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Scaling Up and Evaluating Salt Reduction Policies and Programs in Latin American Countries

High salt diets are a major cause of high blood pressure, a leading risk factor for death, and account for close to two-thirds of strokes and one-half of heart disease incidents worldwide. This project will address Latin America's high blood pressure rates through research that will strengthen and expand existing salt reduction programs. The project will also introduce new programs in Argentina, Brazil, Costa Rica, Paraguay, and Peru. Sodium reduction policy options The Costa Rican Institute of Research and Teaching in Nutrition and Health's A. Blanco Metzler will lead the project. Metzler is working on an IDRC-funded project on salt reduction. The research team will identify public policy innovations for sodium reduction in food systems in the five project countries. The goal is to promote healthy diets that are lower in sodium. The research team will -assess and compare sodium content of food in the five countries -analyze the health and economic benefits of population-wide sodium reduction -assess the drivers and barriers for consumers to change -develop social marketing strategies -evaluate the success indicators for initiatives and partnerships Knowledge translation and awareness Project results will help strengthen abilities in the governmental and non-governmental sectors to inform and influence policy change, while increasing consumer awareness in the region. The project team will leverage the research through the Pan American Health Organization's SaltSmart Consortium. It aims to reduce dietary salt intake across the Americas to levels of less than 5 grams per day, as recommended by the World Health Organization. This project includes a knowledge translation strategy that will promote optimal reach, uptake, and adoption of research findings. The strategy will also provide the basis for a broader application to healthy diets to help reduce non-communicable diseases in Latin America.

Project ID
108167
Project Status
Completed
End Date
Duration
36 months
IDRC Officer
Roberto Bazzani
Total Funding
CA$ 1,199,946.00
Location
Argentina
Brazil
Costa Rica
Paraguay
Peru
Programs
Global Health
Global Health
Institution Country
Costa Rica
Project Leader
Adriana MSc Blanco Metzler
Institution
Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud
Institution Country
Canada
Project Leader
JoAnne Arcand
Institution
University of Ontario Institute of Technology/Institut universitaire de technologie de l'Ontario
Institution Country
Canada
Project Leader
Mary L'Abbe
Institution
The Governing Council of the University of Toronto

Outputs

Relationship between marketing to children on food labeling and critical nutrient content in processed and ultra-processed products sold in supermarkets in Lima, Peru

Relationship between marketing to children on food labeling and critical nutrient content in processed and ultra-processed products sold in supermarkets in Lima, Peru

Article

New regulatory policies for the use of food labelling should be used to improve children’s health at the population level. The study provides information about marketing to kids (M2K) found in labeling of processed and ultra-processed food products sold in a supermarket chain (in Lima, Peru) and to determine how labeling relates to critical nutrient content. Children choose their favourite product based on packaging, specifically on colors and drawings which influence their perception of which product is “healthiest.” The study contributes to evidence-based decision making in policy processes.

Author(s): Torres-Schiaffino, Daniella, Saavedra-Garcia, Lorena

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Language: English

Plan de divulgación de recursos educativos abiertos del proyecto de investigación multicéntrico 108167 del IDRC “escalando y evaluando políticas y programas de reducción de sal en América Latina”

Plan de divulgación de recursos educativos abiertos del proyecto de investigación multicéntrico 108167 del IDRC “escalando y evaluando políticas y programas de reducción de sal en América Latina”

Informes

Author(s):

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Language: Spanish

Program evaluation of a dietary sodium reduction research consortium of five low- and middle-income countries in Latin America

Program evaluation of a dietary sodium reduction research consortium of five low- and middle-income countries in Latin America

Article

Excess dietary sodium is a global public health priority, particularly in low- and middle-income countries where rates of hypertension and cardiovascular disease are high. The International Development Research Centre funded a research consortium of five Latin American countries (LAC) to inform public health policy for dietary sodium reduction (2016-2020). The objective of this study was to determine the outcomes of this funding on short-term (e.g., research, capacity building) and intermediary outcomes (e.g., policies). A summative program evaluation was conducted, using a logic model and multiple data sources including document review, surveys, and interviews. Researchers from Argentina, Costa Rica, Brazil, Peru, and Paraguay produced a significant amount of scientific evidence to guide decision making on sodium policy related to its content in foods, consumer behaviors (social marketing), and the health and economic benefits of dietary reduction. A substantive number of knowledge translation products were produced. The funding enabled training opportunities for researchers who developed skills that can be scaled-up to other critical nutrients and health issues. It was unexpected that intermediary policy changes would occur, however several countries demonstrated early policy improvements derived from this research. A funded research consortium of LAC is a practical approach to invoke policy innovations.

