A first-of-its-kind World Health Organization (WHO) Global report on sodium intake reduction shows that the world is off-track to achieve its global target of reducing sodium intake by 30% by 2025. A significant proportion of sodium intake can be attributed to processed food.

WHO has developed this report to monitor progress and identify areas for action in the implementation of sodium reduction policies and other measures within Member States and across WHO regions and World Bank income groups. For the first time, a Sodium Country Score from 1 (the lowest level) to 4 (the highest level) is allocated to each Member State based on the level of implementation of sodium reduction policies and other measures. The Sodium Country Score is used to estimate the impact of policy progress on population dietary sodium intake and cardiovascular disease.

The global average sodium intake is estimated to be 4310 mg/day (10.78 g of salt per day), which far exceeds the physiological requirement and is more than double the WHO) recommendation of <2000 mg of sodium (equivalent to <5 g of salt) per day in adults.

It is an important component of action to achieve the Sustainable Development Goal target of reducing deaths from noncommunicable diseases. But, as per the report today, only nine countries (Brazil, Chile, Czech Republic, Lithuania, Malaysia, Mexico, Saudi Arabia, Spain and Uruguay) have a comprehensive package of recommended policies to reduce sodium intake.

India have mandatory declaration of sodium on pre-packaged food but no other mandatory measure and so remain in score 2.

A comprehensive approach to sodium reduction includes adopting mandatory policies and WHO’s four “best buy” interventions related with sodium which greatly contribute to preventing noncommunicable diseases. These include: Reformulating foods to contain less salt, and setting targets for the amount of sodium in foods and meals; Establishing public food procurement policies to limit salt or sodium rich foods in public institutions such as hospitals, schools, workplaces and nursing homes; Front-of-package labelling that helps consumers select products lower in sodium; Behaviour change communication and mass media campaigns to reduce salt/sodium consumption.

As per the report Bread and bread products are the most targeted food category for sodium reduction across the implemented reformulation policies in member states. This was followed by meat, poultry, game or fish, ready made and convenience foods and composite dishes and savoury snacks.

Countries are encouraged to establish sodium content targets for processed foods, in line with the WHO Global Sodium Benchmarks and enforce them though these policies.

 THE WAY FORWARD

 • Nutrition labelling Mandatory nutrition labelling policies and other measures can enable consumers to make an informed selection of manufactured products at the point of purchase. Nutrition labelling policies and other measures can prevent labelling that is false, misleading or deceptive, or is likely to create an incorrect view about any characteristics of the product.;should also include nutrient declarations, including sodium, on the back of the package, as well as clear and simple interpretive front-of-pack labelling schemes to indicate products that do not meet basic nutritional criteria.

 Marketing restrictions. Implementing mandatory marketing restrictions is needed to limit exposure to unhealthy foods and beverages, to decrease demand for these products, and to provide industry incentive to reformulate and market healthier products.

  Fiscal policies. There is growing evidence for the triple-win impact of fiscal measures: they can promote healthy foods, discourage the purchase of unhealthy food products, and boost revenue for government budgets. Fiscal policies to reduce population sodium intake include taxes on unhealthy foods and beverages, or removing tax benefits for the development and marketing of foods high in sodium. They can be strengthened by earmarking revenue for subsidies for fresh fruits and vegetables, or for implementation of other sodium reduction strategies.

Dr Tedros Adhanom Ghebreyesus; WHO Director-General

LEARNING FROM HOME/ WITHOUT CLASSES/ BASICS

Sodium is a mineral which is made up of approximately 40% sodium and 60% chloride. The sodium in salt is an important mineral for the human body to maintain fluid balance.

Sodium is an essential nutrient involved in the maintenance of normal cellular homeostasis, and in the regulation of fluid and electrolyte balance. It is crucial for maintaining extracellular fluid volume because of its osmotic action; and it is equally important for muscle and nerve cell function, and for the transport of nutrients through plasma membranes .

However, only small quantities are needed by the body and its excess can increase the risk of high blood pressure, kidney disease and stroke. Excessive salt intake is the single most significant cause for hypertension which predisposes an individual to heart problems.

Sodium reduction plays a key role in protecting populations from the burden of noncommunicable diseases, namely, cardiovascular disease which is the number one cause of death and disability globally. The evidence is clear: the more sodium we consume the more our blood pressure rises, and blood pressure is reduced when dietary sodium intake is reduced. Reducing sodium intake is one of the most cost-effective ways to improve health, On average, we consume over 4 mg sodium every day, which is double the amount recommended by WHO.