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Coalition government derailed measures to cut salt in food

Transfer of responsibility for nutrition policy from the FSA to DH disrupted successful programme

Louise Prime

Thursday, 30 April 2015

The UK’s current coalition government derailed a successful programme to reduce the amount of salt added by industry to processed foods, experts have claimed in this week’s BMJ. In their analysis*, they said the programme’s progress was stalled when newly appointed health secretary Andrew Lansley moved responsibility for nutrition from the Food Standards Agency to the Department of Health and then allowed industry to set its own salt reduction targets.

Graham McGregor, professor of cardiovascular medicine at Queen Mary University of London, and colleagues wrote that soon after the FSA was established in 2000, it had become a “world leader in improving nutrition, in particular pioneering the reduction in the amount of salt added to food by industry”. Although the industry was given voluntary salt reduction targets, the FSA and non-governmental organisations (NGOs) were responsible for close monitoring and enforcement of the targets to ensure that all the major food companies would be involved and that they would all aim for the same targets; the overall aim was an eventual reduction in adults’ salt intake to 6g/day.

By 2006, salt content in foods had been reduced by 10-40%; and by 2011, average salt intake at population level had fallen to 8.1g/day, from 9.5g/day in 2003. This was estimated to have prevented about 9,000 cardiovascular deaths, and made health care savings of about £1.5bn in the UK.

But despite this success, in 2010 the coalition government transferred responsibility for nutrition policy from the FSA to the Department of Health in England and Wales; and in 2011 the responsibility deal was launched, which made the alcohol and food industries responsible for reducing alcohol and improving nutrition and, said the authors, disrupted the salt reduction programme.

Under the responsibility deal, specific targets for salt reduction were not set, reporting mechanisms were relaxed and the majority of NGOs withdrew from the deal because of concerns that the industry’s interests had been prioritised over public health. Professor MacGregor and colleagues argued that this led to a committee dominated largely by industry, many companies stopped or slowed down their planned salt reductions over this period, and some failed to meet targets.

When Anna Soubry became a new health minister in 2014, new salt targets were set, but – thanks to industry lobbying, the authors argue – they were not as low as originally suggested. Further, large food companies have had poor involvement in the 2017 targets because of the lack of enforcement and proper monitoring. The authors calculated that, as a result of the changes, four years of salt reduction were ‘lost’, or 0.9g/day – which corresponds to about 6,000 cardiovascular deaths.

They pointed out that “most of the foods that industry currently provide are very high in salt, fat and sugars and are therefore more likely to cause cardiovascular disease and predispose to cancer than healthier alternatives”, and that the food industry is “the biggest and most powerful industry in the world” . They called for urgent action to appoint an independent agency, exemplified by the FSA, that’s free from political pressure and food industry’s influence, and that can control it. They also called for targets to be introduced to cut sugars and fats (especially saturated fats) in food, which they said would decrease levels of obesity, type 2 diabetes and cancer.

* Graham A MacGregor, et al. Food and the responsibility deal: how the salt reduction strategy was derailed. BMJ 2015;350:h1936

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