Progress on sodium reduction in South Korea

Abstract

IntroductionHigh dietary sodium is a leading contributor to hypertension, and hypertension is the leading underlying cause of death globally. There is a robust body of evidence supporting the health benefits of sodium reduction. Sodium intake in South Korea is high, with about half the population consuming >4000 mg/day, twice the recommended upper limit.MethodsIn 2012, South Korea implemented its National Plan to Reduce Sodium Intake, with a goal of reducing population sodium consumption by 20%, to 3900 mg/day, by 2020. The plan included five key components: (1) a consumer awareness campaign designed to change food consumption behaviours; (2) increased availability of low-sodium foods at schools and worksites; (3) increased availability of low-sodium meals in restaurants; (4) voluntary reformulation of processed foods to lower sodium content; and (5) development of low-sodium recipes for food prepared at home. Monitoring and evaluation included tracking sodium intake and sources of dietary sodium using the Korea National Health and Nutrition Examination Survey.ResultsBy 2014, South Korea had reduced dietary sodium consumption among adults by 23.7% compared to a survey conducted in 2010 prior to implementation of a nationwide salt reduction campaign that used this comprehensive, multipronged approach. The reductions in sodium intake were accompanied by reductions in population blood pressure and hypertension prevalence. Although causal associations between the sodium reduction programme and reduced sodium intake cannot be made, the declines occurred with the introduction of the programme.ConclusionMulticomponent interventions have great potential to reduce population sodium intake. Lessons learnt from South Korea could be applied to other countries and are likely very relevant to other Asian countries with similar food sources and consumption profiles.

Trends in food and nutrient intake over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey

“…The intake of cabbage kimchi, a major source of sodium for Koreans, decreased from 83.8 g in 1998 to 62.9 g in 2018 [ 7 , 19 ]. In addition, as the need for sodium reduction emerged in Korea, a national task force established by the government in 2007 and the National Plan to Reduce Sodium, including a campaign to improve public awareness and voluntary reformulation of processed foods, such as fried noodles, paste, and confectionery to lower the sodium content, was implemented in 2012 [ 20 ]. Consequently, the sodium intake was significantly reduced to 3,255 mg in 2018 compared to 4,586 mg in 1998.…”

The DASH Diet and Cardiometabolic Health and Chronic Kidney Disease: A Narrative Review of the Evidence in East Asian Countries

“…Though the data are not shown in Table 1 , similar trends are observed in South Korea. Indeed, the average sodium intake in South Korea is nearly 4000 mg/d [ 37 ]. In addition, while fruit and vegetable intake has increased over the past several decades, intake of meat and fat has also increased, and intakes of micronutrients such as calcium and potassium remained steady but insufficient [ 38 ].…”

Trends in the prevalence and management of major metabolic risk factors for chronic disease over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey

“…The prevalence of hypertension did not significantly increase compared to that of other chronic diseases. Despite worsening of obesity and physical activity being major risk factors [ 18 ], policies promoted after 1999 (Healthy Lifestyle Practice [1999], National Chronic Diseases Management [2000], and Regional Cardiocerebrovascular Disease Center [2005]) resulted in increased awareness regarding the importance of blood pressure management and lifestyle improvement, leading to early detection of hypertension and increased treatment [ 19 - 21 ]. However, despite follow-up interventions, such as customized home visiting health care service (2007), registration and management of patients with hypertension or diabetes (2007), national health check-up by life cycle (2007), follow-up management on health check-up (2008), chronic disease management in the clinic (2012), and sodium reduction (2012), management indicators have not changed since 2007.…”