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WHO Collaborating Centre for Nutrition

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In September 2008, Warwick Medical School was designated as a WHO Collaborating Centre for Nutrition. The Centre was re-designated for a further 4 years (2014-2018). The terms of reference of the WHO Collaborating Centre are presented as bullet points and briefly describe the scope of the activities that the institution performs as a WHO Collaborating Centre:

Operational support:

  • To compile and keep up-to-date national guidelines on salt reduction at population level in European countries.
  • To extend the search and cataloguing in countries worldwide.
  • To continue systematic reviews to inform policy makers and to monitor international progress.

Research:

  • To increase the research output in the following areas that are of interest to the WHO general framework:
    (a) quantitative monitoring of urinary sodium output;
    (b) analysis of trends in urinary output;
    (c) producing evidence of the effectiveness of implementation programmes.
  • To monitor the development of new policies for the reduction of salt intake.
  • To study how the development of new policies is influenced by research findings.
  • To explore issues of distribution and access to food items reduced in salt and socio-economic barriers to their use.
  • The Centre studies the potential impact of social and health inequalities on the implementation of nutritional policies for a reduction in salt intake and nutritional interventions targeted at low socio-economic groups.

Monitoring within the European Network:

  • To act as an integral partner in the development, implementation and monitoring of national programmes aiming at a reduction in salt intake.
  • To support monitoring and surveillance by providing centralized laboratory measurements of urinary sodium, potassium and creatinine obtained from random samples of participating populations.

Education, Training and Capacity Building:

  • To organize workshops and seminars aimed at the dissemination of information regarding methods, nutritional skills, policy issues and implementation tools for European participation.

Forum and Technical Meeting on Reducing Salt intake to Prevent Cardiovascular Disease.

Paris 2006

WHO organized a forum and a technical meeting on Reducing Salt Intake in Populations, from 5 to 7 October 2006 in Paris, France.

The Forum reviewed the current evidence base on a wide range of topics, including initiatives, policies and programmes aimed at reducing salt intake in the population, methods for measuring salt intake, main contributors to salt consumption and the impact of lowering salt intake on health care spending. Stakeholders involved in the development and implementation of salt reduction policies presented their activities and participated in the forum discussions.

During the technical meeting, which followed the forum, working groups discussed the rationale for recommendations on reducing salt intake, guiding principles for policy development and specific issues to consider at national level when planning an intervention on salt reduction. The WHO temporary advisers who participated in the technical meeting drafted a series of recommendations to different stakeholders on how to facilitate the reduction of salt intake at the population level with the long term objective of preventing chronic diseases.

Click here to download the document "Reducing salt intake in populations - Report of a WHO Forum and Technical Meeting"


Salt as a vehicle for fortification.

Luxembourg 2007

As a follow-up to the forum and a technical meeting on "Reducing Salt Intake in Populations", held in Paris (France) in October 2006, WHO organized an Expert Consultation on "Salt as vehicle for fortification", which was held in Luxembourg in March 2007.

A report of this expert consultation was produced and can be downloaded here.


PAHO/WHO Regional Expert Group on Cardiovascular Disease Prevention through Dietary Salt Reduction.

Washington DC, USA 2009-2011

In 2009, the PAHO Director, Dr. Mirta Roses Periago, convened a two-year Regional Expert Group (EG) to lead and issue recommendations towards the PAHO initiativeCardiovascular Disease Prevention through Dietary Salt Reduction.

The Expert Group successfully completed the two years in October, 2011, culminating with the Second Meeting of the Expert Group and completion of the Final Report. The EG is enriched with new members, and will continue as the Technical Advisory Group (TAG) in the future.

Objectives of Initiative

The main objectives of initiative were to:

  • paho_salt.jpgexplore the current epidemiological situation regarding cardiovascular disease and its link to excessive salt consumption in the Americas;
  • review existing policies, interventions and programs aimed at reducing dietary salt and issue evidence-based recommendations for salt reduction in the Region;
  • review, discuss and agree with relevant partners’ adjustments necessary for use of salt as vehicle for micronutrient fortification;
  • foster public and private partnerships.

About the Expert Group

The Regional Expert Group of PAHO (EG) is a multi-faceted scientific and technical group formed by experts recognized worldwide in the fields of nutrition and cardiovascular disease.

