Salt Really Matters
We're all eating too much salt - here's why that matters
15 March 2022 Tatiana Sherwood British Heart Foundation
Category: Blog
You may know that you should eat no more than 6g of salt per day. But did you know that, on average, working age adults in England consume 8.4g a day - that's 40 per cent above the national guideline.
We're also willing to bet that you didn't know the UK target of 6g is more than 15 per cent higher than the World Health Organisation’s maximum recommended intake of 5g.
At this point, you might be wondering: so what?
This Salt Awareness Week, we're explaining the health impacts of eating too much salt and what individuals and industry can do to reduce salt intake across the UK.
We also highlight some of the sources of salt in your diet – and it may surprise you.
Why excess salt intake matters
We do need some salt in our diet but most of us are eating much more than we need.
A diet too high in salt is linked to high blood pressure, also known as hypertension, as the sodium in salt leads to more water in your blood vessels, causing higher pressure.
An estimated 28 per cent of adults in the UK have hypertension – that’s around 15 million adults.
Hypertension is the leading modifiable risk factor for cardiovascular disease in the UK and contributes to around half of heart attacks and strokes.
A higher intake of salt is associated with a 23 per cent increase in the risk of stroke and a 14 per cent increase in the risk of cardiovascular disease.
Is it up to me to eat less salt?
It has been argued that the best approach to reducing salt intake is to educate and encourage people to add less salt to meals, for example, through public awareness campaigns, such as the Food Standard Agency’s 2004 Sid the Slug adverts.
It is proven that lowering your salt intake as part of a well-balanced diet can have important health benefits, and our nutritionists have several simple tips to help you do just that.
However, making changes isn’t easy for everyone, and sufficiently lowering salt intake across the population will take more than individual action.
What action can industry take to lower salt intake?
As much as 85 per cent of the salt we eat is already in the food we buy, rather than being added during cooking or eating.
As well as items we might think of as salty, such as crisps, processed meats and sauces, every day foods like bread and breakfast cereals are often high in salt too.
To have the biggest impact on everyone’s salt intake and to reduce heart and circulatory disease, we need to lower salt in food before the point of purchase.
This can be done through food reformulation: manufacturers changing the recipes of their products to reduce the salt (or sugar or fat), without compromising on taste.
So far, reformulation activity has been focused on a series of voluntary programmes. These have seen some progress in reducing salt levels, for example in categories like breakfast cereal and pasta sauces between 2014 and 2017.
The food industry has also drawn some key learning points from the programmes, such as the need for gradual reformulation, so that this is less noticeable to the consumer.
However, on the whole, success has been mixed. Only half (52 per cent) of all the average in-home salt reduction targets set in 2014 were met by 2017.
In 2020, Public Health England set new targets for industry to meet on a voluntary basis by 2024.
But given how critical salt reduction is for our heart health, and that previous voluntary programmes have not delivered sufficient results, we must decide what comes next before this ends.
As the Government considers its next steps on reformulation, we believe it is essential that it adopts mandatory measures to drive this further and faster.
One mechanism for this was discussed in Henry Dimbleby’s 2021 National Food Strategy (NFS), commissioned by the Department for the Environment, Food and Rural Affairs.
The NFS proposed the introduction of an industry levy on salt at wholesale level, to incentivise manufacturers to reduce the salt and sugar content of their products.
This landmark measure could reduce average daily salt intake by up to 0.6g, which would be a significant step, taking us 25 per cent of the way to the UK’s 6g a day guideline.
What else should be done?
For the greatest health impact, reformulation must be combined with other population level measures.
Improving diets will require a comprehensive strategy with multiple interventions, each making an important contribution to reduced salt intake.
This means integrating salt into diet-related policy in a more effective way, including by ensuring that the impact of salt on health is considered in policies which restrict the advertising and promotion of less healthy foods.
Such policies can have dual benefits: as well as supporting consumers to make healthier choices, they can drive reformulation.
A good example of this comes from New Zealand, where a voluntary labelling scheme called the Star System was adopted which details how much salt, sugar and other nutrients is in a product and gives an overall score out of five for health.
This informed consumers on what was in their food, and spurred industry action: an evaluation found that companies that adopted this system reduced the sodium content of their food on average by 4 per cent.
This might not sound like a lot, but every small change makes a difference, and the combined impact of these measures will be substantial.
The evaluation also noted that the impact of the Star system on reformulation would’ve been significantly greater if its use was compulsory.
Time to shake the habit
Reducing the population’s salt intake to WHO, or even UK, guidelines will not be easy.
But given the serious health risks associated with a diet high in salt, it is critical that government and industry take bold action now, starting with mandatory reformulation and front of pack labelling.
Supermarket shelves and restaurant menus have been full of salty products for too long – it’s time for industry to shake the habit.