Salt solution

by David Strain

This week marks Salt Awareness Week, the annual campaign shining a light on the hidden salt in our favourite foods, and which lobbies for restrictions on the amounts added to processed food

Location: UK
Published: Friday 19 May 2023

As doctors, we are all too aware of the health impacts of salt. High salt intake is causally associated with strokes, heart attacks, heart failure, and kidney disease. There is also an association with stomach cancer, obesity, and diabetes, although the causative nature of these links is uncertain.

It may be direct, but just as likely to be a result of sweetened soft drinks consumed to quench the thirst or other potential confounders.

There are two heart attacks or strokes every five minutes in the UK. For the individual and their family, these often come with the debilitating long-term consequences. For the nation, there are wider economic effects, not to mention the strain on our struggling NHS.

Hypertension carries the most attributable risk for these cardiovascular events, and reducing our salt intake is the easiest way to address this. Eating less salt is one of the quickest and most effective ways of improving our health – just one less ‘pinch’ a day could prevent more than 4,000 heart attacks and strokes every year in the UK.

But how can we cut back on our salt, when so little of it is within our control? Everything from fish fingers and chips to a cheese ploughman’s salad has added salt. In fact, three quarters of the salt we eat is already in the foods we buy, and it’s impossible to take it out once it’s been added in, and not necessarily where we may expect.

A single slice of bread has a similar salt content to a small portion of pre-salted fries from McDonald’s (and most likely other fast-food chains – this just happens to be the one tested). Two slices of dry toast and you’ve reached your daily requirement!

I use the word requirement carefully. The recommended daily allowance of 5g by the World Health Organisation and 6g from the UK Government are arbitrary targets to reduce cardiovascular risk. We only actually require about 1 gram of salt (approximately 0.4g of sodium) per day to conduct nerve impulses, contract and relax muscles, and maintain the proper balance of water and minerals.

Clearly, we need to better understand where all the salt is in our food. The BMA campaigned heavily to have salt included in the minimum requirements when the Food Information to Consumers Regulation (EU) came into force in December 2016. The requirement is limited to added salt; however, most manufacturers voluntarily add naturally occurring sodium.

As laid out in the BMA’s Our country is getting sicker report, the Government’s failure to implement the policies proposed in the obesity strategy published in 2020, seriously puts the populations health at risk.

Alongside mandatory sugar and salt reformulation, policies must address the availability, labelling, and marketing of high salt foods. There must be no more delays to policies that tackle ill-health and protect the public’s health.


David Strain is chair of the BMA board of science