Target Salt 2025: A Global Overview of National Programs to Encourage the Food Industry to Reduce Salt in Foods

Reducing population salt intake has been identified as a priority intervention to reduce non-communicable diseases. Member States of the World Health Organization have agreed to a global target of a 30% reduction in salt intake by 2025. In countries where most salt consumed is from processed foods, programs to engage the food industry to reduce salt in products are being developed. This paper provides a comprehensive overview of national initiatives to encourage the food industry to reduce salt. A systematic review of the literature was supplemented by key informant questionnaires to inform categorization of the initiatives. Fifty nine food industry salt reduction programs were identified. Thirty eight countries had targets for salt levels in foods and nine countries had introduced legislation for some products. South Africa and Argentina have both introduced legislation limiting salt levels across a broad range of foods. Seventeen countries reported reductions in salt levels in foods—the majority in bread. While these trends represent progress, many countries have yet to initiate work in this area, others are at early stages of implementation and further monitoring is required to assess progress towards achieving the global target.     

Can food variety add years to your life?

The traditional food habits of Greeks and Japanese differ widely, yet both populations have the longest life expectancies in the world. Food variety is one feature common to both food cultures. By eating a wide variety of foods, numerous chemicals that give rise to the diverse range of colours, tastes, textures and smells of different foods are consumed. Many of these naturally occurring chemicals are likely to play a role in health. Within the broad scope of foods available, foods for thought include fish, legumes and nuts. These foods are also likely to protect older adults against some of the diseases more prevalent with ageing such as coronary heart disease and cancer.     

Food composition data in health communication

Food quality has increasingly become one of the main drivers of food choice, and attributes such as food composition are gaining importance in product quality considerations. This paper describes food quality trends observed in the international context and the manifestation of these trends within the food industry. From a consumer's perspective, improved knowledge of the composition and function of foods has contributed to many of these food trends. Science-driven health education could continue these positive changes in nutritional behaviour. Consumer health education projects, often called social marketing campaigns, aim to promote awareness of the health and nutritional advantages of foods, on the basis of composition data, in an effort to change behaviour. Agents of change in this process must be believable and trustworthy. To effectively promote healthy lifestyles to reduce the global burden of malnutrition and non-communicable diseases, consumer education requires a wide multisectoral approach. This approach needs to involve various sectors, including government, health professionals, the science fraternity and the private sector.     

Communicating foodborne disease risk.

The food industry, like many others, has a risk communication problem. That problem is manifested in the public''s desire to know the truth about outbreaks of foodborne diseases; ongoing concern about the safety of foods, additives, and food-processing procedures; and continued apathy regarding aspects of routine food hygiene. If these concerns are addressed in a coherent and trustworthy way, the public will have better and cheaper food. However, sloppy risk communication can itself cause public health damage. Because citizens are ill-equipped to discriminate among information sources, the food industry as a whole bears responsibility for the successes and failures of its individual members. We review risk communication research and practice for their application to the food industry.     

Innovations in food technology for health

Modern nutritional science is providing ever more information on the functions and mechanisms of specific food components in health promotion and/or disease prevention. In response to demands from increasingly health conscious consumers, the global trend is for food industries to translate nutritional information into consumer reality by developing food products that provide not only superior sensory appeal but also nutritional and health benefits. Today's busy life styles are also driving the development of healthy convenience foods. Recent innovations in food technologies have led to the use of many traditional technologies, such as fermentation, extraction, encapsulation, fat replacement, and enzyme technology, to produce new health food ingredients, reduce or remove undesirable food components, add specific nutrient or functional ingredients, modify food compositions, mask undesirable flavors or stabilize ingredients. Modern biotechnology has even revolutionized the way foods are created. Recent discoveries in gene science are making it possible to manipulate the components in natural foods. In combination with biofermentation, desirable natural compounds can now be produced in large amounts at a low cost and with little environmental impact. Nanotechnology is also beginning to find potential applications in the area of food and agriculture. Although the use of new technologies in the production of health foods is often a cause for concern, the possibility that innovative food technology will allow us to produce a wide variety of food with enhanced flavor and texture, while at the same time conferring multiple health benefits on the consumer, is very exciting.     

