A salty world: salt reduction initiatives worldwide
Recently our UK charity was in the news about the number of UK cases of stomach cancer that could be prevented by cutting salt intake to the recommended daily amount of six grams. The levels of interest from the UK media prompted us to explore what is happening with salt intake globally.
Salt is necessary for human health and life itself but in wealthier countries where the consumption of processed foods is high, and in countries where traditional diets are high in salt, total salt intake is at much higher levels than is healthy.
With refrigeration and canning processes the need to add salt as a preservative is greatly reduced. However, high levels of salt are still being added in processed food and in food consumed out of the home.
Latest figures indicate that average salt intake varies across the world, from 5g to 18g per person per day (see Table below), often at levels that can increase our risk of health problems.
|Country||Baseline salt intake (g per person per day)|
|Hungary||16 – 18|
|Barbados||12 – 15.0|
|South Africa||8 – 10|
|Australia||6.5 – 12.0|
(Source: Brinsden and Farrand, 2012)
How does this relate to cancer?
Salt and salt-preserved foods can be a cause of stomach cancer. Infection with the bacterium Helicobacter pylori is established as a necessary cause of almost all cases of stomach cancer but the risk of developing stomach cancer is increased by salt consumption.
Cancer of the stomach is the fourth most common type of cancer worldwide. Around one million cases of stomach cancer were recorded in 2008, accounting for around 8 per cent of all new cancer cases. It is predicted that the number of cases will rise to 1.7 million by 2030. Incidence rates are about twice as high in men as in women.
Which countries have taken action on salt?
The World Health Organization (WHO) identifies salt reduction as a priority intervention.
Margaret Chan, Director General of the WHO noted that it is ‘one of the most cost-effective, feasible and affordable health interventions’.
The UK is seen by many to have led the way in salt reduction, with the salt content in processed foods being reduced by 20-50%. So far this has resulted in salt intake falling by a gram from 9.5g to 8.6g, but this is still some way off recommended levels. This is seen to be the direct result of a government-led initiative that secured commitments from producers and retailers to reduce the salt content of their foods. More recently, salt reduction has been one of the key areas for voluntary action by industry as part of the Responsibility Deal. It is essential that the Government ensure salt reduction remains on track to meet ambitious targets.
Many countries around the world are also starting to take action by implementing salt reduction strategies, including Australia, Canada, the US and more recently South Africa, which is the first country working towards setting legislative food targets.
Who leads the process varies from country to country. In the majority of countries initiatives have been government led but in Australia for example it’s NGO led and in the Netherlands industry led.
Industry undoubtedly has an important role to play, but experience shows that governments should play the leading role in developing reformulation initiatives that set standards and targets for industry. Then governments can work together with industry to implement standards and address challenges. This tends to be the most successful way meaningful changes have occurred.
Is this a model for action?
Reducing salt in our foods is a positive step forward to improving health but foods that are high in salt are often also high in sugar and fats as well. In order to avoid the unintended consequences of producers replacing salt with sugar and fats, a multi-nutrient approach needs to be considered. This could also have the added benefit of tackling another serious global problem – obesity.