The WHO recommends that adults consume less than 5 g of salt per day to reduce the risk of CVD. This study aims to examine the average population daily salt intake in the fifty-three Member States of the WHO European Region.

A systematic review was conducted to examine the most up-to-date salt intake data for adults published between 2000 and 2022. Data were obtained from peer-reviewed and grey literature, WHO surveys and studies, as well as from national and global experts.

The fifty-three Member States of the WHO European Region.

People aged 12 years or more.

We identified fifty studies published between 2010 and 2021. Most countries in the WHO European Region (n 52, 98 %) reported salt intake above WHO recommended maximum levels. In almost all countries (n 52, 98 %), men consume more salt than women, ranging between 5·39 and 18·51 g for men and 4·27 and 16·14 g for women. Generally, Western and Northern European countries have the lowest average salt intake, whilst Eastern European and Central Asian countries have the highest average. Forty-two percentage of the fifty-three countries (n 22) measured salt intake using 24 h urinary collection, considered the gold standard method.

This study found that salt intakes in the WHO European Region are significantly above WHO recommended levels. Most Member States of the Region have conducted some form of population salt intake. However, methodologies to estimate salt intake are highly disparate and underestimations are very likely.

To inform strategies aimed at improving blood pressure (BP) control and reducing salt intake, we assessed educational inequalities in high blood pressure (HBP) awareness, treatment and control; physician’s advice on salt reduction; and salt knowledge, perceptions and consumption behaviours in Eastern Europe and Central Asia.

Data were collected in cross-sectional, population-based nationally representative surveys, using a multi-stage clustered sampling design. Five HBP awareness, treatment and control categories were created from measured BP and hypertension medication use. Education and other variables were self-reported. Weighted multinomial mixed-effects regression models, adjusted for confounders, were used to assess differences across education categories.

Nine Eastern European and Central Asian countries (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan).

Nationally representative samples of 30 455 adults aged 25–65 years.

HBP awareness, treatment and control varied substantially by education. The coverage of physician’s advice on salt was less frequent among participants with lower education, and those with untreated HBP or unaware of their HBP. The education gradient was evident in salt knowledge and perceptions of salt intake but not in salt consumption behaviours. Improved salt knowledge and perceptions were more prevalent among participants who received physician’s advice on salt reduction.

There is a strong education gradient in HBP awareness, treatment and control as well as salt knowledge and perceived intake. Enhancements in public and patient knowledge and awareness of HBP and its risk factors targeting socio-economically disadvantaged groups are urgently needed to alleviate the growing HBP burden in low- and middle-income countries.

To compare the frequency and healthfulness of foods being advertised to children and adolescents in four countries of WHO European region.

Cross-sectional quantitative study, guided by an adapted version of the WHO protocol. All recorded food advertisements were categorised by categories and as either ‘permitted’ or ‘not permitted’ for advertising to children in accordance with WHO Regional Office for Europe Nutrient Profile Model.

Four countries: Russia, Turkey, Kazakhstan and Kyrgyzstan

TV channels most popular among children and adolescents

Analysis included 70 d of TV broadcasting for all channels, during which time there were 28 399 advertisements. The mean number of advertisements per hour varied from eleven in Turkey and Kazakhstan to eight and two in Russia and Kyrgyzstan. In all countries, the majority of the food and beverages advertised should not be permitted for advertising to children according to the WHO Nutrient Profile Model. The mean number of non-permitted food and beverage advertisements per hour was high in Turkey and Kazakhstan (8·8 and 8·5 ads) compared with Russia (5·1) and Kyrgyzstan (1·9). Turkey was the only country where nutritional information was fully available, and no values were missing that prevented coding for some product categories.

Results revealed that children and adolescents in four countries are exposed to a considerable volume of food and beverage advertisements, including sugary products on broadcast television. As such, policymakers should consider protecting youth by developing regulations to restrict these marketing activities within media popular with children.

To demonstrate the potential impact on population health if policies designed to reduce population trans fatty acid (TFA) intake are successfully implemented in the Eurasian Economic Union (EAEU) in line with the WHO’s guidelines to lower intake of TFA as a percentage of total energy intake to less than 1 %.

A projection exercise was conducted to estimate reductions in CVD-related deaths in countries of the EAEU if TFA policies are implemented in the EAEU. Plausibly causal, annual effects (in %) of Denmark’s TFA policy on the evolution of CVD mortality rates were applied to project the potential effects of recently announced TFA policies in Armenia, Belarus, Kazakhstan, Kyrgyzstan and the Russian Federation under three TFA exposure scenarios.

Member States of the EAEU: Armenia, Belarus, Kazakhstan, Kyrgyzstan and the Russian Federation.

Data used for the projection exercise were based on estimates from natural experimental evidence from Denmark. National CVD mortality rates used were from WHO and the Organisation for Economic Cooperation and Development datasets.

In all countries and in all scenarios, deaths averted were ≤ 5 deaths/100,000 in year 1 and rose in years 2 and 3. The highest projected impacts in the high-exposure scenario were seen in Kyrgyzstan (39 deaths/100 000), with the lowest occurring in Armenia (24 deaths/100 000).

This study demonstrates the potential population health gains that can be derived from effective policies to reduce TFA in line with WHO guidance. Monitoring and surveillance systems are needed to evaluate the effectiveness of the TFA reduction policies in a national context.