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.
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.
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
Zainal Arifen Z
(2023)
Perceptions, barriers and enablers on salt reduction in the out-of-home sectors in Malaysia (MySaltOH) from the perspective of street food vendors, caterers and consumers
in Public Health Nutrition
Vellinga RE
(2024)
Nutritional composition of ultra-processed plant-based foods in the out-of-home environment: a multi-country survey with plant-based burgers.
in The British journal of nutrition
Valero-Morales I
(2022)
24-hour sodium and potassium excretion in the Americas: a systematic review and meta-analysis.
in Revista panamericana de salud publica = Pan American journal of public health
Trieu K
(2023)
Estimated Dietary and Health Impact of the World Health Organization's Global Sodium Benchmarks on Packaged Foods in Australia: a Modeling Study.
in Hypertension (Dallas, Tex. : 1979)
Tan M
(2022)
Spot urinary sodium to monitor relative changes in population salt intake during the UK salt reduction programme.
in Journal of hypertension
Song J
(2023)
Salt intake, blood pressure and cardiovascular disease mortality in England, 2003-2018.
in Journal of hypertension
Song J
(2022)
Delayed Finalization of Sodium Targets in the United States May Cost Over 250 000 Lives by 2031.
in Hypertension (Dallas, Tex. : 1979)
Mohd Isa D
(2021)
Associations of Health Literacy with Blood Pressure and Dietary Salt Intake among Adults: A Systematic Review.
in Nutrients
Michael V
(2021)
Barriers, Enablers, and Perceptions on Dietary Salt Reduction in the Out-of-Home Sectors: A Scoping Review.
in International journal of environmental research and public health
| Description | Our main outcome was the development of a policy to reduce salt levels in the out of home sector (e.g. street food, restaurants, cafes), which is a leading source of salt in Malaysian diets. Excess salt is the leading risk factor for raised blood pressure, which in turn leads to stroke and heart disease - leading causes of death in Malaysia. This strategy will help to protect health and avoid many preventable deaths each year. We interviewed 285 stakeholders (policy makers, industry, consumers, NGOs, health professionals) across Malaysia to identify the opportunities for and barriers to a policy that would reduce salt levels in the out of home sector. We summarised and analysed their perspectives and developed a policy with three sections: Monitoring, Awareness and Product. Actions in the Monitoring section include monitoring population salt intake, salt levels in food sold by manufacturers and vendors, salt levels in school food, and compliance of manufacturers with labelling salt levels on products. Actions in the Awareness section include training Ministry of Health officers and other ministries on salt reduction, integrating the need for salt reduction into food handling courses for canteen operators and developing targeted awareness campaigns for schools, universities and workplaces. Actions in the Product section include setting salt reduction targets for 14 categories of food, enforcing compliance with mandatory salt labelling on product packaging and increasing the number of food outlets in the out of home sector that comply with a healthy eating initiative. This project has also led to the development of salt reduction toolkits for soy sauce and traditional fish crackers. |
| Exploitation Route | The policy developed will now be reviewed and implemented by the Malaysian Ministry of Health and other government departments. This will lead to lower salt levels in food served in the out of home sector and help reduce population salt intake to protect health. All countries must develop policies to address salt levels in the out of home sector, and Malaysia is the first to do so. Other countries in the region, and globally, will learn from their experience. The salt reduction toolkits will be widely disseminated and can be used by any country where soy sauce and/or fish crackers are consumed to lower salt levels. |
| Sectors | Agriculture Food and Drink Healthcare Government Democracy and Justice |
| Description | Our findings have resulted in the development of a comprehensive policy to help reduce salt levels in food served in the out of home sector (restaurants, street food, take aways, fast food outlets). This policy has the support of the Malaysian Ministry of Health and will now be reviewed and implemented by them. This project has also led to the development of salt reduction toolkits for soy sauce and traditional fish crackers which can be used by food companies that produce these products. |
| Sector | Agriculture, Food and Drink,Healthcare,Government, Democracy and Justice |
| Impact Types | Societal Policy & public services |
| Description | Meeting with Ministry of Health and other government ministries in Malaysia to discuss ownership of developed out of home salt reduction strategy |
