Dietetic Programme, Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
Centre for Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Health Res Policy Syst. 2023 Feb 9;21(1):17. doi: 10.1186/s12961-023-00965-z.
High salt intake is a major cause of hypertension and cardiovascular diseases. The out-of-home sectors have been identified as one of the contributors of high salt intake in the population. The National Salt Reduction Policy of Malaysia was initiated in 2015; however, out-of-home sectors are yet to be emphasized and perception by policy-makers and the food industries towards salt reduction are yet unknown. This study aimed to determine the perceptions, barriers and enablers towards salt reduction in the out-of-home sector in Malaysia, as well as among policy-makers and the food industries.
This is a qualitative study via semi-structured in-depth interviews (IDI) and focus group discussions (FGD) involving several stakeholders consisting of policy-makers from five ministries, five nongovernment organizations (NGOs) and food science/food technology researchers from five regions (West, North, East, and South Peninsular and East Malaysia/Borneo), as well as the food industries. The IDI and FGD sessions were recorded, transcribed verbatim and analysed thematically using Nvivo software version 12.
All participants agreed that salt intake in Malaysia is high and leads to hypertension and cardiovascular diseases. Lack of awareness, poor eating culture and behaviour and frequent eating out were among the causes of high salt intake. Awareness campaigns and education, sodium content labelling and product reformulation were strategies that have been implemented by the government; whilst for the food industries, some of them have tried to reduce salt and labelled the sodium content on their food products. However, there were several barriers including perceived poor consumer acceptance, lack of knowledge and resources, and challenges in reformulation, as well as unavailability of guidelines and salt targets. Hence, several enablers have been suggested, which include prioritizing the salt reduction strategy, creating more awareness, collaboration and engagement, research and technology particularly for reformulation and shelf-life stability, incentives and salt tax.
Salt reduction efforts of the out-of-home sector in Malaysia could be achieved through several measures or enablers that can overcome the barriers currently faced by stakeholders, especially policy-makers, food industries and the consumers themselves. This study will benefit the policy-makers to improve the salt reduction policy of out-of-home sectors and highlight the concerns among the food industries on the policy.
高盐摄入是高血压和心血管疾病的主要原因之一。外出就餐场所已被确定为人群中高盐摄入的原因之一。马来西亚的国家减盐政策于 2015 年启动；然而，外出就餐场所尚未得到强调，政策制定者和食品行业对减盐的看法尚不清楚。本研究旨在确定马来西亚外出就餐场所以及政策制定者和食品行业对减盐的看法、障碍和促成因素。
这是一项通过半结构式深入访谈（IDI）和焦点小组讨论（FGD）进行的定性研究，涉及包括五个部委的政策制定者、五个非政府组织（NGO）以及来自五个地区（西、北、东、半岛南部和东马来西亚/婆罗洲）的食品科学/食品技术研究人员以及食品行业在内的几个利益相关者。IDI 和 FGD 会议进行了录音、逐字记录，并使用 Nvivo 软件版本 12 进行了主题分析。
所有参与者都认为马来西亚的盐摄入量很高，会导致高血压和心血管疾病。缺乏意识、不良的饮食文化和行为以及频繁外出就餐是高盐摄入的原因之一。政府已经实施了宣传运动和教育、钠含量标签和产品配方改革等策略；而对于食品行业，他们中的一些人已经尝试减少盐的用量并在其食品产品上标注钠含量。然而，存在一些障碍，包括消费者接受度低、缺乏知识和资源、配方改革困难以及缺乏指南和盐目标等。因此，提出了一些促成因素，包括优先考虑减盐策略、提高认识、合作和参与、研究和技术，特别是配方改革和保质期稳定性、激励措施和盐税。
通过采取一些措施或促成因素，可以克服利益相关者（特别是政策制定者、食品行业和消费者本身）目前面临的障碍，从而实现马来西亚外出就餐场所的减盐工作。本研究将使政策制定者受益，以改善外出就餐场所的减盐政策，并突出食品行业对该政策的关注。
