title: Salt reduction in the United Kingdom: a successful experiment in public health.
abstract: The United Kingdom has successfully implemented a salt reduction programme. We carried out a comprehensive analysis of the programme with an aim of providing a step-by-step guide of developing and implementing a national salt reduction strategy, which other countries could follow. The key components include (1) setting up an action group with strong leadership and scientific credibility; (2) determining salt intake by measuring 24-h urinary sodium, identifying the sources of salt by dietary record; (3) setting a target for population salt intake and developing a salt reduction strategy; (4) setting progressively lower salt targets for different categories of food, with a clear time frame for the industry to achieve; (5) working with the industry to reformulate food with less salt; (6) engaging and recruiting of ministerial support and potential threat of regulation by the Department of Health (DH); (7) clear nutritional labelling; (8) consumer awareness campaign; and (9) monitoring progress by (a) frequent surveys and media publicity of salt content in food, including naming and shaming, (b) repeated 24-h urinary sodium at 3-5 year intervals. Since the salt reduction programme started in 2003/2004, significant progress has been made as demonstrated by the reductions in salt content in many processed food and a 15% reduction in 24-h urinary sodium over 7 years (from 9.5 to 8.1 g per day, P<0.05). The UK salt reduction programme reduced the population's salt intake by gradual reformulation on a voluntary basis. Several countries are following the United Kingdom's lead. The challenge now is to engage other countries with appropriate local modifications. A reduction in salt intake worldwide will result in major public health improvements and cost savings.
authors.affiliation: Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
authors.forename: F J
authors.initials: FJ
authors.lastname: He
authors.affiliation: Centre for Food Policy, City University, London, UK.
authors.forename: H C
authors.initials: HC
authors.lastname: Brinsden
authors.affiliation: Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
authors.forename: G A
authors.initials: GA
authors.lastname: MacGregor
mesh_terms: D002318:Cardiovascular Diseases / Q000178:diet therapy / Q000517:prevention & control; D004039:Diet, Sodium-Restricted / Q000379:methods*; D005260:Female; D017144:Focus Groups; D005515:Food Labeling; D017408:Guidelines as Topic; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000517:prevention & control*; D008297:Male; D015397:Program Evaluation; D011634:Public Health; D017673:Sodium Chloride, Dietary / Q000009:adverse effects* / Q000652:urine; D006113:United Kingdom; D016482:Urinalysis
chemical_list: D017673:Sodium Chloride, Dietary