National salt guidelines ignore WHO advice, says professor

By Jess Halliday

- Last updated on GMT

Related tags: Salt intake, South america, Africa

Global salt intake is still too high, according to a leading
academic, and many countries ignore the WHO's advice on a maximum
intake of 5g/day by issuing guidance far in excess.

Excess salt intake is linked to an increased risk of cardiovascular disease by raising blood pressure - the main cause of strokes and a major cause of heart attacks. In addition, a high salt diet has been connected to other adverse effects and diseases, such as osteoporosis, cancer of the stomach, asthma and obesity. Professor Franco Cappuccio of the University of Warwick Medical School, UK, recently presented a report on reducing salt intake in world populations to the World Health Organisation. During the course of his research he found huge differences in salt intake advice between countries, indicating that there is still much to be achieved in raising awareness and finding ways to encourage people to eat less - whether that be through education or reformulation of foods. The WHO intake goal of less than 5g per day is contained in the joint WHO/FAO report on diet, nutrition, and the prevention of chronic diseases. But Prof Cappuccio said: "Efforts to reduce salt intake are still not a reality in many countries and recommendations must result in action, which should be tailored to the national context."Voluntary, as well as statutory initiative are thus necessary." ​ But in Europe, national guidance varies from Belgium, which has one of the highest at less than 8.75 grams a day, to Portgual which recommends less than 5g. In some countries such as Greece and Hungary no specific quantities are given but consumers are simply advised to "avoid salt and foods rich in salt".​ In the UK, which has one of the liveliest campaigns for salt reduction, the recommendation is less than 6g per day - around half of current average consumption - spearheaded by the Food Standards Agency. According to the UK's Food and Drink Federation (FDF), a survey last year showed that its members reformulated £7.4bn worth of products to have lower levels of salt compared to the year before, while £2.4bn worth of products have been launched with lower salt variants. However the organisation Consensus Action on Salt and Health wants even more to be done. It recently urged consumers to boycott foods that still contain large and unnecessary amounts of added salt. It said that shoppers should not to buy products that contain either more than 1.25g of salt (0.5g of sodium) per 100g or more than 2.4g of salt per serving, and hopes that this will force manufacturers to take action and reformulate excessively salty foods. "If we halve our salt intake, i.e. make a reduction of 6g/day from the current intake of 10-12g, we will save approximately 70,000 people [in the UK] from developing strokes and heart attacks each year, 35,000 of which are fatal,"​ said CASH chairman Graham MacGregor. Australia, New Zealand, Canada and the US share the less than 6 grams/day guidance. But according to Prof Cappuccio, it's grim story in Asia, only four countries have any guidance at all, ranging from less than 5g per day in Singapore to less than 10g per day in Japan. Guidance is also patchy in Africa and South America. Nigeria and South Africa are the only two African countries to have any guidance at all, and Brazil is the only South American country with specific guidance (in line with the WHO's less than 5g per day). "The lack of policies and/or recommendations to reduce salt intake in African and Latin American countries demonstrates regional differences in the work achieved to date to tackle this risk factor for cardiovascular disease,"​ said Prof Cappuccio. In some countries where iodine deficiency is common, the salt problem is compounded by conflicting advice. On the one hand people are advised to use iodized salt, but on the other hand they are advised not to consume too much salt because of the potential effect on the cardiovascular system. Prof Capuccio is believes that such policy should be "urgently revisited".

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