Salt Reduction in the United Kingdom: A Successful Experiment in Public Health

J Hum Hypertens. 2014 Jun;28(6):345-52. doi: 10.1038/jhh.2013.105. Epub 2013 Oct 31.

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 8.1 g 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.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / diet therapy
  • Cardiovascular Diseases / prevention & control
  • Diet, Sodium-Restricted / methods*
  • Female
  • Focus Groups
  • Food Labeling
  • Guidelines as Topic
  • Health Promotion / organization & administration*
  • Humans
  • Hypertension / diet therapy
  • Hypertension / prevention & control*
  • Male
  • Program Evaluation
  • Public Health*
  • Sodium Chloride, Dietary / adverse effects*
  • Sodium Chloride, Dietary / urine
  • United Kingdom
  • Urinalysis

Substances

  • Sodium Chloride, Dietary