Technical Documents

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  • shake resumen cover ENThe SHAKE package is a set of common-sense, evidence-backed policy options and examples which support governments to lower population salt consumption. The options have been chosen because there is evidence that they work as a complete package, are inexpensive as a public health investment, and because WHO has experience in helping countries implement them to the highest standards.

    This document presents a summary of the WHO publication "SHAKE. The Salt Habit. The SHAKE Technical Package for Salt Reduction"

  • shake cover  ENThe SHAKE package outlines the policies and interventions which have been effective in reducing population salt intake, provides evidence of the efficacy of the recommended interventions, and includes a toolkit containing resources to assist Members States to implement the interventions. A shorter document that can be used to advocate for action on salt reduction is also included in the package.

    It has been developed by WHO in collaboration with the WHO Collaborating Centre for Population Salt Reduction at the George Institute for Global Health in Sydney, Australia, with input from a global network of salt reduction experts. It is designed to assist Member States with the development, implementation and monitoring of salt reduction strategies to enable them to achieve a reduction in population salt intake.

  • Technical Document: Salt Smart AmericasIn this year dedicated to the fight against the major public health issue, Hypertension, and marked by the celebration of World Hypertension Day, PAHO launches the Salt Smart Americas Guide for Action in the Countries, underscoring the important work of a team of distinguished experts, country program leaders and representatives of civil society and their unwavering commitment to stimulate, orient and support action in the countries. The guide highlights the recommendations, protocols and guidelines developed under the Regional initiative.

  • A Guide for Setting Targets and Timelines to reduce the Salt content of food. 2013Typical modern diets provide excessive amounts of salt, from early childhood through adulthood. In high income countries processed foods account for most dietary salt intake, and in lower and middle income countries their consumption is rapidly increasing as nutrition transition evolves. While people can control the salt added at the table and in cooking, it is the food industry that determines how much salt is added during food processing.

  • Questionnaire on Industry ReformulationObjectives:

    - Determine a baseline on the nature and extent to which commercial food processors are reformulating food products to reduce their sodium content or are formulating new product lines with low/no sodium o in aid of gaining commitment for (re)formulation plans that align with national targets or in their absence the internationally recommended target of 5g salt or 2000mg sodium/person/day by 2020. 

    - To identify the leaders in (re)formulation.

  • Survey on knowledge, attitude and behavior toward dietary salt and health protocolPAHO expert group conducted a survey to be realized in 5 countries by national consumer associations, a project to be led by Consumers International and financed by PAHO. The overall aim of this quantitative survey is to establish a base line on consumer knowledge, behavior and labeling preference with respect to salt and sodium. 

  • Questionnaire on Knowledge, Attitudes, Behavior toward Dietary Salt and HealthQuestionnaire on Knowledge, Attitudes, Behavior toward Dietary Salt and Health.

  • Applying a Social Marketing Framework to Salt Reduction. 2012With the goal of moving beyond public awareness to actually changing behavior, designing programs using a social marketing framework, will link supply and demand side activities, and allow us to integrate best practices from salt reduction programs gathered since the 1960's. Following is an outline for a SOCIAL MARKETING STRATEGY. Each component of the strategy includes outputs and a step by step process.

  • Protocol for Population Level Sodium Determination in 24-Hour Urine SamplesThe PAHO/WHO Protocol for Population Level Sodium Determination in 24-hour Urine Samples is a resource to countries that want to start monitoring salt intake in population.

  • A Review of Methods to Determine the Main Sources of Salt in the Diet. 2010For countries to effectively direct their policies and interventions at lowering dietary salt, they need to monitor how much salt people are eating and identify the main food sources of salt

  • White Paper on Improving Public Health by Optimizing Salt and Iodine Intakes. 2011A group of technical experts and stakeholders in both IDD and dietary salt reduction programs, convened by PAHO, has developed this White Paper to facilitate a broad collaboration between the programs, having agreed to a common goal and a Framework for Collaborative Action. It is directed to stakeholders for the two programs active within countries as well as those operating at the international level.

  • Improving Public Health in the Americas by Optimizing Sodium and Iodine Intakes – A Meeting Summary. 2011 Synchronization of salt iodization and dietary salt reduction programs brings together several stakeholders at international and national levels: the agencies working to optimize iodine supplementation and those focused on cardiovascular disease prevention; national governments; and various sectors of the salt and food industries. When the knowledge and experience of the stakeholders involved in the two programs are coordinated, at a common goal of mutual benefit, cost savings can be realized for healthcare systems.

  • WHO/PAHO Regional Expert Group for Cardiovascular Disease Prevention through Population-Wide Dietary Salt Reduction Final Report. 2011In September 2009, the Pan American Health Organization (PAHO) launched the initiative – Cardiovascular Disease Prevention through Population-wide Dietary Salt Reduction – by convening an Expert Group with a 24-month mandate. Its key contributions are summarized in this report.

  • Dietary  Sodium/Salt Reduction in the Americas 2011 Statement of Rio de JaneiroEvent held in Rio de Janeiro, Brazil between 27-29 April, 2011.

  • Databases on salt content in foodsYou will find a collection of regional and international databases that include sodium (salt) content of food products to assist our member states in engaging with the respective food industries and facilitating, where possible, food product comparisons.

  • Literature Review The following is a list with links, where available, to literature the Expert Group uses as a core reference when exploring and formulating action towards salt reduction population-wide initiatives.