Developing a policy to reduce salt levels in food eaten outside the home in Malaysia

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Mhairi Brown, International Programme Lead for World Action on Salt and Health

In February of this year, we were delighted to be awarded funding by the Newton Fund Impact Scheme to investigate how to lower salt levels in the out of home sector (which includes restaurants, cafes and street food vendors) in Malaysia, along with our colleagues from Universiti Kebangsaan Malaysia, University of Malaya, Sunway University and the Malaysian Ministry of Health. This came about as a result of our previous project in the country, where we uncovered the sources of salt in the Malaysian diet, of which food eaten outside the home was a major contributor, along with awareness and knowledge of salt in the general public. We found that while most people knew that eating too much salt could cause health problems, more than half of the people involved in our study thought they consumed just the right amount of salt. However, salt intake in Malaysia is very high; around 9g per day, almost double the World Health Organization’s recommended maximum level of 5g. And public health is suffering as a result – almost a third of adults have high blood pressure in Malaysia and cardiovascular diseases such as heart disease and stroke are the main causes of death. Our new  grant will allow us to interview stakeholders across the country, everyone from chefs and business owners to doctors, nutritionists and health policy specialists, on how we might go about building a consensus for a policy that will remove unnecessarily high levels of salt from dishes, which everyone can get behind and make work for them.

Of course, our funding was granted BC: Before Coronavirus. In the time before this pandemic took over our lives, eating out was commonplace. In our new normal, the heart of many cities has gone quiet, with the familiar sight of bustling cafes and restaurants having disappeared to be replaced by eerily empty streets.

And yet… we cannot ignore or forget the huge toll the food and drink industry has had on our lives, even now. They spend a lot of money on advertising and marketing their unhealthiest products, deliberately driving the narrative that it is purely ‘personal responsibility’ to eat a healthy, balanced diet. All the while, emerging data highlights that many of the thousands of people sadly dying from the virus have had an existing health condition, of which obesity, high blood pressure and heart disease are most prevalent, and are largely preventable. If our environment enabled a healthy lifestyle, that is.

The problem has not just been caused by food we buy in supermarkets: food served in the out of home sector tends to be higher in salt, sugar and fat than dishes we would cook at home, thanks in part to overzealous ‘seasoning’ by chefs, lashings of oil and butter and big portion sizes.  Worldwide, many restaurants have changed their business model to allow them to offer takeaways and deliveries, giving us increased access to unhealthy food at a time in history that has once again reminded us just how important health is for society to function. While some of us may be spending more time getting creative in the kitchen, let’s not overlook the fact that healthy home cooking requires a kitchen to cook in, access to appropriate utensils and, crucially, access to a full range of appropriately priced ingredients. It is again the poorest in society who find themselves having to deal unfairly both with Covid-19, and with more prevalent rates of obesity, type 2 diabetes and high blood pressure.

While every country deserves to have a thriving food industry which benefits business owners and the economy, this cannot any longer come at the expense of public health. Post-coronavirus seems an opportune time to support local businesses and rely less on global brands who invest so much in influencing our decision making processes, to sell us food we don’t need, leading to health conditions we don’t want. Our project gives us a fantastic opportunity to address these issues and make sure all businesses act responsibly on nutrition in the ‘new’ future, and we can’t wait to get started.

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