Reduce Salt Consumption Research Articles

An Application-based programme to reinforce and maintain lower salt intake (AppSalt) in schoolchildren and their families in China

IntroductionSalt intake is very high in China, with ≈80% being added by the consumers. It is difficult to reduce salt in such settings. Our previous study (School-based Education programme to...

Age-Period-Cohort Analysis of Stroke Mortality Attributable to High Sodium Intake in China and Japan.

Background and Purpose- The aim of this study is to assess the long-term trends in stroke mortality attributable to high sodium intake in China and Japan during the period 1990 to 2016. Methods- The mortality data were obtained from the GBD study (Global Burden of Disease) 2016 and were analyzed using an age-period-cohort method. Results- The age-standardized mortality rates showed declining trends for high sodium intake-related stroke mortality. The overall net drifts per year were -3.1% for Chinese men and -5.0% for Chinese women; and -4.6% for Japanese men and -5.7% for Japanese women. The local drift values were below zero in all age groups for both sexes in both countries, and all local drift values of female participants were below their counterparts of male participants. The longitudinal age curves of high sodium intake-attributable stroke mortality increased rapidly for both sexes in China, whereas those of Japanese were slowly rising. The period and cohort rate ratios were found to have similar downward patterns for both sexes in both countries, with a quicker decline for women than for men (significantly with P<0.05 for all). Conclusions- The age-standardized mortality rates, the period effect and the cohort effect of stroke mortality attributable to high sodium intake in China and Japan have been declining in both sexes and all age groups from 1990 to 2016. Consequently, sodium-reduction strategies are of low cost and effective for the prevention of stroke. It is necessary to educate the nation with the correct knowledge on healthy diet and techniques to reduce salt consumption.

Knowledge, attitudes, and practices related to salt consumption in Nepal: Findings from the community-based management of non-communicable diseases project in Nepal (COBIN).

High salt/sodium intake is associated with an increased risk of hypertension, which is a major risk factor for cardiovascular diseases. This paper aims to examine the association between salt consumption and salt-related knowledge, attitudes, and practices (KAP) in Nepal. The cross-sectional data used in this study were collected as part of the community-based management of non-communicable diseases project (COBIN) to understand the amount and KAP related to salt consumption in Nepal. Multivariate hierarchical logistic regression was performed to assess the association of salt-related KAP and determinants of high salt consumption in Nepal. The mean per capita salt intake was 8.0 (±3.7) g/day, with 81.6% of the population reporting higher intake than the WHO recommendation of <5g/day. People of upper castes [adjusted odds ratio (aOR)=0.7; 95% confidence interval (CI): 0.5-0.9], people in large families (aOR=0.6; 95% CI: 0.5-0.7), respondents who were advised to lower salt intake (aOR=0.6; 95% CI: 0.4-0.9) and who checked salt/sodium labels in food (aOR=0.6; 95% CI: 0.4-0.9) were less likely to consume higher amounts of salt. Similarly, people who added extra salt to their food at the table (aOR=1.4; 95 CI: 1.1-1.9) and who reported consuming high amounts of salt (aOR=1.5; 95% CI: 1.1-2.3) were more likely to have high salt intake. High salt intake was documented in this population. This study suggests the need for culturally tailored community-based behavior modification through health education and dietary counseling to effectively reduce salt consumption and thereby support a reduction in hypertension and cardiovascular diseases in Nepal.

Mean Dietary Salt Intake in Vanuatu: A Population Survey of 755 Participants on Efate Island.

Non-communicable diseases are responsible for 63% of global deaths, with a higher burden in low- and middle-income countries. Hypertension is the leading cause of cardiovascular-disease-related deaths worldwide, and approximately 1.7 million deaths are directly attributable to excess salt intake annually. There has been little research conducted on the level of salt consumption amongst the population of Vanuatu. Based on data from other Pacific Island countries and knowledge of changing regional diets, it was predicted that salt intake would exceed the World Health Organization’s (WHO) recommended maximum of 5 g per day. The current study aimed to provide Vanuatu with a preliminary baseline assessment of population salt intake on Efate Island. A cross-sectional survey collected demographic, clinical, and urine data from participants aged 18 to 69 years in rural and urban communities on Efate Island in October 2016 and February 2017. Mean salt intake was determined to be 7.2 (SD 2.3) g/day from spot urine samples, and 5.9 (SD 3.6) g/day from 24-h urine samples, both of which exceed the WHO recommended maximum. Based on the spot urine samples, males had significantly higher salt intake than females (7.8 g compared to 6.5 g; p < 0.001) and almost 85% of the population consumed more than the WHO recommended maximum daily amount. A coordinated government strategy is recommended to reduce salt consumption, including fiscal policies, engagement with the food industry, and education and awareness-raising to promote behavior change.