Optimising food composition data flow within the UK food supply chain and to external stakeholders

The UK national food composition tables provide reasonable coverage of primary produce and basic raw and cooked foods, but it is difficult for them to keep abreast of the fast moving processed and convenience food market. The food industry has an inherent need to generate and share food composition data on food products and therefore many of these data exist within the food industry, embedded in their core Enterprise and Resource Planning (ERP) software. A survey was conducted to explore the current uses and flow of food composition data within the UK food supply chain, and identify potential barriers to effective data transfer. Results indicate that providing food composition data is perceived as a frustrating, time-consuming task, and limitations lie in the lack of commonly agreed systems, processes and standards for the transfer of these data from those who generate it to those who need it. Within logistics and finance functions, industry is moving closer to a completely collaborative model via implementation of the Global Data Synchronisation Network (GDSN) infrastructure and methodology. This approach, if implemented for food composition data, has the potential to enable high quality food composition data to be accessible ‘at the push of a button’.     

Trade and the nutrition transition: strengthening policy for health in the Pacific

This article describes pathways through which trade policy change in two Pacific Island countries has contributed to changes in the food supply, and thereby to the nutrition transition. The effect of various trade policies from 1960 to 2005 on trends in food imports and availability is described, and case studies are presented for four foods associated with the nutrition transition and chronic disease in the Pacific. Trade policies (including liberalization, export promotion, protection of the domestic meat industry and support for foreign direct investment) have contributed to a reduced availability of traditional staples, and increased availability of foods associated with the nutrition transition, including refined cereals (particularly polished rice and white flour), meat, fats and oils, and processed food products. This study suggests that promoting healthier imports and increasing production of healthier traditional foods, in both of which trade policy has an important effect, has the potential to improve diets and health, in conjunction with other public health intervention.     

Functional foods: An Australian perspective

There are many definitions of functional foods, although with a common element of providing some functional advantage to consumers, and they are almost universally associated with food innovation. In Australia, the National Centre of Excellence in Functional Foods (NCEFF) was established with five-year federal innovation funding to help build capability in functional food research and development. This review sets the context for the NCEFF science program, by first outlining global concepts of functional foods and the nature of the scientific enterprise associated with it. The review provides a working definition of functional foods, describes the types of research reported in Medline in the last year and compares this with the NCEFF program of research. The 'working space' for functional foods was found to relate to the nutritional and food sciences, regulatory conditions, consumer/market and health concerns and industry opportunity. The term is appearing increasingly in Medline, mostly under review articles, but also with respect to in vitro and animal model studies, human clinical trials and consumer research. The spectrum of research undertaken in the NCEFF science program was consistent with this pattern. The review found that Australian researchers and practitioners have the capacity to deliver on major fronts in the functional foods domain and to be part of the challenges for food and nutrition research that have been exposed through the functional food phenomenon.     

Trade and the Nutrition Transition: Strengthening Policy for Health in the Pacific

This article describes pathways through which trade policy change in two Pacific Island countries has contributed to changes in the food supply, and thereby to the nutrition transition. The effect of various trade policies from 1960 to 2005 on trends in food imports and availability is described, and case studies are presented for four foods associated with the nutrition transition and chronic disease in the Pacific. Trade policies (including liberalization, export promotion, protection of the domestic meat industry and support for foreign direct investment) have contributed to a reduced availability of traditional staples, and increased availability of foods associated with the nutrition transition, including refined cereals (particularly polished rice and white flour), meat, fats and oils, and processed food products. This study suggests that promoting healthier imports and increasing production of healthier traditional foods, in both of which trade policy has an important effect, has the potential to improve diets and health, in conjunction with other public health intervention.     

Position of the American Dietetic Association: Functional Foods

All foods are functional at some physiological level, but it is the position of the American Dietetic Association (ADA) that functional foods that include whole foods and fortified, enriched, or enhanced foods have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels. ADA supports research to further define the health benefits and risks of individual functional foods and their physiologically active components. Health claims on food products, including functional foods, should be based on the significant scientific agreement standard of evidence and ADA supports label claims based on such strong scientific substantiation. Food and nutrition professionals will continue to work with the food industry, allied health professionals, the government, the scientific community, and the media to ensure that the public has accurate information regarding functional foods and thus should continue to educate themselves on this emerging area of food and nutrition science. Knowledge of the role of physiologically active food components, from plant, animal, and microbial food sources, has changed the role of diet in health. Functional foods have evolved as food and nutrition science has advanced beyond the treatment of deficiency syndromes to reduction of disease risk and health promotion. This position paper reviews the definition of functional foods, their regulation, and the scientific evidence supporting this evolving area of food and nutrition. Foods can no longer be evaluated only in terms of macronutrient and micronutrient content alone. Analyzing the content of other physiologically active components and evaluating their role in health promotion will be necessary. The availability of health-promoting functional foods in the US diet has the potential to help ensure a healthier population. However, each functional food should be evaluated on the basis of scientific evidence to ensure appropriate integration into a varied diet.     

