Policy action – labelling, marketing restrictions and fiscal policies

Implementing policies for effective nutrition labelling, marketing restrictions and pricing of foods to support lower salt intake

Why it matters

Prior to the implementation of nutrition policies such as front-of-pack labelling, marketing restrictions, and fiscal policies, it is important to understand the major sources of sodium in the local diet. The methods and resources for measuring the main contributors to sodium in the diet is described in detail in the Surveillance, Monitoring & Evaluation section. 

In addition to understanding main contributors to sodium in the diet, it is also critical to know if back-of-pack nutrient (including sodium) information for packaged foods is mandatory in the country where policy action is being considered. The Codex Guidelines for food labelling (Resource 1) recommend that all pre-packaged foods label the nutrient content in a “Nutrition Facts” box or “Nutrition Information Panel (NIP)”. This information is needed to support policy actions that use the sodium content as a criteria or cut-off e.g. for eligibility of front-of-pack nutrition labelling, marketing restrictions or fiscal policies. 

How to do it

1. Front-of-pack nutrition labelling (FOPL)

Front-of-pack nutrition labelling (FOPL) is interpretative labelling that provides simplified nutrition information in the form of symbols, colours and words to help consumers understand the nutritional quality of products and select healthier products. FOPL makes it easier for consumers to interpret the healthiness of products and choose to purchase healthier products. This can motivate food manufacturers to improve the nutritional quality of their products.

The WHO Regional Office for Europe has developed a “Manual to develop and implement front-of-pack nutrition labelling” (Resource 2) that countries can use to select and test evidence-informed front-of-pack nutrition labelling systems. 

An overview of current global practice of front-of-pack nutrition labelling and lessons for strengthening this initiative can be found in Resource 3. 

An example of the UK government’s guidance for food companies wanting to apply front-of-pack nutrition labels on their packaged food products can be in Resource 4.

An example of the process of obtaining approval for a new Food Act to mandate sodium warning labels in Chile can be found in Resource 5. 

2. Marketing Restrictions

While nutrition labelling aims to drive consumers towards making healthier food choices, food manufacturers can employ a range of marketing techniques, some of which may misrepresent foods as healthy options despite containing high amounts of salt or sodium. Therefore, it is necessary to implement standards or regulatory measures to prevent the use of misleading marketing strategies of foods. 

In 2010, the World Health Assembly adopted the “Set of recommendations on marketing of foods and non-alcoholic beverages to children” (Resource 6) that aimed to reduce the impact of marketing foods high in saturated fats, trans fatty acids, free sugars and salt. In 2012, the WHO provided a framework (Resource 7) for implementing the set of recommendations, which outlines the four steps of the policy cycle on implementing regulations on marketing of foods to children; 1) Policy development, 2) policy implementation, 3) policy monitoring and evaluation, and 4) policy revision. 

In 2018, the Obesity Policy Coalition collated the different restrictions on marketing unhealthy food to children policies from around the world as a policy brief, which can be found in Resource 8. 

3. Fiscal policies related to salt

Another policy option is taxing unhealthy foods to influence what people eat. While there is growing evidence and policies on taxing products high in sugar or unhealthy foods more broadly, there are currently few examples of countries taxing foods high in sodium or salt. The potential effectiveness and feasibility of taxing salt and foods high in sodium can be found in Resource 9. 

Hungary’s 2011 Public Health Product Tax, which includes a tax on salty snacks and condiments with sodium content above a certain level, was evaluated and described (Resource 10). Learning from the evaluations of other countries’ taxes is an important step to developing and implementing an effective tax on foods high in salt or unhealthy foods more broadly.

Other Resources

Surveillance, monitoring and evaluation

Collecting data is important to inform the intervention, to monitor the extent to which it is being implemented effectively and having the intended effect, and to evaluate the impact of the intervention. It is important to do surveillance before (plan & design), during (monitoring & adaptation) and after (evaluation) program implementation. The figure below shows how the findings from surveillance and monitoring can be used at each stage of a program.

Industry and Reformulation

In most high-income countries, and increasingly in low and middle-income countries, 70-80% of salt consumed comes from processed foods and meals (including meals eaten out of the home and takeaway foods)

Developing Strategies

Salt reduction strategies are much more likely to be effective and sustainable if time and effort is put into developing a strategic approach and ensuring stakeholder commitment. If you are clear about what you are trying to

Consumer Awareness and Behaviour Change

Targeted and sustained communication and behaviour change strategies can be used to empower people to improve their salt intake and diet, create consumer demand for lower salt food products, and improve uptake of