- Everyone knows salt affects our health but few know its harmful effects. (ref: Q1 & Q2)
- 1 in 4 people don’t know how much salt they should be eating. (ref: Q4)
- Salt was ranked the lowest out of four concerns, GM causes no deaths in a year whereas salt causes 70, 000 deaths a year. (ref: Q3)
- 85% of both men and women found sodium labelling not comprehensible. (ref: Q9)
- The majority (55%) of people would like to see salt labelled (ref: Q10 & 11)
- 3 in 4 people think that the food industry is the best strategy for reducing the salt intake of the UK population. (ref: Q13)
- Consumers are confused as to what is the major source of salt in their diet. (ref: Q5)
- The food industry are potentially misleading consumers into consuming more salt by labelling products with sodium and not salt (Ref: Q7)
- The FSA initiative to reduce salt consumption is not reaching public health policy makers & health professionals, yet alone the average consumer with a consumption of 10 – 12 g. (ref: Q12)
Aim of the survey
The theme for this year’s 5th National Salt Awareness Day is salt and consumers. In light of this we have conducted a pilot study to find out what consumers understand about salt and any misconceptions that they may have.
The aim of the pilot was to explore consumer perceptions of salt and salt labelling, thus leading to a fuller investigation at a later date.
Analysis of data
The pilot survey was conducted in two phases in December 2003. It consisted of a self-report questionnaire. The questionnaire comprised 13 questions.
The first phase was self-administered and sent electronically (emailed) to all the Members of Parliament. The second phase was an ‘interviewer’ administered questionnaire in which health professionals and members of the general public were chosen at random using a random set of numbers for selection purposes and asked to fill in the questionnaire and to hand it back once completed.
The questionnaire design consisted mainly of quantitative questions to ascertain a percentage of what various groups surveyed felt. A pilot questionnaire was used to test the robustness of the questions, along with the method of completing and returning the form electronically. The design was altered to ensure that Ministers were able to complete it electronically and return it completed as quickly as possible.
A brief introduction along with instructions on how to fill out the questionnaire was included at the top of each questionnaire. Personal information regarding occupation and gender were placed last on the questionnaire form.
A total number of 91 participants completed and returned the questionnaire.
Thirty three MPs completed the survey and returned it electronically within the time period in the first phase of the study.
The second phase included a total of 59 participants being randomly selected at the entrance of St. George’s Hospital. All questionnaires were completed and immediately returned to the interviewer.
The participants comprised 33 MPs, 19 Health Professionals and 39 from ‘other occupations’. There was a near equal proportion of men and women taking part in the survey, which comprised 46% men and 54% women.
There was a total of 91 people surveyed comprising 36% Health Policy Makers (Members of Parliament), 21% health implementers (Health professionals), and 43% general consumers (from other occupations), of which there was an approximately equal distribution of men and women, 46% and 54% respectively.
Question 1 - Do you think eating too much salt affects your health?
There is no disputing it! Every one knows that salt affects their health, according to those surveyed.
Policy makers (MPs), health implementers (Health Professionals) and general consumers all agreed that eating too much salt will affect their health.
Question 2 –A high salt intake can cause?
However, the effects of a high salt intake are less well known. Whilst the majority (98%) claim to know that salt causes high blood pressure, only one in ten (11%) knew that salt is also a factor in osteoporosis. Only one in six (15%) were aware that a high salt diet is linked to stomach cancer, one in three (27%) understood that salt is a major cause of kidney disease, approximately half (44%) knew that salt caused fluid retention and just over half (58%) knew that a high salt intake was a primary cause in stroke.
A comparison of occupation types showed that those either making government policy or implementing health policies, were more aware of the connection to high blood pressure, stroke, osteoporosis, fluid retention, stomach cancer and kidney disease than the average consumer (other occupations).
The majority of MPs (97%), health professionals (100%) and other occupations (97%) said that salt caused high blood pressure. For stroke, 67% of MPs, 58% of health professionals and 51% from other occupations. Fifty three percent of health professionals stated they knew that salt caused fluid retention, whilst 48% of MPs and 36% from other occupations knew of this effect. 18% of MPs stated they knew the link with stomach cancer, Health Professionals had a greater idea with 26% stating they knew, but those from other occupations had little knowledge of any link (8%). Kidney disease was selected by 42% of MPs, 21% of health professionals and 18% from other occupations.
There was little difference between men and women surveyed.
Question 3 – Which one of these four mostly worries you about food?
Survey participants were asked which food items worried them most. The options included GM foods, pesticides, salt in food and food poisoning.
Policy makers are more worried about pesticides, which have not been known to cause any deaths, than salt that causes thousands of deaths each year. Two out of five (39%) of MPs were concerned with the use of pesticides on our food compared to only 15% of MPs being most concerned about the effects of high salt consumption in the UK population’s food. Health Professionals on the other hand were more worried about mopping up the effects of bad food, with the majority (63%) stating they were most worried about food poisoning compared to 5% being most worried about salt consumption.
The general consumer also felt most strongly about the immediate effects of bad food compared to the real risk of a reduced life expectancy or quality of life as a result of a high salt intake, with 54% reportedly being more worried about food poisoning than about anything else. GM foods and pesticides also provoked a greater fear for the average consumer than salt intake, with an equal number being concerned about GM foods (23%) or pesticides (23%) compared to their salt intake (0%).
