A pinch of salt? The need for consumer awareness and industry reformation in salt intake
The January Nutrition Society Paper of the month is from British Journal of Nutrition and is entitled ‘Fewer adults add salt at the table after initiation of a national salt campaign in the UK: a repeated cross-sectional analysis’
The UK Food Standards Agency’s consumer awareness campaign and trends in discretionary salt use
There is a strong body of evidence that links high dietary salt intakes to hypertension, which is a major cause of cardiovascular disease. The UK Food Standards Agency (FSA) and the Department of Health have been working since 2003 to reduce the salt intake of the UK population to no more than 6g per day. The strategy has involved reformulation of processed foods together with consumer awareness campaigns informing consumers why a high salt intake is harmful to health and what can be done to reduce salt intake.
Our study investigated the impact of the first phase of the FSA’s consumer awareness campaign which happened in 2004 on self-reported salt use at the table in England. We analysed data from large cross-sectional datasets from the Health Survey of England collected between 1997 and 2007. Our analysis found that there was great variability in discretionary salt use in England: men use more salt than women, and people living in the north of England and those in poorer income groups also use more salt. Interestingly, we found that there was a steady decline in salt use at the table over the period 1997-2007. While it is difficult to prove causality, this decline was significantly greater after the introduction of the salt campaign in 2004 (even after controlling for age, sex, ethnicity, total household income, region, and background trends).
Previous evaluations of the campaign have revealed increases in both public awareness of the salt campaign and the selection of processed foods based on their reported salt content. The FSA’s own analyses of 24h urinary sodium excretion levels suggest a reduction in mean population salt intake from 9.5g per day in 2001 to latest estimates of 8.6g per day in 2011. This study provides additional supportive evidence and is indicative of a positive effect of the FSA’s salt campaign on reducing the prevalence of salt use at the table in England.
Despite the positive findings of this analysis, it is recognised that changing consumer behaviour forms only part of a national strategy to reduce population salt intake. A large proportion of dietary salt comes from processed foods and reformulation in industry has proved to be a particularly successful approach. Together with the observation that the mean UK salt intake remains far above the target level of 6g per day, further efforts with reformulation in industry are needed. It is also clear that the observed differences in reported salt use at the table between population subgroups mean that future campaigns may benefit from more tailored approaches to reducing the salt intake of the UK population.
Nutrition Society Paper of the Month
Each month a paper is selected by one of the Editors of the five Nutrition Society Publications (British Journal of Nutrition, Public Health Nutrition, Nutrition Research Reviews, Proceedings of the Nutrition Society and Journal of Nutritional Science). This paper is freely available for one month.