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Salt intake and social inequalities in Britain and Europe

Raised blood pressure (BP) is a common preventable cause of death and disability in adults worldwide, responsible for heart attacks and strokes. Both high BP and its consequences are more prevalent in socio-economic disadvantaged groups. A reduction in BP prevents vascular events.

One of the main factors leading to a population rise in BP is high salt intake. A reduction in salt intake in individuals and populations lowers BP and may cause large reductions in strokes and other cardiovascular events (CVD). A policy of population reduction in salt intake to prevent CVD is highly cost-effective and it is advocated nationally by NICE and worldwide through WHO, as, crucially, it would also reduce health inequalities.

Using data from the British National Diet and Nutrition Survey and applying Bayesan geo-additive models, the project will establish the geographic distribution of salt intake in Britain, estimate the spatial effects of socio-economic and demographic covariates across regions and test linear and non-linear effects of covariates. The results will inform public health decisions for a successful salt reduction policy that would reduce health inequalities for a sustained impact over time.


  • Cappuccio FP, Ji C, Donfrancesco C, Palmieri L, Ippolito R, Vanuzzo D, Giampaoli S, Strazzullo P. Geographic and socioeconomic variation of sodium and potassium intake in Italy: results from the MINISAL-GIRCSI programme. BMJ Open 2015;5:e007467
  • Ji C, Kandala N-B & Cappuccio FP. Spatial variation of salt intake in Britain and association with socio-economic status. BMJ Open 2013; 3: e002246
  • Ji C & Cappuccio FP. Socio-economic inequality in salt intake in Britain 10 years after a national salt reduction programme. BMJ Open 2014; 4: e005683

  • Rodriguez-Fernandez R, Siopa M, Simpson SJ, Amiya RM, Breda J & Cappuccio FP. Current salt reduction policies across gradients of inequality-adjusted human development in the WHO European region: minding the gaps. Public Health Nutrition 2014; 17 (8): 1894-904
  • World Health Organization. Mapping salt reduction initiatives in the WHO European Region. Copenhagen, World Health Organization (WHO) 2013; pp. 1-50

Principal Investigator

F.P. Cappuccio

Research Fellow

C. Ji


J. Breda (WHO, Copehangen)

S. Giampaoli (Italy)

P. Strazzullo (Italy)


The Bupa Foundation


WHO Collaborating Centre


In progress