Seminar 2: Should you be eating that much salt?

Bruce Neal

On 19 July 2010, Professor Bruce Neal (The George Institute for Global Health, University of Sydney) gave the second in C3’s series of International Breakfast Seminars, on the subject ‘Should you be eating that much s**t (salt)?’ It was held at the House of St Barnabas, Soho.

• Slides from the event are available here >>.
• A full precis of the event is available here >>

Professor Neal spoke first about how, although ‘hypertension’ is defined as systolic blood pressure as 140 mmHg and above, the risk of stroke increases from a BP of just 115 mmHg. Around half of strokes are suffered by those with hypertension – leaving half of strokes among those who are seen as being a at lower risk. Lowering blood pressure among those with blood pressure already below 140 mmHg will help to reduce the burden of stroke. Could the Aus$1 billion a year be better spent? He estimated that 1-2% of this spend could deliver a ‘gold-plated national salt reduction programme’ that could be very influential.

He spoke about the potential benefits of working with industry – both the pharmaceutical industry and the food industry – and then turned to a new food composition monitoring initiative (run from the George Institute in Sydney) that will allow cross-country comparisons of a large number of food products, using data sources from companies, company websites, nutrient databases and (if necessary) labels in-store. Foods differ greatly between countries – he cited the example of bread, where in the UK salt levels have been reduced, but they remain high in many other countries.

The key outputs of the project will be scientific reports and media reports, and also very important will be the technical reports to industry, government and regulators. As the data will be collected regularly, the trends in food composition will become clearer within countries, as well as between countries.

Discussion on the subject was lively, and included:

• Striking a balance in working with industry – if companies are too easily criticised when they make steps in the right direction, we may be victims of a ’self-fulfilling prophecy’ whereby companies give up on trying to make healthy changes.
• Voluntary codes versus regulation – strong, objective, third-party monitoring of voluntary processes could be nearly as influential as regulation.
• Discussion on whether there are any signs that food companies are following tobacco companies’ tactics – for example, in terms of focusing on ‘personal responsibility’. There were strong feelings about this – food is, after all, qualitatively different from tobacco (we all need food).
• Changes by industry (e.g. salt reduction) will have much greater impact at a population level than trying to encourage individuals to change their behaviour.
• Access to existing data was also highlighted – companies will have significant information about their sales and markets, and greater transparency on this would be very helpful.