The Responsibility Deal has failed. We need mandatory salt reduction targets

Reducing population salt intakes has long been identified by the World Health Organization as one of the most cost-effective ways of improving public health.

The UK was itself a pioneer of salt reduction in the early 2000s. However, new research from Queen Mary University of London, published in the Journal of Hypertension, reveals in the last 10 years we have failed to reduce population salt intakes in England, putting thousands of lives at risk.

The latest research shows average salt intake, blood pressure and deaths from stroke and heart disease in the adult population of England decreased between 2003 and 2014, coinciding with the development of a comprehensive salt reduction programme led by the Food Standards Agency.

However, beyond 2014, improvements in all three measurements stopped. This is despite better blood pressure treatment, increased fruit and vegetable consumption and reductions in smoking across the population – all of which should have improved blood pressure and reduced deaths from stroke and heart disease. However, it didn’t – and the stalled reduction in population salt intake is very likely the culprit.

So how did this happen, especially when the UK had a pioneering salt reduction programme that was replicated around the world? The problem lies within changes in governance. The responsibility for the salt reduction programme was effectively handed over to the food industry in the failed Responsibility Deal.

What came to pass can only be described as a complete butchering of the programme – no effective monitoring, no accountability and no incentives for the food industry to make further reductions. It was a salt reduction programme in name only, resulting in stalled reductions in salt intakes between 2014 and 2018. Unsurprisingly, this has meant no further reductions in population blood pressure or deaths from heart disease and stroke – a missed opportunity for population health.

Preventing two of the leading causes of death should be a priority for industry and government. These are needless deaths, vastly preventable by changes in the nutritional make-up of our food – changes that are mostly out of our hands, given the limited choices we, as individuals, have at our disposal. Many of us are eating far more salt than the current recommended limit, but more than 75% of that is added by somebody else, be it food manufacturers, fast food outlets, restaurants or takeaways.

Salt reduction is simple, easy to implement and, more importantly, has the potential to save not only thousands of lives but millions of pounds for the NHS. Relying on the food industry to deliver reductions in salt content without leadership is a foolish ideology from government. Urgent resuscitation of the programme is needed if we are to get back on track with saving lives, protecting the NHS and boosting the economy.

Action on Salt, together with 30 leading experts and health organisations, is calling on party leaders to prioritise salt reduction through a mandatory and comprehensive programme.

We believe a mandatory reformulation programme is the next logical step to encourage food companies to improve the nutritional quality of food with less salt. This will create the much needed level playing field, but must be enforceable, be it through incentives or disincentives for noncompliance. We are supportive of the Recipe for Change Campaign, which calls for industry levies to make food and drink healthier.

Failure to act will have a detrimental impact on the health and wellbeing of the population, as well as on the economy.