Research

Reducing the sodium content of high-salt foods: Effect on cardiovascular disease in South Africa

Melanie Y Bertram, Krisela Steyn, Edelweiss Wentzel-Viljoen, Stephen Tollman, Karen J Hofman

Abstract


Background. Average salt intake in South African (SA) adults, 8.1 g/day, is higher than the recommended 4 - 6 g/day recommended by the World Health Organization. Much salt consumption arises from non-discretionary intake (the highest proportion from bread, with contributions from margarine, soup mixes and gravies). This contributes to an increasing burden of hypertension and cardiovascular disease (CVD).
Objectives. To provide SA-specific information on the number of fatal (stroke, ischaemic heart disease and hypertensive heart disease) and non-fatal CVD events that would be prevented each year following a reduction in the sodium content of bread, soup mix, seasoning and margarine.
Methods. Based on the potential sodium reduction in selected products, we calculated the expected change in population-level systolic blood pressure (SBP) and mortality due to CVD and stroke.
Results. Proposed reductions would decrease the average salt intake by 0.85 g/person/day. This would result in 7 400 fewer CVD deaths and 4 300 less non-fatal strokes per year compared with 2008. Cost savings of up to R300 million would also occur.
Conclusions. Population-wide strategies have great potential to achieve public health gains as they do not rely on individual behaviour or a well-functioning health system. This is the first study to show the potential effect of a salt reduction policy on health in SA.

Authors' affiliations

Melanie Y Bertram, Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), and Health and Population Division, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg

Krisela Steyn, Chronic Disease Initiative in Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town

Edelweiss Wentzel-Viljoen, Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom

Stephen Tollman, INDEPTH Network, Accra, Ghana, Centre for Global Health Research, Umeå University, Sweden; and MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa

Karen J Hofman, Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), and Health and Population Division, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg

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Keywords

, Stroke, Developing countries; epidemiology; salt; nutrition; sodium

Cite this article

South African Medical Journal 2012;102(9):743-745.

Article History

Date submitted: 2012-03-14
Date published: 2012-06-20

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