Extended Abstract
Background
Non-communicable diseases (NCDs) have become a major global health challenge, leading to increased morbidity and mortality. Among the modifiable risk factors, excessive salt consumption is strongly linked to hypertension and cardiovascular diseases. According to the World Health Organization (WHO), reducing salt intake is a key intervention for lowering disease prevalence and decreasing the burden of NCDs. Studies show that daily salt consumption in Iran (10–15 grams) significantly exceeds WHO recommendations. This study aimed to review and analyze policies and community-based measures for reducing salt consumption worldwide, suggesting the best international practices and potential implementation strategies suited for the Iranian context.
Methods
This study is based on a structured literature review and a policy analysis framework. The community-based policies, national programs, and global interventions aimed at reducing salt consumption were reviewed, following a systematic approach to identify best practices and assess their transferability to the Iranian context. The research employed the READ approach- a qualitative framework for policy analysis- which involves: Reading and scanning relevant documents, Extracting essential information, Analyzing policy elements and strategies, and Distilling insights and recommendations for future implementation. This method facilitates comparative policy analysis and supports context-sensitive interpretation of international evidence.
A comprehensive electronic search was conducted across databases including PubMed, SCOPUS, Web of Science, and Google Scholar from inception until January 2025. The search strategy used Boolean operators ("AND," "OR") along with keywords such as: "national evidence-based policy," "community-based study," "salt reduction," "sodium intake," "food policy," and "dietary sodium/salt." A manual review of reference lists from previous articles was also performed to identify further relevant studies.
The inclusion criteria covered peer-reviewed articles, national health policy reports, WHO guidelines, and global studies on reducing salt intake. Research addressing hypertension prevention through salt reduction was also incorporated. Exclusion criteria involved studies lacking full-text availability in English or Persian, articles where salt reduction was not a primary focus, and clinical trials with limited sample sizes.
This dual-method approach- systematic literature review and contextual policy analysis- enabled a comprehensive understanding of effective salt reduction strategies across diverse settings, ensuring relevance for policy design in Iran.
Results The study categorizes four major policy options: 1) Nutrition awareness campaigns- including face-to-face education for high-risk groups such as individuals with hypertension and public education, 2) Implementation of food labeling strategies- such as traffic light labeling, 3) Food industry strategies- including the gradual reduction of sodium in food products, the use of salt substitutes, and new technologies, 4) Fiscal policies- such as taxation and price increases on high-sodium food products.
These four policy options vary in scope and effectiveness based on socioeconomic settings and enforcement mechanisms. Nutrition awareness campaigns are essential for initiating behavior change, especially among vulnerable groups. Food labeling strategies empower consumers at the point of purchase, while gradual reformulation enables silent reform in dietary habits without requiring consumer decision-making. Though more controversial, fiscal policies have proven powerful in incentivizing healthier choices, especially when combined with subsidies for low-sodium alternatives. When applied in tandem, these measures can create a synergistic effect that enhances overall dietary reform.
By integrating lessons from successful global initiatives and tailoring interventions to Iran’s cultural and socioeconomic context, policymakers can ensure sustainable reductions in salt consumption and enhance national health outcomes. Strengthened government regulations, industry collaboration, and consumer education are crucial for achieving lasting behavioral change and reducing the burden of salt-related diseases.
Conclusion
Reducing salt consumption in Iran requires a comprehensive, multi-sectoral approach integrating regulatory enforcement, industry cooperation, and consumer education. Evidence from successful international strategies highlights the effectiveness of front-of-pack labeling, gradual reformulation of food products, and taxation on high-sodium foods. Given Iran’s cultural and dietary habits, targeted interventions that align with consumer preferences are essential for adoption and sustainability. Strengthening policies through enhanced government regulations and cross-sector collaboration will lead to long-term reductions in salt intake, lowering disease prevalence and healthcare costs. By implementing well-structured strategies, Iran can effectively mitigate salt-related health risks, reduce hypertension prevalence, and improve public health. Sustainable policy enforcement and public awareness campaigns will drive lasting behavioral changes, leading to a healthier population and reduced healthcare expenditures.
The growing burden of hypertension and cardiovascular diseases underscores the urgency of addressing excessive salt consumption in Iran. A phased implementation strategy- starting with public education and voluntary industry reformulation, followed by regulatory enforcement and fiscal instruments- may allow for smoother integration into existing public health frameworks. Moreover, regular monitoring and evaluation mechanisms are necessary to track progress, adjust strategies, and ensure long-term sustainability. Engaging civil society, schools, and healthcare providers can further amplify the reach and impact of policy interventions, building a culture of health around salt awareness.
Practical Implications of Research
This study provides actionable insights for policymakers by identifying four key policy options- nutrition education, food labeling, industry reformulation, and fiscal policies- that have proven effective in global salt reduction efforts. Adapting these strategies to Iran’s cultural and socioeconomic context can guide the development of integrated, sustainable interventions to reduce salt intake, lower hypertension rates, and improve national health outcomes. Furthermore, these findings offer a roadmap for cross-sectoral collaboration between public health agencies, industry stakeholders, and education systems. Iran can establish a scalable and culturally sensitive approach to dietary reform by aligning interventions with existing healthcare frameworks and community practices. Regular evaluation and transparent policy adjustments will maintain public trust and maximize long-term effectiveness. The research also highlights the importance of empowering consumers through accessible information and incentives, paving the way for lasting behavioral change and reduced healthcare costs.