The forum, available on demand here, brought together three salt reduction experts, Professors Franco Cappuccio, Jack Winkler, and Graham MacGregor, with FoodNavigator’s science editor Nathan Gray.
Average UK salt intake has fallen about 15% since the introduction of a national campaign to cut consumption, with salt content in some food categories falling by 40-50%. However, the average British intake is still more than 8 g per day, so there is work to be done to reach the UK’s per capita target of 6 g and the World Health Organisation’s 5 g target.
During the debate, Winkler pointed to two major challenges for the gradual salt reduction strategy: “that the companies and the politicians will have the persistence to stick with it over a couple of decades, and also that public health specialists will have the patience not to try and rush it too fast and to alienate consumers in the process.”
“So it’s a very successful programme… and it has problems ahead,” he said.
One of these challenges is reaching the poorest members of society, who tend to have the highest salt consumption levels.
Cappuccio has analysed data revealing these social inequalities in salt intake over time. Even though salt consumption has come down, his team found a difference of about 5-7% in salt intake of those with the lowest socio-economic status, compared with those with the highest, even allowing for geographic variation.
He said: “The worst off are subjected to greater risk of eating bad food and that includes bad food with high salt.”
However, it seems that the food industry’s efforts are paying off. “There was a very big social inequality ten years ago and, ten years down the line, all have reduced salt intake. We calculated that two-thirds of the reduction is a result of reformulation – although the difference between rich and poor is still there,” he added.
MacGregor said that the ability to target the whole population was “one of the beauties of reformulation”, but added: “We need to look again at the salt targets to work out if there’s some way we can angle it even more to the poorest in the community, because Franco’s right, they have the greatest need.”
Salt and health
When asked about doubts cast on the evidence linking salt to heart disease and stroke risk, Cappuccio said (pun intended): “I would take it with a pinch of salt…We need to talk about how to reduce salt and not whether to reduce salt.”
“Honest people may honestly disagree, but there is more to it than that,” added Winkler. “…The evidence is overwhelmingly on the side of salt reduction but as a social phenomenon, as a communications problem, we have to deal with these disagreements.”
Five grams a day?
All three experts agreed that the WHO’s 5 g average salt intake target was ambitious, but achievable.
Cappuccio said: “We may reach it in 30 or 40 years, it doesn’t matter, I think it is a much safer level.”
MacGregor added: “We will hit the 6 g target by 2020, but the lower the salt intake the better.”
Winkler applauded the UK’s salt reduction programme for a job well done, and added: “If we have the persistence to carry on for 30 years, we’ll get there. It’s a feasible strategy. All we have to do is keep doing it gradually and quietly and we’ll carry people with us.”