| Geographic Reach | National |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Impact | Various government departments were assigned ownership of the actions within the out of home salt reduction strategy and will be taking these forward with the aim of implementing them. |
| Description | Meeting with Ministry of Health and other government ministries in Malaysia to discuss the national salt reduction policy for the out-of-home sector |
| Geographic Reach | National |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Impact | The introduction of a national salt reduction policy for the out-of-home sector motivates the food industry to adopt healthier production practices. This endeavour is geared towards enhancing public health outcomes by reducing the prevalence of Non-Communicable Diseases (NCDs), potentially resulting in substantial economic and social advantages. |
| Description | Meeting with Ministry of Health and other government ministries in Malaysia to discuss the reformulation results of soy sauce products |
| Geographic Reach | National |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Impact | The findings and recommendations related to soy sauce product reformulation encourage the food industry to adopt innovative approaches to reformulating soy sauce products with less salt content. Reduced sodium content in soy sauce leads to healthier options for consumers and a potential decrease in salt-related health issues among the population due to lower sodium intake. |
| Description | Salt Reduction Strategy Training Module for Food Entrepreneurs |
| Geographic Reach | National |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | The training module provides guidance for food industry professionals to reduce salt in their products, which potentially reduces the prevalence of salt-related health issues like hypertension and heart disease. The module helps set new standards for the Malaysian food industry, leading to a shift towards healthier food production practices. As the industry adopts these practices, it could also raise consumer awareness about the importance of low-salt diets, thereby influencing consumer choices and driving demand towards healthier options in food and eating behaviors. |
| Description | Salt Reduction Strategy Training Module in Malaysia: Fish Crackers Manufacturers |
| Geographic Reach | Local/Municipal/Regional |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Impact | The training module for salt reduction in Malaysia influences healthier production practices by guiding small-scale fish cracker producers to reduce the salt content in this traditional snack. Adoption of the module's strategies could set new industry standards, encouraging small-scale producers to innovate and maintain competitiveness. This initiative aligns with national health objectives to reduce salt intake, potentially improving consumer health by decreasing risks associated with high sodium diets, which could contribute significantly to the reduction of non-communicable diseases in Malaysia, easing long-term healthcare costs. |
| Description | Salt Reduction Strategy Training Module in the Malaysian: Food Industry |
| Geographic Reach | National |
| Policy Influence Type | Contribution to new or improved professional practice |
| Impact | The training module plays a significant role in salt reduction among food industry in Malaysia. It serves as a reference for the food industry, including food producers, caterers, and vendors. Firstly, it increases awareness among the food industry about the health impacts of high salt consumption, prompting them to reconsider their product formulations. Secondly, the module facilitates the adoption of innovative techniques to reduce salt in food products without compromising taste, quality or the shelf-life of lower-salt products. This shift could result in a broader availability of healthier food options in the market, potentially contributing to improved public health outcomes by reducing the prevalence of salt-related non-communicable diseases. |
| Description | Salt reduction in the out of home sector strategy document |
| Geographic Reach | National |
| Policy Influence Type | Contribution to a national consultation/review |
| Impact | Document developed to inform the Malaysian Government's strategy to reduce salt intake from the out of home sector, with clear recommendations for implementation meaning that policy makers are better equipped to affect change. |
| Description | Soy sauce reformulation toolkit |
| Geographic Reach | National |
| Policy Influence Type | Contribution to new or improved professional practice |
| Impact | 5 soy sauce manufacturers in Malaysia are now equipped with the necessary information about how to reduce salt levels in their soy sauces, tailored to their particular business. |
| 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 | 09/2020 |
| End | 12/2020 |
| Description | Establishing salt reduction targets in the EMRO region and implementing a salt reduction strategy in Malaysia |
| Amount | £207,060 (GBP) |
| Organisation | Vital Strategies |
| Sector | Charity/Non Profit |
| Country | United States |
| Start | 11/2020 |
| End | 02/2023 |
