Milka Popovic1,2
1 Medical faculty, University of Novi Sad
2 Public Health Institute of Vojvodina, Novi Sad, Serbia
Noncommunicable diseases (NCDs) are the leading cause of death globally, causing preventable death of more people each year than all other causes combined (1). The major NCDs currently account for approximately 60% of all deaths and 43% of disease burden globally. Cardiovascular disease (CVD) itself accounted for 30% of all deaths. Hypertension is considered a major risk for CVD, especially heart attack and stroke (2).Excess body weight (body mass index > 25 kg/m2), excessive consumption of energy, saturated fats, trans fats, sugar and salt, as well as low consumption of vegetables, fruits and whole grains are leading dietary risk factors for NCDs (3). Among them, excessive dietary salt intake, greater than 5 g/day, is major risk factor for hypertension, positively correlated with mean blood pressure in a population (4) and causes more deaths than any other dietary risk factor (5). Also, there is evidence substantiated relation between salt intake and incidence of CVD, especially heart attack and stroke (6). High salt intake is recognized as risk factor for end stage of renal failure (7), it is in a positive association with stomach cancer (8) and osteoporosis (9).
Salt intakes across the world’s populations vary, in wide range of values, greatly exceeding physiological needs (10). Most adult populations have mean sodium intakes between 9 and 12 g/day, although in some population’s average salt intake exceeded 20 g/person/day. In most countries over 75-80% of salt consumed comes from processed and ready-to-eat foods.
In Japan and China, as opposed to, 75% of salt consumed comes from cooking from high sodium products (10).
Population based modest reduction of salt intake is followed by the statistically significant reduction of the mean blood pressure, prevalence of hypertension, morbidity and mortality rate of CVD and all causes of death (11). The recognized problem and beneficial outcome of salt intake reduction within population motivated national health authorities worldwide to implement programs on salt intake reduction (12). The World Health Organization (WHO) recommends reducing salt intake in the general population as a cost-effective strategy.
Measures in this direction are considered a “best-buy” approach to preventing NCDs (13).
A prevalence of hypertension in the Republic of Serbia (RS), blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg, among adults aged 18 year and more is 46.5%. In the RS cardiovascular diseases are leading cause of death. They participate with 55.2% in the total death cases (14). National salt intake survey in Republic of Serbia (RS) is yet to be done.
Results of the pilot survey on salt intake conducted in Novi Sad in 2011-2012, showed that the average salt intake in a sample of adult population of the city of Novi Sad, aged 18-65 years, using the internationally recognized 24 h urinary sodium excretion method was 12,12 g/d. Nearly all of the subjects exceeded the World Health Organization population salt intake goal of 5 g a day, and none of them consumed the amount of salt recommended in non-pharmacological treatment of hypertension (15). Another studiesperformed in Novi Sad showed that salt content in meals in public kindergartens, elementary schools, boarding schools and student restaurants were high (16, 17) and that the salt content in ready-to-eat food
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retailed in Novi Sad have high hidden salt content and that could be considered as an important contributor to relatively high salt consumption of its citizens (18).
Results of these studies urges national health authorities to implement National Program on Cardiovascular Diseases Prevention, Treatment and Control in the RS up to 2020 year, which recognized the importance of salt control intake and food products salt labeling (19).
In several Member States in the WHO European Region, salt reduction strategiesarethe priority in NCDs prevention programmes. European Food and Nutrition Action Plan (2015–
2020) points to the impact of integrated salt reduction programmes. The primary objective is to take a stepwise approach to reducing sodium content across food product categories and market segments, with a view to adaptation of consumer taste preferences over time. Their success depends on monitoring, stakeholder engagement and establishment of benchmarks and targets, with sophisticated population awareness initiatives (3).
Keywords:Sodium Chloride, Dietary + adverse effects; Adult; Hypertension
Literature:
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17. Trajkovic-PavlovicLj, Popovic M, Velicki R, TorovicLj, Bijelovic S. Salt content control in public mass catering meals dedicated to children, adolescents and students in the city of Novi Sad. 20th International Congress of Nutrition, Granada, 2013, September 15-20, Ann NutrMetab 2013;63(suppl 1):902.
18. Trajkovic Pavlovic Lj, Popovic M, Torovic Lj, Velicki R, Bijelovic S. Salt content in retailed food in Novi Sad. Proceedings of 6th Central European Congress on Food, Novi Sad, Serbia, May 23-26, 2012. Central European Congress on Food 6;
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