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REDUCE SALT TO “GAIN” HEALTH
A shared commitment, without the need for sacrifices
REDUCE SALT TO “GAIN” HEALTH
     A shared commitment,
  without the need for sacrifices
Mediterranean Diet Pyramid
A contemporary approach to delicious, healthy eating




  (Barilla adaptation from Oldways Preservation and Exchange Trust)
FOOD AND NUTRITION: A STORY OF COMMITMENT AND PASSION



For over 130 years, Barilla has been the Italian       Barilla’s commitment is expressed in the way it
family company that has seen food as a communal        shares the culture of the Mediterranean Nutri-
event, filled with flavour and love, helping people      tional Model, as a positive, contemporary model
live better.                                           for choosing to eat foods that are good for us and
                                                       the world in which we live.
Barilla is the company that helps to safeguard
and improve people’s wellbeing and health:
• by transforming high quality nutritional
  ingredients into tasty, healthy foods that satisfy
  the daily nutritional needs of the whole family;
• by developing its own products that respect the
  Mediterranean Nutritional Model and the
  environment.

We genuinely believe that this twofold goal of
protecting people’s health and the environment is
achievable: the Mediterranean Nutritional Model
is the fundamental benchmark for promoting the
right, healthy eating habits, and the foods that are
the basis for this Model are also the ones that have
the least impact on the environment.
WHY IT IS
IMPORTANT TO
REDUCE SALT INTAKE
Moderating your daily
intake of salt has a positive
influence on the health
of your heart and your
circulation



We need some salt. We have used it for centu-            Figure 1 - Sources of the salt consumed every day (Europe and
ries to preserve and flavour foods and it is the          North America): 4

body’s main source of sodium, an essential                  77% from processed
                                                            or restaurant foods
element for life, but not one that should be
                                                            13% added in the
eaten in excess. Salt is 60% chlorine and 40%               kitchen or at the table
sodium.                                                     10% present
                                                            naturally in foods
The sources of sodium in food, as shown in figure 1,
are:
   processed foods, as well as those eaten outside
   the home;
   the salt added by cooks in their own kitchen
   or at the table;
   natural foods (fruit, vegetables, meat etc).

SALT: DO WE EAT TOO MUCH?                                tion (SINU), we eat too much salt. 5,6 We should
According to statistics, both in the USA and in          be eating a total of one teaspoon of salt a day
Europe, 1,2,3 salt intake is too high, at levels of up   (including the salt naturally contained in food)
to (and in some cases over) 9-10 grams a day.3           and yet our daily average reaches and sometimes
In Italy too, according to the Italian National          exceeds 10g a day (1 heaped tablespoon).
Research Institute for Food and Nutrition (IN-
RAN) and the Italian Society for Human Nutri-

                                                                                                                         5
WHY TOO MUCH SALT IS DANGEROUS?
    How much salt is there in the foods                         Too much sodium in the body can be dangerous:
    we eat?                                                        because of its effect on blood pressure;
    (Taken from INRAN. Food composition tables) 7
                                                                   because of the impact on health caused by
     Food                                    Amount of sodium      cardiovascular diseases;
                                             (mg/100g for          for the potential effects on stomach cancer.8
                                             example)
     Dry-cured ham, without bones            2.238
                                                                In contrast, reducing salt intake has a docu-
     Pecorino cheese                         1.800
                                                                mented positive effect on blood pressure, and so
     Bresaola                                1.597
                                                                from that on the health of our heart, arteries and
     Tomato ketchup                          1.120              brain. Even a modest reduction in the daily intake
     Crisps, in a bag                        1.070              of sodium can bring with it a positive impact on
     Taleggio cheese                         873                people’s health and major benefits in terms of
     Uncooked frankfurter                    793                healthcare costs. 9
     Tomato pizza                            775                Scientific studies spanning more than forty years
     Rye bread                               580                on around 177.000 people from different coun-
     Milk rolls                              460                tries show that five grams less salt a day results
     Emmental                                450                in a relative reduction in the risk of a heart attack
     Beans - Cannellini in a tin, drained    431                (- 17%) or a stroke (- 23%).10
     Croissants                              390
     Tuna, in oil, drained                   316                 Figure 2 - Estimated effects of reducing salt by
     Whole hen’s egg                         137
     Fresh salmon                            98                                                                         -23%
                                                                                                                    ris
                                                                                                                    risk of a stroke
     Mixed frozen vegetables: peas, corn,    59
     carrots, beans
                                                                   -5 g
     Whole milk yoghurt                      48
                                                                 salt/day
     Cutting chicory                         7
     Salad tomatoes                          3                                                                          -17%
                                                                                                                    ri
                                                                                                                    risk of a heart
     Bananas                                 1                                                                          attack
     Fresh apples (Renetta)                  trace
                                                                Calculated by Strazzullo et al. 2009


