Directory UMM :Data Elmu:jurnal:N:Nutrition And Food Science:Vol30.Issue4.2000:
A case for reducing salt
in processed foods
Joanna Gibson
Gillian Armstrong and
Heather McIlveen
The authors
Joanna Gibson is a PhD Research Student in the
Consumer Studies Division, Gillian Armstrong is a
Lecturer on the Consumer Studies Programme and
Heather McIlveen is Course Director of the Consumer
Studies Programme, all at the University of Ulster,
Jordanstown, Nothern Ireland.
Keywords
Salt, Diet, Processed foods, Food manufacturing
Abstract
Salt is one of the most valuable substances available to
man, with a definitive role in the human body and in food
production. However, the continued use or indeed misuse
of salt has led to adverse effects on health. The increasing
consumption of convenience foods has contributed
greatly to a high salt intake. Highly processed,
convenience foods are known to contain large quantities
of salt to optimise storage stability and flavour
acceptability. Current high salt intakes have therefore
been attributed to processed foods, accounting for 75-85
per cent of total salt intake. Such findings and associated
health implications have prompted a call from health
professionals and food researchers to reduce salt intake.
Effective salt reduction, however, can only be achieved
with the co-operation and commitment of the food
industry in the development of lower-salt processed
foods.
Electronic access
The current issue and full text archive of this journal is
available at
http://www.emerald-library.com
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . pp. 167±173
# MCB University Press . ISSN 0034-6659
Functions of salt
Salt in the human body
Salt is a dietary essential and its role in the
human body is paramount to normal body
functioning. Sodium chloride (NaCl) is the
chemical term given to common salt and it is
the sodium element that is potentially harmful
when consumed in excess. The principal role
of salt in the body is the maintenance of
bodily fluid within close and regulated limits
(American Society for Nutritional Sciences,
1999).
Sodium (Na) is the principal cation in
extracellular fluids in the body. Together with
potassium (K), chloride (Cl) and other ions,
sodium ions maintain the volume of the
extracellular fluid, osmotic pressure, acidbase balance and electrophysiological activity
in muscles and nerves (IFST, 1999). Sodium
chloride is necessary for the creation of
gradients across cells, to enable the uptake of
nutrients, especially from the small intestine
(American Society for Nutritional Sciences,
1999).
Sodium content in the body is controlled by
excretion through the kidneys into the urine.
For this reason, the sodium intake of children
must be carefully monitored and regulated,
since a child's kidneys are not fully developed
and would not be capable of excreting large
quantities of sodium from the body. Sodium is
also excreted from the body in the form of
perspiration. This occurs more intensely in hot
climates and during strenuous exercise,
causing muscular cramps. If body fluids are not
replenished, by increasing fluid consumption,
dehydration may occur. Despite this fact, most
healthy people metabolise sodium normally
and excrete any excess consumed (IFR, 1999).
It is indisputable that salt has an important
function in the human body and careful
attention must be given to the regulation of salt
intake in order to sustain good health.
Salt in food
Salt is a valuable commodity which is used
extensively in food processing. It is a cheap
and versatile product (MacGregor, 1998;
Whitehead, 1998) and its role in the food
industry is twofold:
(1) functionality; and
(2) palatability.
The benefits of using salt in food
manufacturing are far-reaching, for the food
industry and the consumer alike.
167
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
Joanna Gibson, Gillian Armstrong and Heather McIlveen
In food processing, salt is primarily used as
a preservative, to reduce water activity and
maintain food safety. Salt is essential in bread
manufacturing, particularly for fermentation
regulation and gluten formation in dough
(Whitehead, 1998). It has important binding
properties, in that it facilitates water
absorption, which in turn leads to increased
yield, especially in meat products. This
contributes to higher product volume and,
ultimately, increased sales and profit.
The palatability of food has long been
attributed to the flavouring properties of salt
and the additional ability of salt to enhance
other flavours within a product. Salt is
particularly important in processed foods,
which rely heavily on this substance to replace
other flavours which may have been lost
during manufacturing. MacGregor (1998)
has commented that high salt concentrations
are necessary in processed foods because
many food items would otherwise be inedible.
Salt has been reported to have an effect on
other product attributes, such as texture,
consistency, appearance and mouthfeel
(James et al., 1987). The specific effect of
reducing salt on product attributes is,
however, not fully understood.
