Salt is linked to high blood pressure, which means increased risk of the biggest killers, strokes and heart disease. The food industry is working to cut salt levels, but processors can only move as fast as customers’ tastes change, reports Chris Lyddon.


According to Professor Graham A. MacGregor, of St George’s Hospital Medical School in London, the potential gains from cutting salt consumption in the UK are enormous. “If we reduce salt intake to five or six grammes a day we would prevent 30,000 or 40,000 deaths a year from strokes and heart disease. The evidence is overwhelming,” he told just-food.com. “For everyone who has a stroke or heart attack about half die. You’re talking about 70,000 or 80,000 strokes or heart attacks.”


“Salt is a major factor in putting up blood pressure,” he said. “It’s amazing that something hasn’t been done before. I don’t think the food industry has anything to fear at all.”


Professor MacGregor was instrumental in founding the campaign group CASH (Consensus Action on Salt and Health), which runs National Salt Awareness day on 29 January each year. Cutting salt gives a relatively easy health gain, Penelope Gilbert of CASH told just-food.com. “Compared to obesity it’s quite easy to tackle,” she said.


People’s tastes can be changed. “If you don’t have salt for three or four weeks your taste receptors get used to it,” she said. But all food manufacturers have to work together. “If it’s only done in a few places people may start noticing,” she said. And CASH wants the change made gradually.


WHO calls for cuts


The World Health Organisation recommends that salt intake be restricted to fewer than five grammes a day. “Of the many risk factors associated with high blood pressure, the dietary exposure that has been investigated most is daily sodium intake,” it said in an Expert Report on Diet, Nutrition and the Prevention of Chronic Disease published earlier this year. “Dietary intake of sodium, from all sources, influences blood pressure levels in populations and should be limited.”


The UK’s Scientific Advisory Committee on Nutrition (SACN), in its report on Salt and Health, also published earlier this year, held to a target reduction of average salt intake to six grammes a day as recommended by the Committee on the Medical Aspects of Food and Nutrition Policy in 1994, when the average intake was nine grammes a day. According to the British Nutrition Foundation, it still is.


A working group on salt produced a report for the French food standards agency AFSSA last year recommending an eight gramme a day guideline with further intervention for ‘at risk’ groups.


Europe-wide moves likely


Action in salt on a Europe-wide basis is becoming more likely, Sue Oldrieve, Sainsbury nutritionist, told just-food.com. “Italy has just taken over the EU presidency and their health minister is interested in doing something on salt,” she said.


Following the SACN report, the Food Standards Agency has become active in working with the industry for lower salt contents. “The evidence is now a lot stronger,” the FSA’s Louise Ansari told just-food.com. “We have a lot more evidence on how much adults do take in, which is nine grammes a day,” she said. More evidence, increases in stroke, heart disease and high blood pressure and increased consumption of processed food have led to “a pretty big programme of work,” she said.


The industry has responded positively. “The FDF in particular has supported these targets,” she said. “A lot of the big retailers have said they will reduce salt. There’s broad agreement out there that salt levels need to come down.” But the FSA wants to make more progress. “Certainly there’s been movement. It isn’t quite as much as we would like,” she said.


Kate Snowden of the Food and Drink Federation described the FSA’s approach as “precautionary.” “We’re willing to work with them to achieve that and to reduce salt in processed foods,” she told just-food.com. “ Salt has a role to play in terms of flavour, but also in presentation and texture,” she said. “You need to have consumer acceptance on taste. If you can’t sell the product, there’s no point making it.”


The industry has already cut salt in some products, she said, noting that the salt content of bread was down by 25% in the last decade.


Retailers doing their bit


Sainsbury was cutting salt long before the FSA’s latest push, said nutritionist Sue Oldrieve. “Sainsbury has had a policy of salt minimisation since October 1999,” she said. The supermarkets are in a good position to provide information. “We’ve got direct access to consumers, helping them understand about salt and how to use labels,” she said.


Salt reduction is mostly going on behind the scenes. “We’ve kept quiet about the reductions we’re making,” she said. “There aren’t many products labelled as low salt. In our consumer research we found that if we labelled products as “ten percent less salt,” people complained.”


There was increased awareness of salt, but most people were still more concerned about fat and calories. “If people are diagnosed with a particular condition, like heart disease or high blood pressure, they do tend to be more aware of salt,” she said.


Consumer education paramount


Oldrieve expressed some concern that salt needed to be considered as part of a balanced diet. Specific issues are being dealt with very much in isolation,” she said. “The food industry has a role to play in helping the UK population to a healthier lifestyle. Part of that is watching salt intakes.”


As well as reducing salt in existing foods, Sainsbury is talking to suppliers about cutting salt in new products. There is also a need to talk to ingredient suppliers about salt in, for example, cheese, or stock.


“You can cut 10 to 15 percent without any taste change being detectable. More and they don’t buy it a second time,” said Oldrieve. And increased portion size and trends like increased cured meat consumption tend to militate against reducing salt consumption.


“In some products there’s a need for salt for food safety reasons,” she said. “In bread it has a function in controlling the rate of fermentation and therefore the texture of bread. Consumers don’t like big changes, so we can’t just take it out.” Salt is needed in sausages, for binding.


The food industry should not be left to deal on its own with changing consumer perception on salt, Oldrieve felt. “It would be nice to see some more concerted government action on communication. The government can reach a different target audience,” she said.


Need for cooperation


Duncan Bogie of Unilever Bestfoods UK stresses the need for industry cooperation. “You have to take out the competitive element and educate consumer palates to lower salt,” he told just-food.com.


It has to be a gradual process. “There’s no doubt people do like the taste salt delivers. That consumer preference is important,” he says. “We’d already taken action to reduce the salt content in soup by ten percent this year.” Asked how hard it was to make the cut, he said, “it isn’t easy but it isn’t complicated.”


Britain is very much in the lead in Europe on salt content. “Now the public debate has matured,” he said. “To have the debate is good as long as it’s rooted in reason.”