Table 5.

Barrier and motivation/enablers of the salt reduction policy

Sub-theme	Theme		Example of quotes
	Barriers	Motivation/enablers
Awareness	Lack of awareness to reduce daily salt intake	Awareness to healthy life and prevent salt-related diseases	“…Malaysians do not have awareness on salt reduction…”(Male, Food Industry/Snacks, WPM) “…we going to reduce all the cardiovascular complications and morbidities and mortalities if you prepare good food with less salt” (Female, Policy Maker/NGO1, WPM)
Behavior	Exposure of high salt since young and bad eating habit	Creating awareness to change behavior on taking less salt needed to start from young	“…when we were exposed too much…it became our norm…” (Female, Researcher 2, Central region) “…because of our habit is since young…”(Female, Policy Maker/Ministry 4, WPM)
Consumer acceptance	The consumer complaint about the taste of the reduced salt foods	Continuously creating awareness to the public to increase their acceptance on lower salt products	“…if we reduce the sodium, the consumers less prefer it…” (Female, Food Industry/Sauce, NPM) “…he brought this idea of having low sodium salt in this country where he can mix potassium chloride and sodium chloride…one the society will aware…” (Male, Seasoning Industry, Central region)
Knowledge	Lack of knowledge on daily recommended salt intake and salt labelling	Increase of knowledge on salt reduction and salt labelling through promotion via mass and electronic media	“…some people might not even know the daily recommended salt intake…” (Female, Policy Maker/Researcher 4, EPM) “… our consumer might not be ready yet to understand how to use this label.” (Female, Policy Maker/Researcher 1, WPM) “…use social media…” (Male, Policy Maker/Researcher, SPM) “…through their tv programs, radio…get up blast, non-stop…” (Male, Policy Maker/NGO 5, WPM)
	Lack of knowledge on salt substitute	Educate the food industries how to use salt substitute	“…is the salt substitute available in the market?… Does it change or have any effect?” (Male, Food Industry/Processed Food, NPM) “…What are the applications that are suitable and are not suitable…if they are not strong in their research, they wouldn’t know how to use it…” (Male, Food Industry/Salt, WPM)
	Lack of knowledge to reduce salt in cooking	Educate reduction of salt in cooking with the use of natural ingredients, herbs and spices	“…cut down your soy sauce and sauces… whatever you fry, don't add any salt…” (Male, Policy Maker/NGO 5, WPM) “…spices could alter the taste so that we can reduce salt…lemongrass and torch ginger can reduce the salt consumption…” (Female, Food Industry/Frozen Food, EM) “…use a lot of star anise and these stuff to cook meat products…. (Male, Food Industry/Sauce, WPM)
Reformulation	Reformulation challenge using potassium chloride as it has an aftertaste and the problem of food stability and safety with the reduction of salt	Asist the food industries to do reformulation and introduce proper technology to increase the shelf life of the reduced salt products	“…but potassium chloride got after taste… …” (Male, Policy Maker/Researcher, NPM) “…the shelf life will shorten…” (Female, Policy Maker/Researcher 4, WPM) “…the product cannot form properly…” (Male, Policy Maker/Researcher, EM) “…need help in terms of recalibrating or relining back their product reformulations…” (Male, Policy Maker/Government Agency 2, WPM) “…explore other methods how can we preserve food…”(Female, Policy Maker/Researcher 1, WPM)
Resources	Lack of funding to do research, opting technologies in processing, production and marketing of lower salt products	Financial aid to do research, reformulation, using technologies in food processing, production and marketing of lower salt products	“…very hard to get funding in research.” (Male, Researcher, East region) “… we are small and our cost of production is very high…” (Male, Food Industry/Sauce, WPM) “…for all the technologies, the cost is high…”(Female, Policy Maker/Research 4, WPM) “… resources are very limited…for marketing, product development…” (Female, Policy Maker/Ministry 2, WPM) “…to do all the reformulations, innovations…Need to put in a lot of money…” (Female, Policy Maker/Ministry 4, WPM)
	Lack of funding and manpower could hamper campaigns	Grant is needed to run bigger salt reduction campaign	“…I think the motivation is also definitely if we get some grants or something… if we are looking into doing a bigger or larger scale of awareness program, yes then funding might be needed….” (Female, Policy Maker/NGO 1, WPM)
Guideline and salt target	No guideline and salt target make the food industries/providers to use excessive salt and the amount of salt used might vary between different manufacturers	Guidelines and salt targets are important especially for food industries/providers to reduce salt in their food products. There is in need of revision of the Food Act for the new salt target	“…do not have the standard to determine whether the product is high in salt…no guideline…” (Female, Policy Maker/Government Agency 1, EM) “…if we don’t set the proper indicator of what we really want to monitor, what’s the impact we want to monitor. Then, could lose the target…” (Female, Policy Maker/Researcher 1, WPM) “…Revise the food act for the industry to follow…” (Female, Policy Maker/Researcher 1, WPM)
Priority	Salt reduction is not a priority at the ministry and government agency level	Political involvement on salt reduction would make the issue become a priority for the government	“…it should be prioritized when it comes to communication strategies…” (Male, Policy Maker/Ministry 1, WPM) “…so far, salt hasn’t been priority…” (Male, Policy Maker/Researcher, EM) “Perhaps when it involves politicians… to make it sound more serious and more doable” (Female, Policy Maker/NGO1, WPM)
Support	Lack of support from other ministries, the food industries/providers and consumer on salt reduction	All stakeholders need to collaborate and support the salt reduction policy	“…other ministries have their own policy and it is not aligned with our policy …” (Female, Policy Maker/Ministry 2, WPM) “…if the customers don’t want or have no demand…” (Male, Policy Maker/NGO 5, WPM) “…Bigger companies do have their own formulations… for us to introduce them with healthier options, it is quite tough…” (Female, Policy Maker/Researcher 2, NPM) “…Collaboration with all stakeholders…Starting from government, related authorities, researcher, school, parents, food industry…” (Female, Policy Maker/Researcher 4, EPM)
Monitoring and low enforcement	Lack of monitoring and no law enforcement could drive the food industries away from the salt reduction policy as they feel safe from any punishment for not supporting the policy	Monitoring the salt content and low enforcement such as punishment or withdrawal of business license is needed to make sure the food industries/providers follow the requirement of lower salt content	“…if there is no monitoring, no sampling and warning…maybe they will think there is no problem…no action will be taken unto them… So, need enforcement, implementation of act…” (Female, Policy Maker/Researcher, EM) “…if they are reluctant… then we have no choice to either boycott or give some form of a punishment or summon…” (Female, Policy Maker/NGO 1, WPM) “…the authority needs to take proactive action for example for hawkers that want to renew (license) they need to show that their foods are following the recommendation…” (Male, Policy Maker/Researcher 1, NPM)
Price	Cheap price of salt, high salt price of lower salt/premium foods and low availability of lower salt products in the market halt the salt reduction policy	Increase salt price and impose taxation on salt and high salt food products	“…products under the healthy category weather it is organic or natural, less salt… the price is premium… (Male, Policy Maker/Government Agency 2, WPM) “…It’s not easy to choose food that is low in salt. No choice…” (Male, Policy Maker/Researcher, EM) “…salt is the cheapest… low sodium salt would be more expensive…” (Male, Food Industry/Salt, WPM) “…they should be taxed…” (Female, Policy Maker/Researcher 1, WPM) “…raise the price of high salt foods…” (Female, Policy Maker/NGO 2, WPM)