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Sodium availability and food sources in 2018−2019 were estimated and trends analyzed for 15 years (2004−2019) in Costa Rica. Food purchase records from the National Household Income and Expenditure Survey (ENIGH) 2018−2019 were converted to energy and sodium using food composition tables measuring “apparent consumption”. Foods were classified by sodium content. ENIGH is a probabilistic, stratified, two-stage and replicated national survey, carried out regularly by the national statistics institution. Results from the 2004−2005 and 2012−2013 ENIGHs came from previous analysis. Differences between periods were determined through descriptive and inferential statistics. The available sodium adjusted to 2000 kcal/person/day was 3.40, 3.86, and 3.84 g/person/day (g/p/d) for periods 2004−2005, 2013−2014, and 2018−2019, respectively. In this last period, this was 3.94 urban and 3.60 g/p/d rural (p < 0.05), with a non-linear increase with income. During 2004−2019 sodium from salt and salt-based condiments increased from 69.5 to 75.5%; the contribution of common salt increased, from 60.2 to 64.8% and condiments without added salt from 9.3 to 10.7%. From 2012−2013 to 2018−2019, processed and ultra-processed foods with added sodium intake increased from 14.2 to 16.9% and decreased in prepared meals (7.2 to 2.8%). Costa Rica has been successful in reducing salt/sodium available for consumption; after a 12% increase of salt consumption between 2004−2005 and 2012−2013, to a level almost twice as high as recommended, it has stabilized in the last period.

This research aims to study the food practices and perceptions related to excessive consumption of salt/sodium when cooking and eating outside the home in a study population representing the wide intergenerational and sociocultural diversity of Costa Rica. Key communities from around the country, cultural experts, and key informants were selected. Four qualitative research techniques were applied. Data was systematized based on the Social Ecological Model. Women are generally in charge of cooking and family food purchases. Salt is perceived as a basic ingredient, used in small amounts that can be reduced-but not eliminated-when cooking. Changes in food preparations and emotions associated with the consumption of homemade food with salt were identified. The population likes to eat out, where the establishments selected depend mainly on age group and income. Beyond cultural and geographical differences, age aspects are suggested as being the main differentiators, in terms of use of salt, seasonings, and condiments in the preparation of food at home, the recipes prepared, and the selection of establishments in which to eat out. The deeply rooted values and meanings associated with salt in food indicate that the implementation of salt reduction strategies in Costa Rica is challenging.

This article describes the progress-as well as the challenges and limitations-in reducing salt intake in Costa Rica. The National Plan to Reduce Public Consumption of Salt/Sodium in Costa Rica 2011 - 2021 was complemented with multisectoral programs and projects specifically designed to: 1) determine sodium intake and the salt/sodium content of the most widely consumed foods; identify the consumer knowledge, attitudes, and behaviors with regard to salt/sodium, their relationship to health, and nutritional labeling; evaluate the cost-effectiveness of measures aimed at reducing the incidence of hypertension; 2) implement strategies to reduce the salt/sodium content of processed foods and foods prepared at home; 3) promote behavioral changes in the population to reduce salt in people's diets; and 4) monitor and evaluate action geared to reducing salt/sodium intake in the population. Meeting the proposed targets will require successful interinstitutional coordination among the strategic actors, the negotiation of commitments with the food industry and food services, and tighter regulation of critical nutrients in foods associated with chronic noncommunicable diseases. Given the progress made during the implementation of the National Plan, Costa Rica is expected to meet the international goal of reducing salt intake.

The nutritional labeling regulations for prepackaged foods based on the Codex Alimentarius legislation enacted in 2002 in Costa Rica. In the same year, a research was conducted in order to describe the baseline of nutritional labeling. The declared information on the labels of all prepackaged foods was collected, except for alcoholic beverages. Six variables were analyzed using SPSS. 2,910 labels of foods were reviewed and classified in 19 food categories. 58.4% (n = 1698) included nutritional information, proportion that varied by country of origin and food category. Of the labels that included nutritional information, 68.1% had nutritional panel, 1.2% nutrient claims and 27.4%, both. 95% of the nutritional components declared on the labels included energy and macronutrients data. At least 100 different nutritional and health claims were identified. Most frequently used claims were content (74.7%), followed by addition (16.9%). The components most frequently mentioned were vitamins and minerals, vitamins (alone), carbohydrates, total fat, cholesterol and energy. Food groups who reported these descriptors were: cereals and by products, baby foods, milks, beverages, foods for special dietary uses and substitutes. One to five descriptors were used in a label. In a decade the proportion of prepackaged foods with nutritional labeling tripled in the metropolitan area of Costa Rica. It is concluded that the tendency of nutrition information declaration is up, sustained and represents an accessible tool for health promotion, if the information provided is reliable and secure.