Dietary Salt Policy Statement

The following information comes from the "Policy Statement – Preventing cardiovascular disease in the Americas by reducing dietary salt intake population-wide". Click here to download the complete policy statement.

Policy Statement – Preventing cardiovascular disease in the Americas by reducing dietary salt intake population-wide

A group of independent experts on salt and health, convened by the Pan American Health Organization (PAHO), has produced this policy statement. It has the rationale and recommendations for a population-based approach to reduce dietary salt intake among all people in the Americas, be they adults or children.

Policy Goal
A gradual and sustained drop in dietary salt intake to reach national targets or the internationally recommended target of less than 5g/day/person by 2020.

Audience
Policy and decision makers in government, leaders in non-governmental organizations (representing consumers, health, scientific and health care professionals), civil society, the food industry (including food processors and distributors), among food importers and exporters, and in PAHO.

Prevalence of Hypertension
About one in four adults worldwide had hypertension in 2000. (1) As populations age, rates of hypertension will increase. The Framingham study found that 90% of normotensive people aged 55 to 65 will develop high blood pressure if they reach average life expectancy. (2) By 2025, without intervention, 29% of adults around the world are expected to have hypertension. (1)

In Canada, one in five adults has hypertension (3) and in the United States, 29% of adults were estimated to be hypertensive in 2003-04. (4) In the different countries of Latin America, the prevalence of hypertension ranges from 26 to 42% of the general adult population. (5)

Non-optimal Blood Pressure, Health and Salt
WHO states that increasing blood pressure world-wide is the leading risk factor for death (6) and the second leading risk for disability by causing heart disease, stroke and kidney failure. (7)

Whereas most health care professionals consider systolic blood pressure at 140 mmHg and over to be "hypertension", the relative risk for cardiovascular diseases (CVD) begins to rise when blood pressure goes above 115 mmHg. Thus a much wider range of non-optimal blood pressure is adversely affecting health, and has been attributed to most CVD deaths from ischemic heart disease and stroke. (8)

There is strong evidence that salt added to food is a major factor increasing the blood pressure in normotensive and hypertensive people, whether adults or children. A high salt diet also increases the risk of left ventricular hypertrophy and kidney damage, is a probable cause of gastric cancer, and has possible associations with osteoporosis, calcium containing renal stones and increased severity of asthma. Because salty foods cause thirst they are likely an important contributor to obesity, especially among children and adolescents, through association with increased consumption of high-calorie soft drinks. (9,10,11).

A technical report for the WHO and FAO recommends salt intake of less than 5g/day/person, the target for a healthy diet, equivalent to 2000 mg of sodium. (12) Among the countries in the Americas where standardized and comparable sodium excretion was studied, salt intake was found to be as high as 11.5g/day/person. (13) Data for the United States for 2005-06 show average daily intake of sodium among people aged 2 years and over to be 1.5 times the recommended upper limit (UL). (14) In Canada, over 85% of men and 60% of women between 19 and 70 years of age have salt intake exceeding the UL. Over 90% of Canadian children aged 4 to 8, and 83% of girls and 97% of boys aged 9 to 13 ingest more than the recommended maximum. The situation is the same in almost 80% of Canadian children between ages 1 and 3. (15).