WHO targets salt reduction with global benchmarks across 60-plus food categories

06 May 2021 --- In a bid to drive salt reduction, the World Health Organization (WHO) has published global benchmarks for sodium levels in more than 60 food categories. The organization hopes the benchmarks will show countries how they can progressively lower their targets based on their local food environments.

“This is the very first time WHO (and any other organizations to our knowledge) published “global” sodium benchmarks,” Dr. Rain Yamamoto, a scientist at WHO’s department of nutrition and food safety’s healthy and sustainable diet unit, tells NutritionInsight.

The suggestions also aim to encourage industry to lower the sodium content in processed foods accordingly and advance toward the WHO goal of 30 percent reduction in global salt and sodium intake by 2025.

“Current reformulation efforts have been inadequate. There is not enough progress at the moment, and urgent and drastic actions are necessary,” urges Yamamoto. 

“We need countries to establish policies to reduce salt intake and provide people with the information they need to make the right food choices. We also need the food and beverage industry to cut sodium levels in processed foods,” adds Dr. Tedros Adhanom Ghebreyesus, WHO’s director-general.

WHO’s new benchmarks give countries and industry a starting point to review and establish policies to transform the food environment and save lives, he emphasizes.Globally, the consumption of processed food is a rapidly increasing source of sodium.

Targeting 18 categories
The WHO Global Sodium Benchmarks target a wide range of 18 categories of processed and packaged food products that significantly contribute to overly salty diets. Processed and packaged bread, savory snacks, meat products and cheese are among the categories of high-sodium food products identified for the new global benchmarks.

The benchmarks are set as maximum targets as this was considered to be the most feasible approach for global benchmarks. They are also set as single values, rather than as a range of acceptable values, because it is considered important to be working toward a single, harmonized global goal.

These benchmarks are based on currently existing national or regional lowest maximum targets. 

For example, the benchmark for crackers and savory biscuits is 600 mg sodium per 100 g, which is in line with Paraguay’s targets. 

Other food categories with benchmarks include:

• Potato, vegetable and grain chips: 500 mg per 100 g, in line with Australia. 
• Highly processed breakfast cereals: 280 mg per 100g g, in line with Slovenia.
• Processed cheese: 720 mg per 100 g, in line with the UK. 
• Leavened bread: 330 mg per 100 g, in line with Hungary. 
• Meat analogs: 250 mg per 100 g, in line with the UK.

Yamamoto also flags that regional and national adaptation will be important. 

“Countries can adapt the benchmarks to fit their food environments, so they are free to add food categories that are considered important sources of sodium in their country. Also they can take a phased-approach and set progressive targets to facilitate implementation in their country’s context, if necessary,” she details. 

Addressing blind spots
WHO found that there were no appropriate benchmarks identified from existing country examples for nut butters, dry-mixes for sweet bakery, extra-hard ripened cheese, mold-ripened blue cheese and brine-stored cheese.

This was because the existing lowest maximum levels were considered too high, especially since there are products that contain much lower sodium on the market today. A review of possible alternative methods (including market data analysis) is being carried out at present to explore the possibility of setting a global benchmark.

Overall, the benchmarks are intended to serve as a basis for dialog with the food and beverage industry to improve the food environment at the global level, following on from the “constructive dialog” on the reduction of industrially-produced trans-fatty acids.

WHO also positions the benchmarks as a call for accelerated action from Member States in scaling up their efforts to reduce their populations’ sodium intake. They are designed to be complementary to existing and ongoing national and regional efforts and initiatives, and are intended to serve as a reference for such initiatives, where needed.The benchmarks aim to help countries reduce sodium contents in foods to improve diets and save lives.

A global issue
WHO further stresses that reducing sodium content by reformulating processed foods is a proven strategy to reduce population sodium intake, particularly in places where consumption of processed foods is high. 

It can also prevent processed foods from becoming a major source of sodium in countries where consumption of these manufactured foods may be rapidly increasing.

“Access to affordable, healthy foods is critically important for all people in every country,” says Dr. Tom Frieden, president and CEO of Resolve to Save Lives, an initiative of global health organization Vital Strategies.

“These global benchmarks are an important first step. As consumer tastes adjust and technology advances, country governments and the WHO can steadily reduce them over time until population sodium reduction goals have been met. When we reduce sodium gradually, our food will still taste great, and only our hearts will know the difference,” he argues.

Challenges remain
Yamamoto states that sodium reformulation still faces a host of challenges, including those put forward by industry like consumer preference and a need to tailor solutions for different countries.

“However, sometimes there are similar or even the same products sold with different sodium content in different countries. We need to remove these regional differences and disparities,” she explains

She further argues that sodium should be lowered equally in all countries. “We need governments’, consumers’, civil society organizations’ and all stakeholders’ actions, support and demand for lower sodium and salt content in processed foods.”

WHO cites the UK as an example of effective voluntary targets for food manufacturers to reformulate products. They decreased adult salt intake by approximately 15 percent between 2003 and 2011, indicating that target-setting across multiple food categories can achieve meaningful reductions in sodium consumption.  

In February, researchers determined that the UK’s national salt reduction program could prevent almost 200,000 cases of heart disease and save £1.64 billion (US$2.3 billion) in healthcare costs if better enforced by 2050. 

The UK’s ongoing battle against sugar reduction has also come under fire after voluntary measures drove a drop of just 3 percent. This has spurred calls for stronger – and compulsory – regulation.

By Katherine Durrell