Author(s): Padilla-Moseley, Janice, Blanco-Metzlerm, Adriana, L’Abbé, Mary R., Arcand, JoAnne

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Language: English

Escalando y evaluando las políticas y programas de reducción de sal en América Latina : informe técnico final

Escalando y evaluando las políticas y programas de reducción de sal en América Latina : informe técnico final

Informes

Author(s): Blanco-Metzler, Adriana

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Language: Spanish

Monitoring sodium content in processed foods in Argentina 2017-2018 : compliance with national legislation and regional targets

Monitoring sodium content in processed foods in Argentina 2017-2018 : compliance with national legislation and regional targets

Article

Evidence suggests that enhancing sodium reduction in processed foods may be a necessity for public health objectives. This in-depth study presents an assessment of sodium content in a selection of food groups and categories as reported in the nutrient information panels. All food categories presented high variability of sodium content. Food products and product categories are compared with the maximum levels according to Argentinian law. The high variability of sodium content found within each category shows the technical feasibility of reducing sodium levels within these food groups, as has been found in other studies around the world.

Author(s): Allemandi, Lorena, Tiscornia, Maria Victoria, Guarnieri, Leila, Castronuovo, Luciana, Martins, Enrique

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Language: English

FLIP-LAC user guide

FLIP-LAC user guide

Training Materials

This is version 6.4 of the FLIP-LAC manual. The Food Labeling Information Program for Latin America (FLIP-LAC) for data collection and registration is a smartphone-based technology developed by the University of Toronto, Canada. The FLIP iPhone app is meant for quickly capturing a limited amount of information about a food product - most importantly the product barcode and photos of product. Once this information is captured, the data and the photos are later uploaded to the FLIP website where the rest of the data entry can be completed based on photos of the product.

Author(s): L’Abbe, Mary R., Schermel, Alyssa, Franco-Arellano, Beatriz, Vega S., Jaritza, Arcand, JoAnne, Lam, Leo, Leung, Herman, Ho, Brian, Wilson, Mark, Blanco M., Adriana

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Language: English

El desafío de reducir el consumo de sal/sodio en la dieta de la población latinoamericana

El desafío de reducir el consumo de sal/sodio en la dieta de la población latinoamericana

Informe

Author(s): Blanco Metzler, Adriana, Madriz Morales, Karol, INCIENSA, Ramos, Eugenia, Fundación InterAmericana del Corazón

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Language: Spanish

Monitoreo del contenido de sodio en productos procesados de Argentina 2017-2018

Monitoreo del contenido de sodio en productos procesados de Argentina 2017-2018

Informe

Author(s): Lorena, Allemandi

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Language: Spanish

Salt reduction in Latin America : a regional social marketing and communication plan

Salt reduction in Latin America : a regional social marketing and communication plan

Training Materials

Teams from four Latin American countries (Brazil, Costa Rica, Paraguay, Peru) identified social marketing as an approach to combat excessive sodium consumption, which is often double the recommended intake. This report translates research insights identified by each country into a series of creative concepts and communication strategies towards decreasing demand for salt and high sodium ingredients used in household food preparation and consumption. Salt reduction efforts must include changes to the environment that make it easier for a population to consume less salt. Social marketing can be used to generate demand for alternatives, and also aim at influencing the policy environment.

Author(s): Pasha, Mahmooda Khaliq, Metzler, Adriana Blanco

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Language: English

Guía del usuario FLIP-LAC

Guía del usuario FLIP-LAC

Material de formación

Author(s): L’Abbe, Mary R., Schermel, Alyssa, Franco-Arellano, Beatriz, Vega S., Jaritza, Arcand, JoAnne, Lam, Leo, Leung, Herman, Ho, Brian, Wilson, Mark, Blanco M., Adriana, Blanco-Metzler, A.

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Language: Spanish

Scaling-up and evaluating salt reduction policies and programs in Latin American countries : final technical report

Scaling-up and evaluating salt reduction policies and programs in Latin American countries : final technical report

Report

The University of Ontario Institute of Technology (Canada) worked in collaboration with country researchers to assess changes to sodium levels in packaged foods (2015-2018) across four participating countries: Peru, Paraguay, Argentina and Costa Rica. The project determined whether a significantly greater proportion of packaged foods meet the Pan-American Health Organization (PAHO) regional targets. The data generated can provide a basis to inform new policies, and modifications to existing policies and programs (regional sodium targets, economic analyses).

