Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Population-based Cardiovascular Disease Prevention Measures Aimed at Reducing Salt Intake: Analysis of International Strategies and Prospects for Implementation in the Russian Federation

https://doi.org/10.20996/1819-6446-2020-12-08

Full Text:

Abstract

High salt intake is an important risk factor for cardiovascular diseases (CVD), closely related to the level of blood pressure in the population. The purpose of the review: to study population-based interventions for CVD prevention, aimed at reducing salt intake; to assess the potential for their implementation in the Russian Federation. We presented population-based strategies for dietary salt intake reduction used in different countries. The main components of strategies aimed to correct this risk factor in the Russian Federation were identified. The main components of the population-based approach to reducing salt intake are: determining population salt consumption, identifying sources of salt in the diet, monitoring of salt content in products, engaging with the food industry, consumer awareness campaigns, changes in product labeling, tax measures. An integrated approach to the problem is the most successful. Measures which were highly effective have not yet been fully implemented in the Russian Federation. At the moment, taxation of high-salt foods and tax subsidies for healthy food are not applied. Food manufacturers are not sufficiently involved - there are no legislatively introduced measures to reduce salt through food reformulation. Firstly it has to be applied to diet-forming products that are consumed daily, such as bakery and dairy products, and meat products.

About the Authors

Yu. A. Balanova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Yulia A. Balanova - MD, PhD, Leading Researcher, Department of Public Health Promotion, National Medical Research Center for Therapy and Preventive Medicine.
Petroverigsky per. 10, Moscow, 101990.



A. V. Kontsevaya
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Anna V. Kontsevaya - MD, PhD, Deputy Director for Scientific and Analytical Work, Head of Department of Public Health Promotion, National Medical Research Center for Therapy and Preventive Medicine.
Petroverigsky per. 10, Moscow, 101990.



N. S. Karamnova
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Natalia S. Karamnova - MD, PhD, Head of Nutrition Epidemiology Laboratory, National Medical Research Center for Therapy and Preventive Medicine.
Petroverigsky per. 10, Moscow, 101990.



D. K. Mukaneeva
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Dinara K. Mukaneeva - Junior Researcher, Department of Public Health Promotion, National Medical Research Center for Therapy and Preventive Medicine.
Petroverigsky per. 10, Moscow, 101990.



O. M. Drapkina
National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

Oxana M. Drapkina - MD, PhD, Professor, Corresponding Member of Russian Academy of Sciences, Director, National Medical Research Center for Therapy and Preventive Medicine.
Petroverigsky per. 10, Moscow, 101990.



References

1. World Health Organization. Meeting of the WHO Action Network on Salt Reduction in the Population in the European Region (ESAN). Meeting Report - Bern, Switzerland, 2019 [cited by Mar 24, 2020]. Available from: http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/publications/2019/11th-meeting-of-the-who-action-network-on-salt-reduction-in-the-population-in-the-european-regionesan.-meeting-report-2019].

2. Trieu K., Neal B., Hawkes C., et al. Salt reduction initiatives around the world-a systematic review of progress towards the global target. PloS one. 2015;10(7):e0130247. DOI:10.1371/journal.pone.0130247.

3. World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Geneva: WHO; 2013 [cited by Mar 24, 2020]. Available from: https://www.who.int/nmh/publications/ncd-action-plan/en/.

4. Trieu K., McLean R., Johnson C., et al. The science of salt: a regularly updated systematic review of the implementation of salt reduction interventions (June-October 2015). The Journal of Clinical Hypertension. 2016;18(6):487-94. DOI:10.1111/jch.12806.

5. Thout S. R., Santos J. A., McKenzie B. The Science of Salt: Updating the evidence on global estimates of salt intake. The Journal of Clinical Hypertension. 2019;21(6):710-21. DOI:10.1111/jch.13546.

6. Johnson C., Santos J. A., McKenzie B. et al. The science of salt: a regularly updated systematic review of the implementation of salt reduction interventions (September 2016-February 2017). The Journal of Clinical Hypertension. 2017;19(10):928-38. DOI:10.1111/jch.13099.

