Changes in the salt content of packaged foods sold in supermarkets between 2015–2020 in the United Kingdom: A repeated cross-sectional study

Abstract

Background Excess consumption of salt is linked to an increased risk of hypertension and cardiovascular disease. The United Kingdom has had a comprehensive salt reduction programme since 2003, setting a series of progressively lower, product-specific reformulation targets for the food industry, combined with advice to consumers to reduce salt. The aim of this study was to assess the changes in the sales-weighted mean salt content of grocery foods sold through retail between 2015 and 2020 by category and company. Methods and findings Information for products, including salt content (g/100 g), was collected online from retailer websites for 6 consecutive years (2015 to 2020) and was matched with brand-level retail sales data from Euromonitor for 395 brands. The sales-weighted mean salt content and total volume of salt sold were calculated by category and company. The mean salt content of included foods fell by 0.05 g/100 g, from 1.04 g/100 g in 2015 to 0.90 g/100 g in 2020, equivalent to −4.2% (p = 0.13). The categories with the highest salt content in 2020 were savoury snacks (1.6 g/100 g) and cheese (1.6 g/100 g), and the categories that saw the greatest reductions in mean salt content over time were breakfast cereals (−16.0%, p = 0.65); processed beans, potatoes, and vegetables (−10.6%, p = 0.11); and meat, seafood, and alternatives (−9.2%, p = 0.56). The total volume of salt sold fell from 2.41 g per person per day to 2.25 g per person per day, a reduction of 0.16 g or 6.7% (p = 0.54). The majority (63%) of this decrease was attributable to changes in mean salt content, with the remaining 37% accounted for by reductions in sales. Across the top 5 companies in each of 9 categories, the volume of salt sold decreased in 26 and increased in 19 cases. This study is limited by its exclusion of foods purchased out of the home, including at restaurants, cafes, and takeaways. It also does not include salt added at the table, or that naturally occurring in foods, meaning the findings underrepresent the population’s total salt intake. The assumption was also made that the products matched with the sales data were entirely representative of the brand, which may not be the case if products are sold exclusively in convenience stores or markets, which are not included in this database. Conclusions There has been a small decline in the salt content of foods and total volume of salt sold between 2015 and 2020, but observed changes were not statistically significant so could be due to random variations over time. We suggest that mandatory reporting of salt sales by large food companies would increase the transparency of how individual businesses are progressing towards the salt reduction targets.

Salt intake, blood pressure and cardiovascular disease mortality in England, 2003–2018

“…According to a recent study in the UK, there has been little change in both the mean salt content and the total volume of salt sales from processed foods sold in supermarkets from 2015 to 2020 [14]. In addition, the overall salt content (g per serving) of menu items served by large UK restaurant chains remained constant from 2018 to 2020, and notably an upward trend for salt content (g per serving) was observed for mains, appetisers and sides [26].…”

“…The PHRD came to an end as the Coalition Government was replaced by the Conservative Government in 2015, and thereafter it was unclear where responsibility lay between the Department of Health and Public Health England. The reduction in the average salt content of processed foods and average population salt intake appears to have stalled ever since [13,14]. The extent to which this has affected average BP levels and CVD mortality rates in England remains unclear.…”

Progress in Multisensory Synergistic Salt Reduction

“…Various national governments and organizations have implemented diverse measures to attain this objective. In the United Kingdom, the government has implemented several policies, including public awareness campaigns, improvements in food salt content labeling and adjustments in food formulation to decrease sodium levels [ 13 , 44 , 45 ]. South Africa has enacted legislation to restrict the maximum sodium content in processed foods, and Finland has enforced sodium content labeling regulations [ 17 ].…”

Reducing salt intake as a first step to prevent hypertension

“…The joint result of these activities was a population reduction of salt by 20% to 50% for a period of 10 years with a consequent reduction in the incidence of hypertension and CVD [11]. Great Britain continues monitoring the declared salt content and for the period from 2015 to 2020, a decrease in the declared salt content was observed, especially in ready-to-eat cereals (-16%), followed by processed vegetables (-10.6%) and meat / seafood (-9.2%) [41].…”