6
THE “GAINING HEALTH”
PROGRAMME
Reducing salt in foods:                                           Among other recommendations, the initiative
                                                                   encourages the primary manufacturers and food
 a strategic objective                                             processing industry to gradually reduce the level
 in Italy and the world                                            of salt added to products. 11
                                                                   The majority of sodium intake from food is not
                                                                   from adding salt when cooking or at the table,
                                                                   but rather from industrially manufactured food
                                                                   and food that we eat outside the home, as shown
    Since 2009, the EU has compiled recommenda-                    in figure 1. 4
    tions, based on the World Health Organisation                  In a country like Italy, bread and pizzas (as well as
    (WHO) recommendations, for reducing salt in                    salamis and cheese) are consumed in very high
    foods. Italy has demonstrated its commitment                   quantities. So reducing the amount of salt used
    to these recommendations with its “Guadagnare                  when preparing foods, such as bread for example,
    salute - Rendere facili le scelte salutari” (Gain-             can make a valuable contribution to our health
    ing health - Making healthy choices easy) pro-                 and wellbeing, without forcing us to make exces-
    gramme, launched by the Ministry of Health.                    sive sacrifices.


       Five critical years for health
       2006           The World Health Organisation (WHO) recommends a reduction in daily salt intake given its
                      impact on health.3
       2007           The European Union adds a similar recommendation in its white paper, “A Strategy on Nutrition,
                      Overweight and Obesity-related health issues”.2
       2008           In the USA, the National Salt Reduction Initiative (NSRI) is launched, based on the British model,
                      in response to the continued excessive consumption of salt.3
       2009           Europe too adopts the “National Salt Reduction Initiative”, aimed at continuing initiatives inten-
                      ded to reduce salt intake, with a particular focus on 12 food categories including bread.2
       2010           The Council of Europe officially recommends the pursuit of this goal.12
                      The Italian Ministry of Health launches the “Guadagnare salute - Rendere facili le scelte salutari”
                      (Gaining health - Making healthy choices easy) programme.11



8
BARILLA’S
COMMITMENT




 Focusing on over 100         BARILLA IS SIGNED UP TO THE “GAIN-
                              ING HEALTH” PROGRAMME
 products, the company will   Alongside its commitment to adopting the Medi-
 reduce the salt used in      terranean Model as a cultural and nutritional point
 the production process by    of reference, Barilla has also established its
 11% by the end of 2011       own Nutrition guidelines for the development
                              of new products. These include limits for salt,
                              fat, fibre and sugar content, inspired by interna-
                              tional guidelines and also backed up by scientific

                                                                                    9
Barilla’s strategy to reduce salt in its products
       • Reduce salt gradually to help people get used to the taste;
       • Rebalance the aromatic profiles of products;
       • Use different proportions of the key ingredients.



  research. As far as salt is concerned, Barilla’s par-   than 100 products, the company will remove over
  ticipation to the “Gaining Health” programme has        600 tonnes of salt overall (equivalent to 11% of
  helped it achieve a significant reduction in the salt    the salt used by the company), mainly in breads,
  content of some categories of its food products         crackers and prepared sauces. A large proportion
  marketed in Italy and Europe, all in a very short       of the products in these categories did not need
  time.                                                   adjustments, as they were already in line with the
  In particular, by the end of 2011, working on more      reduced salt levels.


