The Washington Post
We have a huge salt problem. Millions will die without action, WHO warns.
Leo Sands – March 14, 2023
Seven million people could die of diseases linked to excessive salt consumption before the decade’s end unless governments immediately pass tighter restrictions on salt, a report by the World Health Organization warned this month. Its authors are calling on governments to implement stricter sodium targets for food, mark salt content more clearly on packaging and boost public awareness of the health dangers posed by eating a lot of salty food.
“Excessive sodium intake is the top risk factor for an unhealthy diet, and it is responsible for 1.8 million deaths each year,” said Francesco Branca, director of the WHO’s Department of Nutrition for Health and Development.
Eating too much salt is one of the causes of cardiovascular disease, which kills an estimated 17.9 million people each year, according to the WHO. It can also lead to strokes, which kill 5 million people each year globally – and other serious medical conditions.
Governments could save many of those lives by introducing mandatory limits on the amount of salt the food industry is permitted to add to processed foods, Branca said – adding that this accounts for the majority of sodium consumed by most Americans, rather than salt sprinkled on food in the kitchen.
“This is really something that doesn’t cost money to anybody,” Branca said. “It’s a simple intervention, but it’s incredibly effective.”
Most people in the world consume about 10.8 grams of salt a day, more than double the level recommended by both the WHO and the Centers for Disease Control and Prevention, which suggests consuming no more than a teaspoon of salt a day. While salt is an essential nutrient, sodium – which constitutes 40 percent of it – narrows and stiffens blood vessels.
“If you retain more salt in the body, it slowly puts up the blood pressure,” said Graham MacGregor, a professor of cardiovascular medicine at Queen Mary University of London, who was not involved in the report but campaigns for reducing salt intake. “That raised blood pressure then causes strokes, heart attacks or heart failure.”
Many other health organizations – including the American Heart Association, the American College of Cardiology, and the National Academies of Sciences, Engineering and Medicine – also recommend that consumers dramatically reduce their sodium intake. That position is based on decades of scientific evidence (including analyses of hundreds of published studies that underscore sodium’s health dangers) that remains unchanged despite several studies in recent years that have challenged it.
The WHO is hoping to reduce global salt intake by 30 percent from 2013 levels, a 12-year target agreed to by all 194 of its member states at the time – but which none is on track to meet, it said. Branca said he was considering extending the target to 2030.
In a review of salt reduction policies that have been implemented by world governments, the WHO found that just nine of its members had put sufficiently comprehensive measures in place to reduce excessive salt consumption – 5 percent of its members.
The U.N.’s health agency is calling on governments to improve public awareness around the dangers of an overly salty diet and advertise salt levels more clearly on packaging. WHO officials believe that mandatory salt content levels are also required to wean the world off its deadly salt habit – given the high proportion that is used by food manufacturers rather than added by individual consumers.
“There’s no point in telling people to stop adding salt in their food,” MacGregor said. “It’s already in there.”
More than 70 percent of salt in the American diet comes from packaged and prepared foods, according to the Food and Drug Administration, not from the salt shaker at home.
In September, the FDA announced that it planned to change the rules for nutrition labels on food packages to indicate that they are “healthy.” Manufacturers would be required to adhere to specific limits for, among other nutrients, sodium.
In response, the Consumer Brands Association, which represents 1,700 major brands, including General Mills and Pepsi, said the proposed rule was overly restrictive and instead suggested “revising nutrient thresholds to modestly higher levels for added sugars and sodium.”
Part of the reason food manufacturers continue to add so much salt despite the known health risks, the WHO’s Branca argues, is that years of adding too much salt to our foods has left people’s taste buds desensitized to excessive levels. “You expect a certain amount of salt, and you think that if you don’t have that much salt, the food is tasteless,” Branca said.
“Manufacturers don’t want to take the initiative to reduce sodium if there’s a competitor that has a higher content of salt,” he said, demanding that governments force food manufacturers to reduce those levels through mandatory targets.
The benefits of reducing salt intake begin relatively rapidly, scientists say. Blood pressure starts falling within weeks for most people, according to the CDC, and sensitivity to salt returns soon.
“Your taste buds will adjust to a reduction in salt, and you’ll be able to better taste the other flavors,” Branca said. Your food, he suggests, may even start tasting better.
The Washington Post’s Marlene Cimons and Laura Reiley contributed to this report.