The EG worked for a span of two years, from 2009 until 2011, and will continue its work as the Technical Advisory Group. PAHO served as the Secretariat for the initiative and worked with the chair, Dr. Norm Campbell, and the co- chairs, Drs. Rainford Wilks and Ana Beatriz Pinto de Almeida Vasconcellos (until 2011) and Patrica Jaime (during 2011), on a regular basis in order to report on progresses and to stimulate further actions.

To learn more about the EG, please click here.

Advances

Policy Statement

The Policy Statement provides countries with a roadmap for concerted action by governments, nongovernmental organizations (NGOs), and the food industry. It is currently available for open distribution and endorsement. To learn more about the Policy Statement, click here.

Advocacy Resources

Fact Sheets

Monitoring and Evaluation Resources

A Review of Methods to Determine the Main Sources of Salt in the Diet to determine the main sources of salt intake.

Protocol for detection of salt in 24 hour urine and position on the use of spot urine for monitoring

Liaison with Industry Products

Questionnaire of industry reformulation practices geared toward multinational food industries with markets in the Americas in order to learn about their effort to reduce salt in packaged foods

PAHO/WEF Statement of Rio de Janiero

Salt/Iodine Collaboration

White Paper

Final Report of Improving Public Health through the Optimal Intake of Iodine and Sodium Meeting

visit website here

Salt Experts Sub-group on Dietary Salt Surveillance.

Mexico City and Cuernavaca, Mexico, 11-12 March 2010

 PAHO Mexico

Dr R Correa-Rotter (Mexico), Dr D Ferrante (Argentina), Dr N Campbell (Canada; Group Chair), Prof R Wilks (Jamaica; Group Co-Chair), Dr B Legetic (PAHO/WHO, USA), Prof FP Cappuccio (UK; Sub-panel Chair), Dr O Dary (USA), Dr B Legowski (Canada), Dr Luz Maria Sanchez (Mexico), Dr Simón Barquera (Mexico).


WHO GLOBAL STATEGY ON DIET, PHYSICAL ACTIVITY AND HEALTH AND 2008-2013 ACTION PLAN FOR THE GLOBAL STRATEGY FOR THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES

As part of the implementation of the WHO Global Strategy on Diet, Physical Activity and Health and the 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases, WHO will convene three multistakeholder information exchange forums and technical meetings focusing on three aspects of population sodium reduction strategies:

  1. Creating environments which enable the reduction of sodium intake. Building on existing experiences, which will focus on interventions for consumer education and reformulation of industrially produced foods to enable consumers to make appropriate choices to reduce the total sodium content of their diet.
  2. Evaluating and monitoring population sodium consumption and sources of sodium in the diet. This will focus on identifying the appropriate tools and protocols that are effective to monitor and evaluate population sodium consumption and sources of sodium in the diet.
  3. The role of fortified salt in iodine deficiency prevention. This will focus on analysing how the two strategies (salt reduction and iodine fortification) can efficiently and effectively work together for the benefit of populations affected.

It is expected that the outcomes of these meetings will constitute a useful resource for Member States and other stakeholders, when planning and implementing interventions aiming at reducing population-wide sodium intake.

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1. Creating an enabling environment for population-based salt reduction strategies.

London, UK, 30 June - 2 July 2010

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In July 2010, the World Health Organization and the United Kingdom Food Standards Agency jointly convened a technical meeting in London on: "Creating an Enabling Environment for Population-based Salt Reduction Strategies." The meeting provided an opportunity for detailed discussion on interventions for consumer education and reformulation of industrially produced foods to enable consumers to make appropriate choices to reduce the total sodium content of their diet.

This report is a summary of the evidence and experiences presented during the technical meeting, as well as the discussions of the working group sessions and conclusions reached by the participants.

Read the Final Report here.
 

2. Strategies to monitor and evaluate population sodium consumption and sources of sodium in the diet.

Calgary, Canada, 19-20 October 2010

In October 2010, the World Health Organization and the Government of Canada jointly convened a technical meeting in Calgary on: "Strategies to monitor and evaluate population sodium consumption and sources of sodium in the diet." The meeting provided and opportunity for detailed discussions on monitoring sodium intake levels at population level, assessment of dietary sources of sodium, and knowledge, attitudes and behaviours towards sodium and health.

This report is a summary of the evidence and experiences presented during the technical meeting, as well as the discussions of the working group sessions and conclusions reached by the participants.

