ArticlePublic health nutrition2019
Using regulation to limit salt intake and prevent non-communicable diseases: lessons from South Africa's experience.
Article in Public health nutrition, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Identifying barriers and facilitators in the development and implementation of government-led food environment policies: a systematic review.Nutrition reviews · 2022Pooled it
- Assessing the implementation of national sodium reduction policies in Nigeria: an interim qualitative evaluation of stakeholder perspectives.Frontiers in nutrition · 2026Article
- The effectiveness of mandatoryThe British journal of nutrition · 2025Review
- Contributions of Dietary Patterns and Factors to Regulation of Rheumatoid Disease.International journal of molecular sciences · 2025Review
- Multisectoral action to address noncommunicable diseases: lessons from three country case studies.Frontiers in public health · 2024Review
- Stakeholder arguments during the adoption of a sugar sweetened beverage tax in South Africa and their influence: a content analysis.Global health action · 2023Article
- Determining food industry compliance to mandatory sodium limits: successes and challenges from the South African experience.Public health nutrition · 2023Article
- Review
- Health policy considerations for combining exercise prescription into noncommunicable diseases treatment: a narrative literature review.Frontiers in public health · 2023Review
- Prioritizing population-based nutrition-related interventions to prevent and control hypertension in Iran: a multi-criteria decision-making approach.BMC medical research methodology · 2022Review
- Intersectoral collaboration in the management of non-communicable disease's risk factors in Iran: stakeholders and social network analysis.BMC public health · 2022Article
- Hypertension in the South African public healthcare system: a cost-of-illness and burden of disease study.BMJ open · 2022Article
- Article
- International Trade and Investment Agreements as Barriers to Food Environment Regulation for Public Health Nutrition: A Realist Review.International journal of health policy and management · 2021Review
- Barriers, Enablers, and Perceptions on Dietary Salt Reduction in the Out-of-Home Sectors: A Scoping Review.International journal of environmental research and public health · 2021Article
- Health policy triangle framework: Narrative review of the recent literature.Health policy OPEN · 2020Review
- Effect of Formulation, Labelling, and Taxation Policies on the Nutritional Quality of the Food Supply.Current nutrition reports · 2019Review
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo analyse the policy process for the South African regulation setting upper limits for salt in thirteen commonly consumed food categories, to inform future policy action for prevention of non-communicable diseases.
designSemi-structured interviews (n 10) were conducted with key stakeholders from government, academia, non-governmental organisations and the food industry. Interviewees were asked about the content, context, process and actors involved in developing the regulation. Data were analysed according to Walt and Gilson's health policy analysis triangle.
settingSouth Africa.
participantsKey actors and stakeholders in the policy process to develop the salt regulation.
resultsThe regulation was a response to research establishing the effectiveness of food supply interventions and to a shared perception that government regulation was the quickest way to address the problem of salt overconsumption. While the regulations were developed through a consultative process, food industry stakeholders perceived the consultation as inadequate. Implementation is currently underway, supported by a health promotion programme. Monitoring and enforcement were identified as the most likely challenges due to capacity constraints.
conclusionsComprehensive mandatory salt limits are an innovative approach to food reformulation. Factors that enabled regulation included robust scientific evidence, strong political and bureaucratic leadership, and the pragmatic use of existing regulatory instruments. The main challenges identified were disagreement over the appropriate nature and extent of food industry participation, and monitoring and enforcement challenges due to capacity constraints.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.