Developing a policy to reduce the salt content of food consumed outside the home in Malaysia

Lead Research Organisation: Queen Mary, University of London
Department Name: Wolfson Institute of Population Health

Abstract

Salt intake in Malaysia is very high, with an average intake of around 9g per day. A high salt intake raises blood pressure and high blood pressure increases the risk of developing a cardiovascular disease (CVD), which includes stroke and heart disease. Almost a third of adults have high blood pressure in Malaysia and CVD is the main cause of death and disability, which places a huge burden on communities and health services.

We previously assessed awareness and knowledge of salt in Malaysia. The majority of the population knew that eating too much salt could cause health problems but more than half thought they consumed just the right amount of salt. We also found that foods consumed outside the home e.g. from restaurants are major contributors of salt to the typical diet and the majority of the population eat out on a regular basis. The salt content of food consumed outside the home is likely to be very high, but without nutrition labelling consumers are unaware of the salt content.

We will interview stakeholders across the country to determine what factors they feel might prevent a policy to reduce salt levels in the out of home sector and we will use this data to develop a strategy, addressing all issues raised. We will then gain commitment from policy makers to implement our strategy as policy. To ensure engagement and support for the policy, we will organise workshops to explain to chefs and other food industry representatives why salt should be reduced, and the methods they can use to reduce salt in food.

Our work will benefit the entire population - almost everyone stands to benefit from a reduction in salt intake as almost everyone eats far more salt than recommended.

Technical Summary

Salt intake in Malaysia is around 9g per day. According to Malaysia's National Health and Morbidity Survey, 35.3% of adults aged 18 years and over had hypertension in 2015 and cardiovascular disease is the main cause of death and disability in the country.

In our previous project, we assessed knowledge, attitudes and behaviours of Malaysian adults, salt intake in a representative sample of the population and sources of salt in the diet. While 86.2% of respondents know salt is linked to negative health outcomes, 61.8% do not think they consume too much salt. A leading contributor to daily salt intake is food consumed outside the home.

This impact grant will fund qualitative research with stakeholders to determine barriers to salt reduction in the out of home sector. We will interview 385 stakeholders from government and policy, catering operators, the food industry, street vendors and consumers via focus groups or semi-structured interviews to identify perceived barriers, analyse via thematic analysis and use these results to develop a strategy to reduce salt content in food sold in the out of home sector. We will also organise high level meetings with policy makers to gain commitment to the strategy and conduct capacity building activities, including training workshops and lectures, to help raise awareness of the need for salt reduction in chefs and caterers.

Publications

10 25 50
 
Description Gain commitment from policy makers to implement the strategy
Geographic Reach National 
Policy Influence Type Participation in a national consultation
Impact Obtaining the perception, motivation and barriers of stakeholders on developing a strategy to reduce salt levels in the out of home sector and gain commitment from policy makers to implement the salt reduction strategy in Malaysia.
 
Description Development of country support tools to promote salt action in SEAR member States
Amount £19,098 (GBP)
Organisation World Health Organization (WHO) 
Sector Public
Country Global
Start 10/2020 
End 12/2020
 
Description Establishing salt reduction targets in the EMRO region and implementing a salt reduction strategy in Malaysia
Amount £206,006 (GBP)
Organisation Vital Strategies 
Sector Charity/Non Profit
Country United States
Start 11/2020 
End 09/2022
 
Description Focus group discussion and indepth interview with stakeholders from various ministries 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact A total of 10 policy makers, 15 researchers, 13 catering operators, 34 food industry partners, 5 street vendors and 21 consumers joined the in-depth interview and focus group discussion which sparked questions and discussion on the feasibility of the salt reduction and the motivation and barriers on salt reduction in Malaysia.
Year(s) Of Engagement Activity 2020,2021
 
Description Meeting with Deputy Health Minister Malaysia and media practitioners in conjunction with World Salt Awareness Week 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Associate Professor Dr Hazreen Abdul Majid participated in an interaction session between the Ministry of Health (Malaysia) and media practitioners in conjunction with World Salt Awareness Week on 3 March 2021. Dr Majid met Deputy Health Minister Malaysia and talked about the needs of the general public to have strong willpower to choose healthy eating, especially in consuming less salt. Besides, the message of '4 out of 5 Malaysian adults take too much salt' was disseminated through broadcast Buletin 1.30 on TV3 news channel on 3 March 2021 to increase public awareness of salt reduction.
Year(s) Of Engagement Activity 2021
URL https://www.bernama.com/en/general/news.php?id=1937226