On the 30th January 2008 a lunchtime reception was held at the House of Commons. There were around 100 guests including representatives from retailers, food manufacturers, caterers, non-government organisations, MPs and Peers, Department of Health, Food Standards Agency, media and other stakeholders.
Mary Creagh , MP for Wakefield , Denby Dale and Kirkburton and sponsor of the event introduced the speakers:
Dawn Primarolo, MP Minister of State for Public Health
Professor Graham MacGregor, Chairman of CASH
Dr Ian Reynolds, Deputy Chair of the Food Standards Agency
Cathy Court , Director of Food and Nutrition, Netmums
Mary Creagh, MP
Mary Creagh thanked everybody for their attendance prior to introducing the speakers. Mary agreed with the speakers regarding a need for a reduction in salt in children's foods, particularly salt 'hidden' in sweet foods and a need for one standard for labelling. Mary endorsed the traffic light system as being the most helpful.
Dawn Primarolo, MP - Minister for Public Health
Dawn Primarolo extended her congratulations to the work of Professor MacGregor and CASH . Dawn Primarolo stated that "the Government was committed to improving diet, decreasing obesity, cardio-vascular disease and cancer now and in the future, and stands buy its aim of reducing salt intake to 6g a day by 2010". Dawn quoted the 2003 SACN report on salt and health, stating it was "inadvisable for children to become accustomed to salt, suggesting negative long term health impacts, which is reflected in the prominence the reduction of salt has amongst other Public Health messages to combating CVD . High blood pressure causes 60,000 deaths in the UK every year, and salt is a major risk factor in increasing blood pressure".
Dawn Primarolo went on to say that there were parallel, detailed discussions on the effects of salt on health taking place at a high level at the CEU group on Nutrition and Physical Activity in Brussels, noting that the UK has led the way in Europe and that salt is now recognised as a major health priority in other EU countries.
Dawn Primarolo urged all sectors to work with the Food Standards Agency to build on the reductions already made to ensure we are on target for 2010.
Dawn Primarolo highlighted other areas of concern in children's diets. The increased prevalence of obesity projected in the Foresight Report showed a need for a wake up call. In particular, government and food industry are implored to take action. Dawn spoke of the government's obesity strategy 'Healthy living, healthy lives', which sets out an action plan to improve diet and participation in exercise. Through the Healthy Food Code of Good Practice, Dawn wants the government to work with industry and key stakeholders to establish a code and challenged industry to provide:
• A single, simple approach to food labelling in shops and in catering
• To produce smaller portion sizes for energy dense and salty food
• To change the balance of food promotion so children's exposure to foods high in fat, salt and sugar will be reduced
• Increase fruit and vegetable consumption
• To work with government to produce a single set of healthy eating messages.
Dawn Primarolo finished by stating she was encouraged by the breadth of support for Salt Awareness Week as illustrated by the attendees, and by the commitment of CASH and their stakeholders. Dawn is looking forward to working with the attendees on this and broader agendas encouraging people to have healthier diets.
Professor Graham MacGregor - Chairman of Consensus Action on Salt and Health
Professor MacGregor thanked Mary and Dawn, welcoming a strong participation from the Department of Health.
Professor MacGregor explained why CASH had selected children as the focus of Salt Awareness Week, "The commonest causes of death in the UK are stroke, heart attacks and heart failure, the major causes are blood pressure and smoking. When post-mortems were done on 4 year olds who died in road traffic accidents, they were already showing signs of high blood pressure, with vascular streaks in their arteries, signs of the vascular disease that is going to kill most of us in this room. The seeds are sown early in childhood. There is good evidence that salt puts up blood pressure in children and if you reduce the salt intake in childhood, it lowers blood pressure. Additionally, blood pressure tracks in childhood, so the higher blood pressure ends up in teenagers, the higher it will be in adult life". Professor MacGregor highlighted the importance, therefore, of lowering salt intake not only in ourselves, but also in our children.
