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Salt reduction initiatives around the world

Webster, Jacqueline La; Dunford, Elizabeth Ka; Hawkes, Corinnab,c; Neal, Bruce Ca

doi: 10.1097/HJH.0b013e328345ed83
Reviews and meta-analyses

Objective To provide an overview of national salt reduction initiatives around the world, describe core characteristics and develop a framework for future strategy development.

Methods National strategies were identified from existing reviews and from searches of the literature and relevant websites. Standardized information was extracted about governance and strategy development, baseline assessments and monitoring and implementation.

Results Thirty-two country salt reduction initiatives were identified. The majority of activity was in Europe (19 countries). Most countries (27) had maximum population salt intake targets, ranging from 5 to 8 g/person per day. Twenty-six of the 32 strategies were led by government, five by nongovernment organizations and one by industry. Twenty-eight countries had some baseline data on salt consumption and 18 had data on sodium levels in foods. Twenty-eight countries were working with the food industry to reduce salt in foods, 10 had front-of-pack labelling schemes and 28 had consumer awareness or behaviour change programs. Five countries had demonstrated an impact, either on population salt consumption, salt levels in foods or consumer awareness. These strategies were led by government and were multifaceted including food reformulation, consumer awareness initiatives and labelling actions.

Conclusion This is the first review to concisely summarize the most important elements of the many existing salt reduction programmes and highlight the characteristics most likely to be important to programme efficacy. For most countries, implementing a national salt reduction programme is likely to be one of simplest and most cost-effective ways of improving public health.

aThe George Institute for Global Health/School of Public Health, University of Sydney, Australia

bConsulting Services, Food and Nutrition Policy, France

cVisiting Fellow, Centre for Food Policy, City University, London, UK

Received 14 October, 2010

Revised 14 February, 2011

Accepted 18 February, 2011

Correspondence to Jacqui Webster, PO Box M201, Level 10 KGV Building, Missenden Rd, Camperdown, NSW 2050, Australia Tel: +61 2 9993 4520; fax: +61 2 9993 5402; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.