november 2013

November 2013

Policies to Reduce Sodium Consumption and Eliminate Trans Fats in Argentina.

Chronic non-communicable diseases (CNCD) and prevalence of risk factors in Argentina.

Source: National Survey of Risk Factors 2005 and 2009

80% Of deaths can be attributed to CNCD*80% Of deaths can be attributed to CNCD*

*Source: WHO- Source: Ministry of Health

76% Of DALY can be attributed to CNCD*76% Of DALY can be attributed to CNCD*

33% Of deaths attributed to cardiovascular diseases. They represent the 1° cause of death

33% Of deaths attributed to cardiovascular diseases. They represent the 1° cause of death

21% Of the deaths attributed to cancer. It represents the 2° cause de death

21% Of the deaths attributed to cancer. It represents the 2° cause de death

Salt Consumption in Argentina 2005-2009.

Source: National Survey of Risk Factors 2005 and 2009

12 Grams per day is the consumption of sodium per person in Argentina

12 Grams per day is the consumption of sodium per person in Argentina

5 Grams per day is the consumption of sodium recommended (WHO)

5 Grams per day is the consumption of sodium recommended (WHO)

4 Grams per day comes from bread4 Grams per day comes from bread

60% of salt ingested comes from processed foods60% of salt ingested comes from processed foods

Source: Ministry of Helath

¿Do you always/almost always add salt to the food after it was cooked?

2009

National Strategy for Prevention and Control of Non-communicable Chronic Diseases

(Ministry of Health Resolution N° 1083/09)

Actions that promote healthy diet

Less Salt, More LifeArgentina 2014, Free from Trans Fat

Both strategies are accompanied by campaigns that promote fruit and vegetable consumption and physical

activity.

Elimination of Trans Fat and Reduction of sodium: Background.

Trans Fat (TF)

1. Its consumption ↑ the risk of coronary disease and diabetes.

2. There are technically and economically feasible procedures to replace them

3. ↓ 2% in consumption of TF would avoid between 30.000 and 130.000 cases of ischemic heart disease each year in México, Centroamerica and South America.

Sodium

1. ↑ risk of cardiovascular diseases and hypertension.

2. ↑ risk of stroke- cardiac hypertrophy- proteinuria and renal disease

3. Obesity, stomach cancer- osteoporosis-nephrolithiasis- aggravation of asthma.

Elimination of Trans Fat and Reduction of sodiumIMPLEMENTED ACTIONS

INTER-SECTORAL APPROACH

Ministry of Health called different sectors involved in the regulation, production and distribution of food to agree on joint actions to eliminate

trans fats and reduce sodium consumption.

National Commission to Eliminate Trans Fats and Reduce Salt National Commission to Eliminate Trans Fats and Reduce Salt

-Ministry of Health-Ministry of Agriculture, Livestock and Fishing-National Institute of Industrial Technology(INTI)-National Food Institute (INAL)-Ministry of Social Development-Ministry of Science and Technology-Ministry of Economy

-Coordinator for Food Product Industries (COPAL)-Argentinean Federation of Baked Products Industries (FAIPA)-Argentinean Association of Fats and Oils (ASAGA)-Universities and scientific societies-Business Chambers-Cooperative workers-Consumer associations

Argentina 2014 Free from Trans Fat

Argentina 2014 Free from Trans Fat

Trans FatTrans Fat

RegulationRegulation

- Regulation-Dissemination of information to small and medium industries(Guidelines)-Campaigns for consumers

- Regulation-Dissemination of information to small and medium industries(Guidelines)-Campaigns for consumers

Elimination of Trans Fat and Reduction of sodium: IMPLEMENTED ACTIONS

RESULT: Amendment of the Food Code article Nº 155 tri, Chapter II of The Argentine Food Code

RESULT: Amendment of the Food Code article Nº 155 tri, Chapter II of The Argentine Food Code

Less salt, More lifeLess salt, More life

SodiumSodium

Self-RegulationSelf-Regulation

-Voluntary agreements with the industry -Reduction of salt content in artisanal bread-Public awareness on the need to lower salt intake

-Voluntary agreements with the industry -Reduction of salt content in artisanal bread-Public awareness on the need to lower salt intake

RESULT: 44 companies and chambers of commerce have adhered to the agreement-8000 bakeries and NATIONAL LAW

RESULT: 44 companies and chambers of commerce have adhered to the agreement-8000 bakeries and NATIONAL LAW

Elimination of Trans Fat :BACKGROUND

2008: Declaration of Río de Janeiro: “Trans Fat Free Americas”2008: Declaration of Río de Janeiro: “Trans Fat Free Americas”

1. Replace trans fats in processed foods and use a concentration of not more than 2% of total fat in oils and margarines, and no more than 5% in processed foods;