Read the Final Report here

3. Salt reduction and Iodine fortification Strategies in Public Health.

Sydney, Australia, 25-27 March 2013

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Read the Final Report here:


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EMRO - WHO Regional Workshop on Salt Reduction and Setting Up Protocols for Measuring Salt and Fat Intake and Content in Food.

Amman (Jordan), 10-12 September, 2013

The main objectives of the workshop were to:

  • develop broad guidance on trans-fat elimination and saturated fat reduction

  • prepare protocols for reducing salt in bread and other specific food categories

  • discuss and train participnats on salt measurements with a focus on the 24h urinary collection method.

  • assist Member States in the Eastern Mediterranean Region of WHO interested and committed to develop a national action plan on salt and fat reduction.

  • Participants

Prof GA MacGregor, Prof P James, Prof FP Cappuccio (UK), Dr H Kuusipalo (Finland), Dr N Gharib, Mr SAE Almeer (Bahrain), Dr S Zaghloul, Dr HAA Meguid (Egypt), DR T Neyestani (Iran), Dr A Shalaan (Iraq), Dr M Tarawneh, Ms M Khamaise, Dr A Hadadine, Dr A Amr, Dr B Abdalla, Ms H Masa'd (Jordan), Dr Q Al Baghli, Mrs WY Al-Jowhar (Kuwait), Mr MM Aledawar, Dr H Hamade (Lebanon), Dr L El Ammari, Dr H Aguenaou, Dr A Derouiche (Morocco), Dr S Al Ghannami, Mr SM Al Zadjali, Dr M Kaur (Oman), Eng. MR Al-Halaika (Palestine), Dr A-A M Al-Thani, Mr PV Rajagopla, Mrs W Al Baker (Qatar), Mr L Abu Baker, Dr KS Almurshed (Saudi Arabia), Dr J El Ati, Mrs D Dogul, Dr L Alouane (Tunisia), Mr A Altalay, Dr MHS Al-Yousuf (UAE).

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Selection of participants of the Workshop in Amman, Jordan

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Prof. F P Cappuccio (Speaker) and Prof. P James (Chair) in session

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

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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).

 

EMRO - WHO: Technical Consultation on Salt and Fat Reduction.

Tunis, 30-31 March 2015

The objectives are to:

  • review the progress achieved by Member States on the implementation of salt and fat reduction strategies and action plans, and to identify challenges
  • provide technical guidance to Member States to scale up the implementation of the regional and national action plans

Photo Tunis


WHO Action Network on Salt Reduction in the Population in the European Region (ESAN)

Athens, Greece, 16 - 17 June, 2015

To complete


Expert Reference Group for European NCD Action Plan.

UN City, Copenhagen, 31 August - 1 September 2015

Scope: to support the WHO European Regional Office in preparation of the draft European NCD Action Plan, and to ensure that the Action Plan is based on best available evidence.

Purpose: to advise the Regional Office on key trends and issues for NCDs, their risk factors and determinants in the WHO European Region, and to put forward strategic options for consideration for NCD prevention and control during the next decade.

Participants:

Dr S Asma
(Atlanta, USA)
Prof T Laatikainen
(Helsinki, Finland)
Prof P Puska
(Helsinki, Finland)
Prof R Balicer
(Tel Aviv, Israel)
Prof D Leon
(London, UK)
Ms B Sinclair
(London, UK)
Prof S Boytsov
(Moscow, Russian Federation)
Dr S Løgstrup
(Brussels, Belgium)
Prof E Vartiainen
(Helsinki, Finland)
Prof FP Cappuccio
(Coventry, UK)
Prof M McKee
(London, UK)
Prof J Vestbo
(Manchester, UK)
Dr F Cardoso
(Lisbon, Portugal)
Prof J-M Oppert
(Paris, France)
Prof K Wahlbeck
(Helsinki, Finland)
Dr D Cavan
(Brussels, Belgium)
Prof PE Petersen
(Copenhagen, Denmark)
Dr K Wickramasinghe
(Oxford, UK)
Ms C Cohen
(Tel Avib, Israel)
Mr B Pettersson
(Stockholm, Sweden)
Prof AD Woolf
(Truro, UK)
Dr J Flanighan
(Rockville, USA)
Prof W Philipp
(Luxembourg)
Dr O Rotar
(St. Petersburg, Russian Federation)
Dr A Korotkova
(Moscow, Russian Federation)
Dr M Pðtschke-Langer
(Heidelberg, Germany)
Dr Y Zhernakova
(Moscow, Russian Federation)


