WHO Global report on sodium intake

Functions of Sodium

• Essential nutrient involved in the maintenance of normal cellular homeostasis and in the regulation of fluid and electrolyte balance.
• Crucial for maintaining extra-cellular fluid volume because of its osmotic action.
• Essential for muscle and nerve cell function.
• Essential for transport of nutrients through plasma membrane.
• In many high-income countries, and increasingly in low- and middle-income countries, a significant proportion of sodium intake can be attributed to processed food. 

Guidelines for Sodium Intake

Sodium intake is extremely unlikely in healthy individuals. The minimum intake level required for physiological needs is not well established although it is estimated to be <500 mg/day. Hence, most populations are consuming much more sodium than sodium than is physiologically necessary.

However, there adverse effects with a diet high in sodium:

• Raised blood pressure.
• Gastric cancer
• Obesity
• Meniere’s disease
• Osteoporosis

WHO Guidelines on Sodium Intake recommends

• A reduction in sodium intake to reduce blood pressure and risk of cardiovascular disease, stroke and coronary heart disease in adults. WHO recommends a maximum intake of <2000 mg/day sodium (<5g/day salt) in adults.
• A reduction in sodium intake to control blood pressure in children. Recommended maximum intake of <2000 mg/day sodium and (<5 g/day salt) in adults should be adjusted downward based on the energy requirements of children relative to those of adults.
• Lowering sodium content in food products
• Implementing front of pack labelling to help consumers select food products with lower sodium content.
• Conducting mass-media campaigns to alter consumer behaviour around sodium.
• Implementing public food procurement and service policies to reduce sodium content in food served or sold. 
• All 194 Member States of WHO have committed to reducing population sodium intake by 30% by 2025 in 2013. However, as no country in the world is on track to attain this target. WHO has proposed 30% reduction target for 2030.
• WHO has documented progress to date on policies through Sodium Country Score Card. It assesses country implementation of sodium reduction policies and other measures, allocating a score from 1 (for lowest level of implementation) to 4 (for highest level of implementation).

Suggestions for reducing Sodium Intake

• Maximum sodium content limits in foods: Setting of global sodium benchmarks is critical to facilitate reformulation of food products, which contributes to driving progress in sodium reduction.
• Healthy public food procurement & service policies: Government should lead by example through the implementation of mandatory policies of sodium reduction that cover food and beverages purchased, subsidised, prepared, served in public agencies.
• Nutrition Labelling: This tool empowers informs consumers about ingredients; nutrition content of food and influences consumers to make healthier choices and induce food manufactures to develop healthier food products. Mandatory labelling policies should also include nutrient declarations, including sodium, on the package and clear and simple interpretive front of pack labelling schemes.
• Marketing restrictions: Implementing mandatory marketing restrictions is needed to limit exposure to unhealthy foods and beverages, to decrease demand for these products and to provide industry incentive to reformulate and market healthier products.
• Fiscal policies: Fiscal policies to reduce population sodium intake include taxes on unhealthy foods and beverages or removing tax benefits for development and marketing of foods high in sodium. They can be strengthened by earmarking revenue for subsidies for fresh fruits and vegetables, or for implementation of other sodium reduction strategies.
• Prioritisation: Action is required to increase the demand for change, drive societal shift, catalyse response and influence policy and decision makers to prioritise mandatory legislation.
• Data: Regular reporting of data on sodium content in foods, and global access to such data, are needed to develop, monitor and evaluate sodium reduction policies and other measures.