Table 3 Perception of salt intake and salt reduction policy in Malaysia

Perception on salt intake in Malaysia

Salt intake among Malaysians is high and could lead to health problems including hypertension and cardiovascular diseases

“…we are consuming much more salt than recommended by the Malaysian dietary guideline or even by WHO”. (Female, Policy Maker/NGO 1)

“…Hypertension can lead to a lot of stroke problem…” (Male, Food Industry/Soy Sauce, WPM)

Fast foods, processed foods, snacks, fermented and local seasoning foods, salted foods, pickled foods, sauces, seasoning/food enhancer contributed to high salt intake

“Fast foods are among the options….” (Female, Policy Maker/Researcher, EM)

“…they buy a lot of these sausages, frozen food, processed food…” (Female, Policy Maker/Researcher 1, WPM)

“…sambal (chili paste) with belacan (shrimp paste) cincalok (fermented shrimp), tempoyak (fermented durian) are high in salt…” (Female, Policy Maker/Ministry 2, WPM)

“… all the outside hawkers been selling their salty keropok lekor (fish cracker), chicken fried… are all salty” (Male, Policy Maker/NGO 5/WPM)

“… snack food is more of a culprit you know…” (Male, Food Industry/Soy Sauce, WPM)

“…if no monosodium glutamate (MSG), not tasty…” (Female, Policy Maker/Researcher 4, EPM)

“…sauces and dressing, the seasoning, the soy sauce, chili sauce, tomato sauce and the sweet soy sauce, salty soy sauce all those are the food products with the high sodium” (Female, Policy Maker/NGO 2, WPM)

Cultural, behavioral, sociodemographic, family factors, availability of food and eating outside influence salt influence salt intake

“…our traditional foods are high in salt like kolok and Sarawak noodles, layer cakes…” (Male, Policy Maker/Researcher, EM)

“…for kids, they like to eat rice with soy sauce… (Female, Policy Maker/Ministry 2, WPM)

“…at home parents decide foods for the family…” (Female, Policy Maker/Ministry 8, WPM)

“… in the rural areas, they will use more of these preserved or highly processed foods, compared to the urban areas.” (Female, Policy Maker/Researcher 1, WPM)

“…They start to dish snack together with their rice…Because they are so poor…So that’s what snack goes into.” (Male, Industry/Salt, WPM)

“…high salt consumption either from the eateries… the restaurant, the people who prepare food…” (Female, Policy Maker/NGO 3, WPM)

“…24-h restaurants/stalls/street foods are everywhere, and the availability and affordability…” (Female, Policy Maker/NGO 2, WPM)

Perception salt reduction policy

Salt reduction policy is led by the Ministry of Health (MOH) as the ministry have the most authority on the policy

“…the main source is MOH… but the delivery is through teachers, community, NGOs…” (Female, Policy Maker/Ministry 6, WPM)

“…we don’t have the authority but we can perhaps create an impact…” (Female, Policy Maker/Researcher 1, WPM)

Salt reduction is feasible

“Reducing the salt intake for the population is feasible. There are actually so many people out there who do want to eat less salt…” (Female, Policy Maker/Ministry 4, WPM)

Not very effective and insufficient

“…our current strategy is insufficient… We need to admit our current strategies are not effective.” (Male, Policy Maker/Ministry 5, WPM)

Salt reduction policy should start off with voluntary and gradually reduce the salt intake before mandatory policy could be implemented

“…we need to get at least one or two companies to show that they can do it… then perhaps voluntarily we will get some other companies to join…” (Female, Policy Maker/NGO 1, WPM)

“… if we change gradually…so they can accept the new formulation…” (Male, Food Industry/Processed Food, NPM)

“So, when the government has made it mandatory, maybe the reduction will gradually happen because of the mandatory order…” (Female, Food Industry Local Fast-Food, NPM)