Impact of mandatory maximum sodium content policies for processed and ultra-processed foods on children’s sodium intake: a simulation study comparing policy scenarios in Uruguay

Excessive sodium consumption is a major public health concern worldwide. In response, a few countries worldwide have implemented mandatory policies to reduce the sodium content of processed and ultra-processed foods. However, evidence on their potential impact on sodium intake remains limited, particularly among children. The aim of this study was to estimate the potential impact of mandatory maximum sodium content policies, varying in scope, on sodium intake among young children, with a specific focus on sodium derived from processed and ultra-processed foods. A two-step modelling approach was applied using dietary data from the 2018 National Survey on Child Development and Health. First, alternative policy scenarios were defined based on the Pan American Health Organization (PAHO) regional sodium targets, varying in their scope. Second, the potential impact of these scenarios on sodium intake was simulated among children aged 6-59 months. Baseline sodium intake from processed and ultra-processed products included in the PAHO targets averaged 673 mg/d and increased with age. Implementation of a comprehensive policy aligned with PAHO targets resulted in a statistically significant reduction in population-level sodium intake (-166 mg/d). Less stringent policies, prioritising subcategories that contributed the most to sodium intake, also led to statistically significant reductions (-148 mg/d and -137 mg/d for policies including subcategories contributing at least 1 and 3 % of children's sodium intake, respectively). However, statistically significant reductions across all age subgroups were observed only when all PAHO subcategories were included. These findings highlight the potential of mandatory maximum sodium content policies to reduce sodium intake among children and underscore the importance of designing interventions that are closely aligned with population dietary patterns.