Contribution of reformulation, product renewal, and changes in consumer behavior to the reduction of salt intakes in the UK population between 2008/2009 and 2016/2017

Mathilde Gressier,Franco Sassi,Gary Frost

doi:10.1093/ajcn/nqab130

Mathilde Gressier, Franco Sassi + Show 1 more

Open Access

https://doi.org/10.1093/ajcn/nqab130

Copy DOI

Abstract

ABSTRACTBackgroundThe UK salt reduction program started in 2003, consisting of education campaigns to raise awareness about the risks associated with a high-salt diet and of a reformulation strategy for food manufacturers. This program is often cited as an example of a successful public health program.ObjectivesThis study aimed to assess: 1) the impacts of changes in food composition and changes in consumer behavior on sodium intakes; and 2) whether changes were similar across socioeconomic groups.MethodsFood intakes for the UK population were derived from food diaries in the UK National Diet and Nutrition Survey for 2008/09 (year 1; n = 1334) and 2016/17 (year 9; n = 995). Year-specific sodium densities of foods were used to calculate the average sodium density of all food and beverage consumed. Changes in sodium density between the 2 years were explained by changes in food composition (change in sodium density of products) and/or changes in behavior (type and quantity of food consumed) using a decomposition approach.ResultsThe program was linked to a 16% (95% CI: −21% to −12%) decrease in sodium intake between years 1 and 9, while the sodium density of foods consumed decreased by 17% (95% CI: −21% to −12%). This decrease was largely driven by reformulation (−12.0 mg/100 g). Changes in food choices reinforced the effects of the program, but had a smaller impact (−1.6 mg/100 g). These effects were similar across socioeconomic groups, whether stratified by education or income, with a consistent effect of reformulation across groups and no differences between groups in behavioral responses to the program.ConclusionsA multi-component sodium reduction strategy deployed in the United Kingdom starting in 2003 corresponded to an important reduction in sodium intakes for the population. This reduction was mostly driven by changes in the food environment (reformulated food products to reduce the sodium density of foods) and, to a smaller extent, by changes in food choices. Impacts were consistent across socioeconomic groups.

Highlights

High blood pressure is the third leading risk factor for premature death in the United Kingdom, affecting more than 25% of adults [1]
To improve our understanding of the pathways through which the UK salt reduction campaign succeeded in reducing salt intakes, we investigated the effects of changes in the demand for and supply of the food products contributing to sodium intakes in the United Kingdom
The sodium density of all foods and beverages consumed by the UK population decreased by 17% between year 1 and year 9 of the National Diet and Nutrition Survey (NDNS) (−16.1 mg/100 g; 95% CI: −20.4 to −11.8 mg/100 g; Table 1)

Summary

Introduction

High blood pressure is the third leading risk factor for premature death in the United Kingdom, affecting more than 25% of adults [1]. The UK salt reduction program started in 2003, consisting of education campaigns to raise awareness about the risks associated with a high-salt diet and of a reformulation strategy for food manufacturers. This program is often cited as an example of a successful public health program. Conclusions: A multi-component sodium reduction strategy deployed in the United Kingdom starting in 2003 corresponded to an important reduction in sodium intakes for the population This reduction was mostly driven by changes in the food environment (reformulated food products to reduce the sodium density of foods) and, to a smaller extent, by changes in food choices.

Objectives

Methods

Results

Discussion

Conclusion