No time to let up in fight against salt say researchers

England’s salt reduction programme will have led to nearly 200,000 fewer adults developing heart disease and £1.64 billion of healthcare cost savings by 2050, according to research by Queen Mary University of London.

However, the researchers warn that the recent stalling of salt reduction programmes is endangering the potential health gains, as salt intake remains significantly higher than recommended levels.

In 2003 to 2010, the Food Standards Agency, in collaboration with the food industry, established salt reduction targets in over 85 food categories, which involved reformulating processed foods, product labelling and public awareness campaigns. Consequently, average population-level salt intake reduced by 15 per cent in the period 2000 to 2011, with the decline attributed to food companies reformulating their products.

The new research, published in the journal Hypertension, used 2000-2018 population survey salt intake data and disease burden data to project the impact of the salt reduction programme, and found that the 2003 to 2018 salt reduction programme in England achieved an overall salt intake reduction of 1 gram/day per adult, from 9.38 grams/day in 2000 to 8.38 grams/day in 2018.

In addition, the research found that if 2018 salt intake levels are maintained, by 2050 the programme would have led to 193,870 fewer adults developing premature cardiovascular disease (comprising 83,140 cases of premature ischemic heart disease and 110,730 premature strokes). This would translate to an estimated £1.64 billion of health care cost savings for the adult population of England.

“Our results are striking because of the large health benefits that we see with an effective government policy of reducing salt in everyday food products,” said lead researcher Professor Borislava Mihaylova from Queen Mary University of London.

“These gains could be seriously endangered if the policy is weakened. The stalling of salt reduction efforts in the past few years is now eating away at the potential population health gains and is costing our health service dearly.

“Over the last few years, quantities of salt in diets have remained steady at levels much higher than recommended. If we can reduce our salt intake to the recommended 5g per day, we will double health benefits and healthcare savings by the year 2050.”

Professor Graham MacGregor, Professor of Cardiovascular Medicine at Queen Mary University of London and Chairman of Action on Salt added: “This study shows the enormous health benefits and cost effectiveness of the gradual reduction in salt intake in the UK that occurred between 2003-2011. Since then, the food industry has stopped reducing the excessive amounts of salt they add to our food (80 per cent of our intake) due largely to government inaction.

“It’s now time for Downing Street to take decisive measures in forcing the food industry to comply. If not, many more thousands of people will suffer unnecessary strokes and heart attacks.”

The researchers say food industry in the UK is still producing high-salt products in spite of strong evidence that it is technologically feasible and commercially viable to produce lower-salt products, and there is ample room for incremental reductions in their salt content.

To get back on track, they say the programme would benefit from a strict enforcement of salt reduction targets, for example, through legislation or financial penalties for food companies failing to comply. In addition, the research team is calling more stringent salt targets to be set, and salt targets to be extended to the out-of-home sector, which researchers say remains lenient and lacks proper monitoring mechanisms.