2. Compulsory nutrition labeling

3. Develop educational programs for the population

4. Establish national working groups with the participation of industry, scientists and public health authorities.

2007-PAHO: Trans Fats-Free Americas2007-PAHO: Trans Fats-Free Americas

2008: Ministry of Health called for inter-sectoral work to implement the recommendations of the Rio Declaration

2008: Ministry of Health called for inter-sectoral work to implement the recommendations of the Rio Declaration

Elimination of Trans Fat:STAKEHOLDERS, FACILITATORS AND BARRIERS

STAKEHOLDERSSTAKEHOLDERS BARRIERSBARRIERSFACILITATORSFACILITATORS

Leading role: - National Food Institute (INAL)- Ministry of Health

Public sector: - Ministry of Agriculture, Livestock and Fishing.- National Institute of Industrial Technology (INTI)

Industry Representatives :

- Coordinator of Food Products Industries (COPAL)- Argentinian Association of Fats and Oils (ASAGA)

Leading role: - National Food Institute (INAL)- Ministry of Health

Public sector: - Ministry of Agriculture, Livestock and Fishing.- National Institute of Industrial Technology (INTI)


- Coordinator of Food Products Industries (COPAL)- Argentinian Association of Fats and Oils (ASAGA)

70% of the companies are already in the process of

retrofitting

-International trend to work on these risk factors

-Growing consumer demand for healthier food

-Technical feasibility and existence of substitutes

70% of the companies are already in the process of

retrofitting



-Technical feasibility and existence of substitutes

-Cost of alternatives

-Unfair competition from small and medium enterprises

-Uniform criteria for monitoring compliance

-Contact small and medium enterprises

-Cost of alternatives

-Unfair competition from small and medium enterprises


-Contact small and medium enterprises

Trans Fat elimination:ACTORS AND STRATEGIES

Ministry of HealthMinistry of Health

-Leaded the process and coordinated actions with other sectors-Called for meetings in 3 committees (Academic, Regulatory, Communication)

-Leaded the process and coordinated actions with other sectors-Called for meetings in 3 committees (Academic, Regulatory, Communication)

National Food Institute- INALNational Food Institute- INAL

-Contributed with monitoring knowledge.-Presented the issue at local levels.- Participated in discussion with the companies-Elaboration of the manuals for Small and medium enterprise (SME)

-Contributed with monitoring knowledge.-Presented the issue at local levels.- Participated in discussion with the companies-Elaboration of the manuals for Small and medium enterprise (SME)

Ministry of AgricultureMinistry of Agriculture

-Contributed with regulatory knowledge-Dissemination of information to SME-Participated in discussion with the companies-Elaboration of the manuals for Small and medium enterprise (SME)

-Contributed with regulatory knowledge-Dissemination of information to SME-Participated in discussion with the companies-Elaboration of the manuals for Small and medium enterprise (SME)

National Institute of Industrial Technology- INTI

National Institute of Industrial Technology- INTI

-Contributed with technical knowledge-Participated in discussion with the companies-Elaboration of the manuals for Small and medium enterprise (SME)

-Contributed with technical knowledge-Participated in discussion with the companies-Elaboration of the manuals for Small and medium enterprise (SME)

Coordinator of Food Products Industries - COPAL

Coordinator of Food Products Industries - COPAL

-Delegated the lead role in Argentinian Association of Fats and Oils (ASAGA)-Delegated the lead role in Argentinian Association of Fats and Oils (ASAGA)

Argentinian Association of Fats and Oils - ASAGA

Argentinian Association of Fats and Oils - ASAGA

-Contributed with technical knowledge-Represented the business sector in negotiating the measures.-Elaboration of the manuals for Small and medium enterprise (SME)

-Contributed with technical knowledge-Represented the business sector in negotiating the measures.-Elaboration of the manuals for Small and medium enterprise (SME)

Elimination of Trans FatRESULTS

1. December 2010: Agreement to eliminate trans fats and amendment of Article N ° 155 tris, Chapter III, the Argentine Food Code

2.Guide for small and medium enterprise: recommendations and strategies to replace trans fats

3.Consumer Information Campaigns

2014: End of adaptation period and starts the monitoring period2014: End of adaptation period and starts the monitoring period

The Ministry of Health and the National Food Institute are working on strengthening the food control system for the monitoring, and evaluation of measures.

Less Salt, More LifeSODIUM REDUCCION: BACKGROUND

2010:Ministry of Health Called for inter-sectoral work to reduce sodium

2010:Ministry of Health Called for inter-sectoral work to reduce sodium

PAHO- Political Declaration for the Reduction of Cardiovascular Diseases in the Americas

PAHO- Political Declaration for the Reduction of Cardiovascular Diseases in the Americas

1. Reducing salt intake in food

2. Goal for 2020: consumption goal of less than 5 grams a day per person

1. Public awareness on the need to lower salt intake.2. Progressive reduction of salt in processed foods through agreements with

the food industry.3. Reduction of salt content in artisanal bread.

