Intended for healthcare professionals


Salt: the forgotten foe in UK public health policy

BMJ 2022; 377 doi: (Published 21 June 2022) Cite this as: BMJ 2022;377:e070686
  1. Hattie E Burt, researcher,
  2. Mhairi K Brown, researcher,
  3. Feng J He, professor,
  4. Graham A MacGregor, professor
  1. Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  1. Correspondence to: H Burt h.burt{at}

The UK has lost ground in its efforts to cut salt consumption and must push industry to further reduce salt in food products and save lives, argue Hattie Burt and colleagues

Strong evidence shows that excess salt intake is linked to multiple non-communicable diseases, including a dose-response relationship with blood pressure and cardiovascular disease,1 the leading cause of death and disability worldwide. And in May 2022, 70 health and scientific organisations, including the World Hypertension League and the International Society of Hypertension, called for “all health care professionals, scientists, and the organisations that represent them to advocate for sodium [salt] reduction to be a high global priority and for all nations to develop effective programs to reduce sodium intake to recommended levels.”2

Individuals can take steps to reduce their salt intake by adding less salt to food and by choosing to consume fewer highly salted foods. However, with around 75% of salt coming from packaged and prepared foods,3 many of which we rely on as affordable and convenient staples, individuals are fighting a losing battle. Action to reduce salt intake across the whole population—for example, through policies that incentivise food manufacturers to reformulate products with less salt—is therefore required.

The UK led the world with its 2003 voluntary salt reduction strategy and saw salt intakes and cardiovascular deaths fall.4 But the most recent national measurements show average salt intake has drifted up.5 The latest public health policies have focused on sugar and calorie reduction and have not included strong enough incentives to reduce salt levels further. Stronger action is needed to reduce the risk of cardiovascular disease and associated costs for health services and society.

Evidence for salt reduction

Some controversy has surrounded the importance of reducing salt intake for preventing non-communicable diseases. Most of this is based on …

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