Salt reduction programme is no longer fit for purpose

New research from Queen Mary University London and published in the Journal of Hypertension shows the Government has failed to reduce population salt intakes and consequently improve public health in England since 2014 when the UK’s successful salt reduction programme was handed directly to the food industry – putting thousands of lives at risk. 

At the height of its success (2003-2014) the UK salt reduction programme led to a 19% reduction in salt intakes and saved more than 9,000 lives a year. Since then, the government handed responsibility for salt policy to food industries, resulting in weak policies which have failed to reduce salt intake. The analysis reveals a decline in salt intake from 9.38g/day to 7.58g/day between 2003 and 2014, followed by an increase to 8.39g/day in 2018.

The impact of this failure can be seen in current trends in population incidence of blood pressure, strokes and heart disease, both people living with these conditions and early death as a result of them.

Action on Salt together with 33 leading experts and health charities, including Sustain's Children's Food Campaign, are calling on both Prime Minister Rishi Sunak and Leader of the Opposition Sir Keir Starmer to prioritise salt reduction through a mandatory and comprehensive programme. Failure to act will have a detrimental impact on the health and wellbeing of the population, as well as on the economy.

At the same time, new consumer polling by Action on Salt shows:

• almost 90% of the UK population would support the government in taking action to protect the public from avoidable health conditions like heart disease and strokes
• almost 80% think ministers should do more to reduce the salt we eat as a nation
• 85% of the population would support the government requiring food companies to reduce unnecessary salt in their products.

Professor Graham MacGregor, Professor of Cardiovascular Medicine at Queen Mary University of London, Chairman of Action on Salt and co-author of the analysis says:

“This study reinforces the urgent need for a robust system where we generate worthwhile reductions in salt intake which make a positive and lasting impact. It is now up to the Government to set up a coherent strategy where the food industry is instructed what to do, rather than the food industry telling the Government what to do. We must get our salt reduction strategy back on track for the benefit of public health, the UK workforce, our overburdened NHS and the economy."

Barbara Crowther, Children’s Food Campaign Manager at Sustain, says:

“This is yet more evidence that, without a proper Government mandatory framework providing the incentive, progress towards healthier food is not going to be achieved. We’ve seen with the Soft Drinks Industry Levy how effective it can be when they do. Now Government needs similar ambitions to push companies harder to change the recipe on salty food. Doing so would protect the nation from a range of health conditions and support a healthier nation and economy.”

The newly published research (Salt Intake, Blood Pressure and Cardiovascular Disease Mortality in England, 2003- 2018) aimed to investigate the impact of the UK’s pioneering voluntary salt reduction programme since its inception. Using publicly available data to evaluate population salt intake, blood pressure (BP) and deaths from heart disease and stroke, the results showed that whilst average salt intake, BP and deaths in the adult population of England initially decreased as a result of the pre-2014 policies, the declines have since stopped:
-    A decline in salt intake from 9.38g/day to 7.58g/day between 2003 and 2014, followed by an increase to 8.39g/day in 2018
-    A decline in population BP from 125.3/74.5 mmHg to 122.6/73.3 mmHg between 2003 and 2014, following by a plateau 122.0/73.8 mmHg in 2018 
-    A fall in stroke and heart disease mortality rates from 12.2 and 43.4 deaths per 100,000 to 8.2 and 27.2 deaths per 100,000 between 2003 and 2014, followed by a plateau afterwards.

Sonia Pombo, Campaign Lead at Action on Salt and co-author says:

“The once successful salt reduction programme is a shell of its former self. Salt reduction is simple and easy to implement, and this research confirms it works. But the UK’s downfall was trusting the food industry to deliver reductions in salt content without an incentive to do so or enforcement from the Government. Urgent resuscitation in the programme is needed if we are to get back on track and save the most lives.”

These findings confirm an already overwhelming body of evidence linking the importance of salt reduction to improved health, and that when done correctly, a salt reduction programme can save thousands of premature deaths from strokes and heart disease. However, the lack of progress since 2014, coinciding with responsibility for the salt reduction programme being handed over to the food industry, indicates that the effectiveness of the programme has been compromised. It was estimated that, if the previous successful programme had continued, there would have been a further reduction of 1.45 g/day in salt intake from 2014 to 2018. This would have prevented over 38,000 deaths from strokes and heart disease in just a 4-year period, of which 24,000 would have been premature.

Jing Song at Queen Mary University of London and first author of the Journal of Hypertension analysis says:

“Reducing salt intake has been identified by the World Health Organisation as one of the most cost-effective measures to improve population health. As a nation, if we cut one gram of salt from our average daily salt intake, this could save over 6,000 lives every year from strokes and heart disease - all of which are completely avoidable – and save the economy £1.5 billion annually."

Read the full story and findings on Action on Sugar website

Read the open letters to Rishi Sunak MP and Sir Keir Starmer MP