Government derailed salt reduction leading to 6000 deaths

By Niamh Michail

- Last updated on GMT

UK salt reduction derailed by government causing 6000 deaths

Related tags Salt reduction Food industry Responsibility deal Nutrition

A pioneering salt reduction scheme was derailed by the UK government leading to 6000 preventable deaths, says Consensus Action on Salt and Health (CASH).

In a report published today​ in the British Medical Journal​, CASH claimed the scheme – a collaborative effort with the food industry which set salt reduction targets for 86 categories of food – had slashed stroke deaths by 42%​ and heart disease by 40% in eight years.

It achieved this by gradually reducing salt in food by 20-40% since its inception in 2005 - without harming industry sales and without the public noticing a difference in taste.

But under the coalition government's Responsibility Deal of 2011, secretary of state for health Andrew Lansley transferred responsibility for nutrition from the independent Food Standard’s Agency (FSA) to the food industry itself.

Derailed by the Responsibility Deal    

CASH claimed that Lansley refused to renew a target for 2014 and withdrew funding to help industry overcome the technical difficulties associated with food reformulation.

The deal also enabled the food industry to present its own feedback, which made the information harder to analyse.

The responsibility deal seemed to be a way of getting the food industry involved in improving nutrition without the Department of Health having to take much responsibility. This gave the food industry the potential to make exaggerated claims on what they were achieving,​” said the report.

As a result, four years of the salt reduction programme were lost.

The National Institute for Clinical Excellence (NICE) estimated that had the targets been maintained, industry would have reached a salt reduction target of 0.9 grams per day today - corresponding to around 6000 preventable deaths, of which 4000 would have been premature.

In the 7-8 years that the FSA and CASH's salt reduction scheme was in place, the salt content in bread — the biggest contributor of salt to the UK diet — fell by 20% from 2001 to 2011. 

On the back of this success, it was copied by other countries including the US, Brazil and Canada.

Labour: We will set maximum limits

The Labour party hit out at the Responsibility Deal saying it added to growing criticisms of the Tory-Lib Dem government’s public health record. 

Luciana Berger, Labour's shadow public health minister, told FoodNavigator:  "Nearly two-thirds of adults and a third of children in England are overweight or obese, affecting the life expectancy of millions and hitting our NHS with a £5 billion bill every year. 

"Yet instead of taking the bold action that we desperately need, ministers, with their voluntary Responsibility Deal, have allowed commercial interests to dictate their public health policy.” 

She said that Labour pledged to take decisive action against the obesity crisis by setting maximum limits on sugar, fat and salt in food that was predominantly marketed to children. 

Give industry ‘a level playing field’

Professor Graham MacGregor, professor of cardiovascular medicine at Queen Mary University of London and leading author of the report called for mechanisms to control the food industry – "the single biggest cause of death and ill health in the UK"​ – in a similar way to the tobacco industry.

The report also said that industry desire to reformulate was there – but that enforcement was essential to its success.

“It is imperative that responsibility for nutrition be handed back to an independent agency, where it is not affected by changes in government, ministers, or political lobbying.

Members of the food industry have said that they are keen to reformulate their foods to make them healthier. All they require is to be on a 'level playing field' with the other major companies, so that they can make their foods healthier in a structured, incremental way.

Although targets for 2017 have been set there has been a poor sign-up so far, with major companies such as Unilever, McDonalds and Kellogg’s failing to commit.

The UK election will take place in May. 

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There is nothng wrong with having salt if .....

Posted by Sylvia,

The fact is that there is nothing wrong at all with having as much salt as you like, as long and you have normal kidneys and cardiovascular system.
There is no proof that salt causes hypertension.
On the other hand, if you have hypertension or problems with your kidneys or cardiovascular system then you should not have excessive salt. It's as simple as that.

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How have we let this happen

Posted by Mythbuster,

Would Graham McGregor be the same bandwagon driver who has also hopped on to the sugar bandwagon. Such a breadth of expertise.
I have been challenging the supposed science gushed forth by CASH for years, but when they get so close to the FSA that their Director is the FSA "Expert" there is something wrong. Likewise I would ask anyone investigating salt and hypertension to look at the supposed pivotal DASH sodium trials and ask what role chronic potassium under nutrition may have played. At least it was a investigative clinical study as oppose to the usual epidemiological study.

In any other area of public health proof of benefit is required before treatment is administered. Where is the actual proof of any reduction in cardiovascular event through salt reduction? I can't find any.

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Take this one with a grain of salt

Posted by David Feder,

What absolute rubbish. Since salt/sodium and HTN/CVD first began being studied in 1942, the greater part of the "boots on the ground" science has failed to establish a definitive connection between dietary sodium intake and disease in healthy persons. This isn't opinion; this is what looking at the results of the hundreds of properly conducted and controlled studies will tell anyone who bothers to read the science rather than hop on the salt-bashing bandwagon. (Keep in mind, for every properly conducted and controlled study, there are at the very least an equal number of poorly conducted and uncontrolled studies out there.) CASH has a history of sensationalism and manipulation of data to promote its own agenda. Rather than giving its politically hysterical pseudoscience a platform, next time perhaps try asking its representatives to provide science-based proof of their assertions beyond misrepresented statistics.
For the record, I have no stake in the salt industry beyond a profound distaste for bad science and even greater distaste for bad science trumping good science in the media. Nutrition science -- any scientific discipline -- should not be a matter of "Whomever is loudest is correct." Meanwhile, for anyone wishing to respond to this, please read at least a couple hundred of the studies first (the results, not just the conclusions). Start with the DASH II. Better, start with the 2010 Adam Bernstein-Walter Willett Harvard School of Public Health study that showed sodium consumption in the American diet to be unchanged after more than half a century…yet incidence of hypertension to have risen dramatically. It's a great 30,000' view of cause and effect disharmony.

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