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Mandatory salt reduction in processed foods may lower CHD mortality rates
Policies focused on the reduction of salt in processed foods could improve overall population health and reduce socioeconomic disparities, according to findings from a study conducted in England.
Researchers stratified adults in England into quintiles according to socioeconomic circumstances, as well as by sex and age. They used the causal, epidemiological, deterministic IMPACTSEC policy model to evaluate a chain of links from policy initiatives to average daily salt intake, to systolic BP, to CHD-related mortality rate through 2025, while also assessing the possible differences in effect due to socioeconomic status.
The model evaluated the potential impact of the following four policies:
- mandatory reduction of salt in processed food products;
- additional voluntary reformulation of processed foods, contingent on the cooperation of food manufacturers;
- social marketing targeted to individuals, focused on healthy eating awareness and promotion; and
- improved labeling of nutritional content in food products.
The researchers also incorporated predictions from a sample of 13 experts to determine a range of uncertainty about future developments related to the effects of salt reduction through product reformulation, social marketing and nutritional labeling initiatives, and the potential for differences in impact according to socioeconomic status.
A mandatory 30% reduction of salt in processed foods would result in a 1.45 g/day reduction in salt intake, with a 14% greater reduction within the most deprived socioeconomic quintile vs. the most affluent quintile, the researchers predicted. Through an effect on systolic BP, this mandatory reformulation of processed foods could potentially postpone or prevent approximately 4,500 CHD-related deaths (range 2,900 to 6,100) by 2025. The impact of such an initiative would be 85% greater effect in the most deprived vs. the wealthiest socioeconomic quintile, they wrote.
Additional voluntary revisions by processed food manufacturers were projected to be less beneficial than mandatory reformulation, averting or postponing approximately 1,500 deaths (range 200 to 5,000), with a 49% greater effect in the most deprived vs. the most affluent quintiles. The policies related to social marketing and labeling improvements were each predicted to avert or postpone between 400 and 500 CHD-related deaths, with a minimal effect on socioeconomic inequality.
“A policy emphasis on mandatory reformulation to reduce the salt in processed foods would likely be an effective and inequality-reducing route to improving population health,” the researchers concluded. “Policymakers and practitioners should, however, be invited routinely to consider the impact of their planned interventions on inequalities, perhaps using qualitative approaches. If this is done, then our forecast indicates that future national strategies to reduce salt intake will become substantially more effective and equitable.” – by Jennifer Byrne
Disclosure: The researchers and the sample of experts report no relevant financial disclosures.