In reducing salt content, the functionality
and palatability of processed foods will
ultimately be affected. The health benefits to
be gained, however, are potentially more
important for consumers suffering from, and
those currently at risk of, hypertension. To
appreciate and understand the implications of
salt on health, salt consumption must be
quantified and considered in view of
recommended daily intakes.
(European Commission's Scientific
Committee for Food, 1993, cited by IFR,
1998).
The most startling fact arising from salt
research is that between 75 and 80 per cent of
our salt intake comes from processed foods.
The remaining 20-25 per cent has been
suggested to come from discretionary salt
(table salt and salt used in cooking) and salt
naturally present in food (IFST, 1999). At
present many consumers are unaware of
current high salt intakes and, in particular,
those foods which are contributing to high salt
consumption. Therefore, there is a need for a
clearer understanding of the main sources of
salt in the diet.
Sources of salt
Current high salt intakes have been attributed
to the increase in consumption of processed
convenience foods. It is now known that the
largest proportion of consumers' salt intake
comes from widely used processed foods
(Halliday and Ashwell, 1994). These include
bread, cereal products, savoury snacks, soups,
sauces, cured meats, ready meals, pizza and
processed frozen foods (see Table I).
It is apparent that the current salt content of
many processed foods is beyond the
requirements for food safety and flavour.
Food manufacturers must therefore take
responsibility for the current state of the
nation's diet, as regards excessive and/or
unnecessary salt content in processed foods.
Health implications
Current salt intake
It is widely acknowledged that current salt
intakes are in excess of recommended daily
intake values, with the greatest amount
coming from processed foods. National
dietary surveys have quantified salt
consumption as an average intake of 10.1g per
day for men and 7.7g per day for women
(Halliday and Ashwell, 1994; Godlee, 1996).
A reduction in salt intake to 6g per day has
been recommended (COMA, 1994, cited by
American Society for Nutritional Sciences,
1999). However, the body only requires 1.5g
per day to ensure normal body functioning
and regulation of extracellular fluid
The association of high salt intake with
hypertension and the associated risk of
cardiovascular disease is at the forefront of
salt research. It is suggested that blood
pressure may be raised as a result of high salt
consumption. The Intersalt Cooperative
Research Group (1988) also outlined the
association between high salt intake and
elevated blood pressure, with increasing age.
Results of the study highlight that habitual
high salt intake is a major risk factor for
cardiovascular disease and, perhaps more
importantly, is one which can be prevented
(Stamler, 1997).
High blood pressure is also known to be the
main cause of strokes and the major cause of
168
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
Joanna Gibson, Gillian Armstrong and Heather McIlveen
Table I Salt and sodium contents of common processed foods
Food product
Salt/serving (g)
Weetabix
Pringles (sour cream and onion)
White bread (thick sliced)
Gravy
Savoury crispy pancakes
Mature cheddar cheese
Cornflakes
0.25
0.4
0.5
0.5
0.75
0.9
1.0
Garlic bread
Chicken supreme with rice
Chicken tikka masala with rice
Baked beans
Tomato sauce for bolognese
Southern fried chicken
Cream of tomato soup (tinned)
Lasagne
Pizza
1.25
1.75
1.75
1.9
1.9
2.25
3.0
3.0
5.75
Sodium/serving (g)
0.1/37.5
0.17/30
0.2/slice
0.2/50ml
0.3/pancake
0.35/50
0.4/30 serving with 125ml
semi-skimmed milk
0.5/half baguette
0.7/meal
0.7/meal
0.75/150
0.75/150
0.9/portion
1.2/300
1.2/meal
2.3/180 serving
heart attacks, which are two of the most
common causes of death and morbidity in the
UK (CASH, 1998). To a lesser extent, high
salt consumption has also been correlated
with asthma, osteoporosis, stomach cancer
and stroke, conditions which are also
recognised for the serious implications on
health status (Wheelock, 1998). The IFST
(1999) have reported an association of high
salt intake with heart failure, cirrhosis,
nephrotic syndrome and idiopathic and
cyclical oedema.
The comprehensive range of illnesses
related to high salt intake emphasises the
severe implications of high salt consumption
and illustrates the need for research into salt
reduction strategies.
