The World Health Organization (WHO) has released the second edition of its “SHAKE the Salt Habit” guide, updating its global policy framework for reducing excessive sodium consumption and addressing the growing burden of cardiovascular diseases.
The guide warns that current global sodium intake remains dangerously high at more than 4,200 mg per day, which is equivalent to roughly 11 grams of salt, more than double the WHO-recommended limit of 2,000 mg sodium (5g salt) daily. According to WHO estimates, high sodium consumption contributes to approximately 1.7 million deaths annually, primarily through hypertension, stroke, and heart disease.
The updated framework argues that voluntary industry commitments alone are insufficient to meet the global target of a 30% reduction in sodium intake by 2030. Instead, WHO recommends stronger government-led regulatory interventions through its SHAKE Framework, covering Surveillance, Harnessing industry, Adopting standards, Knowledge, and Evaluation.
The guide identifies several priority policy interventions, including mandatory sodium limits for processed foods, interpretive front-of-pack nutrition labelling, restrictions on marketing unhealthy foods to children, and sodium standards in public procurement systems such as schools and hospitals.
WHO also highlights the growing role of Lower-Sodium Salt Substitutes (LSSS), where part of sodium chloride is replaced with potassium chloride. These substitutes are identified as a potentially high-impact intervention for reducing population-level blood pressure, provided they remain compatible with national salt iodization programmes and are carefully monitored among individuals with kidney disease.
The SHAKE Intervention Pillars
Food Reformulation: Setting sodium reduction targets across processed food categories.
Interpretive Labelling: Introducing clear front-of-pack nutrition warnings for foods high in salt, sugar, and fat.
Public Procurement Standards: Restricting high-sodium foods in schools, hospitals, and public institutions.
Economic Measures: Considering taxation and pricing tools to incentivize healthier food production.
Behavioural Change Campaigns: Encouraging reduced salt consumption through public awareness initiatives.
What is “LSSS” (Lower-Sodium Salt Substitute)?
Lower-Sodium Salt Substitutes (LSSS) are alternatives in which part of regular sodium chloride salt is replaced with potassium chloride. These substitutes can significantly reduce sodium intake while maintaining a similar taste profile. WHO identifies LSSS as a potentially effective population-level intervention for reducing blood pressure and cardiovascular risk, though caution is required for people with chronic kidney disease.
Policy Relevance
India’s average salt intake remains significantly above the WHO-recommended limit of 5g per day, making sodium reduction an increasingly important public-health priority amid rising hypertension and cardiovascular disease burdens.
Emerging Sodium Reduction Measures: India has introduced nutrition disclosure requirements and public awareness initiatives such as the Eat Right India campaign to encourage healthier food consumption.
Front-of-Pack Labelling Debate: The Supreme Court has pushed FSSAI to accelerate consideration of mandatory front-of-pack nutrition warning labels for foods high in salt, sugar, and saturated fat.
Shift Toward Stronger Regulation: Policy discussions are increasingly moving from voluntary industry action toward clearer regulatory standards for processed foods and packaged nutrition disclosures.
Processed Food Reformulation: Public-health discussions have increasingly focused on reducing sodium levels in commonly consumed packaged foods such as snacks, biscuits, and bread.
Balancing Salt Reduction and Iodization: Any future transition toward lower-sodium salt substitutes would need to remain compatible with India’s universal salt iodization programme.
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