Adherence to voluntary sodium reduction agreements in Brazil

The objective was to assess adherence to voluntary agreements for sodium reduction fir-med between the food industries and the Ministry of Health in Brazil and to compare their targets with the limit proposed in the Pan American He-alth Organization (PAHO) nutritional profile model. We used data from 1.553 foods from 32 ca-tegories included in the agreements and sold in the largest Brazilian supermarket chains in 2017. The frequency of products with sodium equal or below the cut-offs proposed by the voluntary agreements and by PAHO was calculated. Classification con-cordance according to the two was evaluated with Cohen's kappa coefficient (k). Our results showed that 77.7% of products were adequate according to the voluntary agreements, and only 35.9% of them, according to the PAHO model. We identi-fied a weak degree of concordance between both criteria in classifying a product as adequate about sodium content (k = 0.199). In conclusion, the voluntary agreements for sodium reduction are limited in their scope and rigor. The adoption of measures oriented for all products, with more res-trictive and mandatory targets, should be conside-red in the