Feature

Salt: why the pressure is on

The government and the food industry have been slow to act on evidence of the harmful health effects of salt – and it’s time consumers stepped up the pressure, says Gaynor Bussell

It is a fact that we eat too much salt in the UK, and it is also a fact that this is detrimental to our health. The evidence has been around since 1994, when studies showed that we each consumed around 9g of salt a day. It was known that salt caused population-wide increases in blood pressure, leading to stroke and a variety of other health problems, ranging from osteoporosis to gastric cancers. We also knew that cutting salt intake from 9g to 6g would prevent 22 per cent of strokes and 16 per cent of heart attacks.

The government studied the evidence through its Committee on Medical Aspects of Food Policy (COMA), which had been charged to seek answers on why UK mortality rates for cardiovascular diseases exceeded those of other western nations, and decided it was time to act. In 1994, the government endorsed the COMA findings, published them in full and began to draw up action plans to promote a gradual reduction in salt intake in the UK.

The result was a withdrawal of funding for the Conservative Party by some prominent food processing companies. Then, without warning, the chief medial officer declared that as there appeared to be continuing debate about salt and blood pressure, it was no longer to be government policy to reduce the population’s intake of salt.

Over the past decade, the Salt Manufacturers’ Association and sections of the food industry have conducted a public relations campaign to persuade other food manufacturers, government, nutritionists and other health professionals, as well as the public, that the evidence on salt is not clear and that action is not justified.

But this view runs contrary to current medical and scientific consensus. As Professor Graham Macgregor, founder of Consensus Action on Salt and Health (CASH), puts it: ‘It is remarkable that because salt is present in fresh food in small quantities, it is assumed to be quite safe to add to processed food in large quantities.’

CASH was set up in 1996 in response to the refusal of the chief medical officer to endorse the COMA recommendations to reduce salt intake. It counts among its members many researchers whose work had shown the harmful effects of salt on health, and who were incensed by the lack of action.

It was, and still is, a group of specialists concerned with salt and its effects on health. It is working to reach a consensus with the food industry and the government over the harmful effects of a high-salt diet, and bring about a reduction in the amount of salt in processed foods, as well as salt added to cooking and at the table (see box below).

CASH aims to counter the claims made by the food industry’s PR machine with the wealth of scientific evidence that clearly links a high salt intake to ill health. So far, it has been very successful, with many major supermarkets and some food manufacturers choosing to adopt a policy of gradually reducing the salt content of their products.

In the light of recent major studies showing the dangerous effects of salt on health, the chief medical officer, the Department of Health and the Food Standards Agency now recommend a daily average salt intake for adults of 6g or less. The struggle to reach this target will be even harder to achieve now than it was in 1994, given the evidence that current adult salt intake in the UK is closer to 12g per day. Worse, children – who cannot cope with the same salt load as adults – with their high consumption of salty snacks and processed foods, are eating almost as much as adults.

Why is the UK diet so high in salt?

Only 20 per cent of the salt we consume is added during cooking or at the table. The rest – a whopping 80 per cent – is added during food processing. There are three major reasons why manufacturers continue to add large amounts of salt to food.

The first is taste: in the UK, most people have grown used to salty flavours, often to the detriment of more subtle ones. People who get used to eating less salt always remark on how the true flavours of food start to come through. Processed food may well have little flavour without the added salt.

The second is that salt causes food to absorb more water, adding weight to a product at virtually no extra cost. Examples include processed meat products such as sausages, pork pies and bacon. The third reason is simply to create thirst in consumers, encouraging them to drink more, often in the form of commercial soft drinks. Many soft drinks companies know this and team up with the salty-snack industry to bolster each other’s sales.

The food industry claims that salt is also needed for technical reasons: for example, to slow down the fermentation process in bread. Although it is true that some salt is needed, there is plenty of evidence that the amount being added is excessive.

Most supermarkets have made great strides in significantly reducing salt in own-brand foods compared with their branded counterparts. So the evidence shows that technically it can be done, and that consumers readily accept lower salt brands and in many cases even prefer the flavour.

Do you really have a healthy diet?

In January, CASH’s Salt Awareness Day highlighted the fact that so-called ‘healthy foods’ may still be packed with salt. Staples such as breakfast cereals and bread, which may not even taste salty, often contain high levels of salt. Many branded breakfast cereals contain more salt per 100g than a packet of crisps, and weight for weight cornflakes contain as much salt as Atlantic sea water (1g salt per 100g). Eating the recommended six slices of bread a day can provide you with 3g of salt – half the recommended daily intake.

Food labelling

The food industry wants to keep us in the dark about the amount of salt in its food. Most labels will tell you how much sodium per 100g a food contains. Sometimes the packaging does not show the weight of the product and there may be no indication of how much is normally consumed per serving. In addition, a recent survey showed that most people thought salt and sodium amounted to the same thing. In fact, you must multiply the sodium by 2.5 to calculate the salt content.

The bulk (99 per cent) of sodium in the diet comes from salt. People know what salt is and could understand an upper limit of 6g, so for clarity CASH is campaigning for clearer food labelling that will not only state the amount of salt per portion, but also the recommended total intake for the day. Many supermarkets have already started to do this and we hope other manufacturers will follow suit.

What you can do

Don’t add salt to your cooking or to food at the table. If you’re used to a high salt intake the food will initially taste bland but within two to three weeks your taste receptors will become more sensitive and you will find the food tastes good and high-salt foods become unpleasant.

As most people eat large amounts of processed foods such as bread and cereals it is difficult to cut back on salt. Start looking for reduced salt varieties, such as low-salt bread or cereals, which are beginning to appear. As a guide, 0.5g of sodium per 100g or more is a lot of salt, whereas 0.1g or less per 100g is fine. In addition, try to eat more fresh fruit and vegetables and less saturated fat.

Campaign by writing to food manufacturers to request that they clearly label their processed foods with the salt content, and ask them to reduce the amount they add. If you find that food from a take-away, fast-food outlet or a restaurant is too salty, complain. If you see celebrity chefs using excessive salt in their recipes on television, you can also take action by writing to complain.