Sodium reduction

About sodium

• Sodium is an essential nutrient necessary for the maintenance of plasma volume, acid-base balance, transmission of nerve impulses and normal cell function.
• Sodium deficiency is extremely unlikely in healthy individuals.
• Excess sodium is linked to adverse health outcomes including increased blood pressure.
• The primary contributors to dietary sodium consumption depend on the cultural context and dietary habits of a population.
• Sodium and chloride are the main components of regular table salt, but sodium can be found in other forms and is also found naturally in a variety of foods such as milk, meat, and shellfish. It is often found in high amounts in processed foods such as breads, processed meat, and snack foods, as well as in condiments (e.g., soy and fish sauce).
• Sodium is also contained in sodium glutamate, which is used as a food ingredient and additive in many parts of the world.

Recommendations for reducing sodium

• For adults, WHO recommends less than 2000 mg/day of sodium (equivalent to less than 5 g/day salt), or just under a teaspoon.
• For children aged 2–15 years, WHO recommends adjusting the adult dose downward based on their energy requirements. This recommendation for children does not address the period of exclusive breastfeeding (0–6 months) or complementary feeding with continued breastfeeding (6–24 months).
• If choosing to use table salt, WHO suggests replacing regular table salt with lower-sodium salt substitutes that contain potassium.
• All salt that is consumed should be iodized (fortified with iodine), which is essential for healthy brain development in the foetus and young child and optimizing mental function in general.

Public health interventions for sodium reduction

WHO has identified a set of evidence-based best buy interventions to tackle noncommunicable diseases. It undertaken immediately, these interventions are expected to accelerate results in terms of lives saved, healthy years of life gained, cases of disease prevented, and costs avoided. 

There are 4 best buys for sodium reduction:

• reformulate food products to contain less sodium and set target levels for the amount of sodium in foods and meals;
• establish a supportive environment in public institutions such as hospitals, schools, workplaces and nursing homes to provide lower sodium options;
• implement front-of-pack labelling; and
• apply  behaviour change communication and mass media campaigns.

The development, implementation, monitoring, and evaluation of sodium reduction policies should be government-led and safeguarded against possible conflicts of interest.