Reducing salt intake

WHO/Faith Kilford Vorting

Reducing salt intake is a crucial factor in lowering the risk of cardiovascular diseases (CVD) in the WHO European Region.

In many countries in the WHO European Region, more than two thirds of all salt consumed is hidden in processed foods and snacks or food products (such as bread and cheese). In addition, some fast food chains and other restaurants are key suppliers of foods high in salt as well as fats and sugars.  This means that only approximately 20% of salt intake is under the control of the consumer: many people are unaware of how much salt they are consuming, and are not able to cut their salt intake.

The dangers of salt intake

Although an essential mineral needed for our bodies to function, people in the European Region consume too much sodium as part of salt.

In 2008, CVD caused 42% of deaths in the WHO European Region. Today salt consumption is considered one of the leading risk factors of noncommunicable diseases and more specifically CVD.

Research has shown that high salt intake across all age groups results in heightened blood pressure. Children are particularly susceptible to salt taste habituation, which can spur increased demand for highly salted products and initiate life-long behavioural trends. The occurrence of high blood pressure during childhood is likely to continue into adulthood thus increasing the risk of hypertension and CVD in later life.

Despite strong evidence of the benefits of salt reduction, a proportion of the food industry remains reluctant to take up salt reduction programmes for commercial reasons.

What can be done?

Worldwide research has shown that a reduction in salt intake by approximately one half (to the recommended level of 5 grams/day for adults) would result in a 24% decrease in strokes and an 18% decrease in coronary heart disease.

WHO/Europe has listed salt reduction as one of the five priority interventions in the most recent Action Plan for the implementation of the European Strategy on the Prevention and Control of Noncommunicable Diseases (2012-2016).

In recent years there have been numerous successful strategies and salt reduction programmes initiated in the WHO European Region.

Targets set by programmes such as the EU Framework for National Salt Initiatives largely focus on food industry products such as ready meals and meat products, bread and cheeses. Eleven countries in the European Union have agreed to reduce salt intake by 16% between 2008 and 2012.

As part of the WHO Global Strategy on Diet, Physical Activity and Health (DPAS) and the Action Plan for Prevention and Control of Noncommunicable Diseases, three objectives have been set, namely to create enabling environments which facilitate consumer behavioural change re. certain food choices, support the evaluation and monitoring of dietary salt intake, and facilitate the review of salt as a vehicle for fortification to prevent iodine deficiency disorders (IDD).

However, there is still much progress to be made in terms of public awareness, behavioural change, and reducing salt in processed foods.

Country examples

Two of the most successful salt reduction programmes in the Region have taken place in the United Kingdom and Finland.

In 1996, medical and scientific experts in the United Kingdom created Consensus Action on Salt and Health (CASH). This has resulted in significant efforts to lower the levels of salt added to food products by the food industry. Considerable reductions in the salt content of processed foods (up to 30% in certain foods) have already been achieved. Clear labelling of the salt content of all processed foods is an additional feature of the United Kingdom programme, which enables consumers to make more informed decisions when purchasing products.

In Finland, the North Karelia project launched over 30 years ago has received international recognition for its impact on CVD risk factors such as high blood pressure. The population-wide sodium interventions initiated by the project have seen salt intake reduced by one third with a collaborative effort from the food industry and the health and community services.

The success of these programmes is grounded in their intersectoral, multidisciplinary approach which involves public education and engagement alongside the reformulation of products by the food industry, as well as the support of health services.