7. Powles J., Fahimi S., Micha R., Khatibzadeh S., et al. on behalf of the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE). Global, regional and national sodium intakes in 1990 and 2010: a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide. BMJ Open. 2013;3(12):e003733. DOI:10.1136/bmjopen-2013-003733.

8. He F. J., MacGregor G.A. A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. Journal of Human Hypertension. 2009;23(6):363-84. DOI:10.1038/jhh.2008.144.

9. Poteshkina N.G. The decrease of sodium chloride consumption. Efficacy of preventive strategy. Part V. Russian Journal of Cardiology. 2014;(6):85-92 (In Russ.) DOI:10.15829/1560-4071-2014-6-85-92.

10. Takase H., Sugiura T., Kimura G., et al. Dietary sodium consumption predicts future blood pressure and incident hypertension in the Japanese normotensive general population. Journal of the American Heart Association. 2015;4(8):e001959. DOI:10.1161/JAHA.115.001959.

11. He F.J., Pombo-Rodrigues S., MacGregor G.A. Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality. BMJ Open. 2014;4(4):e004549. DOI:10.1136/bmjopen-2013-004549.

12. Ikeda N., Saito E., Kondo N., et al. What has made the population of Japan healthy? Lancet. 2011;378(9796):1094-105. DOI:10.1016/S0140-6736(11)61055-6.

13. Asaria P., Chisholm D., Mathers C., et al. Chronic disease prevention: health effects and financial costs of strategies to reduce salt intake and control tobacco use. Lancet. 2007;370(9604):2044-53. DOI:10.1016/S0140-6736(07)61698-5.

14. Smith-Spangler C.M., Juusola J.L., Enns E.A., et al. Population strategies to decrease sodium intake and the burden of cardiovascular disease: a cost-effectiveness analysis. Annals of Internal Medicine. 2010;152(8):481-7. DOI:10.7326/0003-4819-152-8-201004200-00212.

15. Mason H., Shoaibi A., Ghandour R., et al. A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries. PloS One. 2014;9(1):e84445. DOI:10.1371/journal.pone.0084445.

16. He F.J., Brinsden H.C., MacGregor G.A. Salt reduction in the United Kingdom: a successful experiment in public health. Journal of Human Hypertension. 2014;28(6):345-52. DOI:10.1038/jhh.2013.105.

17. He F.J., Brown M., Tan M., MacGregor G.A. Reducing population salt intake - An update on latest evidence and global action. The Journal of Clinical Hypertension. 2019;21:1596-601. DOI:10.1111/jch.13664.

18. Bhat S., Marklund M., Henry M.E., et al. Systematic Review of the Sources of Dietary Salt Around the World. Adv Nutr. 2020;11(3):677-86. DOI:10.1093/advances/nmz134.

19. Newson R.S., Elmadfa I., Biro G., et al. Barriers for progress in salt reduction in the general population. An international study. Appetite. 2013;71:22-31. DOI:10.1016/j.appet.2013.07.003.

20. Santos J. A., Sparks E., Thout S.R. et al. The Science of Salt: A global review on changes in sodium levels in foods. Journal of Clinical Hypertension. 2019;21(8):1043-56. DOI:10.1111/jch.13628.

21. World Action on Salt and Health (WASH) Global Bread Survey. White Bread, Wholemeal Bread, Flat Bread, Mixed Grain Bread (2018) [cited by Mar 02, 2020]. Available from: http://www.worldac-tiononsalt.com/media/action-on-salt/awareness/salt-awareness-week-2018/FINAL-WASH-Bread-Survey-All-Data.pdf].

22. World Action on Salt and Health (WASH). New Study Reveals Huge Differences in Salt Levels in the Same Iconic Food Brands in Different Countries (2014) [cited by Mar 02, 2020]. Available from: http://www.worldactiononsalt.com/news/surveys/2014/international-product-survey/].

