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Background: International strategies to reduce chronic diseases have called for a reduction in the amounts of saturated fat (SAFA), trans fat (TFA), salt and sugars in the global food supply. This paper describes the development approach and potential impact of a set of standards for these nutrients to drive food (re)formulation., Methods: To set the standards, WHO nutrient guidelines for daily intake were translated into product group specific standards. The impact of reformulation towards these standards on population nutrient intakes was modelled using the food consumption data of five countries: UK, France, US, Brazil and China. The impact of the TFA standards could not be modelled due to lack of data., Results: (Re)formulation of foods and beverages towards these standards would substantially decrease mean population intakes of energy, sodium, SAFA and sugars, with reductions up to 30%., Conclusions: These science-based standards for nutrients to limit could drive impactful reductions in energy, sodium, SAFA and sugars in food and beverage products, enabling mean population intakes to move closer to WHO nutrient guidelines.

Potassium chloride is a leading reformulation technology for reducing sodium in food products. As, globally, sodium intake exceeds guidelines, this technology is beneficial; however, its potential impact on potassium intake is unknown. Therefore, a modeling study was conducted using Dutch National Food Survey data to examine the dietary impact of reformulation (n = 2106). Product-specific sodium criteria, to enable a maximum daily sodium chloride intake of 5 grams/day, were applied to all foods consumed in the survey. The impact of replacing 20%, 50% and 100% of sodium chloride from each product with potassium chloride was modeled. At baseline median, potassium intake was 3334 mg/day. An increase in the median intake of potassium of 453 mg/day was seen when a 20% replacement was applied, 674 mg/day with a 50% replacement scenario and 733 mg/day with a 100% replacement scenario. Reformulation had the largest impact on: bread, processed fruit and vegetables, snacks and processed meat. Replacement of sodium chloride by potassium chloride, particularly in key contributing product groups, would result in better compliance to potassium intake guidelines (3510 mg/day). Moreover, it could be considered safe for the general adult population, as intake remains compliant with EFSA guidelines. Based on current modeling potassium chloride presents as a valuable, safe replacer for sodium chloride in food products.

Hypertension is a major modifiable risk factor for cardiovascular disease and mortality, which could be lowered by reducing dietary sodium. The potential health impact of a product reformulation in the Netherlands was modelled, selecting packaged soups containing on average 25% less sodium as an example of an achievable product reformulation when implemented gradually. First, the blood pressure lowering resulting from sodium intake reduction was modelled. Second, the predicted blood pressure lowering was translated into potentially preventable incidence and mortality cases from stroke, acute myocardial infarction (AMI), angina pectoris, and heart failure (HF) implementing one year salt reduction. Finally, the potentially preventable subsequent lifetime Disability-Adjusted Life Years (DALYs) were calculated. The sodium reduction in soups might potentially reduce the incidence and mortality of stroke by approximately 0.5%, AMI and angina by 0.3%, and HF by 0.2%. The related burden of disease could be reduced by approximately 800 lifetime DALYs. This modelling approach can be used to provide insight into the potential public health impact of sodium reduction in specific food products. The data demonstrate that an achievable food product reformulation to reduce sodium can potentially benefit public health, albeit modest. When implemented across multiple product categories and countries, a significant health impact could be achieved. [ABSTRACT FROM AUTHOR]

Some food products fit better within a healthy diet than others, but how can consumers tell? The Choices programme is a simple and internationally-applicable programme to help consumers make a healthy choice on food and beverages and to stimulate industry towards healthy product innovation in all food groups. The essence of the programme is a front-of-pack stamp on products that pass an evaluation against scientific criteria. To that end generic criteria have been established for levels of saturated fat, trans fat, sugars and sodium, which are based on international dietary guidelines (FAO/WHO). For some food categories there are specific criteria for these nutrients as well as for dietary fibre and calories. In this way the criteria are challenging without being impossible to meet. The programme has been initiated by food industry and is open to all companies in food industry, retail and catering. The approach is also supported by nutritional scientists, governments and NGOs. An independent scientific committee is responsible for designing and periodically reviewing the qualifying criteria. The current qualifying criteria were developed by scientific committees in the Netherlands and Belgium. These criteria will now be reviewed by an International Scientific Committee, consisting of internationally-recognised food and nutrition experts. To accommodate the developments in nutrition science and food technology, this review will take place every two years. [ABSTRACT FROM AUTHOR]