Professor MacGregor went on to say that "salt also affects the bones, by leaching calcium in bones. This is important particularly in teenage girls who generally have an appalling diet which is low in calcium, as such they are much less likely to achieve a good peak bone mass and are more likely to develop osteoporosis later in life. Salt also aggravates (but does not cause) asthma and can make an attack worse". Professor MacGregor stated he was pleased to see Professor Martin Wiseman from World Cancer Research in attendance, as "salt is also important in cancer of the stomach and some other cancers".
Professor MacGregor referred the audience to the salt survey conducted by CASH , and congratulated the food industry on doing a great job, whist highlighting that there are still some very high salt products that are consumed by children, "Morrison's Baked Beans had 2.8g salt in a small serving, remember that the total recommended intake for a 6 year old is 3 grams a day, so the total salt intake for one day is in one small can. What was surprising to me was the sweet products, like roly poly pudding, treacle pudding, chocolate drinks, why do they have salt in? It is ridiculous how ubiquitous salt has become and we need to get it out, and get the food industry to stick to the FSA targets to achieve the lower amount".
Professor MacGregor went on to mention soft drink consumption, referring to a soon to be released paper showing that there is a direct link between soft drink consumption and salt intake in children.
Professor MacGregor briefly touched upon the findings for the Netmums survey, stating that the labelling is critical, as most parents confuse sodium with salt, as though sodium was salt, whereas you have to multiply the declared sodium content by 2.5 to find the salt content.
Professor MacGregor stated that he was very pleased that there were more than 250 events taking place across the country, as well as 18 countries involved from World Action on Salt and Health, from Australia to Georgia and Bangladesh .
Professor MacGregor thanked the sponsors and the retailers, noting the absence of Tesco's and Morrison's.
Dr Ian Reynolds - Deputy Chair Food Standards Agency
Dr Reynolds opened his speech by praising Professor MacGregor and the work he has achieved over the years.
Dr Reynolds stated he was pleased with the recent results of getting the national adult average down from 9.5g to 9g, based on urine samples rather than stated intakes, which are highly statistically significant. Ian went on to say that "whilst this is a long way form the target of 6g, it is heading in the right direction, but this is a long road to travel and we can't take the investment and pressure off".
Dr Reynolds admitted that the FSA have been concentrating on adults, and that they are now ready to focus more on children, which is a difficult area that needs addressing if we want to make progress. Ian highlighted the guidelines the FSA published for a range of intakes for children under the age of 11 that industry will be trying to achieve. "It is important industry and government work together, and we're proud to have 75% of industry on board, we now need to focus on the 25%." Ian commented on FSA research that showed the number of adults trying to limit salt in their diets has increased from 34% to 42%, and that the percentage who are aware of the 6g target has increased from 3% to 34%, but that this figure needs to increase further.
Dr Reynolds talked of FSA initiatives, including the 'All Salted' project with the National Children's Bureaux, a reduced salt and life skills programme to support teen parents to sustain low intake and therefore their children's intake. The FSA also work with Netmums, demonstrating foods that are 'full of it' and 'not so full of it'.
"The Traffic Light labelling system is our choice and recommendation", Ian went on to say, "as research shows it's easiest to use in the supermarket setting". Ian hopes the current research work will result in the system being the national model.
The third initiative Ian discussed was to continue to work with industry, implementing a gradual reduction to avoid consumer detection and reaction.
Dr Reynolds concluded by stating that the FSA would place more significance on children, who are our future.
Cathy Court - Director of Food and Nutrition Netmums
Cathy Court opened her speech by explaining that Netmums is a parenting website set up in 2000 to provide local information and support to parents, and to stop isolation amongst mothers with young children, which now has 150 sites with over 370,000 members.