     Already less salt from 2011:
     Product groups                                         Average salt reduction in reformulated products
                                                             (considerable variations from product to product)

     Mulino Bianco pani soffici (soft bread)                                          - 17%

     Harry’s pani soffici                                                             - 13%

     Wasa crispbread                                                                 - 19%

     Mulino Bianco and pavesi dry bread substitutes                                  - 20%

     Barilla tomato-based sauces                                                     - 23%

     Barilla pasta ripiena (filled pasta)                                             - 23%



                                                                         For more information contact:..................................
10                                                                                                www.gruppobarilla.it
11
HOW TO CUT DOWN
ON SALT WITHOUT MAKING
 UNNECESSARY SACRIFICES
Reduce or moderate
                                                         Ten simple suggestions for cutting
salt intake is our                                       down on salt (from the National
responsability: it is not as                             Research Institute for Food and
difficult as it may seem                                 Nutrition-Italy):7




                                                          1
                                                                    Both at the table and in the kitchen,
                                                                    gradually reduce the amount of salt you




                                                         2
                                                                    add to food
                                                                    Avoid putting a salt shaker on the table
                                                                    and reduce the amount of salt used in




                                                          3
                                                                    cooking and for seasoning
As well as the salt reduction achieved by Barilla                   Do not add salt to baby food, at least for




                                                         4
and the “Gaining Health” campaign, every one of                     the whole of your child’s first year. Reduce
us personally affects our own health. Reducing                      the use of alternative seasonings that
                                                                    contain sodium
the amount of salt in our diet is not as difficult
                                                                    Remember that salt enhances flavours



                                                          5
as it might sound.                                                  and it can be an essential ingredient in
                                                                    cooking, but some foods don’t need salt
                                                                    to taste good
A FEW HANDY COOKING TIPS


                                                         6
                                                                    Use raw or frozen rather than canned
                                                                    vegetables
Add some chopped herbs in lemon juice (or vinegar) to
marinate food before you roast it                                   Reduce your consumption of foods with




                                                          7
                                                                    a high salt content, and get used to choo-
Add some chilli peppers when cooking to enhance the                 sing less salty alternatives, by reading the
flavour of pasta or sautéed vegetables                               nutritional information on products




                                                         8
Add handful of carrots, celery and onion in water when              Even when you’re in a restaurant, choose
boiling food                                                        dishes that are not too salty
                                                                    Use spices, herbs, lemon juice and vinegar



                                                          9
Add dusting of nutmeg for potatoes or cauliflower                    to “trick” your palate
Add sage, bay, juniper berries and garlic for roasts                Only drink water to replenish the liquids
                                                                    lost during physical activity




                                                         10         Follow the Mediterranean model as clo-
                                                                    sely as possible by eating fresh foods that
                                                                    have been processed as little as possible
                                                                    and are naturally low in salt.




                                                                                                                   13
REFERENCES AND SOURCES



  1. Bernstein AM, Willett WC. Am J Clin Nutr 2010;92(5):1172-80.

  2. UE - European Commission Public Health. National Salt Initiatives. June 2009.

  3. WHO - World Health Organization. Creating an enabling environment for population-based salt reduction strategies. July 2010.

  4. Brown IJ, Tzoulaki I, Candeias V, Elliott P. Int J Epidemiol 2009;38(3):791-813.

  5. INRAN. Il sale? Meglio poco. Linea Guida n.6. http://www.inran.it/fi les/download/linee_guida/lineeguida_06.pdf

  6. SINU Società Italiana di Nutrizione Umana. LARN Minerali. http://www.sinu.it/larn/mineral1.asp#SODIO

  7. INRAN. Tabelle di composizione degli alimenti. http://www.inran.it/646/tabelle_di_composizione_degli_alimenti.html

  8. World Health Organization. Diet, nutrition and the prevention of chronic diseases. Report of a Joint WHO/FAO Expert Consultation.
     WHO Technical Report Series, No. 916. Geneva World Health Organization 2003.

