A Tragedy for Public Health

 

For Media Coverage: Salt Awareness Week Media Coverage

According to NEW research by CASH¹, shocking data reveals that a number of everyday shopping basket ‘essentials’ now contain more salt than before – with canned tomato soup, cheddar cheese and chilled ready meals being among the worst offenders.  This is despite the major progress made prior to 2010 when the salt reduction program was under the Food Standards Agency (FSA).

Raised blood pressure is one of the two leading factors in causing death and disability from strokes and heart disease. Consensus Action on Salt and Health (CASH) is urging David Cameron to set up an independent agency for nutrition and to rescue the salt reduction programme which has halted or is now being reversed.

The findings are startling:

Tinned Tomato Soup
Nearly half (47%) of the soups surveyed today contain the same amount of salt (or more) per serving than two slices of Domino’s Cheese & Tomato Pizza². The saltiest soup culprit was Baxters Vegetarian Italian Tomato & Basil with 3.5g salt per 400g serving which contains more salt than a McDonald’s Big Mac and large fries³!

CASH reviewed the salt content of tinned tomato soups at regular intervals between 2007 and 2016, and found that despite seeing a successful reduction in salt under the FSA (average 27% reduction between 2007 and 2010), progress has now lapsed. Surprisingly, the salt content in 55% of the products contain the same amount of salt or more now than they did in 2010!

Examples of soups with the biggest increases are:
* Tesco Everyday Value Tomato Soup (50% increase from 0.4g/100g to 0.6g/100g)
* Baxters Favourites Cream of Tomato (40% increase from 0.5g/100g to 0.7g/100g)
* Sainsbury’s Basics Cream of Tomato Soup (25% increase from 0.48g/100g to 0.6g/100g)

Cheddar and Cheddar Style Cheeses
Cheddar - the nation’s favourite cheese⁴ contains very high levels of salt (99% red warning label on front of pack) e.g. the majority of cheese products surveyed in 2016 (95%) were found to contain more salt per serving than a packet of ready salted crisps⁵. Salt reduction in cheddar and cheddar style cheeses since 2006 has shown little progress. In fact, values of salt per 100g have remained around 1.8g since 2006⁶.

Examples of cheeses with the largest salt increases between 2012 and 2016 include:
* Sainsbury's Lighter Mature British Cheese (increased 16% from 1.7g/100g to 1.98g/100g)
* Morrisons Medium Cheddar (increased 13% from 1.6g/100g to 1.8g/100g)

Ready Meals
When surveying the salt content of chilled cottage pie ready meals, minimal changes have been made in the last nine years, with the salt content per 100g slightly increasing from 0.52g in 2007 to 0.54g in 2016 (~4% increase).

Both Sainsbury’s Basics Cottage Pie 300g (increased 186% from 0.5g to 1.43g per 300g serving) and The Co-operative Truly Irresistible Cottage Pie 400g (increased 93% from 1.5g to 2.9g per 400g) are among the products with the most disappointing increases.

Luxury meals such as Marks & Spencer Gastropub Cottage Pie in a Rich Red Wine Gravy with Cheese Mash (2.9g/400g serving) and The Co-operative Truly Irresistible Cottage Pie (2.9g/400g) rank even higher with salt content. That’s near the equivalent of 2 Pot Noodles! (3g) and almost half your daily limit of salt⁷.

Although all of the meals surveyed in 2016 meet the Department of Health’s (DH) maximum salt target for ready meals⁸, over half (52%) still have a red warning label for salt on front of pack, indicating these meals are dangerously high in salt and contribute to as much as a third of an individual’s daily salt intake. This demonstrates that the targets for salt in many categories, which were seriously eroded by pressure from the industry when they were set in 2014, are far too weak.

Bread
Bread is the largest contributor to salt in the UK diet⁹ and has declined in salt content from an average of 1.2g per 100g in 2001 to 1.00g per 100g in 2011 (17% reduction). Since then, the salt content of bread has only slightly reduced to 0.97g per 100g in 2016 (3% reduction). Some products still have appeared to increase in salt, such as Tesco White Stay Fresh Medium Sliced Bread increased 33% from 0.6g/100g to 0.8g/100g.

Cornflakes
When surveying the salt content of the popular breakfast cereal, it is clear that a major reduction programme took place between 2004 and 2012, with average levels of 2.32g per 100g in 2004 down to 1.03g per 100g in 2012 (56% reduction). Whilst CASH is glad to see further reductions have been made since then, progress has not been as significant (30% further reduction in 2016 to 0.72g/100g), with some even increasing in salt content, e.g.  Sainsbury’s Cornflakes increased 42% from 0.74g/100g to 1.05g/100g. Kellogg’s Cornflakes has the highest salt content of all Cornflakes surveyed, three times more salt than Aldi’s Harvest Morn Corn Flakes (1.13g/100g v 0.34g/100g).

Action
Within each category of food there were very large variations in the salt content e.g.  The Co-operative Truly Irresistible Cottage Pie2.9g/400g serving vs The Co-operative Loved by Us Cottage Pie Low Fat 1.45g/400g serving.
This clearly demonstrates that the food industry could easily reduce these very high salt containing foods, but under the Responsibility Deal they have little or no incentive and no pressure exerted on them by the DH. In fact, if you were to switch the saltiest examples with the least in each category, you’d have a 4.74g difference in salt intake¹⁰, more salt than is found in 2 Big Macs!