Integrating the development agenda with noncommunicable disease prevention in developing countries: a quasi-experimental study on inter-sectoral action and its impact on self-reported salt consumption-the INPARD study.

The determination of behaviours that lead to noncommunicable diseases (NCDs), such as high dietary salt intake, are multifactorial. The prevention of NCDs, including the promotion of healthy dietary choice, including low salt intake, therefore requires multisectoral working. Although the need of a multisectoral approach to risk factor modification has been globally accepted, there is minimal evidence for its application in the real world. This quasi-experimental trial was designed to study the impact of a community led multisectoral approach to integrate nutrition prevention into the development agenda, in two districts in Sri Lanka, a lower-middle income country undergoing a phase of rapid socioeconomic development. Results from logistic regression found that those living in the district (Ampara) that identified salt intake as a health issue had significantly higher odds (OR =1.4; 95% CI =1.1, 1.9) of high salt consumption (>5 grams/day) at baseline compared to control areas (Kurunegala), in multivariable models. Post-intervention, individuals in this district had lower odds (OR =0.6; 95% CI =0.4, 0.9) of consuming high levels of salt in all models, including multivariable models whilst controlling for baseline high salt consumption. The findings from this study demonstrate the positive impact in improved diet, in reduced salt consumption, through a community led multisectoral intervention, in areas in which the community identified high salt consumption as a health issue. These findings demonstrate that multisectoral approaches can be effective in the real world setting and highlight the need to engage with many stakeholders, including targeted communities throughout their development and implementation.

Salt-Related Knowledge, Attitudes, and Behaviors on Efate Island, Vanuatu.

In Vanuatu, mean salt intake exceeds the recommended maximum daily intake, and contributes to the high proportion of deaths attributable to cardiovascular diseases. Understanding salt-related knowledge, attitudes, and behaviors of the Vanuatu population can inform appropriate interventions. This cross-sectional study was conducted as part of the 2016–2017 Vanuatu Salt Survey. In total, 753 participants aged between 18 and 69 years from rural and urban communities on the Island of Efate were included. Demographic and clinical data were collected and a salt-related knowledge, attitudes, and behaviors survey was administered. Knowledge relating to the need to reduce salt consumption was high, but reported behaviors did not reflect this knowledge. A total of 83% of participants agreed that too much salt could cause health problems, and 86% reported that it was “very important” to lower the amount of salt in the diet. However, more than two-thirds of the population reported always/often adding salt to food during cooking/meal preparation and at the table, and always/often consuming processed foods high in salt. Strategic, targeted, and sustained behavior change programs in parallel with interventions to change the food environment to facilitate healthier choices should be key components of a salt reduction program. Actions should implemented as part of a comprehensive strategy to prevent and control non-communicable diseases in Vanuatu.

Treatment of Early Vascular Ageing.

Artery disease can be identified from ankle-brachial index (peripheral artery disease), pulse wave velocity (arterial stiffness), carotid intima media thickness (atherosclerosis) and flow-mediated dilation (endothelial dysfunction). Arterial stiffness is a marker of cardiovascular disease associated with cardiovascular events. Increased vascular ageing is the acceleration of arterial stiffness inappropriate for the given chronological age. Treatment of early vascular ageing seems to be important if we target primary cardiovascular prevention. Known factors that postpone the progression of vascular ageing may include lifestyle interventions such as physical exercise, moderate alcohol consumption, reduced salt consumption and weight reduction, factors that may preserve the vessels healthier than what expected for the chronological age. Hypertension, diabetes mellitus, obstructive sleep apnea and dyslipidemia are factors accelerating vessels damage and should be treated and maintained over time well controlled. In the future, trials are needed in order to identify the best combination of treatment as well as to identify drugs targeting on the vessels ageing.

都市部における保健所の減塩運動 ―小学生の塩分・食生活調査研究―

都市部における保健所の減塩運動 ―小学生の塩分・食生活調査研究―

Changing views on the common physiologic abnormality that mediates salt sensitivity and initiation of salt-induced hypertension: Japanese research underpinning the vasodysfunction theory of salt sensitivity.

