Packages of sodium (Salt) sold for consumption and salt dispensers should be required to have a front of package health warning label: A position statement of the World Hypertension League, national and international health and scientific organizations

Campbell, Norm R.C.; Webster, Jacqui; Blanco-Metzler, Adriana; He, Feng J; Tan, Monique; MacGregor, Graham A.; Cappuccio, Francesco P.; Arcand, JoAnne; Trieu, Kathy; Farrand, Clare; Jones, Alexandra; Zhang, Xinhua

doi:10.1111/jch.13698

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Excessive salt consumption is not only known to contribute to raised blood pressure but also increases the risk of CVD events and kidney disease [ 8 ]. The World Health Organisation (WHO) has recommended reducing salt consumption by 30% by 2025, with a long-term target of less than 5 g/day [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Whilst there is a large amount of research on how social mobilisation can address communicable diseases—for example HIV/AIDS [ 8 , 24 – 26 ], Ebola [ 27 , 28 ] and yellow fever [ 29 ], there has been little research to date considering how it can address NCDs. Among the limited research, social mobilisation has been used to encourage physical activity in Colombia [ 30 ], support to health promotion on reducing NCD risk factors in three Asian and Central American contexts [ 31 ] and involving communities in the development of responses to address alcohol and other drug abuse in South Africa [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

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Developing a social mobilisation intervention for salt reduction: participatory action research in Bombali district, Sierra Leone

Cheedella,

Conteh,

Zou

et al. 2023

BMC Public Health

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Background High salt intake is a major risk factor for hypertension, which in turn contributes to cardiovascular diseases, the major cause of death from non communicable diseases (NCDs). Research is limited on social mobilisation interventions to tackle NCDs, including in fragile health settings such as Sierra Leone. Methods Participatory action research methods were used to develop a social mobilisation intervention for salt reduction in Bombali District, Sierra Leone. A team of 20 local stakeholders were recruited to develop and deliver the intervention. Stakeholder workshop reports and interviews were used to record outcomes, enablers, and barriers to the intervention. Focus group discussions were used to observe knowledge, attitudes, and behaviours of community members pre- and post- the intervention. Results Stakeholders showed enthusiasm and were well engaged in the social mobilisation process around salt reduction. They developed radio jingles, radio show talks, organised community awareness raising meetings, school sensitisation outreaches, and door to door engagements. Stakeholders reported benefiting personally through developing their own skills and confidence in communication and felt positive about their role in educating their community. The interventions led to reported increased awareness of risks of high salt intake and NCDs, resulting in a reduction of salt use in the community, leading to perceived health gains. However, salt reduction was also met with some resistance due to social factors. Local community structures were also reactivated to work on the interventions and connect the community to the local health facility, which saw an increase in patients having their blood pressure checked. The comparison villages also experienced an increase in awareness and perceived reductions in salt intake behaviours. This was as messages had cascaded via the radio and initial focus group discussions. The social mobilisation stakeholders also agreed on future activities that could continue at no or low cost. Conclusion Social mobilisation interventions can provide low-cost strategies to tackle NCDs in fragile settings such as Sierra Leone through the utilisation of community structures. However, more research is required to ascertain the key enablers for replicability and if such successes can be sustained over a longer follow up period.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Developing a social mobilisation intervention for salt reduction: participatory action research in Bombali district, Sierra Leone

Cheedella,

Conteh,

Zou

et al. 2023

BMC Public Health

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Guideline-Driven Management of Hypertension

Carey

Wright

Taler

et al. 2021

Circulation Research

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Several important findings bearing on the prevention, detection, and management of hypertension have been reported since publication of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline. This review summarizes and places in context the results of relevant observational studies, randomized clinical trials, and meta-analyses published between January 2018 and March 2021. Topics covered include blood pressure measurement, patient evaluation for secondary hypertension, cardiovascular disease risk assessment and blood pressure threshold for drug therapy, lifestyle and pharmacological management, treatment target blood pressure goal, management of hypertension in older adults, diabetes, chronic kidney disease, resistant hypertension, and optimization of care using patient, provider, and health system approaches. Presenting new information in each of these areas has the potential to increase hypertension awareness, treatment, and control which remain essential for the prevention of cardiovascular disease and mortality in the future.

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Blood Pressure Effects of Sodium Reduction

et al. 2021

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Background: The relationship between dietary sodium intake and blood pressure (BP) has been tested in clinical trials and nonexperimental human studies, indicating a direct association. The exact shape of the dose–response relationship has been difficult to assess in clinical trials because of the lack of random-effects dose–response statistical models that can include 2-arm comparisons. Methods: After performing a comprehensive literature search for experimental studies that investigated the BP effects of changes in dietary sodium intake, we conducted a dose–response meta-analysis using the new 1-stage cubic spline mixed-effects model. We included trials with at least 4 weeks of follow-up; 24-hour urinary sodium excretion measurements; sodium manipulation through dietary change or supplementation, or both; and measurements of systolic and diastolic BP at the beginning and end of treatment. Results: We identified 85 eligible trials with sodium intake ranging from 0.4 to 7.6 g/d and follow-up from 4 weeks to 36 months. The trials were conducted in participants with hypertension (n=65), without hypertension (n=11), or a combination (n=9). Overall, the pooled data were compatible with an approximately linear relationship between achieved sodium intake and mean systolic as well as diastolic BP, with no indication of a flattening of the curve at either the lowest or highest levels of sodium exposure. Results were similar for participants with or without hypertension, but the former group showed a steeper decrease in BP after sodium reduction. Intervention duration (≥12 weeks versus 4 to 11 weeks), type of study design (parallel or crossover), use of antihypertensive medication, and participants’ sex had little influence on the BP effects of sodium reduction. Additional analyses based on the BP effect of difference in sodium exposure between study arms at the end of the trial confirmed the results on the basis of achieved sodium intake. Conclusions: In this dose–response analysis of sodium reduction in clinical trials, we identified an approximately linear relationship between sodium intake and reduction in both systolic and diastolic BP across the entire range of dietary sodium exposure. Although this occurred independently of baseline BP, the effect of sodium reduction on level of BP was more pronounced in participants with a higher BP level.

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Packages of sodium (Salt) sold for consumption and salt dispensers should be required to have a front of package health warning label: A position statement of the World Hypertension League, national and international health and scientific organizations

Cited by 3 publications

References 15 publications

Developing a social mobilisation intervention for salt reduction: participatory action research in Bombali district, Sierra Leone

Developing a social mobilisation intervention for salt reduction: participatory action research in Bombali district, Sierra Leone

Guideline-Driven Management of Hypertension

Blood Pressure Effects of Sodium Reduction

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