Pioneers sodium legislation linked to lower blood pressure and fewer deaths

Excessive sodium consumption can aggravate high blood pressure, which is linked to cardiovascular disease, which in turn is responsible for 20 million deaths a year worldwide.

Stroke, a type of cardiovascular disease, is also an important cause of disability.

In response, South Africa became one of the first countries in the world and the first in Africa to have adopted regulations on sodium content. The idea was to encourage people to eat less salt and other sodium -rich food.

Salt and sodium are not the same. Sodium is the part of salt that increases blood pressure and leads to an increased risk of heart disease and strokes. Table salt comprises 40% sodium.

A study by researchers from Wits University and Harvard, entitled “Sodium reduction legislation and sodium and blood pressure of urine in South Africa”, published in Jama Cardiology In February 2025, it now reveals that this legislation has worked and can continue to have an impressive impact in the coming years.

The World Health Organization recommends less than 2 grams of salt per day; Participants in this study reduced their sodium intake by 10% for seven years.

“Moreover, many more people reached the ideal sodium consumption: the number went from 7% to 17% and with every gram of sodium reduction there was a reduction in blood pressure,” says Professor Steve Tollman, director of the SAMRC/Wits Rural Public Health and Health Transitions Research (Agincourt – where).

Sa’s sodium legislation The most extensive country has passed

The legislation has seen that 13 categories of food reduce their sodium content, including bread, grains, fat spreads, chips, processed meat, soups, sauces and broth concentrates.

By 2016, manufacturers had to reduce the sodium content in these foods between 20% and 70%, and then further reduce them, between 5% and 46%, by 2019.

Blood pressure reductions

“If this reduced sodium consumption remains constant over time, this can be associated with lower percentages of cardiovascular disease, as well as a stroke, heart failure, kidney disease in the final stage and vascular dementia, all of whom are also associed with high blood pressure, Harvard Thomasha says Head teacher Thomashathenthastentian or PERPLOCENHENTHTHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHHENTHTHHITENTH THOMASHENTH ORASHENTH ORASHENTH ORASHENTH ORASHENTH ORASHENTH ORASHENTH ORASHENTH OF COCENTHENTH ORASHENTH OF COCENTHENTH. Gaziano is also the head and accompanying author of the research.

He notes that lowering even 1 millimeter mercury (MMHG) can lead blood pressure to tens of thousands of deaths that are averted every year.

Tollman adds: “This type of research insight suggests that other countries can adopt comparable laws and possibly see reductions in death and disability, including the US.”

Possible reversal of increased blood pressure levels linked to the aging population

South Africa has a growing aging population and so-called “transition” societies. When an area is in transition, chronic diseases such as heart disease, cancer, obesity and diabetes infectious diseases as the most important causes of death. This shift takes place as countries develop economically and the population migrates from national to urban settlements, undergo changes in lifestyle and where the national/urban gap is less well defined.

It is in this aging cohort that the study has settled and is part of the health and aging in Africa: longitudinal studies in South Africa (Haalsa) program, a partnership between Wits, Harvard, University of Cape Town and the Columbia University Department of Neurology.

Haalsa evaluates how policy and other motives of health influence chronic and infectious diseases, including dementia, cardiometabolic disorders and HIV, among South Africans aged 40 and older, to better understand the health results within an ever -aging society.

To assess the effectiveness of sodium regulation, the study of salt consumption and blood pressure under the Haalsa cohort, consisting of more than 5,000 adults aged 40 and older, looked in the SA countryside.

The researchers measure the sodium levels in the urine of the participants and took their blood pressure at three different times: in 2014, before the regulations were implemented, and again in 2018 and 2021.

“Most governments around the world have only encouraged or advised sodium reduction with limited effectiveness. Strenter legislation is better than a voluntary approach,” says Tollman. “This study shows that the government’s action with accountability can not only influence the intake of the sodium, but also the blood pressure levels.”