  9. Bibbins-Domingo K, Chertow GM, Coxson PG et al. N Engl J Med 2010;362(7):519.

  10. Strazzullo P, D’Elia L, Kandala N - B, Cappuccio FP. BMJ 2009;339:b4567.

  11. Ministero per la Salute. Poco sale per… guadagnare salute. http://www.salute.gov.it/imgs/C_17_pubblicazioni_605_allegato.pdf

  12. Heart Wire. Réduction du sel alimentaire: les Européens passent aux actes. The Heart.org 2010. http://www.theheart.org/article/1107511.doc




14
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Riduzionale sale consumer us pag singole_3_08 tab mod

  • 1. REDUCE SALT TO “GAIN” HEALTH A shared commitment, without the need for sacrifices
  • 2.
  • 3. REDUCE SALT TO “GAIN” HEALTH A shared commitment, without the need for sacrifices
  • 4. Mediterranean Diet Pyramid A contemporary approach to delicious, healthy eating (Barilla adaptation from Oldways Preservation and Exchange Trust)
  • 5. FOOD AND NUTRITION: A STORY OF COMMITMENT AND PASSION For over 130 years, Barilla has been the Italian Barilla’s commitment is expressed in the way it family company that has seen food as a communal shares the culture of the Mediterranean Nutri- event, filled with flavour and love, helping people tional Model, as a positive, contemporary model live better. for choosing to eat foods that are good for us and the world in which we live. Barilla is the company that helps to safeguard and improve people’s wellbeing and health: • by transforming high quality nutritional ingredients into tasty, healthy foods that satisfy the daily nutritional needs of the whole family; • by developing its own products that respect the Mediterranean Nutritional Model and the environment. We genuinely believe that this twofold goal of protecting people’s health and the environment is achievable: the Mediterranean Nutritional Model is the fundamental benchmark for promoting the right, healthy eating habits, and the foods that are the basis for this Model are also the ones that have the least impact on the environment.
  • 6. WHY IT IS IMPORTANT TO REDUCE SALT INTAKE
  • 7. Moderating your daily intake of salt has a positive influence on the health of your heart and your circulation We need some salt. We have used it for centu- Figure 1 - Sources of the salt consumed every day (Europe and ries to preserve and flavour foods and it is the North America): 4 body’s main source of sodium, an essential 77% from processed or restaurant foods element for life, but not one that should be 13% added in the eaten in excess. Salt is 60% chlorine and 40% kitchen or at the table sodium. 10% present naturally in foods The sources of sodium in food, as shown in figure 1, are: processed foods, as well as those eaten outside the home; the salt added by cooks in their own kitchen or at the table; natural foods (fruit, vegetables, meat etc). SALT: DO WE EAT TOO MUCH? tion (SINU), we eat too much salt. 5,6 We should According to statistics, both in the USA and in be eating a total of one teaspoon of salt a day Europe, 1,2,3 salt intake is too high, at levels of up (including the salt naturally contained in food) to (and in some cases over) 9-10 grams a day.3 and yet our daily average reaches and sometimes In Italy too, according to the Italian National exceeds 10g a day (1 heaped tablespoon). Research Institute for Food and Nutrition (IN- RAN) and the Italian Society for Human Nutri- 5
  • 8. WHY TOO MUCH SALT IS DANGEROUS? How much salt is there in the foods Too much sodium in the body can be dangerous: we eat? because of its effect on blood pressure; (Taken from INRAN. Food composition tables) 7 because of the impact on health caused by Food Amount of sodium cardiovascular diseases; (mg/100g for for the potential effects on stomach cancer.8 example) Dry-cured ham, without bones 2.238 In contrast, reducing salt intake has a docu- Pecorino cheese 1.800 mented positive effect on blood pressure, and so Bresaola 1.597 from that on the health of our heart, arteries and Tomato ketchup 1.120 brain. Even a modest reduction in the daily intake Crisps, in a bag 1.070 of sodium can bring with it a positive impact on Taleggio cheese 873 people’s health and major benefits in terms of Uncooked frankfurter 793 healthcare costs. 