Critical review on dietary sodium reduction policies in Malaysia

SHAKE Technical Package outlines the policies and interventions in reducing population salt intake which includes five overarching elements needed to create a successful salt reductionprogramme followed by the five elements of the SHAKE Package for salt reduction that consist of (1) surveillance, (2) harness the industry, (3) adopt the standards for labelling and marketing,(4) knowledge, and (5) environment. The aim for the present work was to critically review the documents related to the dietary sodium reduction strategies in Malaysia as compared to theSHAKE Technical Package. This review involves online and physical document searches of documents related to dietary sodium reduction within the Ministry of Health Malaysia. Visitsto each related department via a liaison officer were done for clarification about the documents. Data was sorted according to the SHAKE Framework and a SWOT analysis was done. A totalof 32 documents related to salt reduction policies and 15 health education materials were identified. Malaysia’s salt reduction policies comply to four out of five overarching elementsof a successful salt reduction program with the presence of political commitment, dedicated programme leadership and governance, partnership with other ministries and stakeholdersand integration with iodine deficiency elimination programme. For the SHAKE Package, Malaysia’s policies comply with all the five SHAKE Package elements. However, further investigation revealed that the food products involved in the food reformulation programme were limited. The SWOT analysis revealed that Malaysia has developed a specific plan for a national salt reduction strategy by producing its own Salt Reduction Strategy to Preventand Control Non-Communicable Diseases for Malaysia Guidelines 2015-2020. Currently, there is no comprehensive database on the salt content of processed foods in Malaysia mainlydue to the absence of mandatory labelling for sodium content in processed foods, which is a significant threat to the implementation of salt reduction initiative in the country. Pro-active non-governmental organisations (NGOs) and civil society groups advocating salt reduction in the community is needed to place salt high on the political and developmental agenda Saltreduction strategy as a policy in Malaysia includes almost all recommendations in the SHAKE Framework Malaysia. However, it is still in its early stage.