Salt, damned lies and statistics? UK's reformulation success challenged

By Niamh Michail contact

- Last updated on GMT

Salt, damned lies and statistics? UK's reformulation success challenged
The UK’s food industry is congratulating itself on the success of voluntary salt reduction after a government survey shows average salt intake has fallen, but the figures are being questioned by public health campaigners.

The amount of salt consumed by British adults fell by 0.9 g per day between 2005 and 2014, according to figures released yesterday from the National Diet and Nutrition Survey​.

This means an 11% decrease since the first 2005 survey where average intake was 8.8 g. According to Public Health England (PHE), the body which advises the UK government on policymaking and which commissioned the survey, levels then decreased to 8.5 g in 2011 and 8.0 g in 2014.

The survey analysed the sodium levels in 24-hour collection urine samples of 689 adults aged 19 to 64 years in England. While the sample was intended to be representative of the population, the report notes the number of participants in the youngest age bracket was low.

Although this still puts average intake well above the recommended maximum daily intake of 6 g per day,  chief nutritionist at PHE, Dr Alison Tedstone said there is a clear downward trend in salt consumption.

Tim Rycroft, corporate affairs director at the Food and Drink Federation (FDF), credited this downward trend to food and drink companies that were driving much of the progress through voluntary recipe changes.

Success or status quo?

However, the findings have been disputed by campaign group Consensus Action on Salt (CASH) which says the survey results highlight that Brits are in fact eating the same amount of salt they did three years ago - 8.1 g per day in 2011 compared with 8.0 g per day in 2014.

“[Public Health England] state that salt consumption was 8.5 g per day in 2011, however the previously published result by the National Diet and Nutrition Suvey is 8.1 g per day and they’ve used the same methodology in both 2011 and 2014. Between these years, there has been no fall in salt intake. It is unclear how Public Health England recalculated the result that was previously published at 8.1 g per day to 8.5 g per day.”

However, PHE has defended the analytical techniques used. Alison Tedstone said: “PHE used the latest analytical techniques to generate the most recent data and applied an algorithm to previous data to make them all directly comparable. It gave us the most accurate assessment of how much salt consumption has reduced in the last decade.”

Foodservice in the spotlight

All are agreed that more action is required to push intake further down. Tedstone said: “The majority of the salt we eat is in everyday foods so it’s important to check labels and choose lower salt options. Many manufacturers and retailers have significantly reduced the salt levels in everyday foods. However, more needs to be done, especially by restaurants, cafes and takeaways."

Rycroft acknowledged that the rates of reduction have slowed down in recent years, adding that producers of packaged foods are finding it harder to further reduce salt without compromising product safety, quality, taste or shelf-life. “Continued public education and action from more companies across the food industry is needed to drive further progress,​” he said.

FDF is waiting on the publication on a report, due in 2017, by the Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity (COT) on whether potassium-based salt replacers are suitable for salt reduction.

In the meantime, FDF has also called on restaurants, cafes and takeaways to step up their game in reducing salt. “Salt reduction in foods eaten out of the home would also help people to adapt to a less salty taste, which has an additional benefit of helping producers of prepared and packaged foods to overcome consumer acceptance challenges,”​ the trade group said.

CASH attributes the static salt intake levels to the derailing of a successful industry-wide collaborative salt reduction programme started in 2005 which set targets that, although voluntary, were closely monitored by an independent committee. The Conservative government’s Responsibility Deal later allowed the food industry to monitor its own progress which, CASH says, meant companies abandoned efforts, costing the country five years of effective salt reduction. “This is a national tragedy as for every gram of salt reduction saves approximately 6-7,000 deaths per year from strokes and heart disease, 4,000 per year of which are premature,” ​says the group.

According to the British Heart Foundation (BHF), cardiovascular disease - linked to a high salt intake - causes 155,000 deaths in the UK and costs the British economy £19bn (€24) each year. 

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1 comment

Do urinary sodium levels correlate to blood pressure

Posted by Mythbuster,

The key test of the benefit of sodium reduction is not whether there has been a reduction but whether there is actually any correlation between urinary sodium and blood pressure.

If we are using blood pressure as a surrogate for cerebro-vascular adverse events and are using salt as a surrogate for blood pressure then we are using salt reduction as a double surrogate.

Is this really how we run public health evidence based policy?

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