Abstract
Background: Excessive sodium intake is a major modifiable risk factor for hypertension and cardiovascular disease and remains well above recommended levels globally. Although sodium reduction strategies have traditionally focused on individual behaviour change, food environments largely determine sodium consumption by shaping food availability, affordability, preferences, and purchasing options. However, no conceptual framework has specifically characterized food environments according to their capacity to promote excessive salt intake. Objectives: To introduces the concept of the salinogenic food environment and proposes a conceptual framework integrating environmental determinants of sodium exposure across food systems, dietary behaviors and cardiovascular health outcomes. Methods: A narrative conceptual review synthesized evidence from ecological health models, particularly the ANGELO framework, food environment research, sodium epidemiology, dietary behaviours, and cardiovascular health. Evidence from retail, out-of-home and institutional food settings, sociocultural and economic influences, and policy environments informed framework development. Results: The salinogenic food environment is defined as an environment that promotes high salt intake through the widespread availability of high-sodium foods and the reinforcement of salty taste preferences. The framework encompasses four interrelated domains: physical, economic, sociocultural, and policy/governance environments. Evidence indicates that processed and ultra-processed foods, restaurant and institutional meals, food pricing structures, cultural dietary practices, and insufficient regulatory measures collectively contribute to excessive sodium exposure. The framework highlights how these domains interact to shape sodium exposure, reinforce salty taste preferences, and contribute to socioeconomic inequalities in sodium intake. It also proposes approaches for operationalizing salinogenic environments through objective indicators, perceived environment measures, and composite indices. Conclusions: The salinogenic food environment framework reorients sodium reduction from an individual responsibility toward to a structural property of contemporary food systems. By providing a common conceptual language for research, surveillance and policy evaluation, it may facilitate the development of more effective multisectorial strategies to reduce sodium exposure and improve cardiovascular health.