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Salt shakers and food packaging should have a tobacco-style health warning

Salt shakers in restaurants should have a tobacco-style health warning placed on them, experts say.

A group of doctors from around the world have demanded urgent action to drive home the dangers of high salt consumption.

They envision salt shakers and table salt bought in supermarkets to have a label on the front saying ‘limit your use’.

It would also read: ‘Too much sodium in the diet causes high blood pressure and increases risk of stomach cancer, stroke, heart disease and kidney disease.’

The hard-hitting approach could contribute to saving millions of lives, the doctors hope.  

But critics argued such extreme measures ‘infantiles’ adults and diminishes their freedom of choice.

Salt shakers in restaurants should have a tobacco-style health warning placed on them, experts say. They envision it to read: ‘Too much sodium in the diet causes high blood pressure and increases risk of stomach cancer, stroke, heart disease and kidney disease’. Mock-up

Dr Norm Campbell, University of Calgary, was the first author of a statement in the Journal of Clinical Hypertension.

The former President of the World Hypertension League said: ‘Unhealthy diets are a leading cause of death globally.

‘And excess salt consumption is the biggest culprit, estimated to cause over three million deaths globally in 2017.

‘The World Health Organization established a target for countries to reduce sodium intake by 30 per cent by 2025.


As many as 400,000 heart disease deaths were linked to high sodium diets in 2015. 

Most agencies recommend eating three quarters of a teaspoon of salt each day, but many adults eat more than that. 

An individual-sized bag of chips accounts for about seven to 12 percent of daily sodium intake, so a high salt diet would be the equivalent of eating more than eight bags each day.  

The balance of fluids and sodium in the body is crucial to homeostasis, which keeps systems operating in sync. 

When there is too much sodium in our systems, our bodies retain excess fluid to try to balance out the salt. 

The fluid makes the heart have to work harder to pump blood, leading to higher blood pressure. 

High blood pressure, in turn, raises risks for stroke and heart disease.  

Higher blood pressure also makes it more difficult for the heart to push oxygen-carrying blood to various organs, including the brain, which lead to cognitive declines.

‘And governments and the food industry have been working together to reduce salt in processed foods.’

Dr Campbell added: ‘However, urgent action now needs to be taken to raise consumer awareness of these dangers.’

Dr Tom Frieden, president and chief executive officer of Resolve to Save Lives, said: ‘Most people aren’t aware that the amount of salt they are consuming is raising their blood pressure and shortening their lives.

‘Adding warning labels to all salt packaging is another way to make the healthy choice the easy choice.’

Sodium, the main component of salt, can be dangerous in excess by raising blood pressure.

This could lead to heart disease or stroke, but there is some evidence that too much salt can damage the heart and kidneys without increasing blood pressure.

Acute ingestion of sodium in the range of 17g or more in an adult, and 12.5g or more in an infant can cause seizures, coma, and death, the doctors from the UK, Canada, Australia, the US and China warned.

UK guidelines say adults should eat no more than 2.4g of sodium per day.

That’s the equivalent to one teaspoon of salt a day – but many people are eating far more without even realising.


The vast majority of packaged foods in the UK come with nutritional information printed on the label. 

The main things to look for are fat, saturated fat, salt (which may be called sodium), fibre and sugar – which is often listed as ‘of which sugars’ beneath carbohydrates.

Generally speaking, foods with higher fibre and lower saturated fat, salt and sugar are healthier. 

Some supermarkets also label nutritional value with a traffic light system, in which more green points to healthier food.

The NHS advice on what is high or low is as follows:

Total fat

High: more than 17.5g of fat per 100g 

Low: 3g of fat or less per 100g

An adult’s recommended daily allowance (RDA) of fat is around 70g.

Saturated fat 

High: more than 5g of saturated fat per 100g 

Low: 1.5g of saturated fat or less per 100g

An adult’s RDA of saturated fat is around 20g.

Sugars (aka of which sugars)

High: more than 22.5g of total sugars per 100g 

Low: 5g of total sugars or less per 100g

An adult’s RDA of sugars is around 90g.

Salt (aka sodium) 

High: more than 1.5g of salt per 100g (or 0.6g sodium) 

Low: 0.3g of salt or less per 100g (or 0.1g sodium)

An adult’s RDA of salt is 6g or less. 

Source: NHS Choices   

On average, Britons are consuming 8.1g a day, which is about a third more than the maximum recommendation.

The largest source of sodium is processed foods, such ready meals, crisps, sandwiches, pasta sauces and cured meats.

Foods packaging is required to display information about the salt content on the front of the packaging.

But it’s not easy to understand, and should be clearer, the doctors sate.

Dr Jacqui Webster, of the World Health Organization Collaborating Centre on Population Salt Reduction, said: ‘Although most countries require sodium levels on labels in processed foods, they are difficult for people to interpret and don’t warn of any health risks.

‘Health warnings on salt package and dispensers would be a simple, cost-effective way of conveying the dangers of salt to billions of people worldwide.’

Some countries have adopted extensive measures to reduce dietary salt.

Argentina, Uruguay, Mexico City have banned salt shakers from restaurant tables.

But none, as of yet, have started plastering health warnings on supermarket products.

The authors on the statement wrote: ‘It would increase awareness of the dangers of high‐sodium diets by people purchasing sodium and a reminder of the dangers by people seeing the containers at stores, food service establishments, or in the home.’

Think tank Institute of Economic Affairs (IEA) are against the idea, which mirrors targets drawn up by Public Health England to reduce sugar, salt and calories in foods by up to 20 per cent. 

Christopher Snowdon, Head of Lifestyle Economics: ‘The Government has led a decade-long campaign against salt, and since 2017 there have been 220 different active salt and sugar targets for food. 

‘If current government proposals come into force, it will give the UK one of the most restrictive food markets in the world.

‘Health warnings on salt packets will do nothing for public health and everything to continue infantilising the British public, eroding individual responsibility for what we choose to eat.’ 


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