{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T07:27:54Z","timestamp":1774510074354,"version":"3.50.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Population-wide dietary sodium reduction is a global priority and a highly cost-effective strategy to lower blood pressure and reduce cardiovascular disease risk. In response, the Nigerian government launched the National Multi-sectoral Action Plan (NMSAP) in 2019, recommending evidence-based policy actions including limiting sodium in processed foods, restricting food advertising especially for children, promoting public awareness, integrating nutrition education in schools, and front-of-package labeling. We conducted a qualitative study to examine progress, barriers, and facilitators in implementing these policy actions 3\u202fyears post-launch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between March and September 2024, we conducted 47 key informant interviews and 5 focus group discussions with 22 participants from sectors relevant to sodium reduction, including government, education, food manufacturing and retail, civil society, non-governmental organizations and consumers. Guided by the Integrated Theoretical Framework, we identified determinants influencing policy implementation. Three coders independently coded the data, which were thematically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Policy characteristics that facilitated implementation included emerging nutrient profiling and dietary surveillance systems and ongoing nutrition education; however, limited baseline data, the absence of nationally endorsed front-of-pack labeling frameworks, and unreliable labeling impeded progress. Within inter-organizational relationships, challenges in coordination, governance, and cross-sector communication emerged as overarching barriers to implementation. Implementing agency capacity was constrained by inconsistent enforcement, limited funding, workforce turnover, low awareness of national sodium policies, and resistance from food manufacturers. Regarding attributes and responses of those affected by the policy, strong support for educating children as agents of household change facilitated school-based nutrition education, although entrenched cultural norms around salt use, financial constraints, and limited public knowledge of the health risks of excessive salt consumption hindered broader behavior change. Finally, within the policy context and external environment, the existing use of local herbs and traditional potassium-rich flavorings was identified as a promising opportunity to promote lower-sodium diets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings offer critical insights for enhancing implementation, sustainability, and scale-up of evidence-informed policy actions in Nigeria and in other low- and middle-income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>Trial Registration: NCT04765865.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1704402","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T05:19:05Z","timestamp":1774502345000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the implementation of national sodium reduction policies in Nigeria: an interim qualitative evaluation of stakeholder perspectives"],"prefix":"10.3389","volume":"13","author":[{"given":"Chisom","family":"Obiezu-Umeh","sequence":"first","affiliation":[{"name":"Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine","place":["Chicago, IL, United States"]},{"name":"Center for Dissemination and Implementation Science, Northwestern, University Feinberg School of Medicine","place":["Chicago, IL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Alfa","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Unit, University of Abuja Teaching Hospital","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clementina E.","family":"Okoro","sequence":"additional","affiliation":[{"name":"Federal Capital Territory Primary Health Care Board","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikechukwu A.","family":"Orji","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Unit, University of Abuja Teaching Hospital","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ucheoma","family":"Nwaozuru","sequence":"additional","affiliation":[{"name":"Department of Implementation Science, Wake Forest University School of Medicine","place":["Winston-Salem, NC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda V.","family":"Van Horn","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Northwestern University Feinberg School of Medicine","place":["Chicago, IL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica L.","family":"Jamro","sequence":"additional","affiliation":[{"name":"Cardiovascular Division and Global Health Center, Washington University in St. Louis","place":["St. Louis, MO, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanna","family":"Ripiye","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Unit, University of Abuja Teaching Hospital","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel L.","family":"Shedul","sequence":"additional","affiliation":[{"name":"Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine","place":["Chicago, IL, United States"]},{"name":"Cardiovascular Research Unit, University of Abuja Teaching Hospital","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel I.","family":"Okpetu","sequence":"additional","affiliation":[{"name":"Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine","place":["Chicago, IL, United States"]},{"name":"Cardiovascular Research Unit, University of Abuja Teaching Hospital","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adedayo","family":"Ojo","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Unit, University of Abuja Teaching Hospital","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Ekechi","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Unit, University of Abuja Teaching Hospital","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morenike","family":"Alex-Okoh","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal Ministry of Health","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anyaike","family":"Chukwuma","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal Ministry of Health","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aloysius N.","family":"Maduforo","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, University of Nigeria","place":["Nsukka, Nigeria"]},{"name":"Department of Community Health Sciences, University of Calgary","place":["AB, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Adurosakin","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal Ministry of Health","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Odoh","sequence":"additional","affiliation":[{"name":"Noncommunicable Disease Division, Federal Ministry of Health","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malau Mangai","family":"Toma","sequence":"additional","affiliation":[{"name":"Noncommunicable Disease Division, Federal Ministry of Health","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alayo","family":"Sopekan","sequence":"additional","affiliation":[{"name":"Noncommunicable Disease Division, Federal Ministry of Health","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uduak","family":"Uwakmfon","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal Ministry of Health","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doris","family":"John","sequence":"additional","affiliation":[{"name":"Department of Public Health, Federal Ministry of Health","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guhan","family":"Iyer","sequence":"additional","affiliation":[{"name":"Cardiovascular Division and Global Health Center, Washington University in St. Louis","place":["St. Louis, MO, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Neal","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, University of New South Wales","place":["Sydney, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Jones","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, University of New South Wales","place":["Sydney, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathy","family":"Trieu","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, University of New South Wales","place":["Sydney, NSW, Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matti","family":"Marklund","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, University of New South Wales","place":["Sydney, NSW, Australia"]},{"name":"Welch Center for Prevention, Johns Hopkins Bloomberg School of Public Health","place":["Baltimore, MD, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maoyi","family":"Tian","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, University of New South Wales","place":["Sydney, NSW, Australia"]},{"name":"School of Public Health, Harbin Medical University","place":["Harbin, China"]},{"name":"Department of General Practice, The Second Affiliated Hospital of Harbin Medical University","place":["Harbin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark D.","family":"Huffman","sequence":"additional","affiliation":[{"name":"Cardiovascular Division and Global Health Center, Washington University in St. Louis","place":["St. Louis, MO, United States"]},{"name":"The George Institute for Global Health, University of New South Wales","place":["Sydney, NSW, Australia"]},{"name":"School of Public Health, Washington University in St. Louis","place":["St. Louis, MO, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dike B.","family":"Ojji","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Unit, University of Abuja Teaching Hospital","place":["Abuja, Nigeria"]},{"name":"Department of Internal Medicine, Faculty of Medicine, University of Abuja","place":["Abuja, Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa R.","family":"Hirschhorn","sequence":"additional","affiliation":[{"name":"Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine","place":["Chicago, IL, United States"]},{"name":"Center for Dissemination and Implementation Science, Northwestern, University Feinberg School of Medicine","place":["Chicago, IL, United States"]},{"name":"Robert J Havey Institute for Global Health, Feinberg School of Medicine","place":["Chicago, IL, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1161\/CIRCULATIONAHA.120.050371","article-title":"Blood pressure effects of sodium reduction: dose-response Meta-analysis of experimental studies","volume":"143","author":"Filippini","year":"2021","journal-title":"Circulation"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1111\/jch.14717","article-title":"Global cardiovascular diseases burden attributable to high sodium intake from 1990 to 2019","volume":"25","author":"Wang","year":"2023","journal-title":"J Clin Hypertens"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e70169","DOI":"10.1111\/jch.70169","article-title":"Trends