Sodium reduction
according to Amanda Shiach, research assistant, Research and Action on Salt and Obesity Unit, Wolfson Institute of Population Health, Queen Mary University of London.
“This work in China was really interesting,” says Shiach, adding “It was a large-scale study that utilised the geographical separation of the villages to control their salt supply and offer either standard sodium chloride salt or a 75%:25% sodium chloride: potassium chloride salt mix as a comparison.” This demonstrated a significant impact of controlling the salt intake, which was adopted with ease and saw a 97% continuation in use.
“The most significant consumption of salt in these populations was through discretionary use in home cooking, in contrast to the UK and many other countries where processed food and food eaten out of the home is the key contributor to salt in the diet. However, this principle of salt substitution can be extended to any food with salt added at varying points in the manufacturing or cooking process,” explains Shiach. Yet if the China study shows what self-discipline can do (in terms of participants sticking to agreed diets) it would be too early to conclude it’s a template that can be readily applied elsewhere. Indeed, as Trieu notes more generally: “While industry is a key stakeholder for switching the world’s salt supply – they cannot do it alone. “Everyone has a part to play, and collaboration with, and between governments, industry, the WHO, public health and civil society organisations, clinicians, and consumers, is essential to accomplish this transition.”
A mixed picture
If the overall objective is based on a series of moving parts coming together more efficiently the potential rewards are significant. Indeed, it’s thought that for every 1g reduction in population salt intakes, over 4,000 premature deaths in the UK can be prevented annually, saving the NHS £288m a year, according to Zoe Davies – nutritionist at Action on Salt – a registered charity based at Queen Mary University of London. Yet the picture in the UK has been mixed, to say the least. “The UK had success at the start of the salt reduction programme,” says Davies, adding “Under the management of the Food Standards Agency, targets were strongly monitored and businesses were held to account.” However, since 2014 there has been a lack of progress in salt reduction as the responsibility has been handed from the FSA to the food industry where businesses are under little pressure to comply and are not meeting expected targets.
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“If continued, it was estimated there would have been a further reduction of 1.45g/day in salt intake between 2014 and 2018, preventing over 38,000 deaths from strokes and heart disease, 24,000 of which would have been premature,” adds Davies.
What are the options?
Potassium salts are not the only viable solution to salt reduction, however – other options include naturally lower-sodium salts, micro granules covering a greater surface area, and other manufacturing and processing solutions. As Davies puts it: “Many food businesses try to match flavour with existing salt profiles, but health by stealth is the overarching approach that would allow consumers’ taste buds to adjust over time with the reduced saltiness of a product.” NuTek Natural Ingredients, for example, offers several sodium reduction options under the brand names Salt for Life and Beyond Salt, including culinary salt options such as Beyond Sea Salt and Beyond Himalayan. Using its own patented process, the bitterness associated with potassium salt has been effectively removed. It can easily be blended with salt yet get the desired sodium reduction in foods at the same time. While many countries have been late to the sodium-reducing party, Japan has been promoting umami for a number of years. Literally translated as ‘delicious savoury taste’, it was discovered in 1908 by Kikunae Ikeda, a professor of chemistry at Tokyo University. He found that glutamate, a flavour-enhancing amino acid, was what gave dashi (a broth made from water, konbu and dried fish) its distinct taste and named it umami. Glutamates then react with ribonucleotides, another naturally occurring chemical in foods, to multiply and magnify flavour. Cooking, drying and fermenting all release these amino acids, resulting in increased levels of umami. The key takeaway argued is that rich umami allows for a reduction in sodium content of food without sacrificing taste. Unsurprisingly, it is now produced by a number of companies locally, including Umami United Japan Co and the Wasabi Company.
Even if the voluntary nature of salt reduction programmes globally acts as an impediment to overall progress, there remains hope as more countries implement legislated salt targets. “Evidence from South Africa for example, shows that in just five years, their legislated targets had led to a large fall in population salt intake, with the biggest falls occurring in the most deprived groups,” says Davies.
In short, if South Africa can show a successful salt reduction programme, what’s stopping other countries, including the UK, from following suit? ●
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