“Use salt and foods high in salt sparingly”: a food-based dietary guideline for South Africa

Increased salt intake leads to an increase in blood pressure and decreased sodium intake relative to the usual or increased results in lowered blood pressure in adults, with or without hypertension. Blood pressure is a strong proxy indicator the risk of cardiovascular disease, coronary heart disease and strokes. Hypertension is estimated to have caused 9% all deaths in South Africa in 2000. In 2008, 42% of men and 34% of women aged 35-44 years, and 60% of men and 50% women aged 45-54 years, were hypertensive. More than 70% of both men and women older than 65 years of age hypertensive in 2008. Multilevel and multisectorial strategies are required to lower salt intake at population level, the legislation of food supply, clearer labelling and signposting of food packaging, and improved consumer on behavioural change regarding salt usage practices. A comprehensive national strategy that focuses on reduction is needed to reduce national blood pressure levels in the future. Legislating the levels of salt in processed is only one part of this national strategy. All health professionals and educators should also provide appropriate recommendations that will educate, motivate and enable consumers to change their nutritional behaviour to salt intake to less than 5 g per day, as recommended. The aim of this review is to revise the current food-based guideline for salt, the implementation of which would contribute to lowering population salt intake, and blood and cardiovascular disease, in South Africa