Salt: The forgotten pandemic

Mhairi Brown, Policy and Public Affairs Manager for Action on Salt, stresses the need for Public Health England to implement a strict and ambitious salt reduction policy

COVID-19 has completely changed life in the UK and has quite rightly demanded our attention and action to protect our loved ones, communities and businesses. But way before this, there was the forgotten pandemic i.e. eating too much salt (and otherwise known as the silent killer) which leads to thousands of needless, preventable deaths each year.

Extensive research from leading experts around the world has found that too much salt leads to high blood pressure, heart disease, stroke, kidney disease and even osteoporosis. In October, the Global Burden of Disease Study highlighted once again that poor diets are a leading cause of death and disability worldwide, with salt being Enemy Number One, leading to 2 million deaths in 2019 alone. Shocking statistics they may be, but these are well-known figures to us.

Salt reduction policy

Since the late 90s, we’ve been calling on the Government and the food industry to reduce levels of salt in food to help the population eat less salt. Initially, they listened: the phrase ‘world-leading’ has been used by politicians so much over the past few months it’s almost lost all meaning. But the UK really did have a world-leading salt reduction policy – it was THAT good. Salt levels fell in everyday products – breakfast cereals, bread, ready meals, cakes and biscuits – by up to 50%. Average blood pressure fell, as did deaths from cardiovascular disease. More than 80 countries now have salt reduction programmes that mirror ours. The National Institute for Health and Care Excellence estimated that 6,000 lives were saved each year, 500 per month, 16 per day – saving the economy a massive £1.5 billion annually.

The UK was riding high. That is until responsibility for salt reduction was moved from the Food Standards Agency to the Department of Health and Social Care and their Public Health Responsibility Deal in 2011. After the Deal was dissolved in 2015, salt was moved once again to Public Health England who found that although some responsible companies and retailers had maintained momentum – across the board, food industry progress with salt reduction had most definitely waned. Salt intake figures from the National Diet and Nutrition Survey held further bad news: salt intake has not fallen for ten years, and at 8.4g per day is 40% higher than our recommended daily limit.

For several years we’ve had far more success setting up salt reduction programmes in Portugal, Malaysia, China, South Africa than we have had in convincing policymakers and the food industry to listen and take meaningful action on salt in the UK. Where once the UK was world-leading, now we’re trailing behind. This summer, Public Health England became political roadkill, meaning responsibility for salt reduction is once again up for grabs.

“That’s all very well”, I hear you cry, “but why should we focus on salt right now?”. In March I would have agreed with you – this was not the time to be fighting a battle against the constant tide of salty products and restaurant dishes. That is, until the evidence started to show that people with pre-existing health conditions appeared to be faring worse in their battle with the virus. High blood pressure is classed as one of those pre-existing health conditions. And what has the biggest impact in raising our blood pressure? You guessed it: Enemy Number One.

Whatever happens next with Public Health England, the future must include a strict and ambitious salt reduction policy. Voluntary programmes have seen their day: now is the time to mandate targets and implement levies. The political will seems to be there – in 2019, the Health Secretary’s own Prevention Green Paper placed salt front and centre. Without a doubt, we must do all we can to tackle COVID-19, but salt has been left off the agenda for far too long. With strong, independent monitoring and mandatory targets, we have real potential to make some progress, get back on track and bring meaning back to ‘world-leading’.