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The Globe and Mail

Canada's voluntary approach to salt limits called into question

Government-led mandatory restrictions on the amount of sodium in packaged and processed foods is 20 times more effective than voluntary limits, the kind Canada is in the midst of developing, a study has found.

An Australian study published on Tuesday in the medical journal Heart compared mandatory versus voluntary sodium-reduction programs and determined that compulsory cuts could avert thousands of cases of cardiovascular disease and help to prevent countless premature deaths.

The findings come as a growing number of countries, including Canada, are in the process of developing programs to help to reduce the sodium consumed by the population. High salt intake is a leading risk factor for high blood pressure, which can lead to cardiovascular disease and other serious health complications.

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Canadians consume, on average, 3,400 milligrams of sodium a day, while the recommended daily consumption is 1,500 milligrams. Nearly 80 per cent of the sodium consumed in Canada comes from packaged and processed foods, such as soups, bread, sauces and cereal.

As a result, public-health advocates have been calling for the food industry to start slashing the amount of salt added to their products as a way of bringing down the amount of sodium consumed in Canada.

A report released last summer by the federally appointed Sodium Working Group has recommended that Canada adopt a voluntary program to reduce sodium consumption to 2,300 milligrams a person by 2016. If the voluntary measures fail, the group has recommended that the government introduce binding legislation to force food manufacturers to cut the amount of salt added to their products.

But the new Australian findings raise fresh concerns about the merit of voluntary programs.

In the study, researchers led by Linda Cobiac, who is with the Centre for Burden of Disease and Cost-Effectiveness at the School of Population Health at the University of Queensland, compared an existing program, which allows food manufacturers that have reduced the amount of sodium they use to put an endorsed health logo on their products, with a projected model of mandatory sodium cuts. They also compared those measures to dietary advice and education aimed at people with an increased or high risk of cardiovascular disease to determine which course of action is most effective.

Researchers used scientific models to make the comparisons and found that dietary advice averted less than 1 per cent of the disease risk associated with high sodium intake, while the voluntary health-logo program cut the disease burden by 1 per cent.

But imposing mandatory limits on the amount of sodium added to bread, margarine and cereal could avert 18 per cent of the disease burden, researchers said, a major reduction that could also save the health-care system a significant amount of money.

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Over all, compulsory cuts could result in the gain of more than 600,000 healthy-life years across the lifetime of the Australian population.

"Food manufacturers have a responsibility to make money for their shareholders, but they also have a responsibility to society," the report says. "If corporate responsibility fails, maybe there is an ethical justification for government to step in and legislate."

Kevin Willis, director of partnerships at the Canadian Stroke Network, said the study calls Canada's voluntary approach to sodium reduction into question.

"My concern is we're basically waiting and stepping back for the voluntary approach to take its course and hope it will be successful," he said. "I don't think it will be. I don't want to see us finding that out two, three years down the road."

Instead of waiting for the outcome of the voluntary approach, Dr. Willis wants the federal government to develop regulations that can be immediately imposed on the food industry if it fails to act.

Canada's food and restaurant industries have committed to the plan to reduce Canada's sodium consumption to 2,300 milligrams by 2016 and typically bristle at the suggestion of legislation to impose sodium limits.

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