Turn against the grain – cutting our saline habit

14 June 2016



It’s well known that too much salt is bad for you, leading to higher blood pressure and dramatically increasingly the risk of cardiovascular disease. So, with pressure now ramping up from health campaigners, what’s the best way to cut it out of consumer products without compromising on taste? Oliver Hotham speaks to experts from inside and outside the food industry about cutting our saline habit.


Our insatiable appetite for salt isn't just down to it spicing up day-to-day dinners: ever since humans realised that meat packed in it lasts a great deal longer, we've used it to keep things fresh. With the advent of cheap processed food, too, it has become even more essential for billions of people, and the World Health Organization (WHO) estimates that over 80% of the sodium in our diets comes from packets.

Unfortunately, this seemingly essential preservative is killing us. In 2014, WHO released a grim report intended to raise awareness about the dangers of excessive salt. More than 5g of it a day, the report argued, massively increased blood pressure and, as a consequence, the risks of heart disease and stroke. Most of us consume 9-12g of it a day, however - more than double what we're supposed to.

"Raised blood pressure is the biggest killer in the world," says Graham MacGregor, a professor of cardiovascular medicine and chairman of Action on Salt. "If you could stop it going up, you'd prevent millions of people dying worldwide. That's what it's all about, and salt is by far the most important factor that puts up our blood pressure: we all eat too much of it."

Follow the trail

The WHO report pointed firmly to governments and individuals as being the key drivers of salt reduction: policymakers should develop new regulations and fiscal incentives, it argued, to encourage consumers to eat less salt and make sure well-funded educational programmes are in place to teach students the dangers of excess sodium in the diet.

The responsibility wasn't just on those in charge, though. "Improving dietary habits is a societal as well as an individual responsibility," the report also said. "It demands a population-based, multisectoral, and culturally relevant approach."

In short, all of us have to cut down on the salt we put on our food, but it's up to government and policymakers to put pressure on the industry. MacGregor, however, argues that consumer multinationals could be doing much more to cut the salt it puts in our food already. From a small office at Queen Mary University in East London, MacGregor and his team at Action on Salt act as watchdogs on an industry that, he believes, hasn't done nearly enough, and needs to take more initiative.

"The problem is that we're eating too much because of the salt that's put into food; you have very little choice," he says. "In the UK, 80% of the salt we eat is added by the food industry: we're passive consumers."

This isn't to say that many who consume too much salt aren't doing so through day-to-day cooking too, and most us could probably afford to move the saltshaker off the dinner table, but when you eat packaged food or go out to eat, it's impossible to monitor your own intake. The only solution, according to MacGregor, is for the industry to take responsibility.

"The strategy is to get the food industry to take the salt out, and that's what we're doing in the UK," he says. "But it took persuading to get the food industry to do it and the government to back it."

Action on Salt focuses on reducing sodium levels in individual products, concentrating on the biggest sources of salt in the British diet. Bread is a good example of this, as "the biggest source of salt in the diet in the UK".

MacGregor explains: "We set targets for bread on an average level that they had to achieve at certain times. It's fairly easy to achieve a 10-15% reduction; you're gradually lowering the level of salt they're allowed to put into foods, over a period of time."

The announcement of WHO's recommendations saw a number of companies come out with plans to meet the new industry targets. Nestlé, for example, has committed to reducing salt content by 10% in all its consumer products; and with a vast portfolio of goods, from breakfast cereals to soups and stocks, that's a lot of salt to cut.

"Nestlé has had policies on using salt since 2005, and in 2013, we updated this policy," says Christophe Bolton, a scientist working on the company's salt reduction programme. "There was an increasingly amount of evidence that an excess of sodium causes elevated blood pressure, and that this is one of the main causes of cardiovascular disease."

Preservation

There are two critical issues that any company has to take into account when reducing the sodium in its food products: taste and preservation. In certain goods, particularly in chilled ones, salt plays a crucial role in reducing water activity - essential to keeping foods like charcuterie or pizza dough fresh and edible. Nestlé has a research centre with close to 550 scientists dedicated to this very challenge, and one proposed solution has been to replace sodium with other minerals.

"It's not a one-to-one replacement," Bolton explains. "The team needs to understand what kind of water activity could take place, and what characteristics these other compounds and minerals would have, and then they can understand what replacements we need."

Unilever is another multinational taking steps to cut the salt out of their products. As part of its Sustainable Living Plan, the company's goal for sodium reduction is to ensure that by 2020, 75% of its foods portfolio will meet salt levels conducive to the recommended intake of 5g a day.

