Preventing cardiovascular disease: Salt reduction’s miraculous role

As party conferences kick off, the forthcoming 2024 General Election highlights healthcares vital mission of preventing cardiovascular disease and the role salt reduction can play

Prioritising salt reduction has emerges as a potent strategy for the future.

After all, in a country with free healthcare, prioritising opportunities to reduce demand on an already struggling system is a no-brainer.

Preventing cardiovascular disease through salt reduction

As suffering caused by significant conditions such as cardiovascular disease (CVD, e.g. heart disease, heart failure and strokes) and cancers increases, now is the time to get serious about prevention.

If the next government wants a quick and precise impact on health, an oven-ready solution awaits them – reducing population salt intake.

Decades of research show that the more salt we eat, the more our blood pressure increases, increasing our risk of CVD.

England alone spends an eye-watering £7.4 billion on healthcare costs linked to CVD annually.

Prioritising salt reduction should be a goal for the food industry

Yet, salt intake is 40% higher than recommended, with the majority of salt added to our food by the food industry. Whether this is packaged foods sold in supermarkets, dishes served in restaurants, or takeaways and fast-food outlets – salt is everywhere.

UK policymakers have long known about the dangers of salt, and in the early 2000s, they implemented a voluntary salt reduction programme.

The programme set out realistic salt targets for more than 80 categories of packaged food and, in subsequent years, extended to meals sold in restaurants and takeaways.

The targets have been reset every few years to be progressively lower.

Research released this week in the Journal of Hypertension has tracked the impact of this programme on health over the past two decades with concerning findings.

The rise and fall of salt intake reduction: A closer look

Although there was an initial success with population salt intake falling by an impressive 19% between 2003 and 2014, by 2018, salt intake had increased again.

Our health felt the benefits of the initial reduction, with reductions in average population blood pressure and CVD deaths, which plateaued by 2018.

So why the rise in salt intake considering the initial success? To answer that, we must consider what happened to the programme then.

Initially, the Food Standards Agency were at the helm, actively encouraging the food industry to work towards the salt targets and transparently monitoring progress.

In 2010, responsibility for nutrition policy (including the salt reduction programme) was transferred to the Department of Health and Social Care, which launched the Public Health Responsibility Deal (PHRD).

On the surface, the PHRD was a partnership between government, industry and health experts, with the industry working towards a series of pledges that would improve health.

Hidden agendas: The unravelling of salt reduction efforts

Behind the scenes, however, few of those involved would have used the term’ partnership’. The food industry used its power to interfere at every level of the PHRD, from setting the parameters of the pledges to ensuring they were allowed to self-monitor progress without independent verification.

Following the 2015 General Election, the PHRD was dissolved and although Public Health England picked up responsibility for salt reduction in 2017; they too were dissolved in 2021. The Office for Health Improvement and Disparities is now in charge, but each change in programme governance has contributed to slowed momentum.

Based on these learnings, more stringent salt targets, with more vigorous enforcement and improved monitoring systems, are urgently needed, and the Public agrees. According to a nationwide poll, 85% of UK adults support more brutal action.

The days of voluntary guidance for the food industry being effective are behind us. CEOs of major food companies have already said they won’t take comprehensive action without legislation.

There are two clear opportunities on the horizon for political action. The first is the current Government’s Major Conditions Strategy, which aims to address the six major causes of death and disability in the UK. CVD is one of those conditions, but the wording in the recent case for action refers more to treatment, with a passing mention of the salt reduction programme.

If the government is serious about preventing CVD, legislation to lower salt intake and blood pressure is essential. With each 1g reduction in population salt intake, more than 4,000 CVD deaths would be prevented, alongside annual healthcare savings of £1.5 billion.

Following the evidence for preventing cardiovascular disease

The other opportunity is Labour’s Building an NHS fit for the future mission. This mission sets out priorities to protect the NHS, including preventing unnecessary illnesses like CVD. The salt reduction was a pioneering Labour initiative, leaving a legacy that has been emulated around the world. 

60 countries have followed the UK’s lead in setting salt reduction targets

Around 60 countries have followed the UK’s lead in setting salt reduction targets. The General Election could give Labour its chance to make the UK world-leading again.

Access to better food, health and longevity shouldn’t be a postcode lottery or held hostage by political will. Instead, we need to see a government committed to doing what is right, following the evidence and driving forward the next phase of actions to protect the nation’s health.

This piece was written and provided by Mhairi Brown RNutr, Policy and Public Affairs Lead, Action on Salt.