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Action on salt will mean longer, healthier lives

Most people in the world eat five times as much salt as they need to be healthy. Daniel Y. Go

Non-communicable diseases – Jacqui Webster looks at strategies for reducing the salt content of our diets.

Non-communicable diseases (NCDs) – typically cardiovascular diseases, cancer, respiratory diseases and diabetes – are all caused by lifestyle factors such as smoking, lack of physical activity and poor diets, which includes high salt intake.

People only need about one or two grams of salt a day to be healthy but most people in most countries are now eating around five times this amount.

Growing awareness of the dangers posed by NCDs means the importance of implementing national salt reduction strategies has obtained renewed recognition in recent months.

More than a grain

Eating too much salt causes blood pressure to rise progressively with age in most people – one of the biggest predictors of developing cardiovascular disease in later life.

High salt intakes also lead to a range of other illnesses including kidney disease, stomach cancer and osteoporosis.

The evidence for this is compelling – as is evidence that it’s possible to reduce population salt intake through programs targeting the food industry’s use of salt in parallel with changing people’s attitudes and behavior.

In view of this, the World Health Organisation (WHO) has been advocating for countries to reduce population salt intakes for over a decade and more than 32 countries now have strategies in place.

Local action

The Australian Division of World Action on Salt and Health (AWASH) was established in 2005 and in May 2007 launched the Drop the Salt! campaign.

AWASH’s primary objectives were to engage the food industry to reduce salt in foods and to persuade the Australian government to make salt reduction a national priority. While the campaign has had some success on both fronts, the battle is far from won.

The Australian food industry was quick to come on board with over 20 major national companies making commitments to reduce salt within the first few years of the campaign.

But then, in 2010, the Department of Health and Ageing established the Food and Health Dialogue, bringing together food companies, public health groups and government organisations to agree on salt level targets for processed foods in line with AWASH’s objectives.

This should have heralded huge health benefits but the progress of the Food and Health Dialogue has been slow and piecemeal – some would say deliberately so.

Rather than building on the technical knowledge amassed in other countries, it appears to have started from scratch and yielded to the pressure of the food industry to set less stringent targets.

To date, there are only a handful of targets for salt levels in foods compared to over 80 in the United Kingdom, the United States and Canada, all established over a shorter time scale.

Best practice

Targets for salt levels in foods have been key to the success of the United Kingdom’s salt reduction strategy which reduced salt intake by one gram (10%) per person in the first few years. The program has since then been estimated to be saving around 6000 lives a year.

Why Australia should take so long to establish targets is unclear but lack of resources or strong government leadership on this issue is likely to be a factor.

This idea was reinforced by the Australian government’s recent decision not to support a strong target for all countries to reduce population salt intakes to five grams a day by 2025, which had been strongly called for by civil society groups.

And while the Health Minister’s commitment to $4 million funding to the WHO to implement its action plan to prevent NCDs made at the UN High-Level Meeting on Non-Communicable Diseases last week is welcome, the sums of money pledged pale into insignificance compared to the tens of billions that were raised to fight HIV/AIDS, tuberculosis and malaria at a similar summit a decade ago.

Leaders talk of an NCD crisis but an appropriate response at global level has yet to be seen.

A better way

Much more appropriate in scale is the $25 million pledged by Health Minister Nicola Roxon to help Pacific Island countries tackle non-communicable diseases.

Pacific Island nations have some of the highest rates of NCDs in the world and one of the key factors is changes in diet, particularly increased reliance on imported processed foods.

Most of these imports are from other countries in the Western Pacific Region including Australia and New Zealand.

So improving the nutritional composition of foods in Australia through the Food and Health Dialogue will also benefit Pacific Island peoples and we hope the Dialogue will become a high priority public health initiative.

New commitment to funding for preventing NCDs from the Australian government provides an excellent opportunity to consolidate existing work on salt reduction and monitoring of the food supply – the key to tackling NCDs in the region.

AWASH looks forward to continuing to work with the World Health Organization and the Australian Food and Health Dialogue to address this important issue.

This is the seventh part of our non-communicable diseases series. To read the other instalments, follow the links here:

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