A call for salt reduction
The compelling need for a reduction in salt
consumption is warranted by the risk of
hypertension and cardiovascular disease,
which has also been confirmed by extensive
medical research. Research has established
that reducing salt consumption lowers blood
pressure significantly (Law et al., 1991a;
Cappuccio et al., 1997; Elliot, 1997). Law et
al. (1991b) reported that blood pressure
varies according to sodium intake.
Consequently, the effect of universal
moderate dietary salt reduction on mortality
may be more substantial and perhaps even
Lowest salt content
!
Highest salt content
greater than the effects of treating blood
pressure with drugs.
Recent recommendations to reduce salt
intake have formalised the calls for salt
reduction and the need to improve the health
of consumers. National and international
health organisations have recommended a
daily salt intake of 6g per day (Tilston et al.,
1993; IFST, 1999), which would entail a
reduction of 30 per cent on current salt
intakes. However, many salt reduction
programmes to date have focused on
encouraging a reduction in discretionary salt
usage and have been problematic; for
example, Law (1995) reports that, whilst one
individual could be motivated to reduce salt
intake by 3g per day, it is impossible to expect
a whole population to achieve such a
reduction. Following many failed attempts to
reduce discretionary salt usage, a well coordinated and workable salt reduction
programme still needs to be implemented.
Salt reductions on a population-wide scale
can only be achieved successfully by reducing
salt in processed foods. Food researchers have
been consistent in their call for a concerted
response from the food industry. Similarly,
the demand for manufacturers to reduce salt
has been supported by the Nutritional
Aspects of Cardiovascular Disease Review
Group. The Review Group (1994) (cited by
de la Hunty, 1995) have recognised that the
recommended reduction in salt intake can
only be achieved through compositional
changes in the salt content of processed foods.
169
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
Joanna Gibson, Gillian Armstrong and Heather McIlveen
In doing so, it is expected that the long-term
health benefits of a co-ordinated salt
reduction programme would be much greater
than those of individual efforts (James et al.,
1987).
Pressure on food manufacturers to reduce
salt in processed foods is undoubtedly
increasing. Some workers (Nan et al., 1995)
have suggested a combined approach to salt
reduction. This approach would involve
alterations in food preparation and product
formulation, in conjunction with changes in
the diet (Adams et al., 1995; North and
Neale, 1995). Clearly, a reduction in salt
intake is dependent on both changes in
individual behaviour and, more importantly,
changes in product formulation. However,
individual behavioural changes are difficult to
achieve and, therefore, in the initial stages at
least salt reduction may depend primarily on
the food manufacturer (Anonymous, 1996).
However, reducing salt in processed foods
presents limitations for the food
manufacturer. The main disadvantage is loss
of flavour, which continues to pose a problem
for food manufacturers. It has been proposed
that a gradual reduction in the salt content of
processed foods offers an achievable means of
successfully reducing salt intake, without
adversely affecting taste and ultimately
consumer acceptability (Antonios and
MacGregor, 1997). Many believe that a
gradual reduction of sodium in existing
products could be achieved without greatly
changing food habits (Engstrom et al., 1997).
Nestle food expert, Professor David
Richardson (cited by Whitehead, 1998), has
commented that stepped reductions in salt
content allow consumers to acclimatise to any
taste variation. As salt intake is reduced, the
salt taste receptors become much more
sensitive, and highly salted food becomes
unpleasant (Antonios and MacGregor, 1997).
For this reason, gradual salt reductions enable
consumers to acquire a taste for less salt and
develop a preference for low-salt foods.
Universal studies have shown little or no
decrease in consumer acceptability for lowsalt produce (Wyatt, 1983; Norton and
Noble, 1991; Rodgers and Neale, 1999).
In addition, the food industry has been
reluctant to reduce salt content because of its
preservative effects, even though many
technological developments have helped to
reduce or eliminate such dependence (Smith
et al., 1990a; 1990b; Williams, 1994).
Fundamental developments such as
refrigeration, packaging developments and
improved standards of food hygiene have
contributed to the somewhat reduced need
for salt as a food preservative.
Reducing salt in processed foods, therefore,
appears to be a critical part of the ongoing
need to improve the health of the population.
Reducing the amount of salt added to
processed foods would lower blood pressure
considerably and prevent some 70,000 deaths
a year in the UK, as well as reducing many
other disabilities (Law et al., 1991a).
