WHO adviser: Laws needed to cut salt, save lives

Franco Cappuccio, head of the WHO’s collaborating centre for nutrition, said voluntary moves by the food industry had brought some progress, but lawmakers should now harness the scientific evidence on salt and seek to change the tastes of nations.

“There is now a total acceptance that salt is bad for us, we eat far too much of it, and it should be reduced,” Cappuccio told reporters in an interview.

“So there is great scope now to consider a regulatory approach to reinforce and sustain the voluntary moves.”

But Cappuccio, a professor of cardiovascular medicine at Warwick University, where the WHO’s nutrition centre is based, said powerful lobbying from the food and drink industry, whose profits are swelled by added salt, have slowed efforts to bring consumption levels down.

Cutting salt intake substantially reduces blood pressure, helping to lower the risk of heart attacks and strokes. High blood pressure is ranked as the the world’s number one killer, accounting for 7.5 million deaths a year.

A 2007 study which analysed all the available evidence at the time found that reducing salt intake around the world by 15 percent could prevent almost nine million deaths by 2015.

Another study in March found that cutting salt intake by just 10 percent in the US could prevent hundreds of thousands of heart attacks and strokes over decades and save the government $32bn in healthcare costs.

There is little doubt that we eat too much salt. In Britain, average adult intake is around 8.6 grams per day, while in the US it is around 10 grams, almost twice the amount suggested by the WHO.

Even the WHO recommendation of five grams a day is far more than we actually need, which is only around 1.5 grams.

Profits swelled by salt
“Most of the salt eaten in the western world – in fact around 80 percent of it – comes from salt added to food from food manufacturers, and only around 20 percent comes from the salt cellar or the salt we use in cooking,” Cappuccio said.

“In terms of consumer freedom we have effectively no choice. At the end of the day, multinationals feed most of the world.”

Food manufacturers use salt to enhance the flavour of food that might otherwise be tasteless, to increase thirst and then seek to quench it with fizzy drinks, and also to boost profits from meat products, which are injected with a solution of salted water to plump them up and add weight.

In the worst cases, Cappuccio said, injected salt water makes up as much as 30 percent of the weight of a product like a chicken breast fillet.

“That 30 percent is pure profit [for the manufacturer],” he said. “We need to start a programme of reformulation of food items. But that’s the really tricky part, because that requires the food industry coming on board.”

But he pointed to some positive steps.

In the US, the New York City Health Department is leading a “National Salt Reduction Initiative”, bringing cities, states and health organisations together to work with food manufacturers and restaurants to try to reduce Americans’ salt intake by 20 percent over five years.

In Britain, it is partly due to public health campaigns and the efforts of the Food Standards Agency (FSA) to work with food makers to cut salt and give clearer labelling that intake levels have come down to 8.6 grams per day average from around 10 grams a day around 10 years ago.

“We know from scientific studies that if you reduce your salt intake by a little amount every day or every week or every month…then you can retrain your taste buds,” Cappuccio said.

“So we really can retrain people – whole populations – to enjoy food with less salt in it.”