The voluntary salt limit of the coalition is a "public health disaster" | Policy

Nearly 10,000 cases of heart disease and stroke and 1,500 cases of cancer could have been prevented in England if the coalition government had not opted for a voluntary agreement with the industry to reduce salt intake in food, say the researchers.

The Responsibility Deal was introduced in 2011 by Andrew Lansley, then Secretary of Health. The agreement called on food and beverage manufacturers and supermarkets to make their own commitments to improve the health of their popular products, including reducing the salt and sugar content.

Until then, the Food Standards Agency (FSA) had urged companies to achieve specific targets for reducing salt content. An article in the Journal of Epidemiology & Community Health states that, according to the FSA, from 2003 to 2010, salt consumption levels decreased by 0.2 g per year for men and by 0.12 g for women , against 10.5 g on average for men and 8 g for men. women a day in England.

But between 2011 and 2014, annual reductions in food salt consumption slowed down to 0.11 g for men and 0.07 g for women.

The authors, from Imperial College London, estimate that the slowdown could have resulted in approximately 9,900 new cases of heart disease and stroke, as well as 710 related deaths, between 2011 and 2018. It would also have been possible being responsible for another 1,500 cases of stomach cancer and 610 badociated deaths.

The researchers said that if this continued, there would be about 26,000 additional cases of heart disease or stroke and 3,800 more stomach cancer cases by 2025, affecting the the more affluent people in society and representing more than £ 1 billion in health care. and loss of productivity costs.

Anthony Laverty of Imperial College's Public Health Policy Assessment Unit stated that his article was part of the debate about whether the industry alone could rely on healthier.

"I would not really say. If they are not encouraged to do so, why would they reformulate?

"I would say that the lesson to be learned from salt and other nutritional issues is that we need an independent and robust system to tell the industry that you need to reach these ambitious goals."

The newspaper, he said, was "another piece of evidence that relying on these voluntary and cowardly arrangements with industry is really not the way to improve public health."

Graham MacGregor, chairman of the Action on Salt campaign group and a professor of cardiovascular medicine, said the document showed that the liability pact was a disaster for public health.

He said: "In the UK, the reduction in salt intake has been slowed down, resulting each year in thousands of strokes, heart failure and heart attacks, especially in the most disadvantaged, many of whom could have been avoided.

"This reinforces the urgent need for a robust system in which we generate attractive reductions in salt consumption, which have a positive and lasting impact.

"It's now up to the Minister of Health, Public Health England and the government to put in place a coherent strategy that says the food industry needs to know what to do, instead of telling the food industry to do what it wants to do. must be done, which currently seems to be the case.

"The UK currently has no active salt reduction strategy, which is appalling. In fact, the last set of targets for reducing salt consumption expired at the end of 2017. It goes without saying that we now have to put our strategy of reducing salt consumption back into health care. our overloaded natural health system and our economy. "

The authors say that their study had certain limitations. It was an observational modeling study that could not establish the cause and the researchers did not collect long-term data on salt intake. among the same people, a factor that could affect the results.

Alun Hughes, professor of cardiovascular physiology and pharmacology at UCL, acknowledged that there were limits, but that the study was overall of good quality.

"Despite the recognized limitations, this study casts doubt on the effectiveness of the Public Health Accountability Agreement in terms of reducing dietary salt intake.

"The findings should help to reflect on future public health strategies and emphasize the importance of a thorough evaluation of any public health intervention."