of global burden of cardiovascular diseases attributable to high sodium intake from 1990 to 2021 and projections to 2030: a population-based study","volume":"27","author":"Lin","year":"2025","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"ref4","volume-title":"The SHAKE Technical Package for Salt Reduction","year":"2016"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"40088","DOI":"10.1038\/s41598-025-23828-9","article-title":"Dietary sources of sodium intake in Nigerian adults: a population-based cross-sectional study","volume":"15","author":"Okoro","year":"2025","journal-title":"Sci Rep"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e041346","DOI":"10.1136\/bmjopen-2020-041346","article-title":"Cost-effectiveness analysis of population salt reduction interventions to prevent cardiovascular disease in Cameroon: mathematical modelling study","volume":"10","author":"Aminde","year":"2020","journal-title":"BMJ Open"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e149","DOI":"10.1161\/hypertensionaha.124.23382","article-title":"Blood pressure\u2013lowering medications, sodium reduction, and blood pressure","volume":"81","author":"Song","year":"2024","journal-title":"Hypertension"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"m315","DOI":"10.1136\/bmj.m315","article-title":"Effect of dose and duration of reduction in dietary sodium on blood pressure levels: systematic review and meta-analysis of randomised trials","volume":"368","author":"Huang","year":"2020","journal-title":"BMJ"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1038\/s41371-022-00690-0","article-title":"2022 world hypertension league, resolve to save lives and International Society of Hypertension dietary sodium (salt) global call to action","volume":"37","author":"Campbell","year":"2023","journal-title":"J Hum Hypertens"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0177535","DOI":"10.1371\/journal.pone.0177535","article-title":"Systematic review of dietary salt reduction policies: evidence for an effectiveness hierarchy?","volume":"12","author":"Hyseni","year":"2017","journal-title":"PLoS One"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2543","DOI":"10.3390\/nu12092543","article-title":"Priority actions to advance population sodium reduction","volume":"12","author":"Ide","year":"2020","journal-title":"Nutrients"},{"key":"ref12","year":"2019"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s12919-024-00303-3","article-title":"Nigeria sodium study 2023 policy meeting on dietary sodium reduction in Nigeria","volume":"18","author":"Ojo","year":"2024","journal-title":"BMC Proc"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1768","DOI":"10.1093\/advances\/nmab008","article-title":"A systematic review of salt reduction initiatives around the world: a midterm evaluation of progress towards the 2025 global non-communicable diseases salt reduction target","volume":"12","author":"Santos","year":"2021","journal-title":"Adv Nutr"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3192","DOI":"10.1093\/eurheartj\/ehae461","article-title":"Multi-stakeholder workshop on reducing population-wide dietary sodium intake in Nigeria","volume":"45","author":"Obiezu-Umeh","year":"2024","journal-title":"Eur Heart J"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1111\/jch.13937","article-title":"Monitoring and implementation of salt reduction initiatives in Africa: a systematic review","volume":"22","author":"Tekle","year":"2020","journal-title":"J Clin Hypertens"},{"key":"ref17","year":"2024"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"681602","DOI":"10.3389\/fpubh.2021.681602","article-title":"Policy implementation science to advance population health: the potential for learning health policy systems","volume":"9","author":"Oh","year":"2021","journal-title":"Front Public Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/s13012-022-01256-x","article-title":"Where is \u201cpolicy\u201d in dissemination and implementation science? Recommendations to advance theories, models, and frameworks: EPIS as a case example","volume":"17","author":"Crable","year":"2022","journal-title":"Implement Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s12961-024-01110-0","article-title":"Policy implementation and outcome evaluation: establishing a framework and expanding capacity for advocacy organizations to assess the impact of their work in public policy","volume":"22","author":"Whitsel","year":"2024","journal-title":"Health Res Policy Syst"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e0280226","DOI":"10.1371\/journal.pone.0280226","article-title":"Stakeholder perspectives on Nigeria\u2019s national sodium reduction program: lessons for implementation and scale-up","volume":"18","author":"Sanuade","year":"2023","journal-title":"PLoS One"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s13012-021-01082-7","article-title":"Understanding the implementation of evidence-informed policies and practices from a policy perspective: a critical interpretive synthesis","volume":"16","author":"Bullock","year":"2021","journal-title":"Implement Sci"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"iii35","DOI":"10.1093\/heapol\/czu063","article-title":"Mapping the existing body of health policy implementation research in lower income settings: what is covered and what are the