Equality in national initiatives in salt reduction programmes needed, say authors
The September Nutrition Society Paper of the month is from Public Health Nutrition and is entitled ‘Current salt reduction policies across gradients of inequality-adjusted human development in the WHO European region: minding the gaps’.
A new review published in Public Health Nutrition links salt intake reduction policies across EU member states to the socio-economic status of those countries and their citizens.
The study found that countries with no national salt reduction initiatives had lower levels of inequality-adjusted human development. A lack of coordinated efforts to address this disparity could lead to widening social and health inequalities.
Evidence from low- and middle-income countries (LMIC) and across the EU member states has confirmed that the quality of food intake is affected by socio-economic variables. Studies have shown that members of higher socio-economic groups typically consume more of the recommended food groups (e.g. vegetables and fruit) than lower socio-economic groups. A 2000–01 National Dietary and Nutrition Survey in Britain also revealed salt intake was higher in low socio-economic groups.
It has been proposed that, as a result of these patterns of dietary inequality, higher salt intakes among the lower socio-economic groups lead to raised blood pressure levels and risk of cardiovascular disease (CVD). Poor fruit and vegetable consumption in this same population reduces potassium intake, another factor linked to high blood pressure. Inequalities in nutritional and economic status like these translate ultimately into inequalities in health.
In 2003, the World Health Organisation (WHO), in conjunction with the Food and Agriculture Organization (FAO), set a worldwide target of less than 5 g salt/day per person and, since 2006, WHO has been supporting the development of national salt reduction strategies by establishing networks in partnership with regional organizations worldwide. The authors consider the lack of policy initiatives with regard to salt reduction in more resource-limited countries a missed opportunity.
With non-communicable diseases (NCD) the leading cause of global mortality and hitting the world’s LMIC populations the hardest, the already weak and overburdened health systems have been put under considerable strain. The study identifies that population-based salt reduction initiatives are a critical part of the public health effort to tackle NCDs both in terms of mortality and morbidity.
The authors state: “Through highlighting patterns and disparities in the applications and impacts of national salt reduction initiatives across the WHO European region, our focus is on the potential of population-level responses to bridge rather than widen health and development gaps. The key is in designing, implementing, and monitoring actions through a rigorously equity-focused lens – making healthier choices, easier choices for all population groups.
The following paper is freely available via the link: http://journals.cambridge.org/phn/salt
‘Current salt reduction policies across gradients of inequality-adjusted human development in the WHO European region: minding the gaps’, Rodrigo Rodriguez-Fernandez, Margarida Siopa, Sarah J Simpson,Rachel M Amiya, Joao Breda and Francesco P Cappuccio
Nutrition Society Paper of the Month
Each month a paper is selected by one of the Editors of the five Nutrition Society Publications (British Journal of Nutrition, Public Health Nutrition, Nutrition Research Reviews, Proceedings of the Nutrition Society and Journal of Nutritional Science). This paper is freely available for one month.