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13/09/2004

Government Attacked On Salt Campaign

A high profile government-backed salt reduction campaign, due to be launched tomorrow (Sep 14), came under attack today for ignoring the need for more conclusive research and failing to make a proper assessment of the risks it could pose to some population groups.

The warning comes from the Salt Manufacturers’ Association (SMA), which points to a body of independent counter opinion. It says the Department of Health and the Food Standards Agency (FSA) are ignoring inconvenient evidence in pursuit of a campaign that unfairly targets one of life’s essentials.

The SMA points to the fact that the Department of Health’s own National Diet and Nutrition Survey, published earlier this year, concluded that there is no significant effect on the blood pressure of healthy people from eating salt. The survey found that the major correlation was between alcohol intake and body mass index and blood pressure.

“The government would have us believe that the evidence for salt reduction is now beyond question,” says the SMA’s general secretary, Peter Sherratt. “The reality is that it is relying heavily on research that is at best inconclusive and contradictory. The Department of Health admits that it has not conducted any assessment of the risks of population sodium reduction to the elderly nor, so far as we are aware, of the risks to any other vulnerable group.

“The campaign loses sight of the fact that if you are a normal, healthy individual, you do not need to cut your salt intake,” said Mr Sherratt. ”Your kidneys very effectively filter any salt that is not essential to your body, and it is excreted.”

The SMA claims that huge amounts of money are being spent by the government and food manufacturers on a campaign based on disputed and questionable evidence.

The group that may benefit from a low-salt diet is those people already diagnosed with high blood pressure. The SMA believes resources being devoted to blanketing the nation with the salt reduction advice would be better directed to more closely targeting those who are hypertensive and treating them with the highly effective drugs now available, as the National Institute for Clinical Excellence recommended only last month.

Groups that may be at risk from reacting to blanket advice to cut salt include the elderly and pregnant women. In the case of the elderly, cutting salt may be dangerous, especially in the summer months. Because they tend to drink less and are less acclimatised to hot weather, salt lost through sweat is not replaced. Their blood pressure rises, so putting added strain on their hearts.

For a pregnant woman, a low-salt diet can cause problems with blood volume in the unborn child, which in turn can cause a rise in the mother’s own blood pressure. Yet the Government’s campaign to reduce salt in the diet has made no assessment of the potential risks of sodium reduction in these vulnerable groups.

The SMA highlights the fact that there is a considerable body of professional opinion that throws doubt on the effectiveness of the FSA campaign. International scientists have repeatedly concluded that there is little or no benefit to the general population in population sodium reduction. (See references below).

“We need to get away from this suggestion that salt is public enemy number one,” says Peter Sherratt. “Each one of us has the equivalent of a cupful of salt in our bodies and it is working very hard to keep us alive. Salt is essential to life - the sodium it contains is an electrolyte that helps maintain the fluid balance in your blood cells and transmits electrical impulses between your brain, your nerves, and your muscles.

“As the oldest preservative known to man, salt also plays a vital role in protecting us from food poisoning. It is also a life-saver in hospitals for saline drips and kidney dialysis.

“Our view is that salt is being damned without adequate evidence. Given the importance of the issue, we fail to understand why the government is not commissioning the research that is so badly needed. In the meantime, we would advocate a much more holistic approach to the nation’s dietary habits designed to reduce alcohol consumption, tackle obesity and increase consumption of fresh fruit and vegetables. There is wide agreement that these factors have a real and lasting effect on reducing blood pressure.“

The SMA has launched a website at www.saltsense.co.uk to bring balance to the salt debate.

references

• The Department of Health’s own National Diet and Nutrition Survey published earlier this year concluded that there is no significant effect on the blood pressure of healthy people from eating salt.
• The 1988 Intersalt study is one of the prime motivators for the current campaign, yet it failed to prove its own primary hypothesis that systolic blood pressure is associated directly with sodium excretion.
• Several large-scale intervention studies have shown that restriction of sodium in the diet has no effect on diastolic blood pressure and only a minimal effect on systolic blood pressure.
• The National Health Service’s own website includes an evaluation of the evidence base for reduction of salt in the diet which concludes that the calculations are “theoretical” and that the authors have “over-emphasised” a key section. The reviewers suggest that further research is needed.
• Since 1995, 10 studies in the United States have reported on whether low sodium diets produce health benefits. All 10 indicate that, among the general population, lower sodium diets don’t produce health benefits. In fact, not a single study has ever shown improved health outcomes for broad populations on reduced sodium diets.
• An independent review by the Cochrane Library (2004) of advice to reduce dietary salt for prevention of cardiovascular disease concludes: “Intensive interventions, unsuited to primary care or population prevention programmes, provide only minimal reductions in blood pressure during long-term trials. Further evaluations to assess effects on morbidity and mortality outcomes are needed for populations as a whole and for patients with elevated blood pressure”.

notes

1 The Salt Manufacturers' Association is the trade association representing UK manufacturers of salt, including domestic salt, catering salt, water-softening salt, industrial salt and de-icing salt. Its members are: British Salt Ltd, Cleveland Potash Ltd, Irish Salt Mining & Exploration Co Ltd, New Cheshire Salt Works Ltd, RHM plc (embracing Centura Foods Ltd and Supreme Salt Co Ltd) and Salt Union Ltd.

2 The UK salt industry produces some two-and-a-half to three million tonnes of salt in a typical year. The greatest proportion (rock salt) is used for de-icing roads in winter. Smaller percentages are used in the chemicals, food manufacturing and pharmaceutical industries and for the softening of water. It has been estimated that salt is used in manufacturing 14,000 products. SMA members employ a total of some 750 people in the UK, the majority in Cheshire but also in the North East and in Northern Ireland.

3 Further information to support this release is available from www.saltsense.co.uk. The media resources available there also include downloadable photographs.