gaps?","volume":"29","author":"Erasmus","year":"2014","journal-title":"Health Policy Plan"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1186\/s43058-023-00497-1","article-title":"Four very basic ways to think about policy in implementation science","volume":"4","author":"Purtle","year":"2023","journal-title":"Implement Sci Commun"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1177\/00491241135004","article-title":"Coding in-depth semistructured interviews: problems of unitization and intercoder reliability and agreement","volume":"42","author":"Campbell","year":"2013","journal-title":"Sociol Methods Res"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e0000050","DOI":"10.1371\/journal.pgph.0000050","article-title":"Aligning policymaking in decentralized health systems: evaluation of strategies to prevent and control non-communicable diseases in Nigeria","volume":"1","author":"Ajisegiri","year":"2021","journal-title":"PLoS Glob Public Health"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"10","DOI":"10.34172\/hpp.2023.02","article-title":"A systematic review of health communication strategies in sub-Saharan Africa-2015-2022","volume":"13","author":"Olaoye","year":"2023","journal-title":"Health Promot Perspect"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e0001496","DOI":"10.1371\/journal.pgph.0001496","article-title":"Cardiovascular health promotion: a systematic review involving effectiveness of faith-based institutions in facilitating maintenance of normal blood pressure","volume":"3","author":"Sanusi","year":"2023","journal-title":"PLoS Glob Public Health"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"29137143","DOI":"10.3390\/nu9111238","article-title":"Evaluation of a mass-media campaign to increase the awareness of the need to reduce discretionary salt use in the south African population","volume":"9","author":"Wentzel-Viljoen","year":"2017","journal-title":"Nutrients"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s12961-024-01124-8","article-title":"Salt reduction policy for out of home sectors: a supplementary document for the salt reduction strategy to prevent and control non-communicable diseases (NCDS) in Malaysia 2021-2025","volume":"22","author":"Harun","year":"2024","journal-title":"Health Res Policy Syst"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.foodpol.2017.07.014","article-title":"Barriers and potential facilitators to the implementation of government policies on front-of-pack food labeling and restriction of unhealthy food advertising in Thailand","volume":"71","author":"Phulkerd","year":"2017","journal-title":"Food Policy"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s12961-025-01358-0","article-title":"An exploratory study of context and factors shaping policies for integrated management of multimorbidity in Malawi","volume":"23","author":"Banda-Mtaula","year":"2025","journal-title":"Health Res Policy Syst"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12961-023-00965-z","article-title":"Perceptions, barriers and enablers of salt reduction in Malaysian out-of-home sectors (MySaltOH): from the point of view of policy-makers and food industries","volume":"21","author":"Harun","year":"2023","journal-title":"Health Res Policy Syst"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1146\/annurev-nutr-111120-094932","article-title":"The influence of front-of-package nutrition labeling on consumer behavior and product reformulation","volume":"41","author":"Roberto","year":"2021","journal-title":"Annu Rev Nutr"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"2630","DOI":"10.3390\/nu15112630","article-title":"Front-of-package nutrition labeling and its impact on food industry practices: a systematic review of the evidence","volume":"15","author":"Ganderats-Fuentes","year":"2023","journal-title":"Nutrients"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e001882","DOI":"10.1136\/bmjgh-2019-001882","article-title":"Front-of-pack nutrition labelling to promote healthier diets: current practice and opportunities to strengthen regulation worldwide","volume":"4","author":"Jones","year":"2019","journal-title":"BMJ Glob Health"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1146\/annurev-nutr-011224-030917","article-title":"The potential effectiveness of front-of-pack nutrition labeling for improving population diets","volume":"44","author":"Kelly","year":"2024","journal-title":"Annu Rev Nutr"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.1136\/heartjnl-2022-321332","article-title":"Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis","volume":"108","author":"Yin","year":"2022","journal-title":"Heart"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"643","DOI":"10.7326\/M23-2626","article-title":"Long-term effect of salt substitution for cardiovascular outcomes","volume":"177","author":"Greenwood","year":"2024","journal-title":"Ann Intern Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1056\/nejmoa2105675","article-title":"Effect of salt substitution on cardiovascular events and death","volume":"385","author":"Neal","year":"2021","journal-title":"N Engl J Med"},{"key":"ref42","year":""},{"key":"ref43","doi-asserted-by":"publisher","first-page":"100432","DOI":"10.1016\/j.lansea.2024.100432","article-title":"Cost-effectiveness analysis of low-sodium potassium-rich salt substitutes in Indonesia: an equity modelling study","volume":"26","author":"Aminde","year":"2024","journal-title":"Lancet Reg