| Description | Mapping salt reduction initiatives and development of a scorecard to track progress in salt reduction policies in the WHO South-East Asia Region |
| Amount | £32,200 (GBP) |
| Funding ID | 202868266 |
| Organisation | World Health Organization (WHO) |
| Sector | Public |
| Country | Global |
| Start | 04/2022 |
| End | 09/2022 |
| Title | RTSL Online Global Nutrition Database 2024 (Malaysia) |
| Description | The Resolve to Save Lives (RTSL) Global Nutrition Database contains nutrient data for packaged foods sold around the world. This dataset provides valuable data on the salt content of packaged foods in Malaysia including the data for processed foods that are key contributors to salt intake, including soy sauce, instant noodles and fish crackers. |
| Type Of Material | Database/Collection of data |
| Year Produced | 2024 |
| Provided To Others? | No |
| Impact | The dataset holds critical value for evaluating the current salt level of packaged foods in Malaysia, and can function as a key resource to monitor the country-level progress toward national targets, as well as regional and global benchmarks. It has significant importance in public health and policymaking. By providing comprehensive nutritional information on the salt content of packaged foods, it aids in identifying unhealthy food trends, supports the formulation of healthier dietary guidelines, and equips governments and organizations with the insights necessary to understand the impact of interventions related to sodium and target interventions more effectively. This database is a critical tool for initiatives focused on reducing non-communicable diseases by promoting better nutrition and influencing food industry standards towards healthier options. |
| Description | Ministry of Health, Malaysia |
| Organisation | Ministry of Health Malaysia |
| Country | Malaysia |
| Sector | Public |
| PI Contribution | Queen Mary University of London, led by Professor Feng He will be responsible for the project evaluation and providing training where necessary. QMUL team will also contribute to the thematic analysis and will support the Malaysian team in meetings with government departments and other stakeholders. The QMUL team are uniquely placed to do this, as Prof He and colleagues are established salt reduction experts and have delivered successful programmes in the UK and other ODA countries. The team will provide training to local researchers and relevant stakeholders to build capacity and strengthen Malaysia's knowledge and delivery of such programmes. All researchers will co-develop the project plan and strategy to reduce salt in the out of home sector. |
| Collaborator Contribution | The Ministry of Health will lead on initiating meetings with other government departments to create engagement with our strategy. |
| Impact | • Organised high-level meetings with policymakers in government departments including the Ministry of Health, Ministry of Education and the Ministry of Domestic Trade and Consumer Affairs to gain commitment to implement our strategy as policy. |
| Start Year | 2020 |
| Description | Sunway University |
| Organisation | Sunway University |
| Country | Malaysia |
| Sector | Academic/University |
| PI Contribution | Queen Mary University of London, led by Professor Feng He will be responsible for the project evaluation and providing training where necessary. QMUL team will also contribute to the thematic analysis and will support the Malaysian team in meetings with government departments and other stakeholders. The QMUL team are uniquely placed to do this, as Prof He and colleagues are established salt reduction experts and have delivered successful programmes in the UK and other ODA countries. The team will provide training to local researchers and relevant stakeholders to build capacity and strengthen Malaysia's knowledge and delivery of such programmes. All researchers will co-develop the project plan and strategy to reduce salt in the out of home sector. |
| Collaborator Contribution | Sunway University, led by Dr Chia will lead meetings with the food industry, which includes practical guidance on lowering salt levels in foods sold outside the home. Researchers at Sunway University will be involved in the implementation and monitoring of the project. |
| Impact | 1) Carried out focus groups and/or semi-structured interviews with stakeholders to identify perceived barriers to salt reduction in the out of home sector; 2) Assisted with the development of a strategy to reduce salt content of foods sold in the out of home sector (restaurants, street vendors, school canteens) using data gained during focus groups; 3) Contributed to capacity building activities such as training workshops and lectures to ensure the food industry, chefs and other relevant stakeholders understand the need for salt reduction, methods to achieve salt reduction and comply with the new policy. |
| Start Year | 2020 |
| Description | Universiti Kebangsaan Malaysia |
| Organisation | National University of Malaysia |
| Country | Malaysia |
| Sector | Academic/University |