Sodium Reduccion:STAKEHOLDERS, FACILITATORS AND BARRIERS - INDUSTRY


Leading role: -Ministry of Agriculture, Livestock and Fishing.

-Ministry of Health

Public sector: -National Institute of Industrial Technology (INTI)

-National Food Institute (INAL)


-Coordinator for Food Product Industries (COPAL)-Chambers of Commerce

Leading role: -Ministry of Agriculture, Livestock and Fishing.

-Ministry of Health

Public sector: -National Institute of Industrial Technology (INTI)

-National Food Institute (INAL)


-Coordinator for Food Product Industries (COPAL)-Chambers of Commerce



-Avoid sudden implementation of measures that can be costly



-Avoid sudden implementation of measures that can be costly

-Discussion more difficult than Trans Fats: Taste, preserves food, no substitutes, component of many foods

-Unfair competition from small and medium companies


-Continuity of policy

-Contact small and medium companies

-Stricter measures

-Discussion more difficult than Trans Fats: Taste, preserves food, no substitutes, component of many foods

-Unfair competition from small and medium companies


-Continuity of policy

-Contact small and medium companies

-Stricter measures

Sodium Reduccion:ACTORS AND STRATEGIES - INDUSTRY


-Coordinated the process and linked actions with other public agencies.

-Disseminated information to consumers.

-Coordinated the process and linked actions with other public agencies.

-Disseminated information to consumers.

Ministry of AgricultureMinistry of Agriculture

-Contributed with regulatory knowledge-Dissemination of information to SME-Participated in discussion with the companies

-Contributed with regulatory knowledge-Dissemination of information to SME-Participated in discussion with the companies

National Food Institute - INALNational Food Institute - INAL

-Contributed with monitoring knowledge.-Presented the issue at local levels.-Participated in discussion with the companies

-Contributed with monitoring knowledge.-Presented the issue at local levels.-Participated in discussion with the companies

National Institute of Industrial Technology - INTI

National Institute of Industrial Technology - INTI

-Contributed with technical knowledge.- Participated in discussion with the companies-Experience with bakers

-Contributed with technical knowledge.- Participated in discussion with the companies-Experience with bakers

Coordinator for Food Product Industries - COPAL

Coordinator for Food Product Industries - COPAL

- Represented the business sector in negotiating the measures.- Organized meetings with companies to agree on the terms and goals to be discussed with the Ministry of Health.- Collected and delivered information on sodium content in food.

- Represented the business sector in negotiating the measures.- Organized meetings with companies to agree on the terms and goals to be discussed with the Ministry of Health.- Collected and delivered information on sodium content in food.

Sodium Reduccion:INDUSTRY RESULTS

Progressive and voluntary reduction of sodium content for four food group (average 5% -15%):

Selection criteria: 1. Large consumption2. High content of sodium3. Feasibility

44 COMPANIES AND CHAMBERS ADHERED FOR 487 PRODUCTS

1. Enforcement of agreements: INTER-SECTORAL NETWORK

2. Ministry of Health + INAL: working on strengthening food control system

Sodium Reduccion:ACTORS, FACILITATORS AND BARRIERS - BAKERIES


Leading Role: -National Institute of

Industrial Technology (INTI)

-FAIPA (Argentinean Federation of Baked Products Industries)

-Ministry of Health

Public sector: -Ministry of Health

-National Institute of Industrial Technology(INTI)

Industry representatives: -Argentinean Federation

of Baked Products Industries (FAIPA)

Leading Role: -National Institute of

Industrial Technology (INTI)

-FAIPA (Argentinean Federation of Baked Products Industries)

-Ministry of Health

Public sector: -Ministry of Health

-National Institute of Industrial Technology(INTI)

Industry representatives: -Argentinean Federation

of Baked Products Industries (FAIPA)

- Argentinean Federation of Baked Products Industries (FAIPA) commitment to health and good eating habits

-Positive image among consumers, without requiring major investments or modifications of the production processes

- Argentinean Federation of Baked Products Industries (FAIPA) commitment to health and good eating habits

-Positive image among consumers, without requiring major investments or modifications of the production processes

-Resistance of bakers to provide information on their products

-30.000 bakeries all over the country-more resources

-Greater dissemination of the bakeries’ efforts.

-Continuity of the policies

-Resistance of bakers to provide information on their products

-30.000 bakeries all over the country-more resources

-Greater dissemination of the bakeries’ efforts.

