In analyzing sodium levels of processed meat and fish in five major countries, a new BMJ Open study has revealed the highest concentrations can be found in China and the US. 

The World Health Organization (WHO) set a 30% global reduction in salt intake by 2025. The BMJ study set out to gauge progress against this target and focused on the salt content of processed meat and fish products in three developed and two developing countries – the UK, US, Australia, China and South Africa.

Speaking to FoodIngredientsFirst, Dr. Rain Yamamoto, scientist of the safe, healthy and sustainable diet unit at WHO, says: “It is a first-ever globally harmonized set of benchmarks for about 60 food categories that define the maximum levels of sodium that processed foods can contain.”

“The food categories for which the global benchmarks were established are commonly consumed processed foods, major contributors to sodium intakes, which include meat and fish products,” she explains. 

Challenges of salt reduction 
In many high-income countries and also increasingly in low- and middle-income countries, a significant proportion of sodium in the diet comes from manufactured foods, including bread, processed meats and dairy products. 

High dietary salt intake, often from processed meat or fish, is a significant cause of high blood pressure, cardiovascular disease, kidney disease and death.According to Yamamoto, an effective way to reduce population sodium intake is through reducing the sodium content of such manufactured foods.

The researchers recognize that it is not easy for food producers or manufacturers to simply replac or reformulate the high sodium products that have already existed for years. 

“The large difference in the sodium content of similar products in different countries, and the difference in sodium content among different brands within the same country, indicate that there is still a lot of room for salt reduction,” the researchers explain.

High dietary salt intake is a significant cause of high blood pressure, cardiovascular disease, kidney disease and death. WHO recommends a maximum salt intake of 2,000 mg a day.

Yamamoto stresses the  importance of reducing the sodium content in these products to, firstly, eliminate regional disparity as similar processed food products often contain different amounts of sodium in different countries.

“All countries should benefit from lower sodium in foods. In this sense, the global benchmarks are meaningful in providing a unified harmonized goal for everyone,” she outlines. 

Food nutrition labels tell a story
The five surveyed countries each have strategies to reduce dietary salt intake. 

The countries are also part of The International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support (INFORMAS), which collates and tracks the nutritional content of processed foods globally. 

WHO recommends a maximum salt intake of 2,000 mg per day.The UK’s salt reduction targets set in 2017 were used to assess the percentage of products reaching those levels across the countries analyzed.

Yamamoto outlines that the common arguments used against lowering the levels of salt content is consumer preference.

“If the plea to lower salt content also comes from consumers, that will be a huge incentive and push for industry to reformulate their products to reduce salt content,” she explains.

The study analyzed the labels of 26,500 (78%) products sourced from major supermarket chains. The total number ranged from 885 for the UK to 17,098 for the US.

They were then ranked according to a traffic light system, wher sodium level was defined as low when below 120 mg/100 g; medium between 120 and 599 mg/100 g and high when above 600 mg/100 g.

Overall sodium content of meat and fish products in each country was high, with only 10% of the products in the UK and US, and no more than 5% in China and South Africa, falling into the green light category.

The UK had the highest percentage of products, achieving its own 2017 salt reduction targets, except for bacon products with just 14% of the target reached. This compares with 28% in the US, 50% in Australia, 75% in South Africa, and 85% in China. 

A significant portion of sodium in the diet comes from manufactured foods including bread, and processed meats such as hamburgers. WHO warns Member States not on trackProgress towards the global target to which the Member States committed in 2013 is insufficient and the world is not currently on track to meet that goal. 

Yamamoto stresses that the current reformulation efforts are “inadequate” but she is hopeful that improvement is possible. 

“Country experience suggests that well-designed strategies with clear targets can lead to considerable progress. This has been demonstrated in the UK, for example.”

Setting sodium targets at a country level is an important step towards reducing population sodium intake, explains Yamamoto. 

Global sodium benchmarks are useful for countries in setting national policies and strategies, and for the ongoing dialogue between WHO and the private sector at the global level.

Shortcomings in research
The researchers of the BMJ Open study acknowledge several limitations to their findings, including that these are based on purchases from seleced outlets at one point in time. 

In addition, the researchers did not capture food purchasing data to quantify the actual sodium consumption of processed meat and fish products.

Data collection spanned several years, from 2012 to 2018, during which time product reformulation may have occurred, they suggest.

For example, the US recently announced sodium reduction targets for a broad range of processed, packaged and prepared foods.

A previous study from the University of Illinois also emphasized that most people in the US consume too much salt. 

Meanwhile, salt and sodium reduction remains high on the agenda for food manufacturers and brands who endure increased pressure from WHO to drive down salt intake.