Measures to reduce dietary sodium and sugar

Subject: food safety and environmental hygiene, health services

Tag Cloud
Sodium and sugar reduction measures in Hong Kong
Sodium reduction measures in South Korea
Industry engagement in product reformulation
Sodium reduction targets for designation as low-sodium food providers
Nutrition teachers to oversee the school lunch programmes
Development of low-sodium recipes for food prepared at home
Monitoring and evaluation mechanism to track sodium reduction initiatives
Sugar reduction measures in the United Kingdom
Imposing "sugar tax" on packaged drinks
Providing clear information on food labels to facilitate healthier food choices
Promoting changes in dietary habits through social marketing campaigns
Concluding remarks
Prepared by Ivy CHENG
Research Office
Information Services Division
Legislative Council Secretariat
27 January 2022

  1. The Population Health Survey 2020 will provide latest information on the health status, health related lifestyles and other health parameters of the local population and help track changes in parameters such as salt intake level of the Hong Kong people.
  2. See Panel on Food Safety and Environmental Hygiene (2019, 2020).
  3. Many overseas places have required food manufacturers to follow a voluntary or mandatory front-of-pack labelling scheme. The scheme is to help consumers make healthier food choices by providing simplified and easy-to-understand information on the key nutritional features of prepackaged foods. The traffic light food labelling system is one of the front-of-pack labelling approaches under which a food product's levels of specified nutrients are colour-coded on the label with red for high level, amber for medium level and green for low level.
  4. See Panel on Food Safety and Environmental Hygiene (2019, 2020), 香港01 (2017, 2018) and 東網(2020).
  5. See Food and Health Bureau and Centre for Food Safety, Food and Environmental Hygiene Department (2020).
  6. Free sugars refer to monosaccharides (e.g. glucose) and disaccharides (e.g. table sugar) added to food by the manufacturers, cooks or consumers, as well as sugars naturally present in honey, syrups and unsweetened fruit juices. See World Health Organization (2017).
  7. An international advisory panel was set up in 2014 to provide professional advice on reducing salt and sugar intake by the local population. The panel comprises five renowned public health experts from the Mainland and overseas.
  8. CRSS was set up in March 2015 to advise the Secretary for Food and Health on the formulation of policy directions and work plans to reduce the intake of salt and sugar by the public. It comprises representatives from various sectors, including food trade, healthcare professionals, academia and the education sector.
  9. These three targets are among those laid down in the "Towards 2025: Strategy and Action Plan to Prevent and Control Non-communicable Diseases in Hong Kong". The document, which was issued jointly by the Food and Health Bureau and the Department of Health in 2018, sets out nine targets to be achieved by 2025 for the prevention and control of non-communicable diseases.
  10. According to information provided by the Centre for Food Safety to the Research Office, restaurants which offer less salt/sugar options to customers are committed to reducing (a) the salt content by at least half a teaspoon and/or (b) the sugar content by at least one teaspoon when preparing the dishes. For restaurants offering tailor-made less-salt-and-sugar dishes, they are required to provide at least three tailor-made less-salt and/or less-sugar dishes, as well as reducing the salt and/or sugar contents through reformulation of the original recipes (though there is no specific reduction target imposed).
  11. The average sodium reduction target set by the Centre for Food Safety for both white bread and wholemeal bread is 380 milligrams sodium/100 grams, with the maximum target for selected bread product set at 490 milligrams sodium/100 grams.
  12. As at May 2021, the participating chained bakery shops had achieved a 6% to 7% reduction in the overall average sodium content of their prepackaged white bread and wholemeal bread products. Meanwhile, participating non-prepackaged bread manufacturers had reduced the overall average sodium content of their non-prepackaged white bread and wholemeal bread products by 11% and 13% respectively. See Food and Health Bureau and Centre for Food Safety, Food and Environmental Hygiene Department (2021).
  13. Regarding sugar intake level of the population, the results of the 2014-2015 Population Health Survey did not include this indicator and there is currently no information on whether the 2020 survey will conduct such measurement.
  14. See Census and Statistics Department (various years).
  15. See Ministry of Food and Drug Safety (2020).
  16. The Korea Health Industry Development Institute is a government-affiliated institution under the Ministry of Health and Welfare tasked to provide professional support for enhancing the development of the healthcare industry of South Korea.
  17. See Korea Health Industry Development Institute (2015) and Park, H. K. et al. (2020).
  18. The NMRSI programme was launched in 2012 to raise awareness of the sodium reduction initiatives among the key stakeholder groups. Subcommittees had subsequently been formed under NMRSI to drive the implementation of initiatives targeting at specific sectors (e.g. the processed food and catering sectors). See Park, H. K. et al. (2020).
  19. During the initial stage of the National Plan, the South Korean government spent 965 million won (HK$6.9 million) between 2012 and 2014 on developing sodium reduction guidelines for selected categories of high-sodium processed food. See Korea Health Industry Development Institute (2015).
