Today, the World Health Organization (WHO) releases the second edition of SHAKE the salt habit, a technical package for sodium reduction, to support countries in accelerating efforts to reduce high salt consumption, a major global health threat.
Most people worldwide have high sodium intake and live in environments that lead to excessive consumption. SHAKE presents a consolidated package of proven policies to help governments protect populations and save lives.
Why now: addressing a risk people cannot control alone
Globally, average sodium intake is estimated to be more than twice the WHO recommended limit of 2000 mg per day (equivalent to 5 g of salt or about one teaspoon), contributing to 1.7 million deaths in 2023. Excess sodium intake is a leading dietary risk factor for hypertension and cardiovascular disease globally. While public health guidance frequently emphasizes reducing salt intake, food environments present persistent challenges, with high levels of sodium embedded in processed, packaged foods and often street food high in salt.
The world remains off track to meet the global sodium reduction target of reduction by 30% by 2030. Currently only 28% of the world population live in countries with mandatory sodium reduction policies. Launched during Salt Awareness Week 2026, the updated SHAKE technical package responds to the urgent need for stronger, more effective government action to protect public health.
"Excess salt consumption remains among the top preventable drivers of death globally, and implementing mandatory policies to reduce sodium intake is one of the most cost-effective actions countries can take to protect people from cardiovascular disease," said Dr Luz Maria De Regil, Director of the Department of Nutrition and Food Safety at WHO. "With the updated SHAKE the salt habit, WHO is equipping countries with practical, evidence-based tools to take decisive, government-led action and prevent millions of deaths each year."
What's new: stronger, actionable direction
The updated resource provides a clear, step-by-step guide to reducing populations' sodium intake, bringing together the latest evidence-based guidance, practical tools and country examples compiled through an extensive collaborative process.
The SHAKE package places a strong emphasis on mandatory, government-led approaches and a structured programme model to support coordinated national action. The package organizes interventions into a coherent framework, defined by the SHAKE acronym: Surveillance, Harness industry, Adopt standards for labelling and marketing, Knowledge and Environment.
Importantly, the updated SHAKE package includes guidance on managing conflicts of interest with the food industry, stating clearly that the industry should not set public health policy. It explains how to regulate and cut back on health-harming products that contain high amounts of added sodium. It also provides detailed annexes on data collection, enforcement, and countering common industry arguments.
"The second edition of SHAKE offers a practical menu of measures that countries can readily apply, with clear, step-by-step guidance, and strong opportunities to scale up mandatory approaches to reduce persistently high salt intake across the region," said Xi Yin, Coordinator, Health Promotion and Policy unit and Acting Lead for the Nutrition and Food Safety unit in the Division of Health Promotion, Disease Prevention and Control of the WHO Regional Office for the Western Pacific. "Several countries in the Western Pacific Region have drawn on SHAKE to inform their salt reduction efforts, grounded in country-specific data and experience, and we look forward to many more following their lead."
What countries will find: a practical package of proven measures
SHAKE brings together the latest WHO guidelines and "best buys" interventions for the prevention and control of noncommunicable diseases (NCDs) into a structured approach which includes:
• food reformulation which sets maximum limits or targets for the sodium content of pre-packaged foods; • front-of-pack labelling (FOPL) which provides interpretive information about sodium content, alongside mandatory declaration; • food procurement and service policies which limit high-sodium foods in public settings; • food marketing restriction policies to protect children; • taxation of unhealthy food; • behaviour change communication and mass media campaigns; and • lower-sodium salt substitutes (LSSS) to replace regular table salt in appropriate settings.
WHO urges policy-makers to commit to bold action with national sodium reduction goals and develop comprehensive programmes with policies and interventions that transform food environments, so that reducing salt intake becomes achievable.
