ARGENTINE INITIATIVE TO REDUCE SODIUM CONSUMPTION Less Salt, More Life

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Morgan Lyons
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1 ARGENTINE INITIATIVE TO REDUCE SODIUM CONSUMPTION Less Salt, More Life

2 Background Salt consumption in Argentina is estimated to be gr. per day/hab WHO and FAO recomends a daily salt consumption < 5 gr. day/hab There is consistent scientific evidence linking excessive salt intake with wt high blood pressure e and the ralationship is direct and progressive Lowering blood pressure by reducing dietary salt at a population levell can reduce premature deaths due to CVD and kidney disease Population level salt reduction initiatives are considered one of the most cost efective strategies Progressive salt reduction has the advantage of not being perceived by the population due to taste adjustment

3 Health consequences of excessive salt consumption Increase in blood pressure and risk of developing CVD: Stroke Coronaryy heart disease Kidney disease Direct effects (independently of BP) Increase risk of stroke Myocardial hypertrophy Proteinuria and kidney disease Indirect effects: Obesity Other effects: stomach cancer, osteoporosis, renal stones, asthma exacerbations He F., MacGregor G., A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. Journal of Human Hypertension(2009)23,

4 LESS SALT, MORE LIFE Aims to reduce population s salt consumption with the objective of reducing the burden of disease that generates cardiovascular and kidney diseases Is among the most important health promotion strategies that the MoH is implementing and is a component of the Comprehensive Strategy of Control and Prevention of NCDs Components 1- Increase population awareness about the salt health effects and the need of reducing salt addition to food 2- Reduction of salt content in handmade manufactured bread through voluntary agreements with bakeries 3- Progressive reduction of salt content in processed food through voluntary agreements with the big food industry

5 The voluntary agreements with handmade manufacturers of bread aims to reduce 25 % the salt content of bread at bakeries. These agreements were sponsored by the baker s union and the National Institute of Industrial Technology (FAIPA and INTI)

6 National Comitee for salt reduction and trans fatty acids elimination Ministryi of Health Ministry of Agriculture Ministry of Social Development Ministryi of Science and Technology SENASA, INTI INAL - DENT CN ONGs COPAL Universities /Propia Food Industry Unions FAIPA, ASAGA Cooperatives Modification of the Alimentary law Argentina libre de trans 2014 Establishment of 4 workgroups related to the food category: 1.Meat and cold cuts, 2.dairy dairyproducts, 3.bread breadandbiscuitsand biscuits, 4. Soups and canned food Comunication strategies 1- Baseline 2- negotiation with 3 Sign of agreements diagnosis food industry for with the obligation of l the settlement of companies to reduce targets of each salt content group 4 Evaluation and surveillance

7 Agreements with food industry Big health impact Technologically feasible Progressive and accepted by consumers Targets a reduction 5-18 % in two years in maximum or average sodium content (depending on each product) Could reach new products 25 companies signed the agreement

8 Companies that signed the agreement

Beginning model for provinces Agreement records

Provincial agreements Framework Convention for

Cometee MEASURES INAL and health promotion

10 Beginning model for provinces Agreement records documents organization DISEMINATION Encourage Provincial agreements Framework Convention for voluntary progressive salt reduction Monitoring Cometee MEASURES INAL and health promotion stakeholders Information management database REGISTRY 10

de Centro de la Industria Industria de Chacinados y Productos Alimenticios

11 Framework Convention for voluntary progressive salt reduction adherence MSN, MAG, COPAL 3 Chambers Cámara Argentina de la Cámara de Industriales de Centro de la Industria Industria de Chacinados y Productos Alimenticios Lechera Afines (CAICHA) (CIPA) (CIL) adherence 16 companies 12 new adherences

12 Coordinated Monitoring Plan Process evaluation Food salt content Sodium intake measurement Reports Sworn statement and update of labelling. Analysis by INAL laboratories Sodium intake Surveys and urinary sodium measurement (La Pampa) Intersectorial Comission

13 Institutional roles National: Rectory, facilitate, big food industry agreements, sensibilization and monitoring plan Provincial and/or municipal. Local food industry agreements and sensibilization. Help with monitoring plan at a local level Provincial Units and Strategies of Health Promotion

14 Estimated impact Modeling of the intervention (reduction of 3gr) CHD Policy Model dl STELLA software (system dynamics) We estimate that a 3 gr. salt reduction in diet could avoid 6,000 cardiovascular deaths, 13,000 myocardial infarctions and 13,000 strokes

15 Prevalence of hypertension Prevalencia de Hipertension Arterial. Proyecciones Caso Base y con Intervencion % Prevalencia % Less Salt More Life 31.7% Año Caso Base Caso con Intervencion Source: own production

16 Potential impact on coronary heart disease (of reducing 3 gr.) 0% % 10% 15% 20% 25% 30% Hombres Mujeres

17 Potential impact on stroke (of reducing 3 gr.) 0% % 10% 15% 20% 25% 30% Hombres Mujeres

18 Conclusions These voluntary agreements are an example of coordinated policies between state, unions and industries Progressive sodium reduction could be an effort of companies towards increasing their social responsability There is a need of increasing the number of companies that adhere and a need of setting new and progressive targets It is crucial the participation of provinces to be able to reach local and small food industries Less Salt More Life Initiative constitutes an example of a population level salt reduction approach and could be replicated in other countries

19 Thank you

ACHIEVEMENTS AND CHALLENGES IN NCD PREVENTION IN FINLAND

ACHIEVEMENTS AND CHALLENGES IN NCD PREVENTION IN FINLAND Pekka Puska Professor, Member of Parliament Past Director General, National Institute for Health and Welfare (THL), Finland Past President, International Association of National Public Health Institutes