9 Tomato pizza 775 Scientific studies spanning more than forty years Rye bread 580 on around 177.000 people from different coun- Milk rolls 460 tries show that five grams less salt a day results Emmental 450 in a relative reduction in the risk of a heart attack Beans - Cannellini in a tin, drained 431 (- 17%) or a stroke (- 23%).10 Croissants 390 Tuna, in oil, drained 316 Figure 2 - Estimated effects of reducing salt by Whole hen’s egg 137 Fresh salmon 98 -23% ris risk of a stroke Mixed frozen vegetables: peas, corn, 59 carrots, beans -5 g Whole milk yoghurt 48 salt/day Cutting chicory 7 Salad tomatoes 3 -17% ri risk of a heart Bananas 1 attack Fresh apples (Renetta) trace Calculated by Strazzullo et al. 2009 6
  • 10. Reducing salt in foods: Among other recommendations, the initiative encourages the primary manufacturers and food a strategic objective processing industry to gradually reduce the level in Italy and the world of salt added to products. 11 The majority of sodium intake from food is not from adding salt when cooking or at the table, but rather from industrially manufactured food and food that we eat outside the home, as shown Since 2009, the EU has compiled recommenda- in figure 1. 4 tions, based on the World Health Organisation In a country like Italy, bread and pizzas (as well as (WHO) recommendations, for reducing salt in salamis and cheese) are consumed in very high foods. Italy has demonstrated its commitment quantities. So reducing the amount of salt used to these recommendations with its “Guadagnare when preparing foods, such as bread for example, salute - Rendere facili le scelte salutari” (Gain- can make a valuable contribution to our health ing health - Making healthy choices easy) pro- and wellbeing, without forcing us to make exces- gramme, launched by the Ministry of Health. sive sacrifices. Five critical years for health 2006 The World Health Organisation (WHO) recommends a reduction in daily salt intake given its impact on health.3 2007 The European Union adds a similar recommendation in its white paper, “A Strategy on Nutrition, Overweight and Obesity-related health issues”.2 2008 In the USA, the National Salt Reduction Initiative (NSRI) is launched, based on the British model, in response to the continued excessive consumption of salt.3 2009 Europe too adopts the “National Salt Reduction Initiative”, aimed at continuing initiatives inten- ded to reduce salt intake, with a particular focus on 12 food categories including bread.2 2010 The Council of Europe officially recommends the pursuit of this goal.12 The Italian Ministry of Health launches the “Guadagnare salute - Rendere facili le scelte salutari” (Gaining health - Making healthy choices easy) programme.11 8
  • 11. BARILLA’S COMMITMENT Focusing on over 100 BARILLA IS SIGNED UP TO THE “GAIN- ING HEALTH” PROGRAMME products, the company will Alongside its commitment to adopting the Medi- reduce the salt used in terranean Model as a cultural and nutritional point the production process by of reference, Barilla has also established its 11% by the end of 2011 own Nutrition guidelines for the development of new products. These include limits for salt, fat, fibre and sugar content, inspired by interna- tional guidelines and also backed up by scientific 9
