In his just published report to the WHO Forum on Reducing Salt Intake in Populations, he points that few countries are following the recommendation of the WHO technical report on primary prevention of essential hypertension and the joint WHO/FAO report on diet, nutrition and the prevention of chronic diseases which state that the intake goal for salt should be less than 5 grams a day. Some countries have developed their own higher targets for salt intake while others do not currently have any national recommendation on salt.

Professor noted that most European countries still recommended intakes in excess of WHO's recommendations or no real advice at all. One of the highest being Belgium for which the recommendation is less than 8.75 grams a day (though in Portugal it is less than 5g/day). In Greece and Hungary, only general dietary recommendations are available (e.g. "avoid salt and foods rich in salt").

The UK recommendation is for less than 6g/day. While this is still slightly higher than the WHO recommendation Professor Cappuccio notes that the UK also has one of world's most active and effective publicity campaigns to try and get people to reduce their salt intake.

The situation is worse in Asia. Here Professor Cappuccio noted that nutritional recommendations were found for four countries and they ranged from less than 5 g/day in Singapore to less than 10 g/day of salt in Japan. In the African continent, only two countries, Nigeria and South Africa, have developed dietary guidelines regarding salt intake.

Things are a little better in Australia, New Zealand, Canada and the US which share the target of less than 6 g/day of salt though this is still above WHO guidelines. However in the USA there is a specific recommendation of less than 4 g/day for special groups. In South America, a few countries have developed general advice (such as "reduce salt intake", "moderation in salt intake") but Brazil is the only country with a nutritional recommendation (actually the same as the WHO target of less than 5 g/day of salt).

Professor Cappuccio also noted that Iodine deficiency is another worldwide public health problem and the main strategy to control IDD is universal salt iodization. Consequently, many countries include in their national dietary guidelines the recommendation to ensure the use of iodized salt, with obvious potentially conflicting public health messages on salt usage. He believes that there is an urgent need to re-visit this policy.

Professor Cappuccio says:

"Efforts and commitments to reduce salt intake are still not a reality in many countries and recommendations must result in action, which should be tailored to the national context. Voluntary, as well as statutory initiatives are thus necessary. The lack of policies and/or recommendations to reduce salt intake in African and Latin American countries demonstrates regional differences in the work achieved to date to tackle this risk factor for cardiovascular diseases."

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