In Kazakhstan, where Salt is an essential ingredient in many traditional dishes, doctors have raised concerns over the high levels of hypertension and strokes caused by excessive salt intake. Currently, cardiovascular disease is the main driver of premature deaths in the country resulting in more than 42 000 deaths each year – and high salt intake is a major contributing factor. 

According to Dr Zhanar Kalmakova, Board Chairman of the National Center of Public Health, Ministry of Health of Kazakhstan, Kazakhs consume more than 17 g of salt a day on average. This is almost 4 times the WHO-recommended daily intake of 5 g. 

Adding salt: a risky tradition

“In Kazakhstan, there is a tradition to stock up on meat for the winter, so it needs to be highly salted,” Dr Kalmakova explains. However, the issue goes beyond just meat.

A 2017 study by WHO/Europe in collaboration with the Kazakh Academy of Nutrition showed that the highest mean salt content in a serving of Food was found in homemade noodles (5.6 g); plov, a traditional rice and meat dish (5.2 g); and kebab (4.3 g). These portions corresponded to 112.4%, 104.2%, and 85.4% of the recommended maximum daily salt intake, respectively. 

Too much salt in food increases the risk of stroke, hypertension, diabetes and other noncommunicable diseases (NCDs) linked to high blood pressure and cholesterol levels. NCDs are behind 87% of deaths in the country, which is higher than the global average of 71%.

Nutrition roadmap to protect health

To combat this issue, Kazakhstan is taking steps to reduce salt consumption. The government has partnered with WHO/Europe and the United Nations Children’s Fund (UNICEF) to develop a nutrition roadmap for 2022–2025. Additionally, a special working group is developing a national policy to reduce consumption of salt, sugar, and trans fats. 

“Salt reduction is the most cost-effective measure to prevent hypertension and cardiovascular diseases in the country, according to a 2019 survey by WHO and United Nations Interagency Task Force on the Prevention and Control of Non-communicable Diseases,” explains Laura Utemissova, National Professional Officer at the WHO Country Office in Kazakhstan. “The salt policy package achieved a benefit-to-cost ratio of 118.4 over 15 years, a return of more than 118 tenge [Kazakh currency] for every 1 tenge invested.”

Countries across the entire WHO European Region need diets that protect people’s health. However, ordinary people can’t fight these health threats by themselves. Many people may not even be aware that the food they eat is excessively salty. So, decision-makers and food producers can contribute to lowering salt levels by creating a set of rules for better nutrition.

Creating a healthier food environment

There is a popular perception that business interests and health conflict. For example, that if the government introduces measures and standards, then small, local food producers will suffer. Another perception is that if products are reformulated with less salt, consumers will no longer buy them, and food manufacturers will lose business. 

“But this is simply not true,” says Dr Kremlin Wickramasinghe, WHO/Europe Regional Adviser on Nutrition, Physical Activity and Obesity. “Evidence shows that introducing policies and legislation creates a level playing field for all companies. Therefore, businesses that reduce salt will not be discriminated against and improvements can be achieved across the food system. Today, governments and the food industry have an opportunity to create a healthier food environment which can save thousands of premature deaths from heart diseases every year by reducing salt intake in the population,” he emphasizes.

The Government of Kazakhstan has taken significant steps to promote healthier diets and lifestyle choices. For instance, in 2014, it decided to limit trans fats in food production. Furthermore, the country has introduced measures to increase physical activity, such as building cycle paths and promoting sports. 

“Positive changes are already happening. Kazakhstan’s salt intake is slightly decreasing since 2010, and the country is keen to continue with this trend,” adds Laura Utemissova.