Intended for healthcare professionals


Sugar, salt, and the limits of self regulation in the food industry

BMJ 2017; 357 doi: (Published 07 April 2017) Cite this as: BMJ 2017;357:j1709
  1. Martin Caraher, professor of food and health policy1,
  2. Ivan Perry, professor of public health2
  1. 1City University, London, UK
  2. 2University College Cork, Ireland
  1. Correspondence to M Caraher m.caraher{at}

Globally, policies are shifting towards mandatory reformulation, subsidies, and taxation

A recent report from Consensus Action on Salt and Health (CASH) shows that only one out of the 28 food categories surveyed are on track to meet Public Health England’s (PHE) 2017 salt reduction targets.1 The food industry will also fail to hit a PHE target to achieve a 20% reduction in sugar content across nine food categories— including breakfast cereals, cakes, and yogurts—by 2020, confirming the long held view of some experts that voluntary agreements aren’t working and we should now move from soft to hard regulation.2

Modest progress towards reducing the salt content of the British diet has stalled, and efforts to reach agreement with the food industry on a voluntary reformulation strategy for sugar look unlikely to succeed. This is not surprising because voluntary agreements between industry and government (including the UK public health responsibility deal) have been shown repeatedly to be ineffective in improving public health.3 Sharma and colleagues have suggested minimum …

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