The capacity of non-government organisations to improve the food supply

Abstract

The totality of evidence shows a dose response relationship between salt intake and blood pressure. Raised blood pressure is one of the most important preventable risk factors for cardiovascular disease. Processed foods supply 75% of dietary salt in Australia. Whether food companies choose to reduce salt has a profound effect on health. Few data quantify the effects of NGO advocacy on corporate actions to support salt reduction. The overall aim of this research was to examine how an NGO can influence corporate actions to reduce salt in Australia. Mixed methods were used to provide evidence on: salt reduction; the determinants of corporate actions for salt reduction; and, the effects of advocacy for voluntary salt reduction. Product data (2008-2013) were used to assess mean changes in salt content of foods. Reviews and textual analyses of publicly available data in the public health and business literature were used to identify and assess external influences on corporate actions to reduce salt. A cluster-randomised trial assessed the effects of advocacy on food companies (n=45). Interim effects of the advocacy program were assessed using mixed methods. Overall salt reduction was modest, with substantial heterogeneity in the findings between food companies and categories. Voluntary salt reduction is at odds with powerful, often more influential external environmental factors in corporate decision making than advocacy. There were no differences between the intervention and control groups in any of the interim measures. Current policy initiatives for salt reduction are failing to achieve public health goals. Several business-based approaches to intervention that could deliver a greater impact from advocacy actions were identified. Ultimately there needs to be government leadership and/or a way of making salt reduction deliver a clear financial return.