Action on Salt has published studies which it says provide new and strong evidence to support salt reduction as a key public health strategy to lower blood pressure and reduce the risk of strokes and heart disease in the UK and worldwide.
On the back of the studies, the campaign group wants the new voluntary salt reduction targets currently under consultation by Public Health England, which it plans to publish later this year, to be made mandatory.
The analysis included 133 randomised trials with 12,197 individuals looking at the effect of salt reduction on blood pressure and showed that salt reduction lowered blood pressure across the whole population, including those with blood pressure within normal ranges. Furthermore, the greater the reduction in salt intake, the greater the fall in blood pressure.
This study, according to the authors, also showed that people who are older, have higher blood pressure, or of black ethnicity, had an even bigger fall in blood pressure for a given reduction in salt intake, with longer term reductions likely to have a greater effect.
Action on Salt claim these findings are important as they indicate that population-wide reduction in salt intake should lower population blood pressure which in itself will cause a large reduction in strokes and heart disease and, at the same time, it is likely to prevent people from developing high blood pressure as they get older.
A second review by researchers at the Wolfson Institute, Queen Mary University of London and Action on Salt and recently published in the JACC (Journal of the American College of Cardiology) (18 Feb 2020) entitled ‘Salt Reduction to Prevent Hypertension and Cardiovascular Disease: JACC State-of-the-Art Review’ looked at almost 200 published studies. This found that a high salt intake is the major cause of raised blood pressure, which in itself is the leading cause of strokes and heart disease, the biggest causes of death and disability in the UK. Too much salt is also closely linked to osteoporosis, stomach cancer, and kidney disease.
'Setting targets without enforcement won't work'
In 2016, Public Health England assumed responsibility for UK salt reduction, and on 6 February 2020 announced a new set of draft voluntary salt targets. However, setting targets without enforcement is unlikely to work, said Action on Salt – as demonstrated by the failed Responsibility Deal and the lack of progress made by the food industry on the previous set of targets.
It wants a clear and transparent monitoring programme implemented to include annual progress reports and strong engagement with the whole sector, along with case studies of successful reformulation to aid industry-wide reformulation.
Professor Graham MacGregor, professor of cardiovascular medicine at Barts and the London Hospital and Queen Mary University of London, chairman of Action on Salt and co-author of the review, said: “Salt reduction has been identified as one of the most cost-effective strategies to reduce strokes and heart disease. From 2005 to 2011, the UK led the world with an effective, coherent salt reduction policy, by getting the food industry to slowly reduce the huge and unnecessary amount of salt they add to our food.
“This led to a reduction in population salt intake and fall in population blood pressure, with major reductions in stroke and heart disease deaths. Since 2011, the government has failed to continue this policy and the new government must now force the food industry to start making further reductions in the amount of salt they add to our food, either with legislation or financial penalties for those who fail to comply.”
Action on Salt also called for stronger engagement with the Out of Home sector and for an independent nutrition agency modelled on the previous FSA.
Professor Feng He, lead author of the review and researcher at Queen Mary University of London, said: “The totality of evidence in the JACC review and this latest BMJ research shows that reducing our salt intake will be immensely beneficial. Salt-reduction efforts should be reinforced in the UK and worldwide to save millions of people suffering and dying unnecessarily from strokes and heart disease each year.”