-Continuity of the policies

Sodium Reduccion:ACTORS –STRATEGIES- BAKERIES


-Supported FAIPA and INTI-Supported FAIPA and INTI

National Institute of Industrial Technology – INTI

National Institute of Industrial Technology – INTI

-Researched on feasibility of reducing sodium in breads-Disseminated evidence

-Provided training to the bakery sector.

-Researched on feasibility of reducing sodium in breads-Disseminated evidence

-Provided training to the bakery sector.

Argentina Federation of Bakers - FAIPA

Argentina Federation of Bakers - FAIPA

-Wide commitment to the initiative -Suported the Ministry of Health to promote the initiative- Distributed and prepared materials to offer training materials to bakers. -Provided training to bakers.

-Wide commitment to the initiative -Suported the Ministry of Health to promote the initiative- Distributed and prepared materials to offer training materials to bakers. -Provided training to bakers.

Sodium Reduccion: OUTCOMES - BAKERIES

- 8.000 BAKERIES HAVE SIGNED THE COOPERATION AGREEMENT

- ↓ 15-30% of sodium that is unnoticed by consumers

- Province of La Pampa : epidemiological study

Sodium Reduccion: LESS SALT, MORE LIFE - RESULTS

Food categories

Average reduction

% of fulfillment

% of participation

in the consumption

#

Bread 25% 80% 20%

Starchy 8% 85,5% 60%

Meat 10% 88% 40%

Dairy 9,2% 81,8% 50%

Soups 6% 96,4% 75%

Snacks 11,4% 100% 60%

Evaluation of voluntary agreements and goals2011-2013*

Evaluation of voluntary agreements and goals2011-2013*

*For progress reports and labeling, pending laboratory analysis

# Estimated from cameras and business reporting

-Reduction of 0.92 grams sodium intake between 2011 and 2013- 6% drop table salt between 2011and 2012*-Reduction of 0.92 grams sodium intake between 2011 and 2013- 6% drop table salt between 2011and 2012*

Source: Ministry of Health

* Ministry of Agriculture, CCR Consulting

Sodium Reduccion: LESS SALT, MORE LIFE

National Law for the Reduction Sodium Consumption

• Sets initial values of maximum sodium content for selected products

• Set future goals• Health warnings on salt packages and

restaurant menus• Limits size of sodium envelopes to 0.5 grams• Dissemination Campaigns• Amend Argentine Food Code• Research• Sanctions

LEARNED LESSONSLEARNED LESSONS

1. Inter-sectoral dialogue and negotiation: Need to coordinate actions with other public sector actors to provide knowledge that are outside the capabilities of the Ministry of Health

2. Leading institution open to dialogue and negotiation

3. International trend that promotes work in promoting healthy diets

4. Increased demand for healthy food

5. The creation of an inter-sectoral working group

1. Inter-sectoral dialogue and negotiation: Need to coordinate actions with other public sector actors to provide knowledge that are outside the capabilities of the Ministry of Health

2. Leading institution open to dialogue and negotiation

3. International trend that promotes work in promoting healthy diets

4. Increased demand for healthy food

5. The creation of an inter-sectoral working group

LEARNED LESSONS-to improve-

LEARNED LESSONS-to improve-

1. Limited resources

2. Small and medium enterprises are missing in the discussion

3. Monitoring and evaluation

4. The voluntary agreements do not have enforcement power. Long term: regulation

5. Lack of policy continuity

1. Limited resources

2. Small and medium enterprises are missing in the discussion

3. Monitoring and evaluation

4. The voluntary agreements do not have enforcement power. Long term: regulation

5. Lack of policy continuity

Conclusions:

HIGHLIGHTS FROM THE EXPERIENCEHIGHLIGHTS FROM THE EXPERIENCE

-The feasibility and need to work in coordination between different sectors involved in food production

-Essential that an institution is the promoter and coordinator of the measures

-The feasibility and need to work in coordination between different sectors involved in food production

-Essential that an institution is the promoter and coordinator of the measures

FUTUREFUTURE

- New sources of financing

- Strengthening monitoring and evaluation systems

- Continue with the regulation of sodium. Law enforcement. - Disseminate information to the public about the risk factors and the actions taken to control them

- New sources of financing

- Strengthening monitoring and evaluation systems

- Continue with the regulation of sodium. Law enforcement. - Disseminate information to the public about the risk factors and the actions taken to control them

2 DIFERENT STRATEGIES2 DIFERENT STRATEGIES

1-TRANS FAT REGULACION:

Amendment to the Argentine Food Code

2- SODIUM SELF-REGULATION:Voluntary agreements to reduce salt in processed foods and in breads

prepared in artisanal bakeries

Thank You very much!

november 2013

Documents

salt ministry

sodium consumption

consumption of sodium

trans fats

reduction of sodium

trans fat tf1

ministry of helathdo

ministry of health76