaviours relating to salt.

Conclusion: The large and increasing number of countries with salt reduction strategies in place is encouraging although activity remains limited in low- and middle-income regions. The absence of a consistent approach to implementation highlights uncertainty about the elements most important to success. Rigorous evaluation of ongoing programs and initiation of salt reduction programs, particularly in low- and middle- income countries, will be vital to achieving the targeted 30% reduction in salt intake.

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Conflict of interest statement

Competing Interests: All authors have completed the ICMJE uniform disclosure form and declare: BN reports non-financial support from Nu-Tek Salt Australia, grants from Australian Food and Grocery Council, grants from World Health Organization outside the submitted work; BN is Chair of the Australian Division of World Action on Salt and Health. ED reports grants from World Health Organization during the conduct of the study. NC is Co-Chair PAHO/WHO technical Advisory Group on dietary salt reduction Member, World Action on Salt and Health President (and Chair of Dietary salt committee), World Hypertension League, HSF CIHR Chair in Hypertension Prevention and Control. BL is Secretariat of the PAHO-WHO led initiative in the Americas "Cardiovascular diseases prevention through population wide salt reduction in the Americas" and coordinates the work of the PAHO Director's Technical Advisory Group on the same initiative. JW reports grants from Vic Health, grants from World Health Organization, grants from Australian National Health and Medical Research Council, during the conduct of the study. JW is Director of the World Health Organization Collaborating Centre on Population Salt Reduction at the George Institute for Global Health. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Identification process of national salt reduction strategies around the world.
Fig 2
Fig 2. Countries’ reported progress towards reduction in population salt intake.
Made with Natural Earth. Free vector and raster map data @ naturalearthdata.com.
Fig 3
Fig 3. Types of salt reduction initiatives adopted by countries.
See this image and copyright information in PMC

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