Cathy stated that healthy eating is massively important to their members, so they work hard to provide them with healthy eating information. This included the survey conducted with CASH to find out what parents knew about salt in food, which had over 2,400 responses. Cathy went on the detail the results, "There is massive confusion between salt and sodium, with nearly half of all respondents thinking 1g sodium was the same as 1g salt. Even if you knew 1g sodium equalled 2.5g salt, I don't feel that customers should have to make this calculation in the shop. Salt needs to be shown on the label. Secondly, hidden salt seems to be a problem area. High sugar products usually have a high amount of salt that you wouldn't expect; only 3% thought a blueberry muffin had more salt than 2 packets of standard crisps. Only 10% knew a serving of a Rice-Krispie style breakfast cereal contained more salt than a packet of ready salted crisps. Although they are not equivalent in terms of nutrition or meal occasion, it really does demonstrate that products that don't taste salty can have more salt than those that do.
Cathy highlighted some good news, that practically everybody said they did not use salt in cooking, and that 96% don't allow their children to add salt at the table, which is a change that has only happened this generation, so the message is getting through.
Netmums encourage mothers to read the labels, and would like to see industry do a lot more. Cathy said Netmums want good, clear front of pack labelling, with salt rather than sodium, to make informed choices, and that the traffic light system works best, with 80% preferring this system. Cathy also said Netmums wanted to see manufacturers showing children's salt allowances on 'kiddy meal' lines. Cathy concluded by saying she was pleased to see food companies being responsible and reducing the salt in their foods, and would like to see more manufacturers following suit.
Question and Answer session
Q1) Baroness Masham of Ilton, House of Lords
How much education in salt and good health is done in schools, as this will filter up to parents?
A1) Dr Ian Reynolds FSA Deputy Chair
The influence of children on parents is clear. We have the food bus, from which they learn lessons in food and hygiene, which are an extremely memorable and effective experience
A1) Mary Creagh, MP
The new nutrition guidelines in schools mean children have a capped salt intake whilst they are in the school premises.
Q2) Andrew Lansley, MP
Of the decrease from 9.5g to 9.g, can you estimate how much is from the contribution of reformulated foods?
A2) Gill Fine FSA
The research won't have taken into account a lot of the reformulation, although we are looking into that with a further survey, so it will be information to come.
A2) Professor MacGregor
These results are from 2005 before many of the cuts had been made. FSA have repeated the 24-hr urinary study which will give us a good picture. Although please remember that the reduction was on the background of an increase in salt intake.
Comment) Ian Gray, Chartered Institute of Environmental Health
We help our professionals to understand issues of salt and nutrition in food safety. If 91% of mums don't add salt in cooking, can we challenge the TV chefs who liberally add salt in cooking and languish in the fact that they promote good nutrition?
Q3) Question from the audience
If significant intake of salt is in take away food or restaurants, what legislation should be provided to give guidance and support in that area?
A3) Mary Creagh, MP
We are looking at the role that regulation can play, however this would need policing by Trading Standards. We would like to see how far we can go with encouraging companies to reduce salt intake before bringing in legislation.
A3) Professor MacGregor
Trading Standards are in an excellent position to do something about high salt in restaurant meals by providing them with advice and following up on it.
NB Ian Grey and Professor MacGregor agreed to collaborate on this issue in future
Q4) Question from the audience
With the survey conducted this week, the Salt Association suggested the research was 'shoddy and not evidential' how do you respond?
A4) Professor MacGregor
When you have no scientific evidence, you become abusive!
The SMA and Salt Institute will rubbish the data, as their profits are from salt. It is a relatively small industry, and given the harmful effects of salt they need to diversify in the face of controlled trial evidence.
Q5) Guy Mason, ASDA
What can we expect from Salt Awareness Week 2009?
A5) Professor MacGregor
We'll let you know!
Stands: House of Commons reception
Five companies had stands: four retailers – Cooperative Group, Sainsbury’s, M&S and Waitrose, Asda and the parenting website Netmums. All of the companies attending displayed literature about the work they have been carrying out on salt reduction.