Author(s): Arcand, JoAnne, Padilla, Janice

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Language: English

Scaling-up and evaluating salt reduction policies and programs in Latin American countries : final technical report

Scaling-up and evaluating salt reduction policies and programs in Latin American countries : final technical report

Report

The Food Label Information Program (FLIP) interface was adapted for use in the five participating Latin American countries (Argentina, Brazil, Costa Rica, Paraguay and Peru). The Canadian team provided technical assistance as well as training support to Latin American researchers involved in collection, entry, processing and analyses of packaged foods for assessing sodium levels. FLIP enables storage, access and inquiry of a branded food product database of approximately 44,000 packaged foods. This report describes the database and the FLIP interface and how it was applied, as well as outputs and outcomes of the project.

Author(s): L’Abbe, Mary, Arellano, Beatriz Franco, Schermel, Alyssa

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Language: English

Sodium levels in packaged foods sold in 14 Latin American and Caribbean countries : a food label analysis

Sodium levels in packaged foods sold in 14 Latin American and Caribbean countries : a food label analysis

Article

This study examined sodium levels in 12 categories of packaged foods sold in 14 Latin American Countries (LAC). Sodium levels were compared to regional sodium reduction targets. In this baseline analysis, 82% of foods met the regional target and 47% met the lower target. Baseline data suggest that sodium reduction targets may need to be more stringent to enable effective lowering of sodium intake. Population-wide sodium reduction is a cost-effective approach to address the adverse health effects associated with excess sodium consumption.

Author(s): Arcand, JoAnne, Blanco-Metzler, Adriano, Benavides Aguilar, Karla, L'Abbe, Mary, Legetic, Branka

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Language: English

An evaluation of the sodium content and compliance with the national sodium reduction targets among packaged foods sold in Costa Rica in 2015 and 2018

An evaluation of the sodium content and compliance with the national sodium reduction targets among packaged foods sold in Costa Rica in 2015 and 2018

Article

Results of the study demonstrate the feasibility of reducing sodium content in packaged foods in Costa Rica. More work is needed to continually support a gradual reduction of sodium in packaged foods, including more stringent sodium targets. Compliance with the national sodium targets among all foods increased from 80% in 2015 to 87% in 2018. A significant reduction in mean sodium content was found in only 3 of the 19 subcategories of packaged food (cakes, tomato-based sauces, and tomato paste).

Author(s): Vega-Solano, Jaritza, Blanco-metzler, Adriana, Benavides-Aguilar, Karla Francela, Arcand, JoAnne

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Language: English

Monitoreo del contenido de grasas trans en los productos procesados de Argentina 2017-2018

Monitoreo del contenido de grasas trans en los productos procesados de Argentina 2017-2018

Informe

Author(s): Lorena, Allemandi

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Language: Spanish

Challenge of reducing dietary salt/sodium intake in Latin American countries

Challenge of reducing dietary salt/sodium intake in Latin American countries

Brief

The project identified sodium content in fast, artisanal and street foods, comparing the results between participating countries (Paraguay, Peru, Costa Rica, Brazil, Argentina). It identified the determinants and barriers affecting the change in dietary sodium intake of consumers in order to design a social marketing plan which would be beneficial for salt reduction. The Food Labeling Information Program for Latin America (FLIP-LAC) was used for data collection and registration. FLIPLAC is a smartphone-based technology and methodology developed by The University of Toronto, Canada. This brief provides recommendations for public policy.

Author(s): Instituto Costarricense de Investigación y Enseñanza

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Language: English

Reducción de sal en América Latina : plan regional de mercadeo social y comunicación

Reducción de sal en América Latina : plan regional de mercadeo social y comunicación

Informe

Author(s): Pasha, Mahmooda Khaliq, Blanco Metzler, Adriana

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Language: Spanish

Protocol for FLIP pilot study

Protocol for FLIP pilot study

Training Materials

This protocol includes a training guide to assist researchers in cataloguing food ingredients through use of the Food Label Information Program (FLIP) interface and database. It includes steps for downloading the “Food Collector App” which can scan information (including both text and image) on food labels. A step by step process is outlined for entering the data for compilation and analysis. Examples are provided for tinned food such as fruit and vegetables, and dry food packaging such as cereals.

