Finland s experiences in salt reduction Pirjo Pietinen, Professor Brussels, 21.10.2009 20/10/09 Presentation name / Author 1
30 years of systematic work concerning salt Recommendation to reduce salt intake by the National Nutrition Council in 1978 1979-1982 The North Karelia Salt project with population surveys in 1979 and 1982 Mass media campaigns, cooperation with food industry to reduce salt voluntarily, education of health care personnel Expanded after the 3-year project to the whole country The public became aware of salt and BP Regular monitoring was established (population surveys every 5 years) The first national labelling decrees were launched in 1993 and have since been updated 20/10/09 Presentation name / Author 2
24-h sodium excretion Na mmol 100 140 180 220 260 300 340 Men, North Karelia Men, Kuopio area Men, Southwestern Finland Men, Helsinki area Women, North Karelia Women, Kuopio area Women, Southwestern Finland Women, Helsinki area 1979 1982 1987 2002 YEAR 20/10/09 Presentation name / Author 3
Salt intake in Finland 1977-2007 NaCl g/d 18 16 14 12 10 8 6 4 2 0 1977 1979 1981 1982 1987 1991 Year 1992 1994 1997 1998 2002 2007 Calculated, men Calculated, women 24h urine, men 20/10/09 Presentation name / Author 4
Sources of salt in the Finnish diet 14,00 Milk products 12,00 Fat spreads 10,00 Bread NaCl g/day 8,00 6,00 Sweet bakery Meat products Fish products 4,00 2,00 Prepared, canned or frozen food, condiment sauces Catering Salt used in households 0,00 1980 1991 1997-1999 YEAR Other sodium sources. Source: Reinivuo et al. Eur J Clin Nutr, 2006 20/10/09 Presentation name / Author 5
Compulsory labelling of salt: Cheese Sausages and other meat products Fish products Bread, crisp bread and thin crisp bread Broths, soups and sauces, also as powder and concentrate Other prepared or semi-prepared foods Mixed spices containg table salt 20/10/09 Presentation name / Author 6
Labelling of salt : criteria Food category NaCl % limits Highly salty (reduced by 0.1 %) Reduced salt >25 % less salt than normal product Fresh bread >1.2 max 0.9 Crisp bread >1.6 max 1.2 Cheese >1.3 max 1.0 Sausages >1.7 max 1.3 Cold whole meat cuts >1.9 max 1.4 Breakfast cereals >1.6 max 1.2 Soups, broths, sauces >0.9 max 0.7 Prepared and semiprepared foods >1.1 max 0.8 20/10/09 Presentation name / Author 7
Distribution of salt intake by choice of low or high-salt products. Findiet 2002. Density 0 e+00 1 e-04 2 e-04 3 e-04 4 e-04 5 e-04 Men Low-salt2 Low-salt1 Present situation High-salt1 High-salt2 0 5 10 15 20 25 30 Salt intake g 20/10/09 Presentation name / Author 8
Distribution of salt intake by choice of low or high-salt products. Findiet 2002. Density 0 e+00 1 e-04 2 e-04 3 e-04 4 e-04 5 e-04 Women Low-salt2 Low-salt1 Present situation High-salt1 High-salt2 0 5 10 15 20 25 30 Salt intake g 20/10/09 Presentation name / Author 9
Over 430 Heart symbol foods on the market More than 70 food companies The Heart Meal has also been launched Better choice in a food category (salt, total fat/ fat quality) In some food categories also fibre, sugar and cholesterol) Food group based criteria available: http://www.sydanmerkki.fi 20/10/09 Presentation name / Author 10
Criteria for the Finnish Heart symbol Bread and cereal products Bread and cereal products are an important source of carbohydrates and fibre. The criterion of the Heart Symbol is especially the salt content, because bread is a notable source of sodium. For sodium the criteria correspond to low-sodium limits set by food laws. In some cereal products there is plenty of fat and hard fat, therefore the criteria include also fat. The criterion for hard fat follows the national nutrition guidelines. Product groups Bread Crisp bread, Finn crisps Pastry (sweet and salted), biscuits and crackers Breakfast cereals Pasta, rice and similar products Criteria relating to product groups Fat 5 g/100g Sodium 280 mg/100g Fibre > 5 g/100 g Fat 5 g/100 g Sodium 480 mg/100g Fibre > 10 g/100 g Fat 25 % of energy Hard fat 33 % of fat Sodium 280 mg/100g Sugars < 20 g/100 g Fat 5 g/100 g, or if fat content 5.1-10 g/100g, hard fat 33 % of fat Sodium 400 mg/100g Sugars < 16 g/100 g Fibre > 6 g/100 g Fibre > 6 g/100 g (dry weight) 20/10/09 Presentation name / Author 11
Criteria for the Finnish Heart symbol Meat products The purpose is to decrease the intake of total fat i.e. the intake of invisible fat. At the same time the intake of hard fat decreases as well. Some meat products may contain high amount of cholesterol; therefore a cholesterol limit has been set. It is based on the recommended maximum intake of cholesterol. Product groups Whole meat products Cold cut sausages and other sausages to be cooked Criteria relating to product groups Fat 4 g/100 g Sodium 800 mg/100g Fat 12 g/100 g Hard fat 40 % of fat Sodium 600 mg/100g Cholesterol 100 mg/100g 20/10/09 Presentation name / Author 12
Conclusions and future challengies Reducing salt intake in the population requires longlasting, systematic work National legislation works especially setting maximum salt levels for normal products Consumer education is very important Overall agreement within Europe would help - food travels Loopholes: unpackaged products have no labels and no requirement to show the ingredients the case of imported, highly salted dough ( Eurobread ) 20/10/09 Presentation name / Author 13
This paper was produced for a meeting organized by Health & Consumers DG and represents the views of its author on the subject. These views have not been adopted or in any way approved by the Commission and should not be relied upon as a statement of the Commission's or Health & Consumers DG's views. The European Commission does not guarantee the accuracy of the data included in this paper, nor does it accept responsibility for any use made thereof.