| PI Contribution | Queen Mary University of London, led by Professor Feng He will be responsible for the project evaluation and providing training where necessary. QMUL team will also contribute to the thematic analysis and will support the Malaysian team in meetings with government departments and other stakeholders. The QMUL team are uniquely placed to do this, as Prof He and colleagues are established salt reduction experts and have delivered successful programmes in the UK and other ODA countries. The team will provide training to local researchers and relevant stakeholders to build capacity and strengthen Malaysia's knowledge and delivery of such programmes. All researchers will co-develop the project plan and strategy to reduce salt in the out of home sector. |
| Collaborator Contribution | The Malaysian team comprises leading research-focused higher education institutions and the Malaysian Ministry of Health. As the lead institution, Universiti Kebangsaan Malaysia will manage the project in Malaysia and all workstreams will be overseen by Professor Suzana Shahar. All Malaysian researchers will be involved in monitoring the project, led by Prof Shahar. |
| Impact | 1) Conducted a stakeholder analysis and created a stakeholder map of all relevant individuals, groups and organisations to engage in Malaysia; 2) Carried out focus groups and/or semi-structured interviews with stakeholders to identify perceived barriers to salt reduction in the out of home sector; 3) Conducted a thematic analysis of stakeholder responses to determine the key themes; 4) developed and published research protocol; 5) Developed a strategy to reduce salt content of foods sold in the out of home sector (restaurants, street vendors, school canteens) using data gained during focus groups; 6) Organised high-level meetings with policymakers in government departments including the Ministry of Health, Ministry of Education and the Ministry of Domestic Trade and Consumer Affairs to gain commitment to implement our strategy as policy; 7) Conducted capacity building activities such as training workshops and lectures to ensure the food industry, chefs and other relevant stakeholders understand the need for salt reduction, methods to achieve salt reduction and comply with the new policy. |
| Start Year | 2020 |
| Description | University of Malaya |
| Organisation | University of Malaya |
| Country | Malaysia |
| Sector | Academic/University |
| PI Contribution | Queen Mary University of London, led by Professor Feng He will be responsible for the project evaluation and providing training where necessary. QMUL team will also contribute to the thematic analysis and will support the Malaysian team in meetings with government departments and other stakeholders. The QMUL team are uniquely placed to do this, as Prof He and colleagues are established salt reduction experts and have delivered successful programmes in the UK and other ODA countries. The team will provide training to local researchers and relevant stakeholders to build capacity and strengthen Malaysia's knowledge and delivery of such programmes. All researchers will co-develop the project plan and strategy to reduce salt in the out of home sector. |
| Collaborator Contribution | The qualitative survey of stakeholders will be overseen by Professor Hazreen of University Malaya. Researchers at University Malaya will be involved in the implementation and monitoring of the project. |
| Impact | 1) Conducted a stakeholder analysis and created a stakeholder map of all relevant individuals, groups and organisations to engage in Malaysia; 2) Conducted a thematic analysis of stakeholder responses to determine the key themes, and published research protocol; 3) Assisted with developing a strategy to reduce salt content of foods sold in the out of home sector (restaurants, street vendors, school canteens) using data gained during focus groups; 4) Contributed to capacity building activities such as training workshops and lectures to ensure the food industry, chefs and other relevant stakeholders understand the need for salt reduction, methods to achieve salt reduction and comply with the new policy; |
| Start Year | 2020 |
| Description | A keynote speech in the 42nd World Health Forum (Shizuoka) |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | Prof Graham MacGregor gave a keynote speech about The Importance of Reducing Salt Intake to Prevent Strokes and Heart Failure at the 42nd World Health Forum (2021, Shizuoka) supported by UNESCO and Ministry of Health, Labour and Welfare, Japan |
| Year(s) Of Engagement Activity | 2021 |
| Description | A presentation in an International e-Seminar organised by Universiti Putra Malaysia, Malaysia |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | On 29 June 2021, Prof Feng He gave a presentation in the International e-Seminar "FMHS UPM's Silver Jubilee: Education & Research Excellence in Diversity", which was organised by Universiti Putra Malaysia, Malaysia. The topic of Prof He's presentation was "Current Successful Experience of Worldwide Salt Reduction Programmes" . |
| Year(s) Of Engagement Activity | 2021 |
| URL | https://medic.upm.edu.my/upload/dokumen/20210621211704e-SEMINAR_FMHS_UPM_POSTER__v7.pdf |