Training Meeting for a National Survey on Salt Consumption

5th December 2015

Chisinau, Republic of Moldova

The W.H.O. Collaborating Centre of the University of Warwick is providing technical support to the National Centre of Public Health of the Republic of Moldova, as part of its remits to support the W.H.O. Region for Europe in the implementation of population salt reduction programmes in Member States. The technical support will help define the methodology and the tools for a national survey on salt intake in Moldova, providing training for national co-ordinators and support during data collection, process and analysis.

The first meeting was held in Chisinau on 5th December 2015 and was attended by Prof Francesco P Cappuccio from the W.H.O. Collaborating Centre, Dr Angela Ciobanu, W.H.O. Representative in Moldova, Dr Valeriu Gonceear representing the Ministry of Health and Dr Ion Salaru and Dr Galina Obreja of the National Centre of Public Health of the Republic of Moldova (see programme).

Photo Chisinau

Participants to the first training day in Chisinau, Republic of Moldova

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

Read also the Report on the composition of prevalent salt varieties



WHO EMRO Region:

Training Meeting for a National Survey on Salt Consumption

10th-16th December 2016

Muscat, Sultanate of Oman

Muscat

The W.H.O. Collaborating Centre of the University of Warwick is providing technical support to the Ministry of Health of the Sultanate of Oman, as part of its remits to support the W.H.O. E.M.R.O. Region in the implementation of population salt reduction programmes in Member States.

The technical support will (i) assist with adapting the W.H.O. E.M.R.O. protocol of the 24h urinary sodium to Oman, (ii) advise on the implementation of the study with identified local experts. (iii) train local staff on implementation of 24h urine collection protocol, (iv) support during data collection, process and analysis.

The first mission was held in Muscat between 10th-16th December 2016 and was attended by Prof Francesco P Cappuccio from the W.H.O. Collaborating Centre. During his stay there were meetings:

  • with Dr Ruth Mabry (Technical Officer of WHO Representative in Oman), to discuss WHO strategies and priorities in the area;
  • with Dr Amel Ibrahim (Nutrition Department/DGHA, Ministry of Health of Oman), Dr Lyutha Al-Subhi (Department of Food Science & Human Nutrition, Sultan Qaboos University), Dr Ruqaya Balushi (Ministry of helath of Oman) and Dr Salima, to discuss practical issues in the design, implementation and analysis of a nutritional survey;
  • with Dr Adhran Al-MAwali (Director of Centre for Statistics and Research), Dr Waleed Nasser Al-Shekaili (Acting Head of Systemts Research) and Dr Magdi Mahamoud Morsi (Statistician), all from the Ministry of Health of Oman, to discuss possible interaction with the National Nutritional Survey of Oman and the assessment and monitoring of national salt consumption;
  • finally, with His Excellency the Undersecretary for Health Affairs of the Sultanate of Oman, Dr Mohammed bin Saif Al Hosni, and his Advisor Dr Mahmood Shaban, to discuss progress and to receive furthger advice, endorsment and support for the National initiaitve.

Head of Centre

Professor F. P. Cappuccio

Members

Professor E. Dowler

Dr C. Ji

Dr M.A. Miller

Index

WHO C.C.

2006 Forum (Paris)

2007 Forum (Luxembourg)

2009 Expert group (Washington)

2010 Forum (Mexico)

2010 Forum (London)

2011 Forum (Calgary)

2013 Forum (Sydney)

2013 Forum (Amman)

2013 Workshop (Bilthoven)

2015 Workshop (Tunis)

2015 ESAN (Athens)

2015 Expert group (Copenhagen)

2015 Training (Chisinau)

2016 ESAN (Lisbon)

2016 Training (Muscat)



Publications


NEWS

The salt debate: does consuming less really save lives? Read in The Conversation.


Is the sodium debate a legitimate scientific disagreement or a “controversy” manufactured by industry? WATCH THESE VIDEOS


Salt: are you eating too much? Channel 4 Disptaches (2015)

Useful links

WHO Collaborating Centre for Nutrition, RIVM, Bilthoven, The Netherlands

WHO Collaborating Centre for Population Salt Reduction, Sydney, Australia