High-salt intake is one of the major dietary determinants of increased blood pressure and cardiovascular disease. Thus, there is scientific and medical interest in understanding the mechanistic abnormalities mediating the pressor effects of salt (salt sensitivity). According to historical theory, salt sensitivity stems from an impairment in renal function (referred to as "abnormal pressure natriuresis" or a "natriuretic handicap"), which causes salt-sensitive subjects to excrete a sodium load more slowly, and retain more of it than salt-resistant normotensive controls. However, this historical view has come under intense scrutiny because of growing awareness that in salt-sensitive subjects, acute salt loading does not usually induce greater increases in sodium balance and cardiac output than those induced by salt loading in salt-resistant normotensive controls. Here we highlight pioneering studies from Japan that challenge the historical thinking and provide insights into a contemporary theory of salt sensitivity termed the "vasodysfunction theory." According to this theory, initiation of salt-induced hypertension usually involves abnormal vascular resistance responses to increased salt intake, not greater renal retention of a salt load in salt-sensitive subjects than in normal subjects. By shifting the focus from the historical theory to a contemporary final common pathway for the pathogenesis of salt sensitivity, research from Japan is building the scientific foundation for more effective approaches to the prevention and treatment of salt-induced hypertension. Among the most promising approaches are dietary strategies for reducing the risk for salt-induced hypertension that do not depend on reducing salt consumption in the population.

Evaluation of the effectiveness of iodine prophylaxis in Poland based on over 20 years of observations of iodine supply in school-aged children in the central region of the country.

IntroductionDue to the mild-to-moderate iodine deficiency in Poland, in 1997 iodine prophylaxis based on obligatory salt iodization was introduced. We attempted to evaluate the effectiveness of such prophylaxis, based on over 20 years of observations of iodine supply in school-aged children in Opoczno district (Central Poland).Material and methodsA group of 603 children (316 girls and 287 boys), aged 6–14, was examined at 4 time points: in the years 1994, 1999, 2010 and 2016. The children were tested for urine iodine concentration (UIC) and in each child the thyroid volume was measured ultrasonographically.ResultsThe median UIC in 1994 (45.5 μg/l) indicated moderate iodine deficiency, while after introducing prophylaxis it corresponded to adequate values (1999 – 101.1 μg/l, 2010 – 100.6 μg/l, 2016 – 288.3 μg/l); however, the last value was higher than the previous two. The thyroid size, assessed by ultrasonography and presented as volume/body surface area (V/BSA), in 1994 was 6.55 × 10–6 m; this value was higher than at other time points (2.73 × 10–6 m in 1999, 2.73 × 10–6 m in 2010, and 2.70 × 10–6 m in 2016).ConclusionsIodine prophylaxis has proved effective in eliminating iodine deficiency. In recent years, the diversification of iodine sources, despite the reduction of salt consumption, has led to an increase in median UIC to values close to the upper limit of UIC, accepted as normal. Further increase in iodine supply may be unfavourable for health; therefore constant monitoring of iodine prophylaxis is required.

Alimentação saudável na perspectiva multiprofissional: A experiência do Projeto “Saúde no Prato” desenvolvido na Atenção Básica

O projeto denominado “Saúde no Prato” teve inicio no primeiro semestre do ano de 2016. Portanto, objetivou-se com este relato descrever a experiência multiprofissional nas atividades de educação alimentar e nutricional e contribuir para a disseminação de experiências relacionadas a este modelo de intervenção na Atenção Básica. Trata-se de um estudo descritivo do tipo relato de experiência acerca da implantação de um projeto desenvolvido por residentes de Nutrição, Enfermagem, Serviço Social, Psicologia e Farmácia do programa de Residência Multiprofissional em Saúde do Adulto e Idoso do Hospital Universitário Professor Alberto Antunes da Universidade Federal de Alagoas, e com profissionais de saúde de uma UBS, onde é realizado o estágio em Atenção Básica da residência. O projeto foi desenvolvido em encontros com os profissionais e usuários inscritos, totalizando seis encontros semanais cujo formato padrão incluía a exposição do tema seguida de uma oficina culinária. Foi possível observar o sucesso do projeto ao longo dos encontros, pois as pessoas participaram de forma ativa, trazendo um feedback positivo através das mudanças de hábitos alimentares, mostrando que a educação nutricional em grupo constitui uma estratégia de fundamental importância para o enfrentamento dos problemas alimentares e nutricionais. Somados a esses pontos positivos, foram citados ainda pelos participantes: redução do peso, da pressão arterial, mudanças de práticas alimentares na família (redução do consumo de sal, açúcar, alimentos industrializados e aumento no consumo de saladas e frutas), maior cuidado na preparação dos alimentos, confecção de horta vertical em casa, maior participação dos homens na cozinha e maior dedicação às caminhadas.