Author(s): Schermel, Alyssa, Vega, Jaritza, Franco-Arellano, Beatriz, Arcand, JoAnne, L’Abbe, Mary R., Blanco-Metzler, Adriana

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Language: English

Facilitators and barriers of research adoption to policy action in five Latin American countries : preliminary results

Facilitators and barriers of research adoption to policy action in five Latin American countries : preliminary results

Brief

The study aims to determine the facilitators and barriers of implementing sodium reduction policies and programs in five Latin American countries: Argentina, Brazil, Costa Rica, Paraguay, and Peru. The findings of the research are categorized according to the Promoting Action on Research Implementation in Health Services (PARiHS), which are factors that promote or impede research uptake into policy decision making. The factors are: content, process, actor, and context, which are described with illustrative examples. A Table of Results provides “Key facilitators to research uptake into political action.” Appendices provide details of the methodology and interview/survey materials.

Author(s): Padilla-Moseley, Janice, Sivakumar, Bridve, Flexner, Nadia, Grajeda, Ruben, Arcand, JoAnne

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Language: English

Evaluation of a multi-national dietary sodium research program in Latin America : executive summary

Evaluation of a multi-national dietary sodium research program in Latin America : executive summary

Evaluation

This multi-national research Consortium successfully achieved intended objectives. It produced high quality and impactful data related to outcomes highly relevant to improved political innovations and food systems. Several innovations were created and/or scaled-up as part of the research, such as the Food Labeling Information Program for Latin America (FLIP-LAC) for data collection and registration. FLIPLAC is a smartphone-based technology developed by The University of Toronto, Canada. Confidence, capacity, and scientific abilities to conduct research to address public health nutrition issues in Latin American countries (LAC) has increased. A food database in each participating country (Argentina, Paraguay, Peru, Costa Rica) has been developed.

Author(s): Arcand, JoAnne, Moseley, Janice

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Language: English

Evaluation of a multi-national dietary sodium research program in Latin America

Evaluation of a multi-national dietary sodium research program in Latin America

Evaluation

This is a summative evaluation of the project “Scaling up and Evaluating Salt Reduction Policies and Programs in Latin American Countries.” The project generated knowledge and research innovations to drive policies and programs for dietary sodium reduction. Knowledge on the sodium content of over 8300 packaged foods and 100 street, artisanal and fast foods has been generated. Quantification of the number of packaged foods that exceed regional and/or national sodium reduction target levels was established. Several innovations were created as part of this research and are available for future use including the Food Label Information Program (FLIP) interface and database.

Author(s): Arcand, JoAnne, Mosley, Janice

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Language: English

Escalando y evaluando las políticas y programas de reducción de
sal en América Latina /Scaling-up and evaluating salt reduction
policies and programs in Latin American countries

Escalando y evaluando las políticas y programas de reducción de
sal en América Latina /Scaling-up and evaluating salt reduction
policies and programs in Latin American countries

Report

The title describes the project aims: "To promote policy innovations to reduce sodium in the food systems of Latin America by strengthening and assessing the scaling of existing salt reduction programs, and the support of new programs by a consortium of institutions from Argentina, Brazil, Costa Rica, Paraguay and Peru " and includes objectives: Nutrition Labelling; Direct Food Analysis; Transfer of knowledge; and, Indicators of success. This report summarizes activities and achievements of the project which includes development and application of the successful “Food Label Information Program” (FLIP) and database.

Author(s): Blanco-Metzler, Adriana, L’Abbé, Mary, Arcand, Joanne, de los Angeles Montero, Maria, Allemandi, Lorena, Nilson, Eduardo, Cañete, Felicia, Khaliq Pasha, Mahmood, Saavedra, Lorena, Ramos, Eugenia, Samman, Norma, Benavides Aguilar, Karla, Vega Solano, Jaritza, Samman, Norma, Benavides Aguilar, Karla F., Vega Solano, Jaritza, Madriz, Karol, Mosley, Janice

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Language: English

Scaling-up and evaluating salt reduction policies and programs in Latin American countries - final technical report -university of Toronto

Scaling-up and evaluating salt reduction policies and programs in Latin American countries - final technical report -university of Toronto

Report

This detailed report reviews activities of the University of Toronto team technical support for the “Scaling-up and evaluating salt reduction policies and programs in Latin American countries” project. It includes 15 Appendices. The specific objective was to provide technical assistance to the teams of each country on the collection, entry, processing and analysis of Latin American packaged foods for the assessment of sodium content. The University of Toronto’s Food Label Information Program (FLIP) and Latin American version (FLIPLAC) interface is an iPhone data collector application, used to capture pictures of food packages, and a web-based database management software which can translate data to Microsoft Excel.

