All WHO Member States agreed to the global target to reduce population salt intake by 30% by 2025, towards the recommended level of less than 5g/day.
On a global scale, excess salt consumption is estimated to cause 1.6 million deaths in 2010.
Approximately 40% of Pacific Island residents have been diagnosed with a noncommunicable disease (NCDs), mainly cardiovascular disease or diabetes and/or have hypertension.
One of the main causes of high blood pressure is excess salt consumption however salt intake patterns and contributors of salt in the diet have not been comprehensively measured.
Since the Pacific Food Summit in 2010, WHO has collaborated with the George Institute for Global Health to support salt reduction consultations and development of salt reduction strategies in 14 Pacific Island Countries. In 2012, Vanuatu Ministry of Health organised a salt reduction consultation and developed a draft strategy.
The next most important step was to measure current salt consumption levels and salt levels in foods in Vanuatu with a view to refining the national salt reduction strategy over the next few years.
In 2014, WHO engaged The George Institute to establish baseline monitoring data on salt consumption however this work was postponed due to the ongoing ramifications of cyclone Pam. In 2016 the George Institute was re-engaged to commence the measurement of salt consumption in Efate, Vanuatu.
The objective of the workshop was to train local staff to gather baseline-monitoring data on population salt intake through spot and 24-hour urine collection; knowledge, attitudes and behaviours related to salt; main sources of sodium in the diet and salt levels in foods.
This will inform a) the evidence for carrying out a program of work to reduce salt intake in the country; b) the development of salt reduction interventions and c) the baseline from which to monitor future progress.
The training workshop was conducted over 5 days with the participation of the Ministry of Health Vanuatu, research assistants and project manager, Vanuatu National Statistical Office, Laboratory representative, WHO technical support and The George Institute WHO CC salt team.
Training included: the evidence for salt reduction; protocol for conducting surveys, taking and recording anthropometric measurements spot and 24-hour urine collection, food frequency questionnaire, and collecting urine samples. Further training was given on how to conduct shop surveys, data entry and analysis.
An in-house practice session was facilitated by TGI, and two pilot sessions to ensure that research assistants to practise approaching households, random selection of participants using the lottery method, administering the survey, undertaking the physical measurements, providing referral forms and instructing on how to collect spot or 24-hour urine samples.
Lessons from the pilot session were collected from researchers, reviewed and incorporated to improve the survey.
The training was completed successfully. A baseline salt surveys was conducted in Vanuatu between October 2016 and January 2017.
Data were analysed to establish the current salt situation in Vanuatu. The mean salt intake was 7.2 (SD 2.3) g/day from spot urine samples, exceeding the WHO recommended maximum amount of 5g/day. Knowledge relating to salt and its effects on health was high, however self-reported behaviours relating to salt use did not reflect this. The most commonly consumed high salt foods included tinned tuna, breakfast biscuits, bread, noodles and canned meat.
This data was provided to the Ministry of Health to inform considerations of a salt reduction strategy in Vanuatu.
Vanuatu Salt Intake Survey Report 2017: A sub-national survey