Pioneering sodium legislation linked to lower blood pressure and fewer deaths

South Africa has taken a bold step in the fight against high blood pressure by passing regulations on sodium content in food. This move makes South Africa one of the first countries in the world, and the first in Africa, to implement such legislation. The aim of these regulations is to encourage people to consume less salt and other sodium-rich foods, as excessive sodium intake can worsen high blood pressure, which is a major risk factor for cardiovascular disease.

It is important to note that salt and sodium are not the same. Sodium is the component of salt that raises blood pressure and increases the risk of heart disease and stroke. Table salt, for example, contains 40% sodium. The World Health Organization recommends consuming less than 2 grams of salt per day to maintain a healthy blood pressure.

A recent study conducted by researchers at Wits University and Harvard, published in JAMA Cardiology in February 2025, examined the impact of South Africa’s sodium reduction legislation. The study found that participants were able to reduce their sodium intake by 10% over seven years. This reduction in sodium consumption led to improvements in blood pressure levels, with more people achieving the recommended sodium intake.

The legislation in South Africa is considered the most extensive of its kind, covering 13 categories of food, including bread, cereals, processed meats, and soups. Manufacturers were required to reduce the sodium content in these foods by significant percentages between 2016 and 2019.

The study also highlighted the potential long-term benefits of the sodium reduction legislation. Even small reductions in blood pressure, such as 1 millimeter of mercury (mmHg), can lead to a significant decrease in cardiovascular disease mortality. This suggests that the regulations could have a profound impact on reducing the rates of heart disease, stroke, and other cardiovascular conditions.

Furthermore, South Africa’s aging population is at a higher risk of developing chronic diseases like heart disease and stroke. The study, conducted as part of the Health and Aging in Africa: Longitudinal Studies in South Africa (HAALSA) program, focused on adults aged 40 and above in rural South Africa. The results showed that stricter legislation on sodium intake can effectively reduce blood pressure levels and improve overall health outcomes.

In conclusion, the study emphasizes the importance of government action in implementing regulations to reduce sodium intake. The success of South Africa’s sodium reduction legislation serves as a model for other countries to follow in the fight against high blood pressure and cardiovascular disease. By adopting similar laws, governments worldwide can potentially save lives and reduce the burden of chronic diseases on their populations.