Introduction: Nutrition labeling provides nutritional information about nutrients present in a food product. It is commonly applied to packaged foods and beverages, where the information can be presented on the back or front of the pack as the nutrient declaration, nutrition and health claims, and supplementary nutrition information. Nutrition labeling is an important policy instrument for improving the nutritional quality of foods and promoting healthy diets, as it allows consumers to make informed purchasing decisions. This document review aims to provide a comprehensive overview of government-endorsed nutrition labeling policies related to nutrient declaration, nutrition claims, and supplementary nutrition information enforced worldwide.Methods: We searched two nutrition policy databases, the Global database on the Implementation of Food and Nutrition Action (GIFNA) and the NOURISHING database, and government websites of some selected countries for the government-endorsed nutrition labeling policies published up to June 2023. We narrated the policy adopting countries' distribution by WHO regions, mode of implementation (voluntary or mandatory), and types of front-of-pack labels implemented.Results: Globally, we found that 95 countries have mandatory policies for nutrient declarations on packages of processed products. These include 41 countries in Europe, 19 in America, 14 in the Western Pacific, nine in Africa, seven in the Eastern Mediterranean region, and five countries from South-East Asia. Additionally, 71 countries have policies on the use of nutrient claims like “fat-free,” “excellent source,” and “fortified.” European region has the highest number of countries (37) that have rules on nutrient claims. Front-of-pack labeling (FOPL) policies have been introduced in 44 countries as supplementary nutrition information. Of these, 16 countries have adopted FOPL as mandatory, while others have implemented it voluntarily. The FOPL systems include warning labels, keyhole logo, health star rating, traffic light labeling, nutri-score, and healthy choice logos.Conclusion: Over recent years, the number of countries adopting mandatory nutrition labeling policies, especially FOPLs, has increased globally. Labeling policies should be evidence-based and follow the best practices to protect consumers from unhealthy nutrients and promote healthy eating. FOPL designs need to be selected based on country-specific evidence of effectiveness and appropriateness, avoiding industry influence.

The World Health Organization recommended reducing one’s salt intake below 5 g/day to prevent disability and death from cardiovascular and other chronic diseases. This review aimed to identify salt estimation at the population level in South Asian countries, namely Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka. We searched electronic databases and government websites for the literature and reports published between January 2011 and October 2021 and also consulted key informants for unpublished reports. We included studies that assessed salt intake from urinary sodium excretion, either spot urine or a 24 h urine sample, on a minimum of 100 samples in South Asian countries. We included 12 studies meeting the criteria after screening 2043 studies, out of which five followed nationally representative methods. This review revealed that salt intake in South Asian countries ranges from 6.7–13.3 g/day. The reported lowest level of salt intake was in Bangladesh and India, and the highest one was in Nepal. The estimated salt intake reported in the nationally representative studies were ranging from 8 g/day (in India) to 12.1 g/day (in Afghanistan). Salt consumption in men (8.9–12.5 g/day) was reported higher than in women (7.1–12.5 g/day). Despite the global target of population salt intake reduction, people in South Asian countries consume a much higher amount of salt than the WHO-recommended level.

Background/Objectives: Front-of-package labeling (FOPL) policies are a useful strategy to inform consumers about foods high in nutrients of concern, but little is known about what type of label works best in Bangladesh, a country with increasing levels of unhealthy food intake and diet-related diseases. Methods: We conducted 10 focus groups with men and women in rural and urban Bangladesh (n = 76). Using a semi-structured discussion guide, we asked consumers for their perceptions of the healthfulness of nutrients and foods, two common FOPLs (a color-coded guideline daily allowance [GDA] label and a warning label), and different visual elements of the warning label (e.g., shape, icon, text). Results: Participants understood the health harms of sugar and salt consumption but were less clear on saturated fat. Both FOPLs were perceived as helpful for identifying unhealthy foods, but the warning labels were perceived as easier to understand and more likely to influence behaviors than the GDA. Regarding the design of warning labels, participants perceived warning devices, holding straps, and octagonal shapes as effective but had mixed reactions to which icons or textual statements were most effective. Conclusions: FOPLs are likely to facilitate Bangladeshi consumers’ ability to identify unhealthy products. Further research is needed to understand the impact on food choices as well as the most effective design in this population.

Processed and ultra-processed foods (PF/UPFs) are becoming a significant public health concern because of their concerningly high nutrient content, including sodium, and rapidly increasing consumption, especially in low- and middle-income countries. This study aimed to analyze sodium levels in commonly consumed PF/UPFs in Bangladesh, compare them to the WHO’s sodium benchmarks, and assess the discrepancies between label-reported and laboratory-analyzed sodium content. A countrywide cross-sectional survey was conducted among adults, adolescents, and children to identify commonly consumed PFs/UPFs. Most common PF/UPFs were analyzed using Mohr’s titration method to estimate sodium content. Discrepancies between actual content and labels were analyzed, accepting a ±20% deviation, to determine gaps. Among the 974 participants surveyed, PF/UPF consumption in the past week was 97%, with higher consumption among metropolitan and urban residents. Amount of sodium, analyzed in 105 PF/UPF across 14 WHO categories and sub-categories, varied by categories, with soups, instant noodles, and chutneys having the highest. Compliance with the WHO’s sodium benchmarks was inconsistent across categories. The accuracy of label reporting was suboptimal, with under-reporting in 40% of products and a lack of sodium labelling in 9%. These findings unveiled high sodium intake from PFs/UPFs and inaccurate labelling as public health concerns in Bangladesh, highlighting the need for appropriate policies and strategies.

According to WHO, reducing salt intake to less than 5 g/day means less death, disability, and suffering from heart disease and stroke, with around 1.89 million lives saved every year. In this scoping review, we have reviewed the salt consumption pattern of South Asia. For this purpose, we searched online databases and websites and consulted key informants to address relevant unpublished reports. The inclusion criteria are English-language publications between January 2011 and October 2021, as well as research that evaluated salt intake in the South Asian region and reported salt/sodium 24-hr urine or spot urine samples involving at least 100 participants. A total of 2043 studies were screened, out of which 12 studies fulfilled all the criteria. Our review revealed that reported salt intake in the South Asian region ranges from 6.7-13.3 g/day, which was higher than the WHO-recommended maximum level of 5 g/day in all countries. Men consumed more salt than women. This review demonstrates the critical importance of implementing a salt reduction program in South Asian countries.