Restrict or eliminate choice^a

• Implement guidelines including salt criteria for foods served in institutions (schools, workplaces, hospitals, care facilities, and prisons).

• Legislation on composition of foods to reduce salt content of foods and beverages is recommended.

Guide choice through (dis)incentives^a

• Taxation on foods high in sodium 'may encourage consumers to reduce consumption and revenues generated could support health promotion efforts.'

Enable or guide choice through changing default^a

Reformulation

• Promoting food reformulation should be among the first salt reduction actions to consider. Engage with the food industry, agree on progressively lower targets for salt levels in foods and meals, and set a time frame. Mandatory approaches using legislation or regulation are more effective than voluntary approaches, possibly more cost-effective as well.
• Successful voluntary reformulation programmes require strong government leadership, close collaboration with industry and publication of good monitoring data on the salt content.
• Besides engaging food industry, other options for supporting reformulation are taxing foods high in salt, implementing effective labelling and communication strategies.

• For effective reduction in salt intake, it is proposed to prioritise food categories contributing most to population salt intake. Food manufacturers should prioritise the products with largest market share and deliver salt reduction across the full range of products from economy to premium items.
• Salt content in products should be reduced progressively in order to allow consumers to adapt to the less salty taste and to ensure continuous progress.

• Encourage the food industry to reformulate products to lower sodium content.

• Reducing the salt content in processed foods such as bread, sausage and cheese is recommended.
• Gradual reduction of salt content allows consumers to adapt to the taste.

Marketing

• Marketing foods high in salt to children should be restricted.
• WHO proposes a nutrient profile model for the European Region. If limits of salt content (g/100g) in different food categories are exceeded by a food product, its marketing to children should be restricted.

• 'Legislation restricting marketing aimed at children of foods that are high in […] salt […] (e.g. on TV, internet, social media and on food packages) is recommended.'

Restrict or eliminate choice^a

• Implement guidelines including salt criteria for foods served in institutions (schools, workplaces, hospitals, care facilities, and prisons).

• Legislation on composition of foods to reduce salt content of foods and beverages is recommended.

Provide information^a

Public health campaigns

• Raise awareness of major sources of salt and health risks associated with salt intake. When major source is discretionary salt, education should be targeted to consumers, cooks and caterers. When major source is from processed foods, the audience should be food industry and policy-makers.
• Focus on the link between salt intake and health, how to interpret salt labelling, how to choose and prepare low-salt alternatives.
• Implement behaviour change programmes (education, communication) in community settings (schools, workplaces, hospitals, care facilities and prisons).
• Set clear and specific behavioural objectives and implement a mix of strategies to provide information.

• Implement public education campaigns to increase the awareness of the health effects of excess added sodium.

Labelling

• 'Countries should introduce clear, interpretive and accurate front-of-pack labelling schemes that enable consumers to understand the salt content of foods quickly and easily.'
• Prevent misleading marketing by allowing health claims only on products that meet certain nutritional criteria, e.g. contain less salt.

• Improve, standardise and implement Nutrition Facts labels and Front-of-Package (FOP) labels to help consumers make informed food choices.

Monitor^a

• 'Establish an effective surveillance system to measure, monitor and evaluate population salt consumption patterns and the major sources of salt in the diet' for finding the greatest regional weaknesses.
• To track the changes of reducing salt content in foods, it is important to collect salt content information either with surveys or by chemical analysis of foods.
• Design monitoring and evaluation plan with defined indicators and time frames. Objective and transparent reporting will encourage the stakeholders to deliver on their commitments.