| Description | A talk in a WHO SERO webinar organised by the WHO SEAR Office |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Prof Feng He gave a talk about "Scaling up population salt reduction in South-East Asia Region (SEAR)" in a WHO SERO webinar organised by the WHO SEAR office, 11th March 2021. |
| Year(s) Of Engagement Activity | 2021 |
| Description | Engagement meeting with industry to familiarise with the soy sauce reformulation toolkit |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Industry/Business |
| Results and Impact | Workshop with multiple representatives from five soy sauce manufacturers and the Ministry of Health to familiarise them with the toolkit with the soy sauce reformulation toolkit including palatability testing of reduced salt samples and discussion on soy sauce maximum salt target. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Engagement with senior leadership at UKM to familiarise with project and share updates |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Other audiences |
| Results and Impact | Engagement with senior leadership at UKM to familiarise with project and share updates. |
| Year(s) Of Engagement Activity | 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 | Focus group discussion/workshop involving range of stakeholders |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Focus Group Discussion (Consumers, teachers, parents and government agencies, Food Industries, Catering Operators, Street Food Vendors, Policy Maker, Researchers, NGO) to investigate the views towards salt levels in the out of home sector and barriers to salt reduction in the sector. The Focus Group Discussion involved 207 people from Central, South, North, East and Borneo Malaysia over several sessions: Central (18 February 2022, in H-Care UKM KL), South (7 April 2022, Berjaya Waterfront), North (29 March 2021, Cinta Sayang Resort), East (14 December 2020, Raia Hotel), Sabah (2 March 2022, Sabah Oriental Hotel) and Sarawak (Malaysian Agricultural Research and Development Institute (MARDI) Sarawak, 3 March 2022). |
| Year(s) Of Engagement Activity | 2021,2022 |
| Description | Formal working group on Out of Home policy |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Meeting for Salt of Reduction Policy of Out of Home Sector was held on 11 February 2022. This was a formal working group that involved around 8 people. The objective of the meeting was to discuss the Salt of Reduction Policy of Out of Home Sector for Salt Awareness Week 2022; The outcomes of the meeting include: • Discussed the results for Focus Group Discussion especially on thematic analysis (except Sabah and Sarawak). • Outlined the Salt of Reduction Policy of Out of Home Sector for Salt Awareness Week 2022. • Segregation of duties on publication of the articles between the members of the project. |
| Year(s) Of Engagement Activity | 2022 |
| Description | In-depth interviews |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Schools |
| Results and Impact | In-Depth Interview with those working in school cafeterias, involving around 14 people from Central, South, North, East and Borneo Malaysia. This Interview aims to determine the health literacy of stakeholders relevant to school and salt reduction strategy with the factors associated with it and to explore the barriers towards the salt reduction efforts among food vendors at schools in Malaysia. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Launch of soy sauce reformulation toolkit event |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | Launch of soy sauce reformulation toolkit to an audience of industry representatives, policy makers, academics, and media representatives. |
| Year(s) Of Engagement Activity | 2022 |
| 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 |
| Description | Meeting with policy makers and stakeholders in Malaysia |
| 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 | Prof Feng He shared the UK salt reduction experience in a face-to-face meeting with policymakers from the Ministry of Health, representatives from the food industry and street food vendors. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Ministry of Health meeting in preparation for Salt Awareness Week 2022 |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Policymakers/politicians |
| Results and Impact | A formal working group that involved around 18 people from different various departments in Ministry of Health, universities and Malaysian Communications and Multimedia Commission. The objective of the working group is to explain the objective of the project during the Salt Awareness Week 2022, to determine the launching strategy for the new salt reduction initiative and to update the number of companies involved in the project. It's agreed that the new project funded by RESOLVE to Save Lives will further support this ongoing Newton fund Project (Salt of Reduction Policy of Out of Home Sector). The working group will update the list-name for collaborators and all members to Person-in-Charge (Salt Awareness Week 2022) in Ministry of Health Malaysia. The launching strategy will be in the poster form and will update the Person-in-Charge about the poster. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Organise the 3rd International Virtual Undergraduates Symposium on Clinical Dietetics |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Undergraduate students |
