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Reducing Sodium in Australian Packaged Food

Published: 2023-01-10
Author: American Heart Association - Contact:
Peer-Reviewed: Yes
Journal Reference: DOI Link to the Study Paper
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On This Page: Summary - Defining Salt and Sodium - Main Article - About/Author

Synopsis: A study speculates on the health impact of reducing sodium in Australian packaged food products. According to a new study, reformulating packaged foods available in Australia to contain less sodium may save about 1,700 lives per year. Using the World Health Organization's (WHO) recommendations for reducing the population's sodium intake, the researchers estimate following the WHO sodium guidance may also prevent nearly 7,000 annual diagnoses of heart disease, kidney disease, and stomach cancer in Australia.


Salt and Sodium

What is the difference between sodium and salt? Salt is what we add to our food. Sodium is found in food - especially processed food containing preservatives. Salt, also known as sodium chloride, is about 40% sodium and 60% chloride. It is sodium that is detrimental to health and chloride that gives food its salty taste.

Main Digest

Estimated Dietary and Health Impact of the World Health Organization's Global Sodium Benchmarks on Packaged Foods in Australia: A Modeling Study.

Reformulating packaged foods in Australia to contain less sodium might save about 1,700 lives per year and prevent nearly 7,000 annual diagnoses of heart disease, kidney disease, and stomach cancer, according to new research published today in Hypertension, an American Heart Association journal.


High sodium intake increases blood pressure, risk of heart disease and stroke, chronic kidney disease, and stomach cancer. To reduce the incidence of these conditions, the World Health Organization (WHO) recommends reducing the population-wide average sodium intake by 30% by 2025, which limits total daily sodium intake per person to about 2 grams (g), or 2,000 milligrams (mg), per day. The U.S. Department of Agriculture's Dietary Guidelines for Americans recommends that healthy adults limit sodium to less than 2,300 mg per day. The U.S.'s current sodium intake is estimated at 3,400 mg/day per person.

Most sodium in people's diets comes from processed and packaged foods.

The American Heart Association estimates that 75% or more of daily sodium intake in the U.S. is from processed/packaged foods and restaurant foods. Reducing sodium in packaged foods through product reformulation programs is considered by WHO as a "best buy" to prevent diseases related to high sodium intake. In 2021, the WHO released guidance for sodium levels in food categories that are the biggest contributors to sodium intake, such as processed meats, bread, and sauces. For example, the WHO benchmark for lunch meat is 540 mg of sodium per 100 g of product, and bread is 330 mg of sodium per 100 g of product. Many countries have implemented reformulation programs for processed foods; however, they may be poorly monitored and include fewer food categories than recommended by the WHO.

Article continues below image.
A large rock and coarse sea salt on the shore of the Dead Sea in Israel. The Dead Sea, known in Hebrew as Yam Ha-Melakh (the Sea of Salt), is the lowest point on earth.
A large rock and coarse sea salt on the shore of the Dead Sea in Israel. The Dead Sea, known in Hebrew as Yam Ha-Melakh (the Sea of Salt), is the lowest point on earth.

The Australian government established a voluntary reformulation program for 27 packaged food categories. The WHO benchmarks, however, include 58 packaged food categories.

"We had previously modeled the potential impact of the Australian program," said the study's co-lead author Kathy Trieu, M.P.H., Ph.D., lead author of the study and senior research fellow in food policy at The George Institute for Global Health, and a senior lecturer at the University of New South Wales, both in Sydney, Australia. "In this study, we wanted to estimate the potential number of additional premature deaths, new cases of disease, and years lived with a disability that may be averted with the WHO sodium benchmarks, which are above and beyond the Australian government's sodium reformulation targets."

In their previous study, Trieu and colleagues found that Australia's plan reduced average sodium intake by 107 mg per day per person and may avert about 500 deaths, 1,900 new cases of cardiovascular disease, chronic kidney disease, and stomach cancer (combined), and 7,355 disability-adjusted life years (DALYs) in Australia each year. DALYs measure years of healthy life lost due to illness or premature death.

They applied the same statistical model to estimate the potential impact of extending the Australian plan to include all 58 packaged food categories in the WHO benchmarks. The model used national data from 2011-2012 on sodium intake, food composition, and sales for the targeted food categories. The researchers first estimated the reduction in sodium intake that may occur if the WHO targets were met. Then, they calculated the potential effect of sodium reduction on cardiovascular and chronic kidney disease rates using published statistics on the relationship between sodium intake and high blood pressure. High blood pressure is a major risk factor for both conditions.

The impact on stomach cancer was calculated using risk estimates derived from published studies of sodium and stomach cancer. The analysis determined the potential number of deaths, new cases of the disease, and DALYs that may be avoided by following the WHO guidance.

The analyses estimated that implementing the WHO sodium targets in Australia may result in:

"Our findings indicate that compliance with WHO benchmarks compared with Australia's current sodium targets may result in substantial health gains and prevent more than three times as many deaths and new cases of disease each year," said Trieu, adding that the greater impact of the WHO benchmarks may be explained by both including more packaged food products and stricter sodium targets.

Study limitations include using national nutrition survey data collected in 2011-12 and based on a single 24-hour diet recall to estimate food consumption. Therefore, this data may not reflect current sodium intake. In addition, estimates of disease burden may be less accurate than estimates of more easily measured outcomes such as death. Also, there may be other ways, in addition to blood pressure, that sodium reduction affects cardiovascular and kidney disease.

Co-authors are Daisy Coyle, Ph.D.; Emalie Rosewarne, M. Nutrition & Diet; Maria Shahid, M.P.H.; Rain Yamamoto, Ph.D.; Chizuru Nishida, Ph.D.; Bruce Neal, Ph.D.; Feng He, Ph.D.; Matti Marklund, Ph.D.; and Jason Wu, Ph.D. The authors' disclosures are listed in the manuscript. The study was funded by an Australian National Health and Medical Research Council Partnership Project.

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This peer reviewed article relating to our Nutrition and Healthy Food section was selected for publishing by the editors of Disabled World due to its likely interest to our disability community readers. Though the content may have been edited for style, clarity, or length, the article "Reducing Sodium in Australian Packaged Food" was originally written by American Heart Association, and published by on 2023-01-10. Should you require further information or clarification, American Heart Association can be contacted at Disabled World makes no warranties or representations in connection therewith.

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