Recent data on salt intake levels in India show consumption is around 11 g per day, higher than the World Health Organization’s (WHO) recommended intake of 5 g per day. However, high-quality data on sources of salt in diets to inform a salt reduction strategy are mostly absent. A cross-sectional survey of 1283 participants was undertaken in rural, urban, and slum areas in North (n = 526) and South (n = 757) India using an age-, area-, and sex-stratified sampling strategy. Data from two 24-h dietary recall surveys were transcribed into a purpose-built nutrient database. Weighted salt intake was estimated from the average of the two recall surveys, and major contributors to salt intake were identified. Added salt contributed the most to total salt intake, with proportions of 87.7% in South India and 83.5% in North India (p < 0.001). The main food sources of salt in the south were from meat, poultry, and eggs (6.3%), followed by dairy and dairy products (2.6%), and fish and seafood (1.6%). In the north, the main sources were dairy and dairy products (6.4%), followed by bread and bakery products (3.3%), and fruits and vegetables (2.1%). Salt intake in India is high, and this research confirms it comes mainly from added salt. Urgent action is needed to implement a program to achieve the WHO salt reduction target of a 30% reduction by 2025. The data here suggest the focus needs to be on changing consumer behavior combined with low sodium, salt substitution.
Objective:Our study analysed evolving regional commitments on food policy in the Pacific. Our aim was to understand regional priorities and the context of policy development, to identify opportunities for progress.Design:We analysed documentation from a decade of regional meetings in order to map regional policy commitments relevant to healthy diets. We focused on agriculture, education, finance, health, and trade sectors, and Heads of State forums. Drawing on relevant political science methodologies, we looked at how these sectors ‘frame’ the drivers of and solutions to non-communicable diseases (NCD), their policy priorities, and identified areas of coherence and tension.Setting:The Pacific has among the highest rates of non-communicable diseases in the world, but also boasts an innovative and proactive response. Heads of State have declared NCD a ‘crisis’ and countries have committed to specific prevention activities set out in a regional ‘Roadmap’. Yet, diet-related NCD risk-factors remain stubbornly high and many countries face challenges in establishing a healthy food environment.Results:Policies to improve food environments and prevent NCD are a stated priority across regional policy forums, with clear agreement on the need for a multi-sectoral response. However, we identified challenges in sustaining these priorities as political attention fluctuated. We found examples of inconsistencies and tension in sectoral responses to the NCD epidemic that may restrict implementation of the multi-sectoral action.Conclusion:Understanding the priorities and positions underpinning sectoral responses can help drive a more coherent NCD response, and lessons from the Pacific are relevant to public health nutrition policy and practice globally.
This review aims to summarize and synthesize studies reporting on changes in sodium levels in packaged food products, restaurant foods, and hospital or school meals, as a result of salt reduction interventions. Studies were extracted from those published in the Science of Salt Weekly between June 2013 and February 2018. Twenty‐four studies were identified: 17 assessed the changes in packaged foods, four in restaurant foods, two in hospital or school meals, and one in both packaged and restaurant foods. Three types of interventions were evaluated as part of the studies: voluntary reductions (including targets), labeling, and interventions in institutional settings. Decreases in sodium were observed in all studies (n = 8) that included the same packaged foods matched at two time points, and in the studies carried out in hospitals and schools. However, there was little to no change in mean sodium levels in restaurant foods. The pooled analysis of change in sodium levels in packaged foods showed a decrease in sodium in unmatched food products (−36 mg/100 g, 95% CI −51 to −20 mg/100 g) and in five food categories—breakfast cereals, breads, processed meats, crisps and snacks, and soups. Twenty‐two of the 24 studies were from high‐income countries, limiting the applicability of the findings to lower resource settings.
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