From Children to the Entire Population: Policy Lessons From a Decade of Successful Sodium Intake Reduction in South...

High sodium intake increases blood pressure and cardiovascular risk, making reduction a highly cost-effective public health strategy. South Korea, which historically had one of the highest global sodium consumption rates, implemented a comprehensive policy to reduce sodium intake, beginning with a child-focused, legislation-supported initiative in 2009. This approach expanded to national population-wide strategies in 2012 and 2016, incorporating sodium-reduced institutional meals, voluntary industry reformulation, enhanced nutrition labeling, and large-scale public education. From 2010 to 2019, mean sodium intake in South Korea decreased by 32.9% (4,831 to 3,243 mg/day; p<0.0001), with consistent reductions across sexes, ages, and income groups. The proportion of the population meeting World Health Organization (WHO) recommendations more than doubled, rising from 11.6% to 25.8%. These reductions were observed during a period characterized by a sustained, early-life-focused and nationwide comprehensive policy approaches. Crucially, however, the decline has plateaued since 2017, and intake remains significantly over the WHO recommendation. This necessitates policy adjustments to overcome stagnation and sustain progress. This review highlights South Korea's decade-long policy strategies to reduce sodium intake, from a child-first, legislation-supported approach to the whole population, and offers transferable insights that may inform and accelerate sodium-reduction efforts in other countries.