Salt Reduction Strategies in Thailand

Evidence has shown that salt (sodium) intake in our population is twice as high as the optimal recommended amount. Sodium intake reduction is one of the best-buy policies recommended by WHO for the prevention of non-communicable diseases especially hypertension, cardiovascular disease, cerebrovascular accident (CVA), and chronic kidney disease. High sodium content in packaged food and street food is commonly found in Thailand. This project on reducing sodium intake in Thailand was carried out by the Thai low salt network which was supported by the Thai Health Promotion, Faculty of Medicine, Ramathibodi hospital, Mahidol University, Ministry of Public Health, and the Nephrology Society of Thailand with a goal of 30% reduction in sodium intake among the Thai population by 2025. This project has been successful in many aspects. Project achievements include: 1) In 2015, the 8th National Health Assembly adopted a strategic policy for reducing sodium intake. This led to the implementation of a national strategy for salt reduction by many stakeholders including the ministry of public health, the ministry of education, and public relations agencies 2) Development of a simple salt meter for measuring sodium content in a food sample. Its application enabled people to reduce salt intake and thus reduce blood pressure. 3) Creation of a sodium database of common food consumed in the Thai population and conduction of a national sodium intake survey by measuring 24-hour urinary sodium excretion which revealed the average sodium consumption in a Thai of 3,636 mg/day. 4) Food reformulation in popular dishes by nutritionists and celebrity chefs. Regarding packaged food, a voluntary target of salt reduction was set in conjunction with the Thai FDA and food industry 4 years ago. Since then, with monitoring of sodium content in food and snacks, little progress has been made in the reduction of their salt content. As a result, policies of maximum sodium limit, regulation of their advertisement, and tax measures on high sodium products are in development and undergoing discussions with the food industry. Furthermore, environmental reforms in hospitals, schools, workplaces, and communities to favor a healthy diet were carried out in many parts of Thailand. 5) Food labeling project in collaboration with the Institute of Nutrition, Mahidol University, and the food and drug administration (FDA) including monochrome GDA, and a "healthier" logo was implemented. An interpretative label