23. Hyseni L., Elliot-Green A., Lloyd-Williams F., et al. Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy? PloS One. 2017;2(5):e0177535. DOI:10.1371/journal.pone.0177535.

24. Beer-Borst S., Eisenblatter J., Jent S., et al. Corporate health management: evaluation of an educational and envi-ronmental intervention to promote a balanced, less salty diet. Part 2: coaching of catering teams. Ernahrungs Umschau. 2020;67(1):M14-M22. DOI:10.4455/eu.2020.002.

25. Food labels - Eat well [cited by Mar 02, 2020]. Available from: https://www.nhs.uk/live-well/eat-well/how-to-read-food-labels/.

26. Zandstra E.H., Lion R., Newson R.S. Salt reduction: Moving from consumer awareness to action. Food Quality and Preference. 2016;48:376-81. DOI:10.1016/J.FOODQUAL.2015.03.005.

27. He F.J., Wu Y., Feng X.X., et al. School based education programme to reduce salt intake in children and their families (School-EduSalt): cluster randomised controlled trial. BMJ. 2015;350:h770. DOI:10.1136/bmj.h770.

28. Cotter J., Cotter M. J., Oliveira P., et al. Salt intake in children 10-12 years old and its modification by active working practices in a school garden. Journal of Hypertension. 2013;31(10):1966-71. DOI:10.1097/HJH.0b013e328363572f.

29. Appel L.J., Lichtenstein A.H., Callahan E.A., Sinaiko A., et al. Reducing sodium intake in children: a public health investment. The Journal of Clinical Hypertension. 2015;17(9):657-62. DOI:10.1111/jch.12615.

30. Cairns G., Angus K., Hastings G. The extent, nature and effects of food promotion to children: a review of the evidence to December 2008. Geneva: WHO; 2009 [cited by Mar 02, 2020]. Available from: http://www.who.int/dietphysicalactivity/Evidence_Update_2009.pdf (accessed: 02.03.2019).

31. Vienna Declaration on Nutrition and Noncommunicable Diseases in the Context of Health 2020 (2013). Vienna: WHO; 2013 [cited by Mar 02, 2020]. Available from: https://www.euro.who.int/en/publications/policy-documents/vienna-declaration-on-nutrition-and-noncommunicable-diseases-in-the-context-of-health-2020-2013.

32. Thow A.M., Downs S., Jan S. A systematic review of the effectiveness of food taxes and subsidies to improve diets: understanding the recent evidence. Nutrition Reviews. 2014;72(9):551-565. DOI:10.1111/nure.12123

33. Martos E., Bakacs M., Tamas J., et al. Assessment of the impact of a public health product tax Geneva: WHO; 2015 [cited by Mar 02, 2020]. Available from: http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/publications/2017/assessment-of-the-impact-of-a-public-health-product-tax-hungary-2016].

34. Ndanuko R.N., Dunford E.K., Wu J.H., et al. Changes in sodium levels of processed foods among the International Food and Beverage Association member companies in Australia: 2013-2017. Journal of Food Composition and Analysis, 2020;103405. https://doi.org/10.1016/j.jfca.2019.103405.

35. Voluntary Sodium Reduction Goals: Target Mean and Upper Bound Concentrations for Sodium in Commercially Processed, Packaged, and Prepared Foods: Guidance for Industry [cited by Mar 02, 2020]. Available from: https://www.fda.gov/media/98264/download.

36. Webster J.L., Dunford E.K., Hawkes C., et al. Salt reduction initiatives around the world. Journal of Hypertension. 2011;29(6):1043-50. DOI:10.1097/HJH.0b013e328345ed83.

37. Federal State Statistic Service. Selective monitoring of diet among the Russian population (2013) [cited by Mar 02, 2020]. Available from: https://www.gks.ru/free_doc/new_site/food1/survey0/index.html (In Russ.)

