Review

Journal of Human Hypertension (2014) 28, 345–352; doi:10.1038/jhh.2013.105; published online 31 October 2013

Salt reduction in the United Kingdom: a successful experiment in public health

F J He1, H C Brinsden2 and G A MacGregor1

  1. 1Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
  2. 2Centre for Food Policy, City University, London, UK

Correspondence: Dr F He, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, London, UK. E-mail: f.he@qmul.ac.uk

Received 22 July 2013; Revised 3 September 2013; Accepted 18 September 2013
Advance online publication 31 October 2013

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Abstract

The United Kingdom has successfully implemented a salt reduction programme. We carried out a comprehensive analysis of the programme with an aim of providing a step-by-step guide of developing and implementing a national salt reduction strategy, which other countries could follow. The key components include (1) setting up an action group with strong leadership and scientific credibility; (2) determining salt intake by measuring 24-h urinary sodium, identifying the sources of salt by dietary record; (3) setting a target for population salt intake and developing a salt reduction strategy; (4) setting progressively lower salt targets for different categories of food, with a clear time frame for the industry to achieve; (5) working with the industry to reformulate food with less salt; (6) engaging and recruiting of ministerial support and potential threat of regulation by the Department of Health (DH); (7) clear nutritional labelling; (8) consumer awareness campaign; and (9) monitoring progress by (a) frequent surveys and media publicity of salt content in food, including naming and shaming, (b) repeated 24-h urinary sodium at 3–5 year intervals. Since the salt reduction programme started in 2003/2004, significant progress has been made as demonstrated by the reductions in salt content in many processed food and a 15% reduction in 24-h urinary sodium over 7 years (from 9.5 to 8.1g per day, P<0.05). The UK salt reduction programme reduced the population’s salt intake by gradual reformulation on a voluntary basis. Several countries are following the United Kingdom’s lead. The challenge now is to engage other countries with appropriate local modifications. A reduction in salt intake worldwide will result in major public health improvements and cost savings.

Keywords:

salt reduction; target; UK programme; public health

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