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This article discusses the efforts made in Finland to reduce salt intake, including national recommendations, population surveys, media campaigns, cooperation with the food industry, and education of healthcare personnel. It also examines the monitoring of salt intake through urinary collections and dietary surveys. The effectiveness of labeling and the impact of consumer choices on salt intake are also explored. Overall, the article highlights the importance of long-lasting, systematic work and the need for national legislation and consumer education.
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Salt intake in Finland Pirjo Pietinen Professor, Head of Nutrition Unit National Public Health Institute
30 years of systematic work • Recommendation to reduce salt intake by the National Nutrition Council in 1978 • 1979-1982 The North Karelia Salt project with population surveys in 1979 and 1982 • Mass media campaigns, cooperation with food industry to reduce salt voluntarily, education of health care personnel • Expanded after the 3-year project to the whole country • The public became aware of salt and BP, regular monitoring was established at KTL, and the first national labelling decrees were launched in the 1980s
Monitoring sodium excretion in Finland 24-h urinary collections: • 1979: North Karelia Salt Project • 1982 and 1987: FINMONICA salt substudy • 2002: FINRISK salt substudy
FINRISK study areas Oulu area 1997- Kuopio area 1982- North Karelia 1982- Southwestern Finland 1982 - Helsinki area 1992 -
24-h sodium excretion Laatikainen et al. Eur J Clin Nutr 2006
24-h sodium excretion as NaCl Laatikainen et al. Eur J Clin Nutr 2006
24-h potassium excretion Laatikainen et al. Eur J Clin Nutr 2006
24-h sodium/potassium ratio Laatikainen et al. Eur J Clin Nutr 2006
24-h urine volume Laatikainen et al. Eur J Clin Nutr 2006
Monitoring salt intake in dietary surveys and FBS • Findiet studies • Dietary substudies of FINRISK surveys • 1992: 3 day food diary • 1997: 24-h recall • 2002: 48-h recall • 2007: 48-h recall • Area, 10-year age group and sex stratified random samples of the population aged 25-64 years • Food Balance Sheets 1980, 1991 and 1997-1999
Daily sodium intake compared to 24-h sodium excretion.FINRISK 2002 salt substudy. Reinivuo et al. Eur J Clin Nutr 2006
Quartiles of salt intake from 48-h recall and 24-hurinary collection. FINRISK 2002 salt substudy. Reinivuo et al. Eur J Clin Nutr 2006
Salt intake in Finland 1977-2007 g/vrk Year
Intake of salt (g) in children by age group age n=567 n=230 n=471 n=554 n=713 DIPP Nutrition Study: Kyttälä P ym.
Intake of salt (mg/MJ) in children by age group age n=567 n=230 n=471 n=554 n=713 DIPP Nutrition Study: Kyttälä P ym.
Sources of salt. Food Balance Sheets 1980-1999. Reinivuo et al. Eur J Clin Nutr 2006
Compulsory labelling of salt: • Cheese • Sausages and other meat products • Fish products • Bread, crisp bread and thin crisp bread • Broths, soups and sauces, also as powder and concentrate • Other prepared or semi-prepared foods • Mixed spices containg table salt
Distribution of salt intake by choice of low or high-salt products. Findiet 2002.
Distribution of salt intake by choice of low or high-salt products. Findiet 2002.
Conclusions • Reducing salt intake in the population requres long-lasting, systematic work • National legislation works – especially setting maximum salt levels for normal products • Consumer education is very important • Overall agreement within Europe helps - food travels