However, despite the evidence to support a
reduction in dietary salt intake, there has been
little concerted effort to reduce sodium intake
in western countries (MacGregor and Sever,
1996). The UK has been slow in its
development of salt reduction in processed
foods, unlike Australia, where research has
been ongoing for many years and is well
established; for example, breakfast cereal
manufacturer, Kelloggs, has significantly
reduced the salt content of their products in
the Australian market. Following such
successful product developments, the UK
breakfast cereal market could surely be
encouraged to adopt a similar approach.
Food industry perspective
With growing concern surrounding high salt
consumption, a response from the entire food
industry is imperative (Hegsted, 1991;
Cappuccio et al., 1997; Elliot, 1997). A report
in the British Medical Journal (Anonymous,
1996) reported that, given the large quantities
of salt in processed foods, there was clearly a
role for food manufacturers to reduce salt
content in food. However, to date, the food
industry has been reluctant to reduce salt in
processed foods (Anonymous, 1996).
Food producers and the salt industry have
opposed the reduction of salt in processed
foods because of potential loss of flavour and
eventual loss of revenue (MacGregor and de
Wardener, 1998). Furthermore, salt
contributes significantly to product yield,
which in turn generates high product volume
and profit. Any arbitrary reductions in salt
content would undoubtedly entail a risk of
losing market share for many food
manufacturers (Matz, 1996).
In opposing salt reductions in processed
food, manufacturers have highlighted their
170
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
Joanna Gibson, Gillian Armstrong and Heather McIlveen
concerns regarding research findings to date.
The food industry demands firm evidence
relating salt and hypertension rather than
suggested relationships. However, as The
Intersalt Cooperative Research Group (1988)
shows, evidence of the relationship between
salt and blood pressure is becoming stronger
(MacGregor and Sever, 1996). A reduction in
salt consumption strongly indicates a
significant reduction in blood pressure (Forte
et al., 1989). Despite re-analysis of results,
food manufacturers have continued to
discredit evidence linking salt to high blood
pressure (Liebman, 1996). Some food
manufacturers have adopted desperate
measures to try and stop government
recommendations on salt reduction.
Manufacturers have lobbied governments,
refused to co-operate with expert working
parties and have encouraged misinformation
campaigns, rather than concentrating on
product reformulation (Godlee, 1996).
Despite the lack of co-operation from many
areas of the food industry in reducing salt,
there have been plausible efforts with regard
to salt labelling. In response to public
demands and government pressure, many
food retailers have included the salt/sodium
content of products in their nutritional
information. This has been an important step
forward for the industry and must be duly
acknowledged. However, the emphatic need
for salt reduction in processed foods still
remains the fundamental issue.
The way forward
The way forward for successful salt reduction
is clearly through co-operation between
government, health professionals, food
researchers and food manufacturers (CASH,
1998). It is surely timely to reach a consensus
to support a reduction in dietary salt intake
and seek to improve the diet and health of the
population nation-wide. Government
intervention in the salt debate is particularly
welcomed, and it is anticipated that
government recommendations on salt
reductions are imminent (Whitehead, 1998).
Such a response would certainly be a positive
move forward and prove valuable in reducing
dietary salt intake.
Consumer demand for reduced-salt
produce is essential in persuading
manufacturers to develop products that
consumers actually want (Hegsted, 1991;
CASH, 1998). Consequently, consumers
must lobby the government and food
manufacturers to reduce the current high salt
content in processed foods and provide more
low salt alternatives. However, it is
anticipated that only consumers who are well
informed and concerned about diet and
health will go to such lengths to secure a
better quality of life for themselves.
In the UK, the major food retailers have
responded positively to concerns surrounding
the high salt content of processed foods. It
could be said that the leading food retailers
have been proactive in seeking to reduce the
salt content of their own brand products.
Heading the developments for ``lower'' salt,
has been ASDA. ASDA initiated salt
reductions by announcing a reduction of 25
per cent on the current salt content in many
of their own brand products. This reduction
has been increased to 40 per cent in a wide
selection of ready meals and processed
poultry products. Following closely in salt
reductions has been the Co-op. The Co-op
has focused on the use of the low sodium
product, ``Lo-Salt''. Recent product
developments and re-formulations have
involved salt reductions by as much as 10 per
cent in standard white bread. Other retailers,
however, have been slower in their response
to the salt issue. Tesco have introduced the
``salt calculator'' information leaflet, to enable
consumers to convert sodium content to salt
content. With this information, it is hoped
that consumers will be able to quantify their
salt intake and adjust it accordingly.
