Salt reduction
for Disease Control and Prevention and commissioner of the New York City Department of Health and Mental Hygiene says the real problem comes from the sodium in our food ingredients and what is added during cooking. In places like India and China, for example, salt is used “literally by the handful”, he says. It’s a view supported by the numbers; low-to-middle income countries account for four in every five of those 2.5 million deaths annually, according to Resolve to Save Lives.
Take it with a pinch of salt Funded by Bloomberg Philanthropies, the Bill and Melinda Gates Foundation and Gates Philanthropy Partners, among others, Resolve to Save Lives was established in 2017. Its main objective is to form partnerships with national and local organisations in low and middle-income countries to co-create, advocate for and scale up activities in heart disease prevention and epidemic preparedness. Its aim is to save 100 million lives over a 30-year period by helping countries improve their preparedness for epidemics and pandemics, eliminating trans fats, improving the treatment of hypertension in primary care and reducing salt intake.
Its work is closely tied to efforts by the WHO to achieve the 30% reduction in sodium consumption by 2025. However, those efforts are off track according to the United Nations agency that in March 2023 warned just 5% of its member states were protected by mandatory and comprehensive sodium reduction policies. It said a staggering 73% lacked policies that would help achieve the reduction targets; just nine countries – Brazil, Chile, the Czech Republic, Lithuania, Malaysia, Mexico, Saudi Arabia, Spain and Uruguay – have a “comprehensive package of recommended policies” it says.
A grainy situation
Speaking at the release of a damning report on the issue, WHO Director General Dr Tedros Adhanom Ghebreyesus said: “Unhealthy diets are a leading cause of death and disease globally, and excessive sodium intake is one of the main culprits. This report shows that most countries are yet to adopt any mandatory sodium reduction policies, leaving their people at risk of heart attack, stroke, and other health problems.” He called on all countries to act and for manufacturers to implement the WHO benchmarks for sodium content in food. Frieden warns that although progress had been made, it was slowing or even stalling. “I think sodium reduction has been one of the hardest areas,” he says. The UK is a good example of that; he says there have been some good progress made for five to ten years, but then the government
Ingredients Insight /
www.ingredients-insight.com
backed off and that progress stopped. That, he adds, is a real lesson: “If the government sets a level playing field, industry can be unharmed, even helped. But if the government calls for voluntary measures, they almost invariably fail.” It’s a view echoed in research released just days after speaking with Frieden. The study by Queen Mary University of London and published in the Journal of Hypertension concluded that thousands of lives in England were being put at risk by a failure of governments to reduce salt intake since 2014. At the same time, Action on Salt along with 33 leading experts and health charities, called for a mandatory and comprehensive programme to tackle the issue. It seems that such measures would have public support. Action on Salt – established in the mid- 1990s to find consensus between government and the food industry to reduce salt intake – said it found nine out of ten polled would support government action to protect the public from avoidable health conditions such as heart disease and strokes, with almost 80% said ministers should do more to help cut salt consumption.
A stubborn industry
The largest hurdle facing sodium reduction targets is that they are pitted against a food industry arguably unwilling to change. “I think most companies would rather not change. There’s a certain financial and human cost of change. So, inertia is a very powerful force,” explains Frieden. But, he adds, the simple fact is salt can be reduced by as much as 15% in food products largely without consumers noticing. The next step would be to replace traditional sodium salt with potassium-enriched substitute to reach that holy grail of a 30% sodium reduction. Frieden acknowledges there are challenges in doing so, including the higher cost of potassium and the risk of consumer disquiet were they to
Too much salt can cause high pressure, a major contributor to heart disease, one of the leading causes of global deaths.
12%
The targeted sodium reduction in food products in the US by 2024.
US Food & Drug Administration 11.8% Mordor Intelligence 75
The percentage of annual growth in the global sodium replacement market between 2020–25.
Sharif Pavlov/
Shutterstock.com
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