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Could stricter salt ‘laws’ save lives?


Morgan Liotta


1/11/2024 3:20:13 PM

Researchers say manufacturers should be made to reduce sodium levels in packaged food, saying it will bring ‘enormous reductions’ in CVD.

Spilled salt on table.
Australia’s current sodium-intake targets are ‘less rigorous’ than the World Health Organization recommendations.

Tighter regulations on salt levels in Australia’s packaged foods would prevent thousands of heart attacks and strokes over the next decade, according to new research.
 
In a first-of-its-kind study, researchers projected the long-term impacts of mandating sodium reductions for processed and packaged foods, comparing the Australian Government’s current voluntary benchmarks with those recommended by the World Health Organization (WHO).
 
The authors say Australia’s sodium targets are currently voluntary and ‘less rigorous’ than the WHO’s sodium benchmarks, and that a move away from this voluntary approach is needed.
 
They found that lower salt mandates could prevent around 40,000 heart attacks and strokes and up to 3000 deaths over a 10-year period. Additionally, around 32,000 new cases of chronic kidney disease (CKD) could also be avoided.
 
GP and University of Melbourne Department of General Practice, Associate Professor Ralph Audehm, agrees it would make a difference if higher standards are set around how much salt is added to food.
 
‘It’s true, reducing salt can have a big impact on cardiovascular outcomes and even renal outcomes,’ he told newsGP.
 
‘In the 70s and 80s, the Finnish Government mandated salt standards in their food – so reduced the amount of salt significantly in processed food, including bread.
 
‘And at a population level, blood pressure actually dropped … but it had a huge impact to public health. Then when they joined the EU with harmonisation of the standards, salt went up again, and the blood pressure there also returned to where it was before.
 
‘It was an experiment that definitely showed salt has an impact on blood pressure for certain, and that public health measures can actually have a huge impact on the amount of salt that we do eat.’
 
Associate Professor Audehm has seen firsthand the impacts of salt reduction in his practice.
 
‘One third of my patients with hypertension will be very salt sensitive, and if I get them to reduce salt, their blood pressure will drop significantly,’ he said.
 
‘I’ve seen that happen on an individual level. Translating that to a public health initiative would be fantastic, but the question is whether the Government has an appetite for it.’
 
Heart disease is among the top two leading underlying causes of death for both males and females in Australia, and an estimated 1.3 million Australians aged 18 and over are living with one or more conditions related to heart, stroke and vascular disease.
 
In 2022, cardiovascular disease (CVD) was the underlying cause of 45,000 deaths – 24% of all deaths.
 
Meanwhile, stroke became the nation’s third leading cause of death in 2023.
 
The study’s findings also estimate $3.25 billion in healthcare costs for both CVD and CKD could be saved over the population’s life span should mandated reduced sodium levels be implemented.
 
‘Our study projected enormous reductions in both cases and deaths from heart attacks, strokes and other heart conditions, as well as from kidney disease, within just a decade if the WHO reduction targets were mandated,’ co-author Professor Jason Wu said.
 
‘Beyond 10 years, we also showed that this reduction in disease burden could generate billions of dollars in savings from healthcare costs related to these diseases.’
 
The study compared benefits between mandating Australian and WHO salt targets, estimating:

  • 13,000 fewer new cases of CVD over 10 years for Australian targets, compared to 44,000 under WHO targets
  • 18,000 CVD deaths from CVD averted over lifetime (75 years), compared to 64,000 under WHO targets
  • 9000 fewer new cases of CKD over 10 years, compared to 32,000 fewer under WHO targets
  • $940 million saved from healthcare costs related to heart attacks, strokes, and kidney disease over the population’s lifetime, compared to $3.25 billion under WHO targets.
Mandating Australian targets is also estimated to result in a reduction of 100 mg per day in sodium consumption, compared to a 400 mg per day reduction under WHO mandated targets.
 
Globally, the WHO estimates 1.89 million deaths each year are associated with consuming too much sodium.
 
Average daily salt consumption in Australia is almost double what is recommended by the WHO, with the majority presenting in processed meats, bread and bakery products, cereal, grain, and dairy products.

As part of its goal to decrease global sodium intake by 30% by 2025, the WHO recommends reformulating food products, aligning with the reformulation program of the Australian Government’s Healthy Food Partnership, working with the food industry to reduce sodium levels, but this Government initiative is voluntary.
 
In Australia, recent calls for a ‘sugar tax’ have made headlines, and while Associate Professor Audehm says the recommendations to review salt intake is not exactly a tax, it is a good idea.
 
‘There’s been quite a few studies done around the world on decreasing salt … but the [Australian] Government hasn’t really done a lot of legislating around public health initiatives such as this,’ he said.
 
‘The sugar tax is really about trying to increase the price of sugary food. Whereas salt, what they’re trying to do is legislate to decrease the total amount of salt in the foods that we eat – whether that be bread, processed food.
 
‘It’s not actually a tax, but a policy and law, but it would make a difference.’
 
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