The risks of excessive dietary sodium are well known. Associated with kidney stones, osteoporosis and, most notably, high blood pressure, salt has long been viewed as one of the villains of the kitchen cupboard. One only need think of ‘Sid the Slug’, the notorious 2004 UK advertising campaign that insinuated salt could kill humans in the same way it wipes out slugs.

Evidently, a person is unlikely to desiccate the second someone approaches them with a salt shaker, but too much sodium can certainly impact their long-term health. It has been predicted that if everyone in the UK reduced their salt consumption by 1g a day, there would be 12,000 fewer annual strokes and heart attacks, leading to 6,000 fewer deaths. Similarly, Canadian estimates suggest if the average daily sodium intake was to drop by 1,840mg, we’d see a 30% drop in rates of hypertension.

It stands to reason that sodium reduction should be a key public health concern. And yet with up to 80% of dietary sodium hidden in processed foods, it is clear the issue extends far beyond the remit of the consumer. Recent years have seen the focus drift away from public education and towards what goes on behind the scenes.

Organisations such as the UK-based Consensus Action on Salt and Health (CASH) and its international arm World Action on Salt and Health (WASH), work on precisely that basis. Established in 1996, CASH pulls together with the food industry, health professionals and the government to reduce the amount of salt in processed foods. "Most people have no idea how much salt they eat or where it’s coming from, so just telling people to reduce salt in their diet will do nothing," says Katharine Jenner, campaign director of CASH and CEO of the charity Blood Pressure UK.

"It’s important to raise awareness so that people don’t purposely have too much salt, but our campaigning work is not really about the consumer. It’s about letting the companies know that we’re keeping an eye on them; telling them how many lives they’ve saved when they’ve done well; and pulling them up by the bootstraps when they haven’t."
Its current target is to reduce the average adult’s salt consumption to 6.0g a day, down from the present figure of 8.1g. This move is predicted to save 17,000 lives. Already, its salt-reduction campaign has shown great success – a recent paper, published in the BMJ Open, concluded that blood pressure had dropped between 2003 and 2011 in tandem with the population’s salt intake.

Sodium levels
In the UK, these sodium-reduction targets have never been legally imposed. Formerly the province of the Food Standards Agency, nutritional targets of this kind now fall under the banner of the Public Health Responsibility Deal, a voluntary programme by the Department of Health. To date, more than 40 companies have pledged to reduce their sodium usage – a commitment driven by social awareness as opposed to regulatory enforcement.

Other countries take a different approach. While the World Health Organization (WHO) has clear goals in place (reducing global salt intake by 30% by 2025, for example), how a member achieves these measures is at its own discretion. South Africa, for instance, introduced groundbreaking legislation in 2013, mandating salt reduction across its food industry. Other nations, such as the Netherlands, Finland and Greece, have long since capped the amount of sodium that can be used in bread or flour.

Certain countries require warning labels on high-salt foods, and others subject these products to a public health tax. And while, in 2012, the American Center for Science in the Public Interest (CSPI) urged the FDA to create mandatory targets, the US and Canada seem happy to proceed on a voluntary basis for now.

"In Canada, the federal, provincial and territorial governments have committed to helping create conditions that make the healthier choice the easier choice," explains Sara Lauer, a spokesperson for Health Canada. "Sodium reduction is an important part of healthy living and the governments have been working together towards supporting Canadians in their efforts. The goal is to work towards reducing the average intake to 2,300mg a day by 2016."

So what does this actually mean for the food industry?
The goal is to reduce sodium at every step of the value chain, whether the product manufactured is destined for consumers, other food manufacturers, or the restaurant and food service sectors. Of course, in many instances, this is easier said than done.

As a low-cost and multipurpose substance, salt has been used for thousands of years to manufacture and preserve foods. It can be extremely difficult to replace; as well as enhancing flavour, it often plays a functional role in food products; for instance, adding texture to cheeses and halting microbial growth in cured meats.

"In the EU and around the world, the regulations leading nutrition and health claims are designed to protect consumers from misleading and false claims."

With certain foods, there is the additional complication that salt is one of the key ingredients. Think tomato juice or ready-salted crisps – simple products with a salty taste. At certain times, the risk of consumer rejection may prove too great, particularly where the consoling familiarity of ‘salt’ on the ingredients list is replaced by a lesser-known chemical substitute.

It also goes without saying that the costs of production may increase. A reformulated product may require expensive new machinery, and any salt substitute used is likely to come at a price. For instance, AkzoNobel has developed a new mineral salt, Suprasel OneGrain, which is a unique alternative to regular salt. OneGrain combines sodium chloride with potassium chloride and flavour in each single salt grain.