Process Evaluation and Costing of a Multifaceted Population-Wide Intervention to Reduce Salt Consumption in Fiji.

This paper reports the process evaluation and costing of a national salt reduction intervention in Fiji. The population-wide intervention included engaging food industry to reduce salt in foods, strategic health communication and a hospital program. The evaluation showed a 1.4 g/day drop in salt intake from the 11.7 g/day at baseline; however, this was not statistically significant. To better understand intervention implementation, we collated data to assess intervention fidelity, reach, context and costs. Government and management changes affected intervention implementation, meaning fidelity was relatively low. There was no active mechanism for ensuring food companies adhered to the voluntary salt reduction targets. Communication activities had wide reach but most activities were one-off, meaning the overall dose was low and impact on behavior limited. Intervention costs were moderate (FJD $277,410 or $0.31 per person) but the strategy relied on multi-sector action which was not fully operationalised. The cyclone also delayed monitoring and likely impacted the results. However, 73% of people surveyed had heard about the campaign and salt reduction policies have been mainstreamed into government programs. Longer-term monitoring of salt intake is planned through future surveys and lessons from this process evaluation will be used to inform future strategies in the Pacific Islands and globally.

Salt consumption by Australian adults: a systematic review and meta-analysis.

Salt reduction is a public health priority because it is a leading contributor to the global burden of disease. As in Australia there is uncertainty about the current level of salt intake, we sought to estimate current levels. Random effects meta-analysis of data from 31 published studies and one unpublished dataset that reported salt or sodium consumption by Australian adults on the basis of 24-hour urine collections or dietary questionnaires. MEDLINE (via Ovid) and EMBASE (to August 2016). Thirty-one published studies and one unpublished dataset (1989-2015; 16 836 individuals) were identified. The mean weighted salt consumption estimated from 24-hour urine collections was 8.70 g/day (95% CI, 8.39-9.02 g/day); after adjusting for non-urinary salt excretion, the best estimate of salt intake in Australia is 9.6 g/day. The mean weighted intake was 10.1 g/day (95% CI, 9.68-10.5 g/day) for men and 7.34 g/day (95% CI, 6.98-7.70 g/day) for women. Mean weighted consumption was 6.49 g/day (95% CI, 5.94-7.03 g/day) when measured with diet diaries, 6.76 g/day (95% CI, 5.48-8.05 g/day) when assessed with food frequency questionnaires, and 6.73 g/day (95% CI, 6.34-7.11) when assessed by dietary recall. Salt intake had not decreased between 1989 and 2015 (R2 = -0.02; P = 0.36). Salt intake in Australian adults exceeds the WHO-recommended maximum of 5 g/day and does not appear to be declining. Measuring salt intake with methods based on self-reporting can substantially underestimate consumption. The data highlight the need for ongoing action to reduce salt consumption in Australia and robust monitoring of population salt intake.

Conditions of Food Consumption Related to Salt Intake in Women Aged 40-59 Years: Characteristics in Working Mothers of Medical University Students

The aims of this study were to clarify the conditions of food consumption related to salt intake in women aged 40-59 years and to determine the characteristics of working mothers. Among all guardians in a medical university, 247 (effective response rate, 32.2%) mothers of 40-59 years of age participated in this study. Factors related to salt intake were the frequency of consuming Japanese dishes (stewed foods, Japanese style rice, pickles, miso soup, noodles, vinegared dishes, marinated foods) and dietary habit (use of low-sodium seasoning when cooking, the amount of broth left unconsumed when eating noodle soup, the use of seasoning at the table). In comparison with the nonworking mothers, a greater number of the working mothers purchased smaller amount of fresh food and prepared meals for dinner in less than 30 minutes. Furthermore, the frequency of consuming Japanese dishes was also lower in the working mothers. This was not related to their state of mind or knowledge about salt consumption in relation to health and conscious effort to eat less salt, but rather to their longer work hours and shorter meal preparation time. Dietary habits are related to the state of mind, flavor, and knowledge and efforts to eat less salt. Working mothers, as well as nonworking mothers had dietary habits. For women in this age group, to reduce salt consumption, adopting ways to eat less salt at the table, which are feasible for everyone, are effective.

