Canadian Initiatives to Prevent Hypertension by Reducing Dietary Sodium

Abstract

Hypertension is the leading risk for premature death in the world. High dietary sodium is an important contributor to increased blood pressure and is strongly associated with other important diseases (e.g., gastric cancer, calcium containing kidney stones, osteoporosis, asthma and obesity). The average dietary sodium intake in Canada is approximately 3400 mg/day. It is estimated that 30% of hypertension, more than 10% of cardiovascular events and 1.4 billion dollars/year in health care expenses are caused by this high level of intake in Canada. Since 2006, Canada has had a focused and evolving effort to reduce dietary sodium based on actions from Non Governmental Organizations (NGO), and Federal and Provincial/Territorial Government actions. NGOs initiated Canadian sodium reduction programs by developing a policy statement outlining the health issue and calling for governmental, NGO and industry action, developing and disseminating an extensive health care professional education program including resources for patient education, developing a public awareness campaign through extensive media releases and publications in the lay press. The Federal Government responded by striking a Intersectoral Sodium Work Group to develop recommendations on how to implement Canada’s dietary reference intake values for dietary sodium and by developing timelines and targets for foods to be reduced in sodium, assessing key research gaps with funding for targeted dietary sodium based research, developing plans for public education and for conducting evaluation of the program to reduce dietary sodium. While food regulation is a Federal Government responsibility Provincial and Territorial governments indicated reducing dietary sodium needed to be a priority. Federal and Provincial Ministers of Health have endorsed a target to reduce the average consumption of sodium to 2300 mg/day by 2016 and the Deputy Ministers of Health have tasked a joint committee to review the recommendations of the Sodium Work Group and report back to them.

The Economic Impact of Dietary Sodium Reduction In Canada

“…Over 27 national and international organizations, including Hypertension Canada, the World Health Organization, Canadian Heart and Stroke Foundation, and the American Heart Association have reviewed the literature, and all support population-wide efforts to reduce dietary sodium consumption (92,120,121). However, concerns still exist among a small group of people who believe that the level of dietary sodium consumption has no impact on the risk of CVD (43).…”

“…In Canada, of the estimated average sodium consumption of 3800 mg/day, 77% is from processed food, 12% is naturally occurring, 6% is added at the table, and 5% is added during cooking. The main source of dietary sodium is processed food, fast food, restaurants and takeaways (121). The consumer has little control over the amount of sodium that is added in this food type.…”

“…The SWG determined the major dietary sources of sodium, and how to reduce sodium additives in various food categories to achieve dietary sodium intake targets. The Federal Minister disbanded the SWG in 2011, and there was no longer a group that could monitor whether companies reduced the level of sodium in their food products (121 Reducing sodium content in processed food is complex and there has been resistance from the food industry (127). Changes in sodium additives are often detectable and alter the taste of the food product, which could result in consumers changing their preferences to another food product.…”

“…This led to an additional 20 million people in the UK saying they would cut dietary sodium consumption, and half of them said they now check food labels (120). Similar to the goals of the consumer awareness campaign in the UK, Canada created a small task force to develop and array of tools to disseminate information to the public, healthcare professionals, and policy makers (127,131 Canada could achieve a more successful national population-wide dietary sodium reduction strategy.…”

Effect of Genetic Information Regarding Salt‐Sensitive Hypertension on the Intent to Maintain a Reduced Salt Diet: Implications for Health Communication in Japan

“…Numerous studies have demonstrated the association of high salt intake with high blood pressure (BP), which increases the risk of cardiovascular disease. Salt intake is also associated with an increased risk of stomach cancer as well as obesity, renal disease, osteoporosis, and other diseases . Several countries have initiated salt‐reduction programs that include efforts such as encouraging food suppliers to voluntarily decrease salt content and improving public awareness and knowledge .…”