Sodium reduction
been consuming too much, generation after generation. We all need sodium in our diet, but excess sodium contributes to cardiovascular disease, pancreatic cancer, diabetes and more.” “Salt is the silent killer,” he adds. “One challenge is that there has not been a solution apart from not eating it, and it is hard to buy food that is salt-free. So, how do you lower sodium in your diet and still have food that tastes good? If you make a cheap product and load it with salt to make it taste good, then that is a problem.”
The WHO is targeting a 30% relative reduction in mean population sodium intake by 2025, with a parallel goal of a 25% relative reduction in the prevalence of raised blood pressure. Many countries, including the UK, Mexico and Canada, are setting limits on suggested intake, and there is a general acceptance worldwide that sodium must come down – especially for children in their formative years – and that this would be one of the most cost-effective ways to improve public health. Progress, however, is slow.
“The problem is that most of the salt we consume is already added in the foods that we buy, and you can’t easily change the dietary habits of an entire nation,” says Sonia Pombo, research fellow at Queen Mary University of London, and campaign lead for Action on Salt. “We are time-poor, so we cook less from scratch at home and are very reliant on foods we buy in the supermarket. For that reason, a lot of responsibility lies with food producers.”
The tools to tackle salt
Changing the way people choose or prepare food is no easy task, but there are many levers that can be pulled to influence behaviour in small ways that, over time, add up to major change. Alongside media campaigns to raise awareness, governments can set targets – the UK is currently advising an intake of less than 6g of salt per day – and legislation can impact the way food manufacturers formulate and sell their products. Front-of-pack labelling (FOPL) is another important tool, putting information on sodium content front-and-centre to influence consumers’ purchasing decisions. Back in 2020, Mexico’s health ministry introduced a rule mandating a FOPL system for all packaged foods to warn consumers about products exceeding strict thresholds for sodium, caloric content, added sugars and saturated fats. Salty snack brands, for example, must prominently display an ‘Excess Sodium’ message when there is more than 350mg of sodium per 100g of product. The challenge, in Mexico and across the world, is to reduce sodium levels without impacting the taste of a product, as a noticeable difference in
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flavour could have a significant impact on sales. “We support more transparency on labelling, and the traffic light labels used in the UK have been very good for making people aware of what they are consuming,” says Pombo. “Consistent labelling makes consumers more aware of sodium content, and encourages food producers to reformulate, as they don’t want a red light on the label for salt.” For food manufacturers, there is a fine line to tread between health and flavour. One suggestion that has gained traction in recent years is to substitute potassium chloride (KCl) for sodium chloride (NaCl). Indeed, a number of randomised controlled trials have shown that potassium- enriched, sodium-reduced salt substitutes are effective for reducing sodium levels and, by lowering blood pressure, also reducing rates of cardiovascular events and death. Problem solved? Well, not entirely. Apart from the many challenges involved in creating robust and reliable global supply chains for KCl on a sufficient scale to replace NaCl, potassium chloride raises its own concerns. While KCl is ‘generally considered as safe’ by the US Food and Drug Administration (FDA), it comes with risks. Apart from the fact that some consumers report an unusual or unpleasant metallic taste, health risks emerge if healthy people completely replace NaCl with KCl, as the body does need sodium. Furthermore, people with chronic kidney disease should avoid potassium chloride, as it may prevent their kidneys from being able to expel excess potassium from the blood. Also, if a person is at risk of hyperkalaemia – an excess of potassium – or if they have conditions such as type 1 diabetes, then substitution may not be the best approach. “In some countries, potassium chloride carries a health warning,” says Guiney. “Often, it is a by-product of potash mining, which is not very
One suggestion to reduce intake is to substitute potassium chloride for sodium chloride.
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