Salt tax could cut heart disease in developing countries: Study

The suggestions come from preliminary data from a study assessing the cost-effectiveness of two interventions - voluntary salt reduction by industry, and taxation on salt - in 19 developing countries.

Presenting the findings at the World Congress of Cardiology in Dubai, lead researcher Dr. Thomas Gaziano from Harvard School of Medicine said that use of the strategies could reduce the number of deaths from cardiovascular disease (CVD) each year by 2-3 per cent in these countries. Gaziano said that the preliminary data are the first findings from a new report from Harvard that will be published later this year.

"These results show that strategies to reduce sodium consumption, even by modest amounts, could lead to significant reductions in CVD mortality in developing countries and potentially save overall healthcare costs associated with these diseases,"​ said Gaziano.

"In developing countries, where the burden of CVD is highest, these simple steps could deliver a significant long-term impact and must be something that governments trying to manage rising healthcare costs should consider,"​ he added.

World Action on Salt and Health (WASH) campaign director Katharine Jenner, told FoodNavigator that although a voluntary salt reduction has been proven successful in countries such as the UK, where over 75% of the salt we eat is from processed foods, “this study shows that countries where salt is added in the cooking or at the table could benefit from a tax which would discourage people from using so much salt.”​

Jenner added that the UK in particular was ‘fortunate’ to have had an “excellent salt reduction programme.”​  

“People in other countries, particularly the developing world, haven't been so fortunate and so aren't preventing these otherwise preventable deaths from strokes and heart attacks,”​ she warned.

Salt reductions​

The required salt reduction levels were modeled on the UK Food Standards Agency (FSA) data. The agency set a series of targets for individual food products that have led to a net intake reduction, so far, of 9.5% overall in the country. Data also suggesting that a taxation increase of 40% on industry prices – similar to that levied on tobacco – could lead to a 6% reduction in consumption was also evaluated.

The analysis found that both strategies would be save money by reducing the number of people needing treatment for high blood pressure (hypertension) and CVD ‘events’ such as heart attacks and stroke.

Gaziano and his colleagues revealed that together, the two strategies could reduce the incidence of heart attacks by up to around 1.7% and 1.47% in China and India respectively, whilst reductions in stroke incidence were estimated to be 4.7% in China and 4% in India.

Sodium risk​

Sodium is a vital nutrient and is necessary for the body to function. However the average daily salt consumption in the western world (between 10 and 12 grams) vastly exceeds maximum recommendations from WHO/FAO of 5 grams per day.

Such high intakes of dietary sodium have been linked to negative health impacts, including the development of hypertension, cardiovascular disease, certain cancers, and other health problems..

The benefits of a global salt reduction strategy were given blinding clarity by a meta-analysis published in The Lancet Chronic Diseases Series in 2007, which concluded that reducing salt intake around the world by 15 per cent could prevent almost nine million deaths between 2006 and 2015.

The topic remains controversial, however, with a prestigious Cochrane review​ concluding that salt reduction did not impact cardiovascular disease risk. However, this was subsequently slammed in a re-analysis of the same data in The Lancet​, with the authors of this paper stating that salt reduction does provide a significant reduction in cardiovascular events.

Industry action​

The process of reducing salt levels in foods is an ongoing process within the industry, with many now acknowledging that high sodium levels in some foods is a major issue for the industry.

However, the reduction of salt in processed foods is a major challenge because in addition to salts role as a flavour enhancer, the food industry has historically added salt (sodium chloride) to foods to enhance shelf life, modify flavour, enhance functionality, and to control fermentation.

Experts in the area have previously noted a clear need for the food industry to identify technical routes to enable these functionalities to be modified whilst reducing the concentration of sodium salts and maintaining the consumer experience.