Health"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"3225","DOI":"10.3390\/nu13093225","article-title":"Barriers and facilitators to implementing reduced-sodium salts as a population-level intervention: a qualitative study","volume":"13","author":"Yin","year":"2021","journal-title":"Nutrients"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e27423","DOI":"10.2196\/27423","article-title":"Availability, formulation, labeling, and Price of low-sodium salt worldwide: environmental scan","volume":"7","author":"Yin","year":"2021","journal-title":"JMIR Public Health Surveill"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1016\/j.numecd.2023.12.015","article-title":"Comparing a range of potassium-enriched low sodium salt substitutes to common salt: results of taste and visual tests in south African adults","volume":"34","author":"Crouch","year":"2024","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1001\/jamacardio.2024.5417","article-title":"Salt substitution and recurrent stroke and death: a randomized clinical trial","volume":"10","author":"Ding","year":"2025","journal-title":"JAMA Cardiol"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"e0134700","DOI":"10.1371\/journal.pone.0134700","article-title":"Applying the triangle taste test to assess differences between low sodium salts and common salt: evidence from Peru","volume":"10","author":"Saavedra-Garcia","year":"2015","journal-title":"PLoS One"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12889-016-3944-6","article-title":"Factors affecting evidence-use in food policy-making processes in health and agriculture in Fiji","volume":"17","author":"Waqa","year":"2017","journal-title":"BMC Public Health"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"457","DOI":"10.3390\/nu13020457","article-title":"Tracking Progress from policy development to implementation: a case study on adoption of mandatory regulation for nutrition labelling in Malaysia","volume":"13","author":"Ng","year":"2021","journal-title":"Nutrients"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"628","DOI":"10.3390\/nu14132628","article-title":"Understanding enablers and barriers to the implementation of nutrition standards in publicly funded institutions in Victoria","volume":"14","author":"Rosewarne","year":"2022","journal-title":"Nutrients"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"70","DOI":"10.5334\/gh.935","article-title":"World heart federation policy brief: front-of-pack labelling: unhealthy changes in the global food system","volume":"15","author":"Champagne","year":"2020","journal-title":"Glob Heart"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"11312","DOI":"10.1136\/bmjgh-2022-011312","article-title":"Evolution of food and beverage prices after the front-of-package labelling regulations in Chile","volume":"8","author":"Paraje","year":"2023","journal-title":"BMJ Glob Health"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"e257","DOI":"10.1017\/S136898002400226X","article-title":"Investigating reformulation in the Canadian food supply between 2017 and 2020 and its impact on food prices","volume":"27","author":"Ziraldo","year":"2024","journal-title":"Public Health Nutr"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"484","DOI":"10.3390\/nu16203484","article-title":"The impact of non-fiscal mandatory and voluntary policies and interventions on the reformulation of food and beverage products: a systematic review","volume":"16","author":"Packer","year":"2024","journal-title":"Nutrients"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1017\/S0007114524001326","article-title":"The effectiveness of mandatory v. voluntary food reformulation policies: a rapid review","volume":"133","author":"Gressier","year":"2025","journal-title":"Br J Nutr"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1007\/s13668-015-0138-2","article-title":"Innovative and collaborative strategies to reduce population-wide sodium intake","volume":"4","author":"Charlton","year":"2015","journal-title":"Curr Nutr Rep"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"101469","DOI":"10.1016\/j.pmedr.2021.101469","article-title":"Effect of South Africa's interim mandatory salt reduction programme on urinary sodium excretion and blood pressure","volume":"23","author":"Charlton","year":"2021","journal-title":"Prev Med Rep"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1316","DOI":"10.1017\/S1368980018003166","article-title":"Using regulation to limit salt intake and prevent non-communicable diseases: lessons from South Africa's experience","volume":"22","author":"Kaldor","year":"2019","journal-title":"Public Health Nutr"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"2551","DOI":"10.1017\/S1368980023000757","article-title":"Determining food industry compliance to mandatory sodium limits: successes and challenges from the south African experience","volume":"26","author":"van der Westhuizen","year":"2023","journal-title":"Public Health Nutr"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1704402\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T05:19:06Z","timestamp":1774502346000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1704402\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":60,"alternative-id":["10.3389\/fnut.2026.1704402"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1704402","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]},"article-number":"1704402"}}