| Results and Impact | The two-day event was organised by the Dietetics Program, Faculty of Health Science, Universiti Kebangsaan Malaysia on 1-2 August 2023. The program included a variety of exciting activities such as Oral Case Presentation (IPD, OPD & Research Category), Plenary Talk and Online Networking Event. It provided an opportunity for dietetics undergraduates to broaden their understanding of the treatment and dietary management of non-communicable diseases, which they will be able to implement in the future. Prof Dr Suzana Shahar contributed to the event as a Plenary Speaker on Hypertension Management and Salt reduction Strategies. Participants were undergraduate students in Nutrition and Dietetics from several universities in Malaysia, Indonesia and the Philippines. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Presentation on salt reduction and sharing experience in a webinar organised by Malaysian collaborators |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Prof Feng He presented evidence for salt reduction and shared experience from the UK and China, in a webinar organised by Malaysian collaborators. The webinar was attended by more than 700 people including policymakers, academics, students and the public. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Prof Feng He gave a Special Lecture about salt reduction at 22nd IUNS-ICN Tokyo, Japan |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Prof Feng He attended the 22nd International Congress of Nutrition (ICN) in Japan in Dec 2022. The aim of the conference is to promote the exchange of knowledge in Nutritional Sciences. Prof He gave a special lecture on Salt and Health in the session on Public Health Nutrition and Environment. She presented the evidence on salt and health, shared the salt reduction experience from the UK and China, and called for action that every country must develop a coherent, workable salt reduction plan and implement the plan to reduce the population salt intake to <5 g/d. Good feedback was received. A team in Japan leading the research on reducing sodium while enhancing taste desirability is very interested in the lecture and expressed their interest to explore the opportunity for further collaboration. |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://icn22.org/program_lecture02.html |
| Description | Prof Feng He gave a presentation about the UK's salt reduction experience at 22nd IUNS-ICN Tokyo, Japan |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Prof Feng He attended the 22nd International Congress of Nutrition (ICN) in Japan in Dec 2022. In the session of Public Health Nutrition and Environment, Prof He was invited to give a talk at the Symposium: Prevention of cardiovascular disease by population approach focusing on nutrition and diet in Europe, America and Japan. Prof He took this opportunity to show the UK salt reduction strategy, how to monitor the salt level and the impacts on public health achieved. |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://confit.atlas.jp/guide/event/icn2022/subject/SY_T6_18-03/category?cryptoId= |
| Description | Senior Officer from Ministry of Health Malaysia visited QMUL |
| Form Of Engagement Activity | Participation in an open day or visit at my research institution |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Dr. Hamdan, Senior Principal Assistant Director (Dietetic) in the NCD Section of the Disease Control Division, the Ministry of Health Malaysia, conducted a study visit to the Research and Action on Salt and Obesity Unit at the Wolfson Institute of Population Health, Queen Mary University of London. The primary objective of this visit was to engage in discussions and presentations related to salt reduction initiatives and strategies, with a specific focus on adapting these approaches to the Malaysian context. During the visit, Dr. Hamdan engaged in meetings with various team members to explore potential collaborations, including discussions about surveys on salt content in specific food categories and salt reduction in Out of Home sector. Furthermore, Dr. Hamdan delivered a presentation on salt reduction efforts in Malaysia, facilitating the exchange of knowledge and best practices between the UK and Malaysia. The visit also featured presentations on related health issues such as kidney function and non-communicable diseases (NCDs) in Malaysian adolescents and discussions on the trials for promoting healthy and sustainable diets. A significant outcome of the visit was the exchange of experiences and strategies between the Malaysian and UK teams, particularly the joint meeting involving the research team at QMUL, Dr Hamdan, the Department of Health and Social Care and the Obesity Health Alliance. The meeting focused on shared learnings on advocacy and food reformulation, which could lead to the development of more effective salt reduction, food labelling, and food reformulation policies. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Training by Malaysian Agricultural Research and Development Institute (MARDI) |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Industry/Business |