"Our targets are volume-based, meaning that our goal is to reduce sodium in our top-selling products so that we can make a greater impact on overall sodium intake," says Dr Karin van het Hof, global nutrition and health director of savoury foods at Unilever. "We routinely screen our total portfolio to understand where we can further optimise the nutritional composition of our products.

"Small changes in nutritional quality can add up to a big public health impact for people who love our products and eat them regularly. By setting ourselves targets, we can also help improve industry-wide standards."

The test of taste

Maintaining taste is also essential to an effective salt reduction programme. Customers have strong attachments to many products, and a dramatic change in how they taste could drive them away. In response to this, Nestlé has set up what it calls a 'sensory panel' at its research centre in Lausanne, Switzerland.

"There we have at least eight people who are specially trained in the subject we want to evaluate," says Bolton. "It's about describing the product: people are trained over ten weeks to evaluate saltiness or specific flavours we could expect, like bitterness.

"It's amazing to see that these people can really say, 'this one is more salty than the other one; this one has more depth of flavour than the other one'. We can then compare how the product was before and what it might be like after."

Another way to make sure taste isn't changed too dramatically is by developing substitutes that replace the salt that's been lost.

"We gradually reduce sodium levels over time, notably by using natural herbs and spices (such as onion, garlic, chilli, thyme, lemon and lime) and salt replacers such as potassium," says van het Hof. "For example, the sodium content in tomato soup has been reduced by increasing the amount of tomatoes, spices and herbs to rebalance the soup in sweetness, sourness and fruitiness."

But not everyone is convinced that the flavour is such a big obstacle to salt reduction, and the question of whether customers even notice the difference is a contentious one. MacGregor argues that with the right approach, sodium can be removed from products without anyone being able to tell, and that the idea that customers complain when it's reduced is a myth perpetuated by the food industry.

"If you do it slowly - and that's what we've done in the UK - in 10-15% reductions, no one can detect that," he says. "Then you do it again, and you're doing it slowly over a period of time. For instance, Kellogg's cornflakes have had 50% of their salt concentration reduced since 2005, and there hasn't been a single complaint. No one's noticed."

Political energies

Central to the salt question is voluntary versus statutory legislation: should companies be compelled to make their products healthier by the law, or does a self-policing environment work better? South Africa, Chile, Argentina and Brazil, to name a few places, have already implemented regulated salt targets.

"This has a lot of advantages," argues MacGregor. "It ensures a level playing field, and you don't need all the media activity that's necessary when you're trying to get the voluntary policy to work - because you can just fine them. They're going to stick to those targets for sure."

The UK has so far had two bodies responsible for overseeing salt reduction programmes. Until 2010, the Food Standards Agency was an independent nutritional body, with a scientific body free from political control. Along with Action on Salt, it set up sodium reduction recommendations with firm targets, and named and shamed companies who didn't comply.

After 2010, however, things changed, and the new Conservative-led coalition handed control over to the Department of Health and shifted the way the department was run. Six years on and the system is still unfocused: an upcoming government announcement on broader health strategy is expected in the next few months.

The takeaway

Sodium intake is falling and, as we all consume less salt, there has been a dramatic fall in strokes and heart attacks - signs that the push by governments and international organisations could be having an effect. And the changes extend to our taste buds, too.

"If you're eating less salt overall, you only need a tiny amount in a product for a salty taste," asys MacGregor, "whereas if you're eating vast amounts, you need much more. In this way, you can retrain your receptors to need less salt."

Salt is central to food. It flavours it, enhances it and is an essential tool in the preparation of everything from steaks to pancakes. It transcends borders and culinary differences, and we produce a quarter of a billion tons worth of it a year to satiate the world's appetites, digging it out of the ground and pulling it from the sea in the kinds of immense feats of engineering usually reserved for oil or precious minerals. It's odd to think that so much time and effort goes into the stuff you might use to give your dinner a bit more of a kick, or to season a stew - and to think about the huge effect it can have on our health.

Graham MacGregor is professor of cardiovascular medicine at the Wolfson Institute of Preventive Medicine and honorary consultant physician at St George's Hospital, London. MacGregor set up CASH in 1996 and WASH in 2005, and is chairman for both.
Christophe Bolton is a research and development project head at the Nestlé Research Center in Lausanne. His background is as a researcher in the metabolic engineering of bacteria at Braunschweig University of Technology in Germany.
Dr Karin van het Hof is global nutrition and health director of savoury foods at Unilever. She previously studied human nutrition at the Wageningen University in the Netherlands. At Unilever, she is involved in addressing overnutrition and undernutrition through product reformulations and external communication.


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