Joint Expert Consensus on the Sodium Reduction Policy in Taiwan: A Collaborative Declaration by the Taiwan Hypertension Society (THS), Taiwan Society of Cardiology (TSOC), International Life Sciences Institute (ILSI), and Nutrition Society of Taiwan (NST).

BACKGROUND: Excess sodium intake is a major modifiable risk factor for hypertension and other non-communicable diseases, including stroke, ischemic heart disease, and chronic kidney disease. Globally, average sodium intake remains more than twice the World Health Organization (WHO) recommended limit of 2 g/day, and Taiwan similarly faces a substantial sodium burden, with mean intake exceeding 3 g/day and a persistent policy implementation gap. Given the salt sensitivity of East Asian populations, these excess levels translate into disproportionately higher cardiovascular (CV) and broader health risks. OBJECTIVE: This consensus provides an evidence-based and culturally tailored roadmap to reduce sodium intake and increase potassium consumption in Taiwan, with the goal of achieving the WHO target of a 30% relative sodium reduction by 2030 and improving national CV health. METHODS: The consensus was developed through a comprehensive review of epidemiological studies, randomized trials, meta-analyses, and global burden models on sodium, potassium, and health outcomes. National intake patterns were assessed using Nutrition and Health Survey in Taiwan data from 2017-2020, while disease burden and cost estimates were informed by the Global Burden of Disease 2019 framework and local health statistics. An interdisciplinary expert panel adapted international evidence to the dietary context in Taiwan through iterative deliberation. THE EVIDENCE: Robust evidence demonstrates a dose-dependent relationship between sodium intake, blood pressure, and CV risk, with each additional gram of sodium increasing CV disease risk by approximately 6%. Meta-analyses indicate that reducing sodium by 1 g/day lowers systolic blood pressure by about 3 mmHg in hypertensive individuals, and randomized trials such as the Salt Substitute and Stroke Study show that potassium-enriched salt can reduce stroke and major CV events. In Taiwan, sodium is derived mainly from salt, sauces, and processed foods, underscoring the need for both household- and industry-level interventions. SCOPE OF THE RECOMMENDATION: The consensus recommends limiting sodium intake to < 2.3 g/day for adults and < 1.5 g/day for salt-sensitive or hypertensive individuals, while promoting potassium intake > 3.5 g/day from fruits, vegetables, legumes, or potassium-enriched salts (with caution in those at risk of hyperkalemia). Key policy actions include mandatory front-of-pack sodium labeling, food reformulation, institutional procurement standards, and sustained public education, supported by multi-sectoral collaboration across government, academia, industry, and civil society.