Objective: To assess the current Na levels in a variety of processed food groups and categories available in the Argentinean market to monitor compliance with the National Law and to compare the current Na content levels with the updated Pan American Health Organisation (PAHO) regional targets. Design: Observational cross-sectional study. Setting and Participants: Argentina. Data were collected during March 2022 in the city of Buenos Aires in two of the main supermarket chains. We carried out a systematic survey of pre-packaged food products available in the food supply assessing Na content as reported in nutrition information panels. Results: We surveyed 3997 food products, and the Na content of 760 and 2511 of them was compared with the maximum levels according to the Argentinean law and the regional targets, respectively. All food categories presented high variability of Na content. More than 90 % of the products included in the National Sodium Reduction Law were found to be compliant. Food groups with high median Na, such as meat and fish condiments, leavening flour and appetisers are not included in the National Law. In turn, comparisons with PAHO regional targets indicated that more than 50 % of the products were found to exceed the regional targets for Na. Conclusions: This evidence suggests that it is imperative to update the National Sodium Reduction Law based on regional public health standards, adding new food groups and setting more stringent legal targets.

Public health policies have been widely utilized to improve population nutrition, such as the newly announced front-of-pack labels (FOPLs) that will be applied to Canadian prepackaged foods to help consumers make healthier selections. However, research on similar health logos in the food service sector has been limited. This study explores the potential application of FOPL-style health logos in the food service sector and its impact on consumer behaviors. A survey was conducted among 1070 Canadians to assess their awareness, perception, and support for health logos on restaurant menus. The results indicate that while participants value healthy food options when dining out, taste, price, and convenience remain the primary factors influencing their choices. Most participants were unaware of existing FOPL policies and demonstrated mixed responses regarding the influence of similar health logos on their restaurant selection. However, a majority expressed a desire to see FOPL-style health logos on menus, and nutrient profile ratings and logos indicating nutrient limitations or encouragements were listed as preferred health logos. Notably, females indicated higher supportiveness for FOPL-style health logos on menus and individuals with food allergies exhibited higher agreement in the likelihood of eating at a restaurant displaying labels. Additionally, findings revealed that FOPL-style health logos alone may not significantly deter consumers from purchasing labelled menu items, especially if price is affected. Overall, this study highlights the need for further understanding consumer perceptions to effectively develop and implement FOPL initiatives in the food service sector.

Background: Sodium reduction is a cost-effective measure to prevent noncommunicable diseases. The World Health Organization (WHO) established a target of a 30% relative reduction in mean population intake of sodium by 2025. The Pan American Health Organization (PAHO) published sodium reduction targets (SRTs) for packaged foods in 2015, expanding and updating the targets in 2021 to help Member States with its efforts in reducing population sodium intake. Objective: This study examined the current sodium levels in packaged foods among five countries in the Americas and monitored cross-sectional and longitudinal compliance with the sodium targets from 2015 to 2022. Methods: Food labels were systematically collected from the main supermarkets in five countries in the Americas region in 2022. Sodium levels per 100g and per kcal for collected food labels in 16 PAHO categories and 75 subcategories were analyzed and compared against the updated SRTs. Further analysis of three countries that have longitudinal data for 2015–2016, 2017–2018 and 2022 was conducted to compare sodium per 100 g against the 2015 SRTs. Results: A total of 25,569 food items were analyzed. Overall, ‘processed meat and poultry’ had the highest sodium levels, although there were large variations within categories. 47% and 45% of products met the sodium per 100g and per kcal 2022 SRTs, respectively. Peru had the highest compliance, whereas Panama had the lowest for both targets. Among Argentina, Costa Rica and Peru, the proportion of foods meeting the 2015 PAHO lower targets were 48, 53 and 61% for 2015–2016, 2017–2018 and 2022, respectively (p < 0.001). Conclusions: This study showed that around half of the examined foods met their respective SRTs and there have been small improvements in compliance over time. Further efforts are required to reach the WHO’s global sodium reduction goal by 2025, such as implementation of mandatory SRTs and front-of-pack labelling regulations.

Restaurant foods are associated with excessive energy intake and poor nutritional quality. In 2017, the Healthy Menu Choices Act mandated food service establishments with ≥20 outlets in Ontario to display the energy content on menus. To examine the potential impact of menu labelling, nutrition information for 18,760 menu items were collected from 88 regulated and 53 unregulated restaurants. Descriptive statistics were calculated for serving size, energy, saturated fat, sodium and total sugars. Quantile regression was used to determine the differences between regulated and unregulated restaurants. The energy content of menu items from regulated restaurants (median (95% CI): 320 kcal (310, 320)) was significantly lower than those from unregulated restaurants (470 kcal (460, 486), p < 0.001). Saturated fat, sodium and total sugars were significantly lower in regulated restaurants (4 g (4, 4), 480 mg (470, 490) and 7 g (6, 7), respectively) than in unregulated restaurants (6 g (6, 6), 830 mg (797, 862) and 8 g (8, 9), respectively, p < 0.001). This study showed that menu items from regulated restaurants had smaller serving size, lower levels of energy and nutrients of public health concern compared to those from the unregulated restaurants, suggesting potential downstream beneficial effects of menu labelling in lowering caloric content and nutrients of public health concern in foods.

In an effort to improve high sodium consumption in the population, in 2012 Health Canada released voluntary sodium reduction targets for prepackaged foods to be met before 2017. This study used the University of Toronto’s Food Label Information Program database (FLIP), 2013 and 2017 collections, to evaluate changes and differences in mean sodium content of Canadian prepackaged foods and manufacturers’ progress in meeting Health Canada’s average and maximum sodium reduction targets. Changes to sodium content (reformulation) in products present in both FLIP years and differences across years including both new and existing products were assessed via paired and independent t-tests, respectively. The average sodium content from FLIP 2017 was also compared to previously published sales-weighted average sodium content published by Health Canada to aid in the interpretation of our results. Our reformulation analyses of consistent products between years revealed that 50% of food subcategories did not have significant changes in mean sodium from 2013 to 2017. Examining both new and existing foods, 59% of subcategories had no significant difference in mean sodium content between 2013 and 2017. The proportion of foods meeting final sodium targets was 33.6% in 2013 and 37.3% in 2017. In 2013 and 2017, 20.8% and 19.6% of products exceeded the maximum sodium targets, respectively. For almost all major food categories, a greater proportion of new products in 2017 met final sodium targets compared to existing foods (present in both FLIP 2013 and 2017). Nearly, half the major food categories examined had more new products meeting the maximum sodium target than existing products. Less than half of food subcategories (48%, n = 45/94) from FLIP 2017 differed by ≥20% compared to sales-weighted averages published by Health Canada. Our findings reveal limited progress in the reduction of sodium in prepackaged foods. Calls for more robust policy initiatives and the continued independent monitoring of food industry efforts in Canada are warranted.