However, it could be argued that the
conversion chart would only benefit the wellinformed, health conscious consumer, trying
to reduce salt intake, as opposed to benefiting
those consumers most at risk of high blood
pressure and cardiovascular disease. In view
of this, it would appear that the way forward is
clearly through a gradual reduction in the salt
content of processed foods. A collaborative
approach, involving food retailers and
manufacturers, may be the only way to
successfully reduce dietary salt intake and
improve the health of the entire population.
Successful salt reductions in processed
foods have been confirmed by numerous
studies (Wyatt, 1983; Ruusunen et al., 1999;
Rodgers and Neale, 1999). These workers
have reported little or no differences in taste,
preference or consumer acceptability of
171
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
Joanna Gibson, Gillian Armstrong and Heather McIlveen
reduced salt products, as revealed from
sensory analysis testing. Such findings
support the feasibility of reducing salt in
processed foods; however, it is important that
initial reductions are small and gradual to
allow consumers to become accustomed to
any changes in taste. With continued
consumption of low salt foods, taste receptors
adapt to less salt and eventually consumers
should acquire a preference for foods lower in
salt. The health benefits to be achieved from
reducing salt in processed foods are
immeasurable. Consumers suffering from
hypertension and those at risk of hypertension
will benefit significantly.
Given the success of existing salt reductions
in processed food and efforts by food retailers
to reduce salt, it is imperative that the food
industry in general responds immediately to
the quest for lowering salt intake. Calls for salt
reduction reinforce the seriousness of the
situation and the severity of the risks to
health. However, effective salt reductions can
only be achieved if food manufacturers adopt
a proactive approach to salt reduction and if
realistic salt reduction programmes are
implemented. Salt reduction strategies must
also have the support of government, health
professionals and dietary advisers, to ensure
complete and effective implementation and,
more importantly, improved health among
the population.
References and further reading
Adams, S.O., Maller, O. and Cardello, A.V. (1995),
``Consumer acceptance of foods lower in sodium'',
Journal of the American Dietetic Association,
Vol. 95 No. 4, pp. 447-53.
American Society for Nutritional Sciences (1999), available
at: http://www.nutrition.org.uk (accessed 15 August
1999).
Anonymous (1996), ``A salty issue'', British Medical
Journal, Vol. 312 No. 7041a, p. 1237.
Antonios, T.F.T. and MacGregor, G.A. (1996), ``Salt ± more
adverse effects'', The Lancet, Vol. 348 No. 9022,
pp. 250-1.
Antonios, T.F.T. and MacGregor, G.A. (1997), in Pearson,
A.M. and Dutson, T.R. (Eds), Production and
Processing of Healthy Meat, Poultry and Fish
Products ± Advances in Meat Research Series
Vol. 11, Blackie Academic and Professional, London,
pp. 84-100.
Cappuccio, F.P., Markandu, N.D., Carney, C., Sagnella,
G.A. and MacGregor, G.A. (1997), ``Double-blind
randomised trial of modest salt restriction in
older people'', The Lancet, Vol. 350 No. 9081,
pp. 850-4.
CASH (Consensus Action on Salt and Hypertension)
(1998), available at: http://www.sghms.ac.uk
(accessed 17 January 2000).
de la Hunty, A. (1995), ``The COMA report on nutritional
aspects of cardiovascular disease: the scientific
evidence'', British Food Journal, Vol. 97 No. 9,
pp. 30-2.
Elliot, P. (1997), ``Lower sodium for all'', The Lancet,
Vol. 350 No. 9081, pp. 825-6.
Engstrom, A., Tobelmann, R.C. and Albertson, A.M.
(1997), ``Sodium intake trends and food choices'',
American Journal of Clinical Nutrition, Vol. 65
(Supplement), pp. 704s-707s.
Forte, J.G., Pereira Miguel, J.M., Pereira, M.J., de Padua,
F. and Rose, G. (1989), ``Salt and blood pressure: a
community trial'', Journal of Human Hypertension,
Vol. 250, pp. 370-3.
Godlee, F. (1996), ``The food industry fights back'', British
Medical Journal, Vol. 312 No. 7032a, pp.1239-40.
