Salt: intake reduced, but still not enough 9 november 2012
Consumed in excess, salt is a risk factor for disease, especially high blood pressure and cardiovascular disease. In 2002, the Agency recommended lowering population intake by 20% through the gradual reduction in the salt content of certain foods. In partnership with the French National Consumers Institute (INC), monitoring of the salt content of a wide range of foods began in 2003. ANSES recently conducted an assessment of the impact of the ingredient changes observed since this monitoring plan was set up. It shows a reduction in salt content, proving the relevance of the voluntary commitment charter strategy implemented through the National Health and Nutrition Programme (PNNS) and National Food Plan (PNA). However, this reduction in salt content is still not sufficient to enable public health objectives to be attained. Therefore, ANSES recommends implementing additional initiatives, and if necessary regulatory ones, in order to increase the number of products targeted by this strategy and the level of reduction in salt content of processed foods.
Excess salt consumption is today recognised as a risk factor in high blood pressure and cardiovascular disease as well as other diseases, including stomach cancer.
As early as 2000, the Agency began recommending reductions in salt intake. To reach this goal, its recommendations targeted a gradual reduction in the salt content of certain foods over a 5-year period, in order to attain a 20% reduction (an average intake of 7 to 8 g of salt per day) for the entire population and to reduce the percentage of high salt consumers.
A reduction of salt intake has therefore been a key objective of the successive National Health and Nutrition Programmes (PNNS). The PNNS 3 (2011-2015) has set an objective of lowering the population's salt consumption to attain in 5 years an average of:
- 8 g\day for adult males;
- 6.5 g\day for adult women and children.
This objective is an intermediate step towards reaching the goal set by WHO, which recommends a maximum of 5 g\day.
For several years now (2003, 2005, 2008, 2011), the French National Consumers Institute (INC), in partnership with the Agency, has been monitoring modifications in the salt content of the foods which contribute most to salt intake in order to assess implementation of the recommendations issued in 2002.
Based on the results of this monitoring plan, ANSES issued an internal request in February 2012 to assess the impact of observed modifications in the salt content of products on the salt intake of the French population. This study was published today.
Salt content reduced, but still not enough
ANSES notes that there has been a decrease in salt intake since 2003, and especially since 2008, due to lowering of the salt content of certain foodstuffs, but this decrease is still insufficient for attaining the global objectives set by the World Health Organisation and the national ones set by the PNNS.
In order to reach the objectives of the PNNS 3, a decrease of 20% with regard to the salt intake estimated in 2002 was needed. However, the monitoring plan conducted by the INC and the Agency showed that the reduction in intake observed, due to modifications in salt content of food between 2003 and 2011, is estimated to be between 4% and 10%, depending on whether or not the changes observed were extrapolated to all the processed food products on the market. This range is consistent with the changes observed between the INCA 1 (1998\1999) and INCA 2 (2006\2007) consumption studies, namely a reduction in salt intake of 5% in adults.
Today, even though the percentage of high salt consumers (> 12g\d) has been reduced (a 20 to 30% decrease between INCA 1 and INCA 2), average adult salt consumption in France remains at 8.7 g\d for men and 6.7 g\d for women, which represents a total of 10g\d for men and 8g\d for women when intake from table and cooking salt are included.
These results confirm the relevance of the voluntary commitment charter strategy implemented in the context of the PNNS and PNA for reducing the salt content of food. But they also reveal the limitations of this approach, since the current tendency to reduce salt levels in this way appears to be insufficient on its own for attaining the public health objectives that have been set.
Additional initiatives, and if necessary regulatory ones, will therefore need to be implemented in order to increase both the number of food products targeted and the levels of salt reduction in processed foods. With regard to the difficulty observed in reaching these public health objectives, ANSES recommends that a study of the potential impact of these additional initiatives be conducted.
Long-term communications plans aiming to promote both dietary diversity and reasonable levels of consumption of high-salt foods should also be pursued.