38. Federal State Statistic Service. Selective monitoring of diet among the Russian population. (2018) [cited by Mar 02, 2020]. Available from: https://gks.ru/free_doc/new_site/food18/index.html (In Russ.)

39. Karamnova N.S., Shalnova S.A., Deev A.D., et al. Nutrition characteristics of adult inhabitants by ESSE-RF study. Cardiovascular Therapy and Prevention. 2018;17(4):61-6 (In Russ.) DOI:10.15829/1728-8800-2018-4-61-66.

40. Guidelines 2.3.1.2432-08 Norms of physiological requirements in energy and nutrients for different groups of the Russian population. Moscow: Federal Center for Hygiene and Epidemiology of Rospotrebnadzor; 2009 (In Russ.)

41. WHO. Sodium intake for adults and children (2012) [cited by Mar 02, 2020]. Available from: https://www.who.int/nutrition/publications/guidelines/sodium_intake_printversion.pdf.

42. Order of the Ministry of Health of the Russian Federation dated August 19, 2016 № 614 "On Approval of the recommendations on improving the standards of food consumption to meet the modern requirements of healthy nutrition [cited by Mar 02, 2020]. Available from: https://www.garant.ru/products/ipo/prime/doc/71385784/ (In Russ.)

43. Guidelines 2.4.5.0107-15. Catering preschool and school-age children in organized groups [cited by Mar 02, 2020]. Available from: https://rospotrebnadzor.ru/documents/details.php?ELEMENT_ID=12330 (In Russ.)

44. Guidelines 2.4.5.0146-19. Catering for children of preschool and school age in organized groups in the Arctic zone of the Russian Federation [cited by Mar 02, 2020]. Available from: https://rospotrebnadzor.ru/documents/details.php?ELEMENT_ID=12330 (In Russ.)

45. Passport of the National project “Demography” (approved by the Presidium of the Presidential Council for Strategic Development and National Projects, protocol 24.12.2018 N16) [cited by Mar 02, 2020]. Available from: http://www.consultant.ru/document/cons_doc_LAW_317388/ (In Russ.)

46. National standard of the Russian Federation Р 51074-2003. Food products. Information for consumer. General requirements [cited by Mar 02, 2020]. Available from: http://www.consultant.ru/document/cons_doc_LAW_135961/ (In Russ.)

47. National standard of the Russian Federation 53598-2009 Food products. Instructions for labeling. Moscow: Standartinform; 2010 [cited by Mar 02, 2020]. Available from: http://protect.gost.ru/document.aspx?control=7&id=175470 (In Russ.)

48. You are stronger! Ministry of Health approved [cited by Mar 02, 2020]. Available from: https://takzdorovo.ru/download/youarestronger/ (In Russ.)

49. Recipes Carusio “On health!” Moscow 2019 [cited by Mar 02, 2020]. Available from: https://gnicpm.ru/wp-content/uploads/2020/01/karushio_russia.pdf (In Russ.)

50. Order of the Ministry of Health of the Russian Federation of March 13, 2019 No. 124n “On approval of the procedure for conducting preventive medical examination and clinical examination of certain groups of the adult population” [cited by Mar 02, 2020]. Available from: https://www.garant.ru/products/ipo/prime/doc/72130858/ (In Russ)

51. Balanova Yu.A., Imaeva A.E., Kontsevaya A.V., et al. Food and beverage marketing to children via television in the Russian Federation. Preventive Medicine. 2018;21(5):98-106 (In Russ.) DOI:10.17116/profmed201821051X.


For citation:


Balanova Yu.A., Kontsevaya A.V., Karamnova N.S., Mukaneeva D.K., Drapkina O.M. Population-based Cardiovascular Disease Prevention Measures Aimed at Reducing Salt Intake: Analysis of International Strategies and Prospects for Implementation in the Russian Federation. Rational Pharmacotherapy in Cardiology. 2020;16(6):966-976. (In Russ.) https://doi.org/10.20996/1819-6446-2020-12-08

Views: 249


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)