By Holly Gabriel, Registered Nutritionist, and Natalie Brabben, Communications Officer, Action on Salt and Sugar, based at Queen Mary University of London.
Over the past decade, UK food policy has focused heavily on obesity, which has driven important progress in calorie labelling, recipe changes in food manufacturing, public awareness, and a stronger political understanding of how the food environment shapes our health. However, this focus has invertedly led to an unintended consequence, pushing other critical dietary risk factors, particularly salt, out of the spotlight.
Salt is far from a solved problem. Despite nutrition awareness being higher than ever, and salt reduction being one of the most effective population health interventions ever implemented in the UK, momentum has stalled. Salt Awareness Week (11-17th May) is as good a time as any to ask: how does salt, the trailblazer of population diet interventions, now fit in today’s nutrition landscape, and why should it still matter to you and your patients?
Why Salt Still Matters
According to the British Heart Foundation (BHF), around one person is admitted to hospital with a heart attack every five minutes in the UK, and cardiovascular disease causes a death every three minutes.1 These are the leading causes of death and disability in this country, and the strain on individuals, on families and on an already overstretched NHS, cannot be ignored. High salt intake is one of the most significant modifiable risk factors behind these statistics. Adults in England consume an average 8.4g/day – 40% more than the recommended limit of 6g. The evidence base is robust and well-established: excess salt drives hypertension, which increases risk of stroke, heart disease and kidney disease, and plays a role in osteoporosis, vascular dementia and stomach cancer.2 Reducing population salt intake lowers blood pressure across the entire nation, without requiring individual behaviour change, making it one of the most cost-effective prevention tools at our disposal.
Modelling even suggests that reducing average intake down to the recommended 6g per day could prevent millions of cases of hypertension and substantially reduce heart disease and stroke over time.3
The Hidden Salt Problem
Salt is used extensively in food manufacturing to enhance flavour, improve texture, and act as a preservative. As a result, around 75% of our salt intake comes from pre-prepared foods, including bread, cheese, ready meals, processed meats and soups. Many of these products are also lower in fibre and protective plant foods and may displace more nutrient-rich meals based around vegetables, beans, wholegrains and minimally processed ingredients.
Ultra-processed foods (UPFs) now dominate discussions around diet and health. These industrially formulated products, designed for convenience and long shelf life, tend to be high in salt, sugar and saturated fat. Unsurprisingly, diets high in UPFs are often high in salt. While the UPF lens captures many important aspects of the modern food system, it does not tell the whole story. Salt is embedded across the wider food supply, including foods that are not always perceived as problematic – or UPF – making it easy for intake to remain high without people realising.
This is reinforced by the awareness gap. A BHF poll found that over half of respondents (56%) weren’t confident estimating their daily salt intake, and only 16% could correctly identify the 6g daily limit. Meanwhile, 73% had heard of UPF- the topic driving the conversation isn’t the same as the nutrient driving the harm.4
What this Means for Practice
Health professionals are well placed to close this gap. It’s worth making the most of moments like Salt Awareness Week to boost visibility and point people toward useful resources. Some straightforward ways to integrate salt reduction into everyday conversations with patients, include:
- Reinforce the 6g message and help patients understand what it looks like in practice (we should be eating no more than the equivalent of 1 level teaspoon for the entire day, including salt already added to food). Most won’t know, and many will be surprised.
- Highlight hidden salt, especially in everyday foods like bread, breakfast cereals, sauces and soups, which aren’t always considered “salty.”
- Encourage flavour-building with herbs, spices, garlic, citrus and other seasonings, which can help reduce reliance on salt while supporting enjoyment of healthier home cooking.
- Encourage label reading, the traffic light system on front-of-pack labels are useful tools that many consumers aren’t using.
- Gradual taste adjustment, salt preference is learned and can be unlearned over time with slow and gradual changes to their diet.
- Connect it to cardiovascular conversations, framed as part of broader blood pressure management and heart health, particularly in higher-risk patients.
- Consider health equity, salt intake and cardiovascular risk are not evenly distributed. People in more deprived areas, and children, have historically had higher intakes. Hypertension is also a key contributor to maternal health inequalities. Population-level messaging and food reformulation are particularly powerful here, precisely because they don’t depend on individual health literacy or resources.
The Bigger Picture: Government and Industry Action
Individual advice matters, but it will only go so far. The UK’s earlier success in salt reduction, recognised internationally as a model programme, was driven by coordinated action across government, industry, and public health bodies. That momentum has slowed considerably, largely because progress has depended on voluntary industry commitments that now lack teeth.
The evidence from other areas, whether we look closer to home at the Soft Drinks Industry Levy, or further afield to South Africa and Argentina’s salt programmes,5 shows that mandatory measures drive faster, more consistent change.
Creating healthier food environments can support both population health and more sustainable food systems when reformulation is paired with wider efforts to increase access to affordable, minimally processed plant-rich foods.
For salt, meaningful progress requires:
- mandatory salt reduction targets with proper accountability and monitoring
- financial incentives (levies) to encourage reformulation across the food industry
- clear, standardised labelling across all food and drink, including the out-of-home sector, which currently sees most restaurants and takeaways fall outside nutrition labelling requirements
Reintegrating salt into wider nutrition policies is essential for delivering meaningful prevention strategies. Unfortunately, current government proposals raise some concerning points. The Healthy Food Standard6 forms a central part of Labour’s 10-Year Health Plan, pitched ambitiously as a ‘moonshot to end obesity’, yet it remains focused almost exclusively on calories, missing even a nod to salt’s pivotal role on health. This is particularly disappointing given that it was a previous Labour government that launched the UK’s world-leading salt reduction programme in the first place. The ambition is welcome, but the blind spot is hard to ignore.
Conclusion
Salt reduction is a key prevention tool, not a niche concern It should sit alongside broader efforts to improve dietary quality, support cardiovascular health and reduce inequalities. The UK once demonstrated global leadership in this area. Reclaiming it through renewed policy ambition, industry accountability and consistent clinical messaging, is both possible and necessary.
Salt Awareness Week offers an opportunity to remind patients, professionals, food providers and policymakers alike that reducing salt remains fundamental to cardiovascular health and healthier food environments.
Key Takeaways for Practice
- Salt reduction is a highly effective, low-cost intervention for preventing cardiovascular disease, and is essential for reducing health inequalities
- Most salt intake comes from processed foods, not added by consumers at the table
- Progress in reducing salt in manufactured foods has stalled due to reliance on voluntary measures
- Clinicians play a vital role in reinforcing public health messaging
Read Action on Salt and Sugar’s latest report.
[1] https://www.bhf.org.uk/what-we-do/news-from-the-bhf/contact-the-press-office/facts-and-figures
[2] https://www.who.int/news-room/fact-sheets/detail/sodium-reduction
[3] https://www.gov.uk/government/publications/sacn-salt-and-health-report
[4] https://pubmed.ncbi.nlm.nih.gov/39123509/
[5] https://www.cambridge.org/core/journals/public-health-nutrition/article/implementing-effective-salt-reduction-programs-and-policies-in-low-and-middleincome-countries-learning-from-retrospective-policy-analysis-in-argentina-mongolia-south-africa-and-vietnam/D6F48CDB4D86504FAC92812965F1186D
[6] https://www.gov.uk/government/news/healthy-food-revolution-to-tackle-obesity-epidemic
