title: Potential effect of salt reduction in processed foods on health.
abstract: BACKGROUND
  Excessive salt intake has been associated with hypertension and increased cardiovascular disease morbidity and mortality. Reducing salt intake is considered an important public health strategy in the Netherlands.
  
  
  OBJECTIVE
  The objective was to evaluate the health benefits of salt-reduction strategies related to processed foods for the Dutch population.
  
  
  METHODS
  Three salt-reduction scenarios were developed: 1) substitution of high-salt foods with low-salt foods, 2) a reduction in the sodium content of processed foods, and 3) adherence to the recommended maximum salt intake of 6 g/d. Health outcomes were obtained in 2 steps: after salt intake was modeled into blood pressure levels, the Chronic Disease Model was used to translate modeled blood pressures into incidences of cardiovascular diseases, disability-adjusted life years (DALYs), and life expectancies. Health outcomes of the scenarios were compared with health outcomes obtained with current salt intake.
  
  
  RESULTS
  In total, 4.8% of acute myocardial infarction cases, 1.7% of congestive heart failure cases, and 5.8% of stroke cases might be prevented if salt intake meets the recommended maximum intake. The burden of disease might be reduced by 56,400 DALYs, and life expectancy might increase by 0.15 y for a 40-y-old individual. Substitution of foods with comparable low-salt alternatives would lead to slightly higher salt intake reductions and thus to more health gain. The estimates for sodium reduction in processed foods would be slightly lower.
  
  
  CONCLUSIONS
  Substantial health benefits might be achieved when added salt is removed from processed foods and when consumers choose more low-salt food alternatives.
authors: National Institute for Public Health and the Environment, Bilthoven, Netherlands (MAHH, RTH, JH, HCB, and JMAvR), and the Division of Human Nutrition, Wageningen University, Wageningen, Netherlands (JMG, HCB, and JMAvR).
authors: Marieke A H
authors: MA
authors: Hendriksen
authors: Rudolf T
authors: RT
authors: Hoogenveen
authors: Jeljer
authors: J
authors: Hoekstra
authors: Johanna M
authors: JM
authors: Geleijnse
authors: Hendriek C
authors: HC
authors: Boshuizen
authors: Joop M A
authors: JM
authors: van Raaij
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000178:diet therapy / Q000401:mortality / Q000517:prevention & control*; D002648:Child; D003430:Cross-Sectional Studies; D004034:Diet Surveys; D004039:Diet, Sodium-Restricted; D057140:Fast Foods / Q000009:adverse effects; D005511:Food Handling; D057141:Food, Preserved / Q000009:adverse effects; D005525:Food-Processing Industry; D019983:Guideline Adherence; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000401:mortality / Q000517:prevention & control*; D008017:Life Expectancy; D008954:Models, Biological; D009426:Netherlands / Q000453:epidemiology; D010349:Patient Compliance; D011788:Quality of Life; D064167:Recommended Dietary Allowances; D012307:Risk Factors