Impact of high salt consumption of blood pressure on a non-hypertensive population

Background There is conflicting evidence regarding the role of salt intake in blood pressure (BP). Aim To estimate the impact of salt consumption on the BP level of a non-hypertensive population aged between 15 and 64 years. Material and Methods Analytical-observational study using data from the National Health Survey 2009-2010. A BP cut-off point at 120/80 mmHg BP was considered to determine risk. Salt consumption was divided into four strata. The prevalence ratios (PR) were determined using the Poisson model with robust variance. The formulas of the studies of Dal Grande and Walter for the estimation of population attributable fraction (PAF) were used. Results The sample was constituted by 1,263 individuals and 24.3% had BP at risk. A statistically significant association was observed between high salt intake and risk BP with PR of 1.91 (95% confidence intervals (CI) 1.44-2.57) in the consumption stratum of 11 g / day and more. It was estimated that 4.7% (95% CI 4.2-5.2) of BP risk can be attributed to salt consumption, when controlling by age group, sex and educational level. Conclusions The 4.7% PAF is lower than the figure of 30% reported abroad. Interventions to reduce salt consumption in the entire population and the identification of risk groups are recommended.

Evaluation of a Mass-Media Campaign to Increase the Awareness of the Need to Reduce Discretionary Salt Use in the South African Population.

The South African strategic plan to reduce cardiovascular disease (CVD) includes reducing population salt intake to less than 5 g/day. A mass media campaign was undertaken to increase public awareness of the association between high salt intake, blood pressure and CVD, and focused on the reduction of discretionary salt intake. Community based surveys, before and after the campaign, were conducted in a cohort of black women aged 18–55 years. Questions on knowledge, attitudes and beliefs regarding salt use were asked. Current interest in engaging with salt reduction behaviors was assessed using the “stage of change” model. Five hundred fifty women participated in the baseline study and 477 in the follow-up survey. Most of the indicators of knowledge, attitudes and behavior change show a significant move towards considering and initiating reduced salt consumption. Post intervention, significantly more participants reported that they were taking steps to control salt intake (38% increased to 59.5%, p < 0.0001). In particular, adding salt while cooking and at the table occurred significantly less frequently. The findings suggest that mass media campaigns may be an effective tool to use as part of a strategy to reduce discretionary consumption of salt among the population along with other methods.

Traducción, adaptación cultural y validación del Salt Knowledge Questionnaire al idioma español

IntroductionIn order to reduce salt consumption in Spanish speaking countries it is necessary to know the level of salt knowledge in the population. However, there are no tools in Spanish to measure salt knowledge, but the only valid tool of measurement is the ‘Salt Knowledge Questionnaire’ (SKQ) developed in Australia, in English. Materials and methodsA validation study was conducted in three phases: (Phase1) Translation of the original Australian version into Spanish; (Phase2) Cultural adaptation based on a Spanish-speaking population such as Peru and following criteria used in the development of the original questionnaire which was evaluated by a panel of experts; (Phase3) Construct validity by comparing the scores of three groups (experts, medical students and non-experts) and reliability by performing a test retest. ResultsThe translation of the SKQ into Spanish maintained a semantic equivalence with the original questionnaire and a panel of experts accepted the cultural adaptation. The SKQ enables discrimination between those who know and those who do not because differences of scores were found between the group of experts, students and non-experts (P<.001). A good overall internal consistency of the instrument was found (KR20=0.69) and a good overall intraclass correlation (0.79) and no test variations in test-retest (P>.05). ConclusionsThe SKQ questionnaire in Spanish is valid, reliable and is a suitable first tool to measure knowledge about salt in the Spanish language. It is considered possible to adapt it culturally to the Spanish-speaking country that wishes to use it.

Collecting Evidence to Inform Salt Reduction Policies in Argentina: Identifying Sources of Sodium Intake in Adults from a Population-Based Sample.

The maximum content of sodium in selected processed foods (PF) in Argentina was limited by a law enacted in 2013. Data about intake of these and other foods are necessary for policy planning, implementation, evaluation, and monitoring. We examined data from the CESCAS I population-based cohort study to assess the main dietary sources among PF and frequency of discretionary salt use by sex, age, and education attainment, before full implementation of the regulations in 2015. We used a validated 34-item FFQ (Food Frequency Questionnaire) to assess PF intake and discretional salt use. Among 2127 adults in two Argentinean cities, aged 35–76 years, mean salt intake from selected PFs was 4.7 g/day, higher among male and low education subgroups. Categories of foods with regulated maximum limits provided near half of the sodium intake from PFs. Use of salt (always/often) at the table and during cooking was reported by 9% and 73% of the population, respectively, with higher proportions among young people. Reducing salt consumption to the target of 5 g/day may require adjustments to the current regulation (reducing targets, including other food categories), as well as reinforcing strategies such as education campaigns, labeling, and voluntary agreement with bakeries.

Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy?

BackgroundNon-communicable disease (NCD) prevention strategies now prioritise four major risk factors: food, tobacco, alcohol and physical activity. Dietary salt intake remains much higher than recommended, increasing blood pressure, cardiovascular disease and stomach cancer. Substantial reductions in salt intake are therefore urgently needed. However, the debate continues about the most effective approaches. To inform future prevention programmes, we systematically reviewed the evidence on the effectiveness of possible salt reduction interventions. We further compared “downstream, agentic” approaches targeting individuals with “upstream, structural” policy-based population strategies.MethodsWe searched six electronic databases (CDSR, CRD, MEDLINE, SCI, SCOPUS and the Campbell Library) using a pre-piloted search strategy focussing on the effectiveness of population interventions to reduce salt intake. Retrieved papers were independently screened, appraised and graded for quality by two researchers. To facilitate comparisons between the interventions, the extracted data were categorised using nine stages along the agentic/structural continuum, from “downstream”: dietary counselling (for individuals, worksites or communities), through media campaigns, nutrition labelling, voluntary and mandatory reformulation, to the most “upstream” regulatory and fiscal interventions, and comprehensive strategies involving multiple components.ResultsAfter screening 2,526 candidate papers, 70 were included in this systematic review (49 empirical studies and 21 modelling studies). Some papers described several interventions. Quality was variable. Multi-component strategies involving both upstream and downstream interventions, generally achieved the biggest reductions in salt consumption across an entire population, most notably 4g/day in Finland and Japan, 3g/day in Turkey and 1.3g/day recently in the UK. Mandatory reformulation alone could achieve a reduction of approximately 1.45g/day (three separate studies), followed by voluntary reformulation (-0.8g/day), school interventions (-0.7g/day), short term dietary advice (-0.6g/day) and nutrition labelling (-0.4g/day), but each with a wide range. Tax and community based counselling could, each typically reduce salt intake by 0.3g/day, whilst even smaller population benefits were derived from health education media campaigns (-0.1g/day). Worksite interventions achieved an increase in intake (+0.5g/day), however, with a very wide range. Long term dietary advice could achieve a -2g/day reduction under optimal research trial conditions; however, smaller reductions might be anticipated in unselected individuals.ConclusionsComprehensive strategies involving multiple components (reformulation, food labelling and media campaigns) and “upstream” population-wide policies such as mandatory reformulation generally appear to achieve larger reductions in population-wide salt consumption than “downstream”, individually focussed interventions. This ‘effectiveness hierarchy’ might deserve greater emphasis in future NCD prevention strategies.

Cost-effectiveness of salt reduction to prevent hypertension and CVD: a systematic review.

To analyse and compare the cost-effectiveness of different interventions to reduce salt consumption. A systematic review of published cost-effectiveness analyses (CEA) and cost-utility analyses (CUA) was undertaken in the databases EMBASE, MEDLINE (PubMed), Cochrane and others until July 2016. Study selection was limited to CEA and CUA conducted in member countries of the Organisation for Economic Co-operation and Development (OECD) in English, German or French, without time limit. Outcomes measures were life years gained (LYG), disability-adjusted life years (DALY) and quality-adjusted life years (QALY). Relevant aspects in modelling were analysed and compared. Quality assessments were conducted using the Drummond and Jefferson/British Medical Journal checklist. OECD member countries. Mainly adults. Fourteen CEA and CUA were included in the review which analysed different strategies: salt reduction or substitution in processed foods, taxes, labelling, awareness campaigns and targeted dietary advice. Fifty-nine out of sixty-two scenarios were cost-saving. The incremental cost-effectiveness ratio in international dollars (Intl.$; 2015) was particularly low for taxes, a salt reduction by food manufacturers and labelling (303 900 Intl.$/DALY). However, only six studies analysed cost-effectiveness from a societal perspective and quality assessments showed flaws in conducting and a lack of transparency in reporting. A population-wide salt reduction could be cost-effective in prevention of hypertension and CVD in OECD member countries. However, comparability between study results is limited due to differences in modelling, applied perspectives and considered data.