Croatia increases health literacy to reduce salt intake

As part of the comprehensive national health promotion project Healthy Living, Croatia has implemented measures to help people choose healthy food options and to encourage food producers to reduce the amount of salt added to foods.

In 2015, salt intake in Croatia was estimated to be around 11.6 grams per person per day – over double the WHO-recommended levels. Salt intake is a key contributor to cardiovascular diseases, which cause around 45% of deaths in Croatia.

In response, the Croatian Institute of Public Health and the Ministry of Health developed the Strategic Plan for Reduction of Salt Intake. It aims to reduce daily salt intake by 4% each year, from 11.6 grams in 2015 to 9.3 grams in 2019.

Easily understandable nutrition labelling can help consumers make healthy food choices

A key aspect of the Strategic Plan is the implementation of the Healthy Living front-of-pack nutrition labelling system, which allows consumers to quickly and easily identify options that are in line with a balanced diet. At the same time, the system encourages food producers to provide more healthy options that meet specified criteria for nutrient content.

Customers have responded positively to this system, and their recognition of these products has increased. At the same time, a greater range of products meeting the criteria has appeared on the market.

Training bakers to reduce the salt added to bread

Bread is one of the main sources of dietary salt in Croatia, and a reduction of the salt content of bread is easily achievable without any effect on taste.

The bakery sector in Croatia is growing, and includes around 30 000 workers that produce up to 380 000 tons of bakery products each year. A key component of the Strategic Plan is to raise awareness among bakers about the health risks of adding too much salt to the food products that they sell.

A number of training sessions and an awareness-raising campaign were conducted to encourage bakers to reduce the amount of salt they add to foods. In addition, a maximum of 1.4% salt content in bread is now in place according to the Croatian national regulation on cereals and cereal products (Official Gazette nr. 81/16).

Associate Professor Sanja Musić Milanović, Head of the Healthy Living project, explains: “Excessive salt intake is a major threat to public health in Croatia. As a country with the third-highest intake in Europe, we needed to take a holistic approach to addressing this problem using all available interventions at our disposal. Therefore, in addition to government actions outlined in the Strategic Plan, it has been crucial to conduct health promotion interventions that help increase health literacy.”

Front-of-pack labelling to make the healthy choice the easy choice, combined with education of both the public and food industry employees, represents a comprehensive approach to increasing health literacy in Croatia. These interventions will be critical to reaching the goal of a 2.3 gram reduction in salt intake per person, per day.