Worryingly, salt which represents the greatest known danger to man kind is the least worried about. Out of the four possible answers given including pesticides and GM, salt was ranked the lowest, if at all. This trend is likely to reflect the fact that most consumers are unaware of how many deaths salt can cause and how many other conditions can be caused due to salt, particularly in comparison to the less established threats of pesticides and GM food.
Question 4 – What is the maximum recommended daily amount of salt for an adult in the UK?
The majority (75%) of policy makers and implementers know that the recommended maximum daily amount is 6 grams per day.
Approximately two out of five general consumers surveyed (43%) are already aware of the 6 gram/day limit. Yet despite this, the average salt intake remains 10 – 12 grams per day. One in nine of all people surveyed (11%) thought the FSA’s reported current intake of 9 grams is the maximum recommended amount.
Overall one in four people (26%) don’t know how much salt they should not be eating.
Clearly women are more aware of the nutritional recommendations. More women (37%) than men (25%) reported the target was 6 grams of salt a day.
Question 5 – What is the main source of salt in the diet of an average person?
All policy markers surveyed (100%) and most of health implementers (89%) know that the main source of salt is in processed foods.
However, one in three (31%) of the general consumers surveyed thought the main source is salt added to cooking.
Question 6- List these foods in increasing order of salt content
Out of the items listed, cornflakes are the saltiest item, followed by crisps, bread and the least salty is ketchup.
Participants appeared to be unaware of the how much hidden salt is found in cornflakes and bread. 9% ranked crisps as being the least salty, whilst only 52% ranked ketchup as being the least salty.
No surprises that 61% ranked crisps as the saltiest when in fact cornflakes are just as high.
Ultimately, this suggests that the majority of people surveyed (61%) are unaware of salt that is hidden in foods like cornflakes. More importantly they confuse items with noticeably added salt as being saltier than items processed with salt as a ingredient.
Question 7 –Which of these statements best describes the relationship between salt and sodium?
One third (33%) of health policy makers and implementers did not know that sodium is a component of salt. Whereas two in three (66%) general consumers did not know that sodium is a component of salt, with one in three (28%) thinking sodium and salt were the same thing.
Overall, only 57% knew that salt contains sodium, 19% thought they were exactly the same and 22 % had no idea about the relationship. Essentially, this highlights the fact that the current method of labelling sodium on foods may serve to mislead consumers into thinking they are consuming less than they actually are.
Question 8 – Do you look for the sodium content of the product when shopping?
Two thirds (68%) of us do not look at the sodium content on the product when shopping. Although over half (53%) of the health professionals surveyed claim to look at the sodium content, only one in three (36%) of MPs do.
Question 9 – Do you think present nutrition information on sodium is comprehensible?
The majority of people (85%) surveyed do not find the current nutritional information on sodium comprehensible.
No health professional agreed that the current information was comprehensible and only 5% of general consumers felt the current information was ok. Public health policy makers (82%) supported the overall view that the present information is not adequate.
Question 10 – Which ingredient should be labelled?
Only 4% of those surveyed want only sodium on the product label. Overall, the majority (97%) surveyed want to see salt being labelled on product information, of which 42% want to see salt as well as sodium being labelled.
There appears to be some difference in opinion between health policy makers and health professionals. Just over half the MPs (52%) surveyed indicated they want both salt and sodium to be labelled on the packets. In comparison, none of the health professionals would like sodium to be labelled on the product information and two thirds (68%) of health professionals indicated that they just wanted to see salt labelled.
This appears to provide an indication that those advising the general public felt that salt by itself might be less confusing than sodium or a combination of salt and sodium.
Question 11 – What method of labelling would you prefer to see?
The majority (73%) of people surveyed would like to see salt content per serving labelled on the packet. Health policy makers and implementers were more forthright with their views than the general public. Only 3% of MPs surveyed preferred existing labelling of ingredients. Overall, the majority of Health Professionals (84%) prefer to have the salt content per serving to be labelled on the products. Interestingly, none of the Health Professionals wanted to have the total salt content on the products, implying that they felt this may also confuse the shopper.
Only one in three general consumers (28%) would like to see the existing labelling continued as the standard product information and only one in ten (10%) would like just the total salt per product. Overall, the general consumer (62%) would prefer to have the salt content per serving as their product information.
This strongly indicates the need for a change in labelling by all manufacturers to the preferred salt per serving type of labelling.
Question 12 - Are you aware of the Food Standards Agency initiative to reduce the salt intake of the UK population down to 6g of salt a day?
Only one third (31%) of general consumers are aware the FSA have a current initiative to reduce the salt intake of the UK population down to 6 g of salt a day.
Just over one half (52%) of health policy makers (MPs) were aware of the FSA current initiative to reduce salt intake. And surprisingly only 26% of Health advocates were aware of any initiative by the FSA.
Overall, less than half (37%) of those surveyed knew that the FSA had an initiative to improve the health of the nation by reducing the average daily consumption of salt.
13 What do you think would be the best strategy for reducing the salt intake in the UK population?
It’s official! Nearly four out of five (77%) of us want the food manufacturers to be more responsible by reducing the amount of salt they use in processed food.
A staggering 95% of health professionals felt that the food industry reducing the salt content of food was the best strategy for reducing the salt intake in the UK population. Only a few (5%) felt that a public health campaign was better.
72% of the general consumers surveyed want the food industry to reduce the salt concentration within processed food.
And two thirds (70%) of MPs also felt that the Food Industry reducing the salt content of foods was the best strategy to take. Only a third (30%) of the members of parliament surveyed felt that a health education campaign was a more worthwhile method of reducing the salt intake in the UK population.