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Social inequalities in salt consumption remain despite national drop in salt intake over last 10 years

FrancoPeople from low socio-economic positions in Britain still eat more salt than those from higher socio-economic positions, irrespective of where they live.

A paper published in the BMJ Open journal and led by Warwick Medical School suggests social inequalities in salt intake have hardly changed in the period from 2000-01 to 2011. This is despite a national average salt reduction over this time.

This paper is the first to monitor social inequalities following the national salt reduction programme. The research was carried out by the World Health Organization Collaborating Centre for Nutrition, based at Warwick Medical School, University of Warwick.

Researchers looked at the geographical distribution of habitual dietary salt intake in Britain and its association with manual occupations and educational attainments, both indicators of socio-economic position and key determinants of health.

The researchers used the British National Diet and Nutrition Survey (2008-11), a national representative sample of 1,027 men and women aged 19-64 years living in Britain. Salt intake was assessed with a 4-day food diary, assessing salt consumption from food. Salt added by consumers at the table and during cooking (discretionary salt) was not measured.

There was a significant reduction in dietary salt consumption from 2000-1 to 2008-11 of 0.9g of salt per day, consistent with the total reduction in salt consumption of 1.4g per day reported nationally when also discretionary use of salt is taken into account.

Professor Francesco Cappuccio, senior author and Director of the WHO Collaborating Centre, said: “Whilst we are pleased to record an average national reduction in salt consumption coming from food of nearly a gram per day, we are disappointed to find out that the benefits of such a programme have not reached those most in need. These results are important as people of low socio-economic background are more likely to develop high blood pressure (hypertension) and to suffer disproportionately from strokes, heart attacks and renal failure.”

Professor Cappuccio continued: “The diet of disadvantaged socio-economic groups tends to be made up of low-quality, salt-dense, high-fat, high-calorie unhealthy cheap foods. We have seen a reduction in salt intake in Britain thanks to a policy, which included awareness campaigns, food reformulation and monitoring. However, clearly poorer households still have less healthy shopping baskets and the broad reformulation of foods high in salt has not reached them as much as we would have hoped.”

“In our continued effort to reduce population salt intake towards a 6g per day target in Britain, it is crucial to understand the reasons for these social inequalities so as to correct this gap for an equitable and cost-effective delivery of cardiovascular prevention”, Professor Cappuccio concluded.

27 August 2014

Notes to editors

  • Cardiovascular disease is the first cause of death and disability in the world among people aged over 60 years and the second among those aged 15 to 59 years old

  • According to the World Health Organization, 62% of all strokes and 49% of coronary heart disease events are attributable to high blood pressure

  • There is a direct causal relationship between levels of dietary salt intake and levels of blood pressure and stroke

  • Most of the salt we eat is added to food in the manufacturing process by industry, caterers and food producers

  • The publication does not necessarily represent the decisions or the stated policy of the World Health Organization and the designations employed and the presentation of the material do not imply the expression of any opinion on the part of the World Health Organization


· Tom Frew – University of Warwick, International Press Officer

Email: a dot t dot frew at warwick dot ac dot uk

Phone: +44 (0) 2476575910

· Professor Franco Cappuccio – Warwick Medical School, University of Warwick

Email: F dot P dot Cappuccio at warwick dot ac dot uk