Author(s): Blanco-Metzler, Adriana, Arcand, JoAnne, Mosley, Janice, Sharmel, Alyssa, Franco Arellano, Beatriz

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Language: English

Final technical report / rapport technique final anexo ii-a informes finales países

Final technical report / rapport technique final anexo ii-a informes finales países

Report

This report reviews objectives and outcomes of the project “Scaling-up and evaluating salt reduction policies and programs in Latin American countries” specific to the participating countries. The sodium content of various foods is established and details are provided in the tables accompanying the Annex documents. The report is in Spanish and English

Author(s): Blanco-Metzler, Adriana, L'Abbe, Mary, Arcand, JoAnne, de los Angeles Montero Campos, María, Allemandi, Lorena, Cañete, Felicia, Saavedra, Lorena, Benavides Aguilar, Karla F., Vega Solano, Jaritza, Madriz, Karol, Trisconia, Victoria, Sequera, Guillermo, Benítez, Gilda, Turnes, Catherine, Ponce Lucero, Vilarmina, Sharmel, Alyssa, Franco Arellano, Beatriz

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Language: English

Sodium levels in packaged foods 2017-2018 : an analysis of four Latin
American countries

Sodium levels in packaged foods 2017-2018 : an analysis of four Latin
American countries

Study

The report provides a country breakdown of sodium content per 100g/ml of packaged foods in Argentina, Costa Rica, Paraguay and Peru, as well as the proportion of packaged foods that meet Pan American Health Organization (PAHO) regional and lower targets. The Food Labeling Information Program for Latin America (FLIP-LAC) was used for data collection and registration. FLIPLAC is a smartphone-based technology and methodology developed by the University of Toronto, Canada. Foods were classified into eighteen commonly consumed packaged food categories established by PAHO and endorsed by the multi-sectorial Salt Smart Consortium.

Author(s): Franco-Arellano, Beatriz, Sivakumar, Bridve, L’Abbe, Mary, Arcand, JoAnne

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Language: English

Instructivo para el registro de datos sobre la presencia y tipo de esquema de etiquetado nutricional frontal en alimentos pre-envasados almacenados en el sistema FLIP-LAC de Costa Rica

Instructivo para el registro de datos sobre la presencia y tipo de esquema de etiquetado nutricional frontal en alimentos pre-envasados almacenados en el sistema FLIP-LAC de Costa Rica

Material de formación

Author(s): Solano, Jaritza Vega

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Language: Spanish

Manual para determinar el contenido de sodio en comidas rápidas, alimentos artesanales y de la calle

Manual para determinar el contenido de sodio en comidas rápidas, alimentos artesanales y de la calle

Material de formación

Author(s): de los Angeles Montero Campos, María, Benavides Aguilar, Karla Francela

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Language: Spanish

Impact of salt intake reduction on CVD mortality in Costa Rica : a scenario modelling study

Impact of salt intake reduction on CVD mortality in Costa Rica : a scenario modelling study

Article

Cardiovascular diseases (CVD) represent the leading cause of death in Costa Rica, and high blood pressure was associated with a mortality rate of 29% (2018). The Preventable Risk Integrated ModEl (PRIME) was used to estimate the number of deaths that would be averted or delayed in the Costa Rican population by following the national and international guidelines to reduce salt consumption. Two scenarios drawn in this study predict the highest percentages of deaths prevented or postponed, by type of CVD: Coronary heart disease (39% and 38%), Hypertensive disease (32% and 33%) and Stroke (22% in both).

Author(s): Vega-Solano, Jaritza, Blanco-Metzler, Adriana, Madriz-Morales, Karol, Fernandes-Nilson, Eduardo-Augusto, Labonté, Marie Eve

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Language: English

Protocol for FLIP study of project IDRC 108167 scaling-up and evaluating salt reduction policies and programs in Latin American countries

Protocol for FLIP study of project IDRC 108167 scaling-up and evaluating salt reduction policies and programs in Latin American countries

Training Materials

This guide assists researchers in cataloguing food ingredients by using the Food Label Information Program (FLIP) interface and database. It includes steps for downloading the “Food Collector App” which can scan information (including both text and image) on food labels. A step by step process is outlined for entering the data for compilation and analysis. Examples are provided for tinned food such as fruit and vegetables, and dry food packaging such as cereals.

Author(s): Schermel, Alyssa, Vega, Jaritza, Franco-Arellano, Beatriz, Arcand, JoAnne, L’Abbe, Mary R., Blanco M., Adriana

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Language: English