Professor Graham MacGregor, Professor of Cardiovascular Medicine at Queen Mary University of London and Chairman of CASH explains: “Under the FSA & CASH, the UK led the world in salt reduction. It is a tragedy for public health that the coalition government in 2010 seized responsibility for nutrition from the FSA to the DH where they made the food industry responsible for policing themselves (‘The Responsibility Deal’)! Unsurprisingly this has failed and has resulted in many thousands of unnecessary deaths from strokes and heart disease. It’s imperative that responsibility for nutrition be handed back to an independent agency where it is not affected by changes in government, ministers, political lobbying and pressure from the food industry.”

Sonia Pombo, nutritionist and campaign manager for CASH adds, “The food we eat is now the BIGGEST cause of death and ill health in the UK, owing to the large amounts of salt, saturated fat and sugars added by the food industry.

“Whilst many food manufacturers initially made a concerted effort to reduce the salt in their products, others are now failing to do so and in turn are putting the nation’s health at risk. To do this, an agency independent of political control and not run by the food industry needs to set regulated targets for salt, saturated fat and sugar to give the food industry a level playing field. Indeed many of the more responsible food companies are now calling on Cameron to do just this.”

About the UK’s Salt Reduction Programme
The UK’s salt reduction programme, which was pioneered by the FSA and CASH, has been considered a worldwide success. The programme involved a collaborative effort with the food industry to reduce salt in the nation’s diet. This was done by setting up specific salt targets for 86 categories of food, with the aim of re-setting them every 4 years. Whilst the targets remained voluntary, strict monitoring of the food industry was maintained throughout, ensuring no company lagged behind. As a result, significant reductions in salt intake were made at a population level, consequently reducing blood pressure and resulting in 9,000 deaths per year from heart attack and stroke prevented¹¹ with a healthcare saving cost of £1.5 billion¹².

Under the coalition government, responsibility for nutrition was taken away from the FSA in 2010 by Andrew Lansley (Secretary of State for Health), halting progress in salt reduction made by the FSA. Lansley’s decision to hand power back to the food industry as part of the flawed responsibility deal has meant potentially 4 years of salt reduction has been lost, putting an estimated 6,000 lives per year at risk and draining valuable NHS resources¹³. Furthermore since the formation of the new government the Responsibility Deal has ceased.

CASH is now calling for urgent action to protect and improve the nation’s health together with an independent agency for nutrition with regulated targets for salt, saturated fat and sugar, with a forceful, transparent monitoring system.

Current guidelines suggest we should be eating no more than 6g salt a day but the latest statistics show we are eating far more than we require (8.1g/day). The DH estimates that reducing salt intakes by just 1g - a pinch of salt - would prevent 4,147 premature deaths and £288 million to the NHS every year⁸.

Salt Awareness Week: 29th February – 6th March 2016

-ENDS-

Notes to Editor
National PR - David Clarke:  david@rock-pr.com M: 07773 225516
Welcome to Consensus Action on Salt and Health

References

1 – Survey details
The survey looked at data collected in 2016 and compared with previous CASH surveys from 2012, 2011, 2010, 2007, 2006 and 2004 as well as surveys from Which? in 2012 (breakfast cereals) and the FSA in 2001 (bread), across 5 categories of food: tinned tomato soup, cheddar and cheddar style cheese, chilled cottage pie ready meals, sliced white bread and cornflakes.
Product data was collected from product packaging and online from the major supermarkets Aldi, Asda, The Co-operative, Iceland, Lidl, Marks & Spencer, Morrisons, Sainsbury’s, Tesco and Waitrose.
Data was collected in store from 26th January 2016 and products mentioned in the release purchased between 24th and 26th February 2016. See appendix for further details.
 
2 - Domino’s Original Cheese and Tomato Pizza (original mozzarella) medium classic crust contains 0.6g salt per slice.

3 - McDonalds Big Mac – 2.3g per serve & McDonalds Large Fries – 0.82g per serve = total 3.12g.

4 - According to the British Cheese Board, in a survey conducted by YouGov, cheese is bought by over 98% of households in the UK and each year we consume around 700,000 tonnes of it. 

5 - A standard 32.5g packet of Walkers Ready Salted Crisps contains 0.46g of salt .

6 – Salt content varied from 1.75g in 2006 to 1.74g in 2012 and 1.78g in 2016. Companies vary in displaying salt content to 1 or 2 decimal places. Under new EU guidelines which were to be applied by December 2014, manufacturers are instructed to display salt information per 100g to 1 decimal place. Therefore whilst a product may have been labelled as 1.75g/100g in 2012, this may now be reported as 1.8g/100g. This would suggest that little change has been made with regards to salt reduction in this category.

7 - Pot noodle Original Curry – 1.5g salt per pot as prepared (305g after prep with water).

8 - Department of Health Salt Targets:
* Salt target for cheddar and cheddar style cheeses in 2012 was 1.8g average per 100g. 2017 targets amended this to 1.75g average and a new maximum of 2g/100g.
* Department of Health 2017 maximum salt target for ready meals is 0.95g/100g
* Reducing population salt intakes by just 1g will prevent 4,147 premature deaths and save the NHS £288 million each year.

9 – According to the latest National Diet & Nutrition Survey (2011/2012), cereals and cereal products was the largest contributor to sodium intake from food for all age groups, providing 31-37%, of which 16-19% came from bread. 

10 – An example of the savings that could be made by swapping the some of the saltiest products with the least if consumed over a day

1 – He F, Pombo-Rodrigues S, MacGregor GA. Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality. BMJ Open 2014; 4:e004549 doi:10.1136/bmjopen-2013-004549

12 - NICE Guidance on the prevention of cardiovascular disease at the population level. June 2010

13 – MacGregor GA, He F, Pombo-Rodrigues S. Food and the responsibility deal: how the salt reduction strategy was derailed. BMJ 2015;350:h1936 doi: 10.1136/bmj.h1936