  20. The government has funded research on the reformulation of kimchi, which is a major contributor of sodium intake of the South Koreans, for reducing its sodium content. The high penetration of "kimchi refrigerators" among the South Korean households from round 2000s has helped facilitate the acceptance of reformulated lower-sodium kimchi: these refrigerators are specially designed to meet the storage and fermentation requirements of kimchi, and their lower storage temperature allows for a reduced sodium content of packaged or homemade kimchi.
  21. South Korea has implemented the "nutrition teacher" system since 2007 under which each school has to recruit a "nutrition teacher" to replace the then dietitian in administering the school meal operation and take up the additional role on nutrition education. As at end-2020, about two-thirds of the schools had recruited a "nutrition teacher". The rest had still been deploying a dietitian in managing the school meal operation.
  22. Low-sodium recipes have been shared to "nutrition teachers" through the Korean Dietetic Association.
  23. The South Korean government spent 86 million won (HK$0.6 million) on developing low-sodium recipes and cookbooks, including analysis on the nutritional content of the recipes, during the first two years of the National Plan. See Korea Health Industry Development Institute (2015).
  24. Being a nationwide survey, KNHANES covers a representative sample of 10 000 South Koreans annually.
  25. Children and young people consumed three times the recommended amount of sugar on average (ranging from 14.7% to 15.6% of their total calorie intake), with adults consuming more than double (12.1%). The recommendation level is set by the Scientific Advisory Committee on Nutrition, a UK-wide advisory committee advising the government organizations on nutrition and related health matters. The committee comprises experts in the related disciplines and lay members. See Public Health England (2015).
  26. The "sugar tax" applies to packaged drinks that are ready to drink or to be drunk in a diluted form; and contain at least five grams of sugar per 100 millilitres that is added during production, or exists naturally (except for fruit juice, vegetable juice and milk).
  27. The tax measure was introduced as part of the sugar reduction and reformulation programme which also featured voluntary initiatives for reducing sugar in other categories of high-sugar food such as breakfast cereals and ice-cream. Under the sugar reduction and reformulation programme, the UK government targeted to reduce the amount of sugar coming from key categories of food that contributed to children's sugar intake by 20% by 2020 through product reformulation, reducing portion size and/or shifting consumer choice to lower or no added sugar options.
  28. According to the UK government, a can of sugar-sweetened soft drink with a volume of 330 millilitres may contain as much as 35 grams of sugar, which is over the maximum recommended daily intake of sugar for a child.
  29. The two tax rates are: (a) £0.18 (HK$1.9) per litre of drink if it contains between five to less than eight grams of sugar per 100 millilitres; and (b) £0.24 (HK$2.5) per litre of drink if it contains eight grams or higher level of sugar per 100 millilitres.
  30. See Gov.UK (2018) and Public Health England (2020).
  31. Percentage reference intake of a nutrient refers to the value that it contributes to the amount needed by an adult to have a healthy and balanced diet in percentage terms calculated per a portion of the product. If a portion of food states that it provides 50% of an adult's reference sugar intake, this means that the serving contains half of an adult's daily maximum amount of sugar intake, and over the rest of the day, options lower in sugar should be chosen.
  32. A research study commissioned by the Department of Health and Social Care in 2016 revealed that over 80% of respondents claimed that they looked at the FOP labels and 69% agreed that a FOP label was useful when trying to choose a healthier diet. Respondents who looked at FOP labels had healthier shopping baskets with fewer calories, less sugar, fat and salt content, and higher fibre content. See Department of Health and Social Care et al. (2020).
  33. See Gov.UK (2016).
  34. It is noted that mandatory FOP labelling schemes have been implemented in Thailand, Mexico and a few South American countries (including Chile; meanwhile, Brazil passed the regulation to put in place such a scheme from October 2022).
  35. Most recently, the UK government conducted a consultation in 2020 to collect views and evidence to inform the future improvements of the FOP labelling scheme, including the suggestion to update the scheme to reflect the latest dietary advice for sugar intake. The current FOP labelling scheme shows the total sugar content of foods, but the new maximum intake recommendations are based on intake of free sugars, excluding sugars naturally occurring in foods such as fruit, vegetables, cereals and milk products.
  36. Social marketing campaign under the "Change4Life" brand was first launched in 2009 to encourage parents and their young children to adopt healthy lifestyle and change their dietary habits. Over the years, Change4Life campaigns had been launched under different themes comprising elements such as mass communication programmes, dissemination of healthy eating tips and recipes through a dedicated portal and a membership programme, and partnership with businesses and non-governmental organizations to provide relevant promotion offers and activities for kids.
  37. See International Association for Measurement and Evaluation of Communication (undated) and Public Health England (2017).

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