  • 12. Barilla’s strategy to reduce salt in its products • Reduce salt gradually to help people get used to the taste; • Rebalance the aromatic profiles of products; • Use different proportions of the key ingredients. research. As far as salt is concerned, Barilla’s par- than 100 products, the company will remove over ticipation to the “Gaining Health” programme has 600 tonnes of salt overall (equivalent to 11% of helped it achieve a significant reduction in the salt the salt used by the company), mainly in breads, content of some categories of its food products crackers and prepared sauces. A large proportion marketed in Italy and Europe, all in a very short of the products in these categories did not need time. adjustments, as they were already in line with the In particular, by the end of 2011, working on more reduced salt levels. Already less salt from 2011: Product groups Average salt reduction in reformulated products (considerable variations from product to product) Mulino Bianco pani soffici (soft bread) - 17% Harry’s pani soffici - 13% Wasa crispbread - 19% Mulino Bianco and pavesi dry bread substitutes - 20% Barilla tomato-based sauces - 23% Barilla pasta ripiena (filled pasta) - 23% For more information contact:.................................. 10 www.gruppobarilla.it
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  • 14. HOW TO CUT DOWN ON SALT WITHOUT MAKING UNNECESSARY SACRIFICES
  • 15. Reduce or moderate Ten simple suggestions for cutting salt intake is our down on salt (from the National responsability: it is not as Research Institute for Food and difficult as it may seem Nutrition-Italy):7 1 Both at the table and in the kitchen, gradually reduce the amount of salt you 2 add to food Avoid putting a salt shaker on the table and reduce the amount of salt used in 3 cooking and for seasoning As well as the salt reduction achieved by Barilla Do not add salt to baby food, at least for 4 and the “Gaining Health” campaign, every one of the whole of your child’s first year. Reduce us personally affects our own health. Reducing the use of alternative seasonings that contain sodium the amount of salt in our diet is not as difficult Remember that salt enhances flavours 5 as it might sound. and it can be an essential ingredient in cooking, but some foods don’t need salt to taste good A FEW HANDY COOKING TIPS 6 Use raw or frozen rather than canned vegetables Add some chopped herbs in lemon juice (or vinegar) to marinate food before you roast it Reduce your consumption of foods with 7 a high salt content, and get used to choo- Add some chilli peppers when cooking to enhance the sing less salty alternatives, by reading the flavour of pasta or sautéed vegetables nutritional information on products 8 Add handful of carrots, celery and onion in water when Even when you’re in a restaurant, choose boiling food dishes that are not too salty Use spices, herbs, lemon juice and vinegar 9 Add dusting of nutmeg for potatoes or cauliflower to “trick” your palate Add sage, bay, juniper berries and garlic for roasts Only drink water to replenish the liquids lost during physical activity 10 Follow the Mediterranean model as clo- sely as possible by eating fresh foods that have been processed as little as possible and are naturally low in salt. 13
  • 16. REFERENCES AND SOURCES 1. Bernstein AM, Willett WC. Am J Clin Nutr 2010;92(5):1172-80. 2. UE - European Commission Public Health. National Salt Initiatives. June 2009. 3. WHO - World Health Organization. Creating an enabling environment for population-based salt reduction strategies. July 2010. 4. Brown IJ, Tzoulaki I, Candeias V, Elliott P. Int J Epidemiol 2009;38(3):791-813. 5. INRAN. Il sale? Meglio poco. Linea Guida n.6. http://www.inran.it/fi les/download/linee_guida/lineeguida_06.pdf 6. SINU Società Italiana di Nutrizione Umana. LARN Minerali. http://www.sinu.it/larn/mineral1.asp#SODIO 7. INRAN. Tabelle di composizione degli alimenti. http://www.inran.it/646/tabelle_di_composizione_degli_alimenti.html 8. World Health Organization. Diet, nutrition and the prevention of chronic diseases. Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series, No. 916. Geneva World Health Organization 2003. 9. Bibbins-Domingo K, Chertow GM, Coxson PG et al. N Engl J Med 2010;362(7):519. 10. Strazzullo P, D’Elia L, Kandala N - B, Cappuccio FP. BMJ 2009;339:b4567. 11. Ministero per la Salute. Poco sale per… guadagnare salute. http://www.salute.gov.it/imgs/C_17_pubblicazioni_605_allegato.pdf 12. Heart Wire. Réduction du sel alimentaire: les Européens passent aux actes. The Heart.org 2010. http://www.theheart.org/article/1107511.doc 14