Why it matters

Settings are defined as places where people live, work and play. A number of approaches have been successful in reducing the levels of salt in food served in schools, workplaces and other institutional settings. As with children in schools, most adults now spend the vast majority of their time in the workplace. Therefore protecting and promoting health in these settings, including lowering salt intake, is critical (1).

What needs to be done

SHAKoffers practical approaches to reducing the levels of salt in food served in workplaces and other institutional settings. It provides initial mapping support to help countries identify the key settings where evidence shows that strategies will have the greatest impact – such as schools, workplaces, hospitals and food outlets. It then offers a selection of proven strategies for promoting healthy eating in these settings – such as developing standards for meals served in schools and workplaces – and for behaviour change interventions in community settings.

SHAKE also includes cross-sectoral guidance, such as regulatory changes which can be made to reduce salt in public catering, and shows how several countries have created and enforced standards on the maximum levels of salt allowed in foods sold in schools and hospitals. Finally, SHAKE incorporates elements from other related WHO guidance such as recommendations on the marketing of foods and beverages to children. Restricting the marketing of high-salt foods to school children will create a supportive environment for healthy eating from an early age and will produce longer-term positive health behaviours in future generations (2).

By bringing all these factors together, the SHAKE package provides a full set of policy tools based on existing practices from around the world. When used in conjunction with strong political commitment, good programme management, a network of partnerships and effective advocacy, SHAKE can help any country create a robust strategy to reduce salt consumption – helping the global population shake its salt habit.

1. Shain M, Kramer D. Health promotion in the workplace: framing the concept, reviewing the evidence. Occup Environ Med. 2004;61(7):642−8.

2. A framework for implementing the set of recommendations on the marketing of foods and non-alcoholic beverages to children. Geneva: World Health Organization; 2012. 28