More Flavor, Less Salt – One of the best buys for preventing and controlling NCDS

– PRESIDENTIAL COMMISSION ON THE PREVENTION AND CONTROL OF NCDS

This past week (March 8-14), the world observed World Salt Awareness Week. Across the world, our diet is too salty. We consume far too much salt. It is for this reason that World Salt Awareness Week 2021 is under the theme “MORE FLAVOR, LESS SALT”.

The Presidential Commission on the Prevention and Control of NCDs in Guyana joins with our colleagues in the Healthy Caribbean Coalition to remind our leaders that we made a commitment in 2007 to reduce, prevent and control NCDs in CARICOM countries and we agreed to a number of actions and, further, we articulated these commitments in the Port of Spain Declaration. The promotion of healthy diets is one of those commitments. We cannot have a healthy diet unless we adopt low-salt diets. One action will not result in CARICOM countries turning their backs on salty food. But scientific studies have shown that “front-of-pack” labeling works. The Presidential Commission on the Prevention and Control of NCDs in Guyana strongly advocate for ‘front-of-pack” labeling as one tool to combat high salt diets.

CROSQ must work with greater diligence to ensure that our debates end with a tangible policy direction on salt-related “front-of-pack” labeling. Since 2018 CROSQ has proposed changes to the 2010 CARICOM Regional Standards for Specification for labeling of prepackaged foods to incorporate front-of-package” labeling. CARICOM must make this a priority. The Presidential Commission is not convinced that CARICOM is doing all it needs to do to ensure that these packaging standards are adopted.     

Cardiovascular disease (CVD), the leading cause of death worldwide, kills 17 million people each year which represents 30% of all global deaths. In Guyana, CVD is also the leading cause of death. In fact, Guyana and Trinidad and Tobago rank as the highest in CVD deaths in the Americas. In CARICOM, CVD is also the leading cause of death. The major risk factor for cardiovascular disease is high blood pressure and excessive sodium (salt)intake is an important cause. Sodium consumption of more than 2g/d is estimated to cause 1.65 million cardiovascular related deaths each year, representing around 1 of every 10 deaths from cardiovascular causes. The World Health Organization (WHO) has recommended salt reduction as a ‘best buy’, recognizing it as one of the most cost effective and feasible approaches to prevent non-communicable diseases (NCDs).

That salt contributes significantly to CVD is not a new revelation. We have known this for decades. That our diet is too high in salt content is a well known fact and has been known for decades. Among the world’s highest salty diet are those in CARICOM countries. We have talked of implementing salt standards for food, including imported food. We have talked about food labeling as a means to control salt in food. We have made much progress in elevating the talk about salt and about doing something to curb the salt epidemic. Our latest talk is front-of-package labeling. But we have made little progress in implementing these “best-buys” for the prevention and control of NCDs.

We know salt in our diet is inimical to our health. We know we can replace salt with chilli, citrus, fresh herbs, garlic, black pepper and spices to have “MORE FLAVOR, LESS SALT”. We know sauces such as soy sauce, ketchup and salad dressings contain lots of hidden salt. And we know ALL salt is salt (even the posh sea, rock and pink salts!).

A total of 75 countries now have a national salt reduction strategy, more than double the number reported in a similar review done in 2010. The majority of programs are multifaceted and include industry engagement to reformulate products. Thirty-nine (39) countries have established sodium content targets for foods, 71 countries have implemented consumer education, 31 countries have statutorized front-of-pack labeling schemes, just 3 countries have placed taxation on high-salt foods and 54 countries have interventions in public institutions. Legislative action related to salt reduction such as mandatory targets, front-of-pack labeling, food procurement policies and taxation have been implemented in 33 countries. Sadly, only 12 countries have reported reductions in population salt intake, 19 reduced salt content in foods and 6 improvements in consumer knowledge, attitudes or behaviors relating to salt.

Guyana and CARICOM countries have not performed well in any of these measurements. We must change this dispensation. We must do much more, talk much less.   

That lowering salt in our diet works has been proven. For example, evaluation of the United Kingdom’s (UK) salt reduction strategy demonstrated a 15% reduction in population salt intake between 2003 and 2011 with average blood pressure in the adult population falling by 3/1.4mm Hg over the same period.

Following the Port of Spain Declaration, in 2011, the United Nations (UN) General Assembly convened a High-Level Meeting to address the Prevention and Control of NCDs worldwide. The General Assembly adopted the Political Declaration of the meeting, which committed all 193 member countries and states to the prevention and control of NCDs. Subsequently, at the 66th World Health Assembly, WHO Member States adopted the global target of a 30% reduction in mean population intake of salt/sodium by 2025. This was one of nine voluntary global targets set to achieve an overarching 25% reduction in premature mortality from CVDs, cancer, diabetes and chronic respiratory diseases by 2025. Guyana and CARICOM countries will not achieve these targets, unless we make drastic policy changes now.

Dr. Leslie Ramsammy

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