The war on sugar and fat has caused plenty of casualties, with government plans to ban junk food ads online likely to hit big food where it hurts – the pocket. But in our fixation on fatty foods and sugar-encrusted treats, we’ve lost track of an equally big enemy: salt.
The average British adult eats 40 per cent more salt every day than they should, according to data from Public Health England. Men consume 9.2g per day of the white stuff, with women managing to eat 7.6g. The average of 8.4g per day is down a gram from 2003, shortly after the Government introduced a national salt reduction programme trying to dissuade us from reaching for the shaker, but it’s still too high. The goal, as set out in Government documents, is to bring down our consumption of salt to just 6g a day. More worryingly, in a world where momentum is everything, progress in the fight against salt has stalled: no statistically significant change in salt intake has been recorded between 2014 and 2018-19, the last time data was collected.
The standstill has alarmed campaigners and academics, who have warned that the good work done in the last two decades – which will have prevented 200,000 cases of heart disease, saving £1.64 billion of NHS resources by 2050 – needs to continue. “To some extent salt has lost out in the war against fat and sugar,” says Professor Graham MacGregor of Queen Mary University of London, who forecast the cost and life savings.
“Raised blood pressure is the biggest cause of strokes and heart attacks,” says MacGregor, who is also the founder of Action on Salt, a pressure group set up in 1996. High blood pressure is the underlying cause behind 60 per cent of all strokes and 50 per cent of all heart disease in the country. Heart disease is a major killer: “It causes a quarter of all deaths in the UK and is the largest cause of premature mortality in deprived areas,” says Dr Stacey Lockyer, senior nutrition scientist at the British Nutrition Foundation.
“If there’s one thing you can measure successfully that predicts someone’s life expectancy apart from their age, it’s their blood pressure,” says MacGregor. “The major factor that puts up blood pressure is high salt intake. Without salt, millions of people would not have high blood pressure. So cutting salt intake is a major way of lowering blood pressure in the population. It has an amazing effect on reducing strokes and heart disease.”
That connection between salt, high blood pressure and the health issues it causes is what caused the Government to instigate its salt reduction programme in 2002. “This programme worked extremely well,” says MacGregor. “We set targets for each food group: for instance, bread, which is the biggest source of salt in the UK diet, had a target which they had to get below within four years. Then when they were getting near the target, we reset it again to a lower level. Those targets have been reset now four times.”
The initial programme managed to reduce the salt intake in the average product in supermarkets by anywhere between 20 and 40 per cent in 15 years. Other countries around the world followed the UK’s lead, introducing their own salt reduction programmes, modelled on ours, that have now bypassed our successes.
The reduction in salt within the industry is important, because most of the salt we consume is added to food during processing, with bread and cereals among the worst offenders. Around a fifth of our salt intake comes naturally in the food we eat – think of salty fish or naturally-occurring sodium in meat and vegetables. A similar proportion is added at the table by us after cooking, or during the preparation of meals. “Salt can play many roles within food products such as acting as a preservative, enhancing the texture and juiciness of some foods, enhancing flavour and for structural properties such as improving elasticity in bread,” says Lockyer.
Meeting the targets was policed by the Food Standards Agency, but Andrew Lansley, then health secretary, removed oversight of the salt reduction programme, trusting food companies to do it themselves. “The food industry can do it, it’s just a question of getting them to do it,” says MacGregor. “There’s no reason for them to do it if they’re not being told to.”
He calls it a “tragedy” that salt reduction has juddered to a halt. “It’s such an easy policy,” he says. “The vast majority of people in the UK have no idea that bread, sausages, bacon, cheese have all come down in the amount of salt added because if you do it slowly, you get used to it, so you don’t notice the difference in taste.”
MacGregor believes it would be easy enough to kickstart the programme again in a meaningful way. “All it needs is Matt Hancock to say: ‘We’re going to do this: if you don’t, we’ll legislate,’ and bang,” says MacGregor. “We showed the world this could work, and now we’re being left behind because we have second-rate politicians leading us.”
So if food manufacturers won’t bring down the salt content, and our politicians have other issues on their plate, how can we shake the stuff? “The simple way of reducing the amount of salt in your diet is eating more fresh produce,” says Duane Mellor of the British Dietetic Association. “If you’re eating fresh meat, dairy products, and fruit and vegetables, that’s very low in salt. Most frozen foods won’t have added salt to them – unless they’ve been processed, like things in breadcrumbs.”
Likewise, Mellor recommends avoiding adding salt during and after cooking wherever possible. “Try and use herbs and spices first, then taste the food,” he advises. “If it does need a little bit of salt to balance the flavours, use as little as possible.” For those who don’t have kidney problems, low-sodium salt alternatives, which use potassium chloride, rather than the traditional sodium chloride, can also help wean you from the problem – though the swap to potassium can clog up kidneys for those with pre-existing issues.
And don’t buy into the hype about there being “healthier” salt, either. Mellor pooh-poohs claims that rock salt or sea salt is less damaging to health because it contains trace elements of other minerals that dilute the sodium content: it’s too minimal an impact. “As for Himalayan pink salt, it looks pretty and what causes some of that pinkness could be dead bacteria, so it’s possibly not healthy,” he says. “Sugar is sugar, salt is salt.”