Creating healthy food environments through global benchmarking of government nutrition policies and food industry practices

Unhealthy processed food products are increasingly dominating over healthy foods, making food and nutrition environments unhealthier. Development and implementation of strong government healthy food policies is currently being circumvented in many countries by powerful food industry lobbying. In order to increase accountability of both governments and the private sector for their actions, and improve the healthiness of food environments, INFORMAS (the International Network for Food and Obesity/non-communicable diseases (NCDs) Research, Monitoring and Action Support) has recently been founded to systematically and comprehensively monitor food environments and policies in countries of varying size and income. This will enable INFORMAS to rank both governments and private sector companies globally according to their actions on food environments. Identification of those countries which have the healthiest food and nutrition policies and using them as international benchmarks against which national progress towards best practice can be assessed, should support reductions in global obesity and diet-related NCDs.     

Role of Food Industry in Promoting Healthy and Sustainable Diets

Sustainable food systems are often defined by greenhouse gases, land use, effects on biodiversity, and water use. However, this approach does not recognize the reason food is produced—the provision of nutrients. Recently, the relationship between diets and sustainability has been recognized. Most accepted models of ‘sustainable diets’ focus on four domains: public health, the environment, food affordability, and cultural relevance. Aligned with the FAO’s perspective, truly sustainable diets comprise foods that are affordable, nutritious, developed with ingredients produced in an environmentally friendly manner, and consumer preferred. Identifying solutions to address all four domains simultaneously remains a challenge. Furthermore, the recent pandemic exposed the fragility of the food supply when food accessibility and affordability became primary concerns. There have been increasing calls for more nutrient-dense and sustainable foods, but scant recognition of the consumer’s role in adopting and integrating these foods into their diet. Dietary recommendations promoting sustainable themes often overlook how and why people eat what they do. Taste, cost, and health motivate consumer food purchase and the food system must address those considerations. Sustainable foods are perceived to be expensive, thus marginalizing acceptance by the people, which is needed for broad adoption into diets for impactful change. Transformational change is needed in food systems and supply chains to address the complex issues related to sustainability, taste, and cost. An emerging movement called regenerative agriculture (a holistic, nature-based approach to farming) provides a pathway to delivering sustainable foods at an affordable cost to consumers. A broad coalition among academia, government, and the food industry can help to ensure that the food supply concurrently prioritizes sustainability and nutrient density in the framework of consumer-preferred foods. The coalition can also help to ensure sustainable diets are broadly adopted by consumers. This commentary will focus on the challenges and opportunities for the food industry and partners to deliver a sustainable supply of nutrient-dense foods while meeting consumer expectations.     

Nanotechnology: its impact on food safety

The use of nanotechnology in the food safety industry is here-and if projections are correct, it will continue to grow rapidly over the next few years. Its potential for providing safer and more nutritious foods is important; however, there are still many uncertainties about the technology and its applications. We must make sure that the technology is safe and properly regulated to ensure maximum food safety and personal health protection.     

Nutrition and health claims – where are we with the health claims assessment process?

Before the European Commission (EC) regulation on nutrition and health claims was developed there was no regulation that specifically dealt with claims made on foods. With voluntary guidance in some European countries and none in others there was increasing concern that claims on food products might be misleading consumers and that claims within Europe might become more and more inconsistent. Since the Regulation came into force in July 2007 a rigorous process of assessing the scientific evidence of approximately 44,000 claims submitted has been carried out by a working group of experts. Given the volume of claims being submitted the assessment process has been met with challenges and many facets of the Regulation have been delayed, including the working document on nutrient profiling. The majority of the third batch of the Euopean food Safety Authority (EFSA) opinions on Article 13.1 claims has received negative opinions and reasons that claims submitted to this Article are being rejected are considered as well as strengths and limitations of the regulation at present. This article will discuss EFSA opinions on health claims as of April 2011. EFSA is engaging with the food industry through stakeholder meetings, guidance documents and web‐consultations. More research is needed to establish consumers’ understanding of health claims and continued engagement and dialogue between EFSA's Dietetic Products Nutrition and Allergies (NDA) panel and the food industry is required, so that the consumer is protected from misleading health claims and innovation is encouraged in the food industry for the production of healthier food products.     

