Cities and NCDs: Montevideo's menu for reducing sodium intake

MANILA — In Uruguay’s capital city, the government has been waging war against high sodium consumption.

A few years ago, the municipality banned salt shakers, ketchup, and mayonnaise at restaurant tables. Recently, a new decree has expanded that, requiring restaurants in Montevideo to have at least 10 percent of their menu contain food items with no added salt — for public health reasons.

High sodium consumption has been linked to the development of several major NCDs, including high blood pressure and increased risk of heart disease, both of which contribute to high mortality rates in Uruguay. More than 60 percent of deaths of those aged between 30-69 years in Uruguay are due to NCDs, according to Montevideo Mayor Daniel Martínez, based on the country’s last national survey.

But results of their second national survey on risk factors for NCDs revealed that not much has changed in terms of the population’s salt usage, which includes food cooked at home and products consumed with high salt content. In the first survey in 2006, 28.6 percent of the population in Uruguay said they added salt to their food. In the second survey, that number was almost 30 percent.

Mayor Martínez, however, is hoping that their latest initiative would at least provide the dining population of Montevideo “the ability to choose” food with no added salt content.

“The population of Montevideo, much like the rest of the world, has begun to face facts about the real consequences of excessive salt consumption. Much remains to be done; in fact, the increase in NCDs and their risk factors proves this, [and] food companies can’t do business without considering the tastes of the majority of the population,” he told Devex. “But there is a minority — and we believe it will grow — that doesn’t add salt to their food, whether by choice or necessity [from] hypertension, and these are customers that [food companies] must capture.”

This is how they were able to convince restaurants — including fast food chains — to accept the new regulations, he said. Pushing for a regulation that would cover more than 10 percent of any restaurant menu however would be too “radical” of a change and a “nonnegotiable” for restaurants, he argued. It would also be too imposing on the part of the consumers.

“The decision to eat food with no salt added is the consumer’s,” Martinez said.

The local government has not yet communicated the new regulations to its population, but they plan to do it along with a public education campaign on the negative impacts and benefits of reduced consumption of food with added salt content. The mayor said they are in the final stages of the campaign design.

What’s going to be different this time is the inclusion of an evaluation at the end of the campaign.

“The city has been working in conjunction with the Uruguay Ministry of Health on this topic for several years. So far, no impact surveys have been conducted that validate results,” he said. But an impact survey will be conducted toward the end of the year for their latest initiative which they are carrying out as part of Bloomberg Philanthropies’ Partnership for Healthy Cities.

This is part of a miniseries on how cities are tackling NCDs in the line up to the third United Nations high-level meeting on NCDs. The cities featured here are all part of Bloomberg Philanthropies’ Partnership for Healthy Cities.

For more coverage of NCDs, visit the Taking the Pulse series here.