Setting sodium targets for pre-packaged foods in China - an exploratory study

Puhong Zhang; Jiguo Zhang; Emalie Rosewarne; Yuan Li; Le Dong; Feng J He; Mhairi Brown; Simone Pettigrew; Rain Yamamoto; Chizuru Nishida; Aidong Liu; Xiaoguang Yang; Bing Zhang; Gangqiang Ding; Huijun Wang

doi:10.3389/fnut.2023.1231979

Setting sodium targets for pre-packaged foods in China - an exploratory study

Front Nutr. 2023 Nov 1:10:1231979. doi: 10.3389/fnut.2023.1231979. eCollection 2023.

Authors

Puhong Zhang^#^{1

2}, Jiguo Zhang^#³, Emalie Rosewarne², Yuan Li^{1

2}, Le Dong¹, Feng J He⁴, Mhairi Brown⁴, Simone Pettigrew², Rain Yamamoto⁵, Chizuru Nishida⁶, Aidong Liu⁷, Xiaoguang Yang³, Bing Zhang³, Gangqiang Ding³, Huijun Wang³

Affiliations

¹ The George Institute for Global Health, Beijing, China.
² Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
³ Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing, China.
⁴ Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
⁵ Standards and Scientific Advice on Food and Nutrition Unit, Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland.
⁶ Safe, Healthy and Sustainable Diet Unit, Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland.
⁷ China National Center for Food Safety Risk Assessment, Beijing, China.

^# Contributed equally.

Abstract

Introduction: Setting sodium targets for pre-packaged food has been a priority strategy for reducing population sodium intake. This study aims to explore the attitudes and considerations of researchers and key stakeholders toward implementing such policy in China.

Methods: An exploratory study comprising a survey and a focus group discussion was conducted among 27 purposively selected participants including 12 researchers, 5 consumers, 4 administrators, 3 industry association representatives and 3 food producers. The survey/discussion covered the key questions considered when developing/promoting sodium targets. Free-text responses were manually classified and summarized using thematic analysis.

Results: Two-thirds of the participants supported target-setting policy. Researchers and administrators were most supportive, and food producers and associations were least supportive. Adapted WHO food categorization framework was well accepted to underpin target-setting to ensure international comparability and applicability for Chinese products. Maximum values were the most agreed target type. The WHO benchmarks were thought to be too ambitious to be feasible given the current food supply in China but can be regarded as long-term goals. Initially, a reduction of sodium content by 20% was mostly accepted to guide the development of maximum targets. Other recommendations included implementing a comprehensive strategy, strengthening research, engaging social resources, establishing a systematic monitoring/incentive system, maintaining a fair competitive environment, and developing a supportive information system. Target-setting policy was acceptable by most stakeholders and should be implemented alongside strategies to reduce discretionary salt use.

Discussion: Our findings provide detailed guidance for the Chinese government when developing a target-setting strategy. The methods and results of this study also provide meaningful references for other countries to set sodium targets for pre-packaged foods and implement other salt reduction strategies simultaneously.

Keywords: China; benchmarks; exploratory study; pre-packaged foods; sodium.

Abstract

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