Halliday, A. and Ashwell, M. (1994), ``Salt in the diet'',
The British Nutrition Foundation Briefing Paper,
pp. 3-19.
Hegsted, D.M. (1991), ``A perspective on reducing salt
intake'', Hypertension, Vol. 17 (Supplement I),
pp. 1201-4.
IFR (Institute of Food Research) (1998), ``The salt debate'',
position statement.
IFR (Institute of Food Research) (1999), available at:
http://www.ifr.bbsrc.ac.uk (accessed 29 September
1999).
IFST (Institute of Food Science and Technology) (1999),
``Salt'', IFST Current Hot Topics, position statement.
Intersalt Cooperative Research Group (1988), ``Intersalt:
an international study of electrolyte excretion and
blood pressure. Results for 24-hour urinary sodium
excretion and potassium excretion'', British Medical
Journal, Vol. 297 No. 644, pp. 319-28.
James, W.P., Ralph, A. and Sanchez-Castillo, C.P. (1987),
``The dominance of salt in manufactured food in the
sodium intake of affluent societies'', The Lancet,
Vol. 8530, pp. 426-9.
Law, M.R. (1995), ``Salt and blood pressure'', British Food
Journal, Vol. 97 No. 9, pp. 33-4.
Law, M.R., Frost, C.D. and Wald, N.J. (1991a), ``By how
much does dietary salt reduction lower blood
pressure? III ± analysis of data from trials of salt
reduction'', British Medical Journal, Vol. 302,
pp. 819-24.
Law, M.R., Frost, C.D. and Wald, N.J. (1991b) ``By how
much does dietary salt reduction lower blood
pressure? I ± analysis of observational data among
populations'', British Medical Journal, Vol. 302,
pp. 811-15.
Liebman, B. (1996), ``Salt: the pressure is on'', Nutrition
Action Health Letter, September, p. 8.
MacGregor, G.A. (1998), ``Salt: blood pressure, the kidney,
and other harmful effects'', Nephrology, Dialysis and
Transplant, Vol. 13, p. 2471.
MacGregor, G.A. and Antonios, T.F.T. (1996), ``Pep(pery)
talk on salt'', The Lancet, Vol. 348 No. 9039,
p. 1453.
MacGregor, G.A. and de Wardener, H.E. (1998), Salt, Diet
and Health ± The Uses and Abuses of Salt
throughout Human History and its Contribution to
Disease in Today's Consumer Societies, University
Press, Cambridge, pp. 193-217.
172
Joanna Gibson, Gillian Armstrong and Heather McIlveen
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
MacGregor, M.A. and Sever, P.S. (1996), ``Salt ±
overwhelming evidence but still no action: can a
consensus be reached with the food industry?'',
British Medical Journal, Vol. 312 No. 9012,
pp. 1287-9.
Matz (1996), Formulating and Processing Dietetic Foods
Pan-Tech International Inc., Texas, pp. 229-45.
Nan, Y., Tian, H-G., Shao, R-C., Hu, G., Dong, Q-N.,
Pietinen, P. and Nissinen, A. (1995), ``Assessment of
sodium and potassium in processed foods in an
urban area in China'', European Journal of Clinical
Nutrition, Vol. 49 No. 4, pp. 299-306.
North, S.L. and Neale, R.J. (1995), ``Knowledge, attitudes
and eating habits of teenagers with respect to salt
in their diet'', British Food Journal, Vol. 97 No. 5,
pp. 3-11.
Norton, V.P. and Noble, J.M. (1991), ``Reduced-sodium
bakery products: consumer acceptance'', Journal of
Foodservice Systems, Vol. 6 pp. 61-8.
Nutritional Aspects of Cardiovascular Disease (1994),
Report of the Cardiovascular Review Group,
Committee on Medical Aspects of Food Policy,
HMSO, London, pp. 1-186.
Rodgers, A. and Neale, B. (1999), ``Less salt does not
necessarily mean less taste'', The Lancet, Vol. 353
No. 9161, p. 1332.
Ruusunen, M., Sarkka-Tirkkonen, M and Puolanne, E.
(1999), ``The effect of salt reduction on taste
pleasantness in cooked `Bologna-type' sausages'',
Journal of Sensory Studies, Vol. 14, pp. 263-70.
Smith, J.P., