European Salt Action Network (ESAN)

WHO Action Network on Salt Reduction in the Population

in the European Region (ESAN)

Bern, Switzerland, 7-8 May, 2019

To help facilitate progress towards the globally agreed target to cut salt intakes by 30% by 2025, the WHO Action Network on Salt Reduction in the Population in the European Region (ESAN) was established in 2007. The 11th ESAN meeting took place from 7-8 May 2019 in Bern, Switzerland, hosted by the Federal Food Safety and Veterinary Office of Switzerland and co-organized by the WHO Regional Office for Europe. The meeting welcomed 33 participants, including 20 representatives of 12 Member States, invited speakers and WHO staff.

The meeting heard about progress with national salt reduction strategies from five countries and discussed developments in methodology for monitoring food composition and progress towards targets. Participants also learned about some of the challenges and opportunities associated with sensory thresholds for consumer perception of salt and technical issues around food safety. New tools for data collection and implementation of salt reduction strategies were presented to support Member States in their efforts. In addition, representatives of non-governmental organizations working in salt reduction provided a summary of their work in the field.

It was agreed that ESAN and WHO would pursue further work on modelling of the health impact, in terms of years of life saved, of effective salt reduction strategies and on the development of understanding and approaches to reducing salt intakes from food eaten outside the home.

Download the Meeting Report

WHO Action Network on Salt Reduction in the Population

in the European Region (ESAN)

Rome, Italy, 12-13 September, 2018

The 10th network meeting took place from 12 - 13 September 2018 in Rome, hosted by the Ministry of Health of Italy. The WHO Regional Office for Europe and the Federal Food Safety and Veterinary Office of Switzerland co-organized the meeting. The meeting welcomed 35 participants, of which 18 were country representatives. Staff from WHO Headquarters and the WHO Regional Office for Europe also joined.

After the introduction session, six countries gave an update on their national salt reduction strategies. This was followed by information from the WHO Headquarters and WHO Regional Office for Europe about their ongoing initiatives. Countries also presented their latest data on sodium in foods and salt intake. Afterwards, invited speakers presented the most up-to-date evidence on salt reduction policies, including tools to improve consumer access to information (including healthy swaps) and salt taxes. In addition the group discussed novel approaches to collect food composition data from online supermarkets.

The first day concluded with an in depth discussion about the recent controversies on salt intake and cardiovascular diseases (CVD) arising from a number of scientific publications that challenge the WHO guidelines. As a result, ESAN developed and published a statement on salt and CVD in December 2018. The statement discusses the scientific evidence and identifies the pitfalls of recent data, which is in many places biased by flawed methodology. The statement concludes that the evidence supporting global actions for a moderate reduction in salt consumption to prevent CVD remains strong and the new studies should not undermine efforts to achieve WHO targets and guidelines.

Day 2 was dedicated to the exchange of scientific know how about the monitoring of sodium intake and of the composition of foods as well as sodium and nutrition labelling.

It was also discussed and agreed that the ESAN network and WHO would work together to update information on national salt reduction strategies, including detailed information about salt reduction targets set for different categories of foods. The intention is to exchange on current practice in countries. The ESAN Secretariat will circulate a short survey to network members in February.

View programme.

Read Scientific statement

WHO Action Network on Salt Reduction in the Population

in the European Region (ESAN)

Dublin, Ireland, 9-10 May, 2017

WHO has identified cutting salt intakes as a priority for preventing non-communicable diseases and, globally, countries have already committed to cut salt intakes by 30% between 2010 and 2025. To help facilitate progress in reducing salt intakes, the WHO Action Network on Salt Reduction in the Population in the European Region (ESAN) was established in 2007. The network—which now consists of more than 20 WHO European Region Member States—met in Dublin, Ireland on 9-10 May 2017.

There has been progress in the Region and the salt reduction efforts of many Member States have demonstrated that real and sizeable reductions in salt levels across a range of foods is possible. Tracking the impact on dietary intakes is more difficult, and, although some countries have also been able to demonstrate a drop in average salt intakes, this has not always been possible.

It is clear that progress is uneven and insufficient—no European country is currently on track to meet the global target—and further progress is needed. This may require more use of regulation and mandatory, rather than voluntary, salt contents for particular foods. In addition, there is a role for country-specific intermediate goals to drive forward progress towards the longer-term, global goal. Innovative front-of pack nutrition labelling shows promise for changing consumer purchases and, potentially, for driving reformulation. Better data are needed to monitor changes in both salt levels and intakes. There is great interest in developing harmonized monitoring of salt in some foods as a tool for both recording progress and highlighting where greater gains are possible.

View programme.

Read the f ull report

WHO Action Network on Salt Reduction in the Population

in the European Region (ESAN)

Lisbon, Portugal, 20- 21 April, 2016

WHO has identified cutting salt intakes as a priority for preventing non-communicable diseases and, globally, countries have already committed to cut salt intakes by 30% between 2010 and 2025. Although countries have been taking policy action, however, it is clear that progress is uneven and insufficient — no European country is currently on track to meet that global target.

The WHO Action Network on Salt Reduction in the Population in the European Region was established in 2007 as a response to the increasing salt consumption of the population. The network, which now consists of 29 WHO European Region Member States, met in Lisbon, Portugal on 20-21 April 2016. The meeting heard about the latest progress on salt reduction from selected countries and explored various methods of measuring and monitoring salt levels in food and salt intakes. Participants learned about state of the art science, including the latest evidence on salt and health outcomes, and the latest technological developments to facilitate further reductions in the levels of salts in foods. The meeting also heard clear evidence that salt reduction strategies can and do work . The growing evidence base on successful salt reduction strategies provides a wealth of information for policymakers to learn from others’ experience and to identify the most effective approaches to reduce salt intakes and improve population health.

View programme

Read the Meeting Report

WHO Action Network on Salt Reduction in the Population

in the European Region (ESAN)

Athens, Greece, 16-17 June, 2015

The 2015 network meeting took place in Athens, Greece on 16-17 June 2015. The Hellenic Health Foundation hosted the meeting. Representatives from 13 countries (Albania, Bulgaria, Croatia, Cyprus, Finland, Greece, Hungary, Ireland, Israel, Norway, Sweden, Switzerland and the Netherlands), the WHO, the European Commission, the WHO collaborating centres RIVM and University of Warwick and invited external speakers attended the meeting.

Several countries gave an update on their salt reduction strategies. Research projects were presented and ideas about further joint research were discussed. This meeting included also a report back on the Working Group “Bread” and there was support for the idea of modifying the tool for use in other food categories. The process for developing the new WHO guidelines was presented and the opportunities and challenges for cutting sugar intakes outlined.

View programme.

Read the final report.

WHO Action Network on Salt Reduction in the Population

in the European Region (ESAN)

Bern, Switzerland, 2-3 April, 2014

The first network meeting was held in Bern on April 2-3, 2014 under the auspices of Switzerland.

Seventeen network countries were able to attend the meeting. Meeting participants also included representatives from the WHO and WHO collaborating centres and speakers invited from research institutions.

Several countries gave an update on their salt reduction strategies. Research projects were also presented and ideas about possible joint research projects were exchanged. An excel file to collect data on the reduction of salt in bread and the first project results were presented. The need for coordinated programs to improve health by optimizing salt and iodine intake was later discussed.

View programme.

Read the final report.

WHO-RIVM Workshop, Bilthoven, The Netherlands

7-8 November, 2013

Workshop on Methodological aspects of health effect projections of salt reduction

National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

Participants photo

L Cobiac (Australia), P Coxson, A Mason (USA), M Brown, FP Cappuccio, C Ji, T Marsh, J Powles, P Scarborough (United Kingdom), H Boshuizen, JM Geleijnse, E Elsman, M Hendriksen, J Hockstra, R Hoogenveen, M Kretzschmar, W Nusselder, M Prijs, I Toxopeus, K van Mourik, J van Raaij (The Netherlands).

Ensuing publication

Hendriksen M, Geleijnse JM, van Raaij JMA, Cappuccio FP, Cobiac LC, Scarborough P, Nusselder WJ, Jaccard A, Boshuizen HC. Identification of differences in health impact modelling of salt reduction. PLoS ONE 2017; 12(11): e0186760