Dietary sodium reduction in Canada: more action is needed to reach the 2025 global targets.

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Date: Mar. 14, 2022
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 10)
Publisher: CMA Impact Inc.
Document Type: Article
Length: 1,704 words
Lexile Measure: 1830L

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Key points

* The World Health Organization prioritized dietary sodium reduction and declared a "30% reduction in population sodium intakes by 2025" as 1 of 9 global targets for noncommunicable disease prevention.

* Although Canada has seen some success in sodium reduction, most people in Canada still consume more sodium than recommended.

* Policy-makers should promote food reformulation and improve nutrition labelling and marketing.

* Health care providers should routinely screen patients and advise them on dietary sodium as necessary to manage and prevent disease.

* Public education and use of sodium self-screening tools could help people take personal action in limiting their sodium intake.

Excess dietary sodium is a leading dietary risk factor for death and disability worldwide, owing to its adverse impacts on cardiovascular health. (1) The World Health Organization prioritized dietary sodium reduction as a "best buy" population health intervention, and included a "30% reduction in population sodium intakes by 2025" as 1 of 9 global targets for noncommunicable disease prevention. (2) This goal is supported by a recent meta-analysis showing a linear association between high sodium intake and cardiovascular disease and death, with a 26% reduction in risk of cardiovascular disease and a 16% reduction in risk of death at the population level when mean sodium intake decreased from 3646 mg/d to 2690 mg/d. (3,4)

In 2010, a Sodium Reduction Strategy was adopted by Canada's federal government and was strongly endorsed provincially. The importance of sodium reduction was re-emphasized in 2019 with Canada's revised Food Guide (https://food-guide.canada.ca). Although Canada has seen some success in sodium reduction, most people in Canada consume more sodium than recommended, with 97% of men and 81% of women exceeding the Adequate Intake level (1500 mg/d), and 74% of men and 49% of women exceeding the Chronic Disease Risk Reduction level (< 2300 mg/d). (5) In 2017, high dietary sodium was associated with more than 150 000 disability-adjusted life years in Canada. (2) Here, we discuss the action that is needed to support people in Canada to reduce their sodium intake and ensure that Canada meets the 2025 global target for dietary sodium.

Strong policy interventions to create a supportive food environment are essential to achieve sodium reduction. In Canada, people obtain most of their dietary sodium from packaged and restaurant foods (e.g., bakery products, processed meats, soups, condiments); salt added during cooking or at the table accounts for only 11% of sodium intake. (6) Reducing sodium in packaged foods is currently left to the discretion of food manufacturers, guided by Health Canada's targets for sodium reduction. However, since 2010, the change in...

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