Position of the American Dietetic Association: Functional foods

It is the position of the American Dietetic Association that functional foods, including whole foods and fortified, enriched, or enhanced foods, have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels. The Association supports research to define further the health benefits and risks of individual functional foods and their physiologically active components. Dietetics professionals will continue to work with the food industry, the government, the scientific community, and the media to ensure that the public has accurate information regarding this emerging area of food and nutrition science. Knowledge of the role of physiologically active food components, from both phytochemicals and zoochemicals, has changed the role of diet in health. Functional foods have evolved as food and nutrition science has advanced beyond the treatment of deficiency syndromes to reduction of disease risk. This position reviews the definition of functional foods, their regulation, and the scientific evidence supporting this emerging area of food and nutrition. Foods can no longer be evaluated only in terms of macronutrient and micronutrient content alone. Analyzing the content of other physiologically active components and evaluating their role in health promotion will be necessary. The availability of health-promoting functional foods in the US diet has the potential to help ensure a healthier population. However, each functional food should be evaluated on the basis of scientific evidence to ensure appropriate integration into a varied diet.     

Position of the American Dietetic Association: Functional Foods

It is the position of The American Dietetic Association that functional foods, including whole foods and fortified, enriched, or enhanced foods, have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis, at effective levels. The Association supports research to further define the health benefits and risks of individual functional foods and their physiologically active components. Dietetics professionals will continue to work with the food industry, government, the scientific community, and the media to ensure that the public has accurate information regarding this emerging area of food and nutrition science. Knowledge of the role of physiologically active food components, both from phytochemicals and zoochemicals, has changed the role of diet in health. Functional foods have evolved as food and nutrition science has advanced beyond the treatment of deficiency syndromes to reduction of disease risk. This position reviews the definition of functional foods, their regulation, and the scientific evidence supporting this emerging area of food and nutrition. Foods can no longer be evaluated only in terms of macronutrient and micronutrient intake. Analyzing the content of other physiologically active components will be necessary. The availability of health-promoting functional foods in the US diet has the potential to help ensure a healthier population. However, each functional food should be evaluated on the basis of scientific evidence to ensure appropriate integration into a varied diet. J Am Diet Assoc. 1999;99:1278-1285.     

The IGD report ‘Energy density and its role in helping consumers make healthy choices’: a resource for food businesses

Energy density is the energy (calorie) content per unit weight of a food, meal or diet. It is important in terms of its impact on an individual's energy intake and overall energy balance. With obesity as a major public health issue in the UK and many other countries, encouraging intake of foods that are lower in energy density could help consumers to reduce their energy intake and eat a healthy, balanced diet. The food industry has a role in helping consumers achieve a healthy, balanced diet. Incorporating energy density as an element of the design or development of their products is one way through which food businesses might support this aim. The Institute of Grocery Distribution's (IGD) Industry Nutrition Strategy Group has produced a report for food businesses to help them to consider energy density as part of new product development or product reformulation. ‘The role of energy density in helping consumers make healthy choices’ provides information on energy density and its role in energy balance, techniques to adjust the energy density of foods, with guidance on using this concept in consumer communications.     

Use of health foods by the elderly

Many nutritionists believe that the elderly are especially prone to food faddism because they seem to possess many characteristics that make them susceptible to the lures of health food advocates. However, to date there has been no systematic survey to determine what percent of the elderly use or buy health foods. We interviewed a total of 354 senior citizens from 15 randomly chosen senior citizen centers in New York City. Health food users were classified in two ways: those who have ever shopped in health food stores, and those who shopped in health food stores regularly (at least once a month) and spent a minimum of $4.00 per trip. The results show that 38.7% had ever shopped in health food stores but only 10.7% had done so regularly. The median amount ($4.00) spent on health foods was less than half of the amount of an average sale reported by the health food industry and represented 7.7% of the food dollar. Both chi-square tests and discriminant analysis revealed that education, distance to a health food store, and average income were significantly correlated with health food use.     

Consumers' willingness to buy functional foods. The influence of carrier, benefit and trust

The goal of the present study was to examine factors that influence willingness to buy functional foods. Data were collected from a representative mail survey in Switzerland (n=249). Results suggest that consumers are more inclined to buy functional foods with physiological health claims compared with psychological health claims. Health claims were most positively evaluated when attached to a product with a positive health image. Results further show that participants who have trust in the food industry are more likely to buy functional foods compared with participants who do not have trust in the food industry. Older consumers were more interested in functional foods than younger consumers.     

Perspektiven für Functional Foods

The increasing nutritional knowledge of the relationship between diet and health leads to new insights into the effects of food ingredients on physiological functions. These insights generate interest among science experts, health professionals and consumers. This in turn stimulates the food industry to match the consumer desire for short and long-term health benefits through food products that promote the general health and wellbeing and reduce the risk of chronic diseases. These foods are called functional foods. Market success of functional foods depends on consumer interest and confidence in these products. This requires a favourable regulatory framework for approval of new products and their associated health claims. In this way it should be possible to achieve a transparent and truthful communication of the health benefit of functional foods to scientific experts, health care providers and consumers.