Although it reduces sodium by up to 50%, it has been billed as looking, tasting and acting the same as regular salt. The sticking point for manufacturers – where there is one – often lies in the upfront costs.

"Salt is the cheapest ingredient after water, so if you’re going to replace that it will always be more expensive," explains Matthijs Bults, business development manager at AkzoNobel. "You need a considerable investment in product development to make sure you get a good product back, and you want the same production efficiency as before, as the total cost of ownership has to be right."

Responding to the trend
Many food companies are responding by taking baby steps, reducing sodium carefully and gradually over a period of years. Nestlé, for example, has a policy of cutting sodium by 10% with each successive recipe change, and the Dutch bakery sector is phasing in successively tighter legal targets.

Incremental reductions of these kind help the company adapt to a different production process, while keeping taste changes to a minimum. In today’s market, taste is king; after all, if the taste of a reformulated product is not right, the consumer will not buy it and therefore won’t reap the benefits. In the UK, voluntary targets were conceived as ameans of minimising risk as all brands fought for market share.

"The idea of the Responsibility Deal was that if everyone reduces sodium at the same pace, it creates a level playing field with no competitive disadvantage," explains Jenner. "Let’s say you take salt out of your food and not many of your competitors do, some people would probably prefer your food, but lots of people would prefer the original."

One of the difficulties here is that, as time goes by, manufacturers are apt to see diminishing returns on their investment. Once they have already eliminated all their excess salt, they will need to work ever harder for progressively smaller gains, and their incentive won’t be so great. Jenner thinks that once all possibilities are exhausted, the focus may flip back to the consumer.

"Let’s say a company reduces 10% of its total salt every two to three years, so it was 10% of 2.0g and now it’s 10% of 1.5g," she says. "It’s harder for people to remove salt when they’ve already made such big reductions, so I think we need to start thinking about bringing consumers into the argument more. We need to talk about where they’re adding salt themselves, and try to get them to choose better options."

From Bults’ perspective, new solutions such as OneGrain are apt to become ever more in demand. "We learn from many of our customers that they first tried to reduce salt step by step, but now they say they’ve come to a point where that’s impossible," he says. "They cannot take out more as there is no more excess salt in the products, so the demand for innovative solutions will only grow."

Encouragingly, the importance of salt seems to have been downgraded in recent years, assuaging early fears that reduction is an untenable goal. When the CASH campaign started out, this was one of the key concerns – was salt essential as a preservative? And if salt wasn’t there for flavouring, would food be bland and unmarketable?

Health in mind: a sign of the times
In actuality, the past few decades have seen leaps and bounds in food production processes, meaning that shelf life can be assured without the need for salt. Today’s food industry uses far better process controls and refrigeration strategies, along with smart tweaks in packaging that render it all but useless.

Similarly, there has been a real push in the direction of higher-quality ingredients. Whereas in the past, manufacturers may have relied on salt, along with fat and sugar, to mask poor quality produce, today’s typical consumer base is far more discerning. As a result, herbs and spices are enjoying something of a revival and highly processed food is on the wane.

Bridging the gap still further will most likely entail further research. Health Canada is yet to discover the outcome of its current sodium-reduction initiative, although an early study of certain food categories has shown promising results. For the time being, the industry continues to focus on new and reformulated products along with educational initiatives.

"The major food-industry associations have been actively engaging their memberships through technical-advisory committees," says Lauer. "Food technology and research centres have also been actively engaged in increasing awareness and providing technical assistance to the food industry, while research has been ongoing in a number of university food science and nutrition research centres across Canada."

Meanwhile in the UK, Jenner sees strong grounds for positivity. Acknowledged by WHO as one of the world leaders in sodium reduction, the country has already made significant inroads into what once seemed an intractable problem. Sodium intake has been slashed by 15% since the start of the century.

The situation isn’t perfect, of course, and she believes certain practical steps would expedite future progress. For instance, she would welcome the introduction of an independent body to monitor salt reduction, rather than leaving the targets entirely in the hands of the government. Equally, she feels that more needs to be done by small businesses in the out-of-home sector, which are lagging far behind the major corporations in terms of cutting out salt.

That said, she is deeply encouraged by what has occurred so far – a sustained drop in salt consumption that has crept upon consumers largely by stealth.

"If you stood outside the supermarket and asked people how much salt they thought was in their trolley compared with ten years ago, they would not believe you if you told them it was 30-40% less," she says. "The food technologists have worked hard to ensure the food tastes great – it’s been amazing, the response we’ve had."