| Results and Impact | A hands-on training by Malaysian Agricultural Research and Development Institute (MARDI) in Pasir Putih, Kelantan. This workshop involved around 8 people from Malaysian Agricultural Research and Development Institute (MARDI) Pasir Putih, a local soy sauce company and Universiti Putra Malaysia. The aim of the workshop is to learn the processing of soy sauce manufacturing from government agencies that teach the local soy sauce manufacturers during their start-out. The research team learnt the soy sauce processing from an expert from a government agency. This workshop was of great importance to improve the questionnaire for In-Depth Interview in a cross-sectional study. This also helped in the research on the reformulation of soy sauce because this analysis will involve with the soy sauce industry. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Various visits at food companies to learn about food processing techniques |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Industry/Business |
| Results and Impact | Various visits were made to industry/companies. The objective was to learn the expertise of their food processing and food analysis from the food company and government agency/research institute. 1) Malaysian Agricultural Research and Development Institute (MARDI) Johor Bahru: MARDI is an institution that teaches new technology to entrepreneurs. MARDI Johor Bahru specializes in making pineapple jam, fresh-cut fruits mainly for pineapple and pineapple juice. 2) Enaq Sauce Sdn Bhd (product: soy sauce): The products include sweet soy sauce, salty soy sauce and chilli soy sauce. The sauce is fermented for 6 months before being processed and packaged. Some of the soy sauce is being fermented for more than 6 months for quality purposes. 3) Dr Aisyah Solution Sdn Bhd (energy bars/granola): All DASTO products are HALAL certified and formulated to have reduced sugar and calorie. The products use natural ingredients, no added preservatives & no added artificial colours. Provide good protein, fibre, and are free of trans-fat & cholesterol. 4) Haji Zainol Food Industries Sdn. Bhd (soy sauce and chilli sauce): Haji Zainal Food Industries (HZF) Sdn Bhd is a company that specialized in manufacturing a variety of sauces. It is a local family run business that produces their own product. No MSG was added in their products; soy and chilli sauce. 5) Hot Pizza - Malaysia: In 2014, Hot Pizza opened for business. From the base to the toppings and packaging, they make, sell, and process pizza ingredients. They supply all of the ingredients. 6) Mummy RQ Sdn Bhd (Baby food): MummyRQ started operating in homemade style in September 2015 and in June 2017, expanded to an industrial premise in Kedah Halal Park, Sungai Petani, Kedah. MummyRQ is Halal, Mesti & Organic baby food manufacturer. 7) Malaysian Agricultural Research and Development Institute (MARDI) Kuala Terengganu: MARDI is an institution that teaches new technology to entrepreneurs. MARDI Johor Bahru specializes in making local fish crackers (keropok lekor). 8) Melati Bakery and Frozen (Pizza, Roti Arab, Nasi Arab, Nasi Briyani, Roti keramat): Bakery and frozen food production with a variety of sauces, curry, and toppings. 9) Teguh Abadi F & B (Salted fish, dried anchovies and dried prawns): The company introduced the production of dried anchovies started from the sea until packaging. 10) Kasmah Hj. Basiran (fish crackers): The fish cracker is made of sea breams and mackerel in the ratio of 6:1. They also add in starch flour, sugar, salt and msg. The company produces about 800 kg of amplang a day. Their product not only has been marketed to the local customer but it is also being exported to Dubai. 11) BiMori Mee Kuning Zaidah (noodles): The company has been offering a better option of noodles to the customer by reducing salt content in its noodles. Our team had advised the company to apply for the Healthier Choice Logo (HCL) as a recognition of their healthy noodles. 12) Usna (burger patties and meatballs): This company uses imported meat from India to produce their products. The company shared their patties recipe which includes boneless minced meat, bread crumbs, potato starch, milk, vegetable proteins, meat paste,onion, black pepper, sugar, salt and msg. There is no food coloring added to their products. The average production of the patties is about 400-500 packs a day. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Visit to soy sauce manufacturer |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Industry/Business |
| Results and Impact | Visit to soy sauce manufacturer (Linaco Specialty Industries Sdn Bhd) as part of collaboration on reducing salt in soy sauce so discuss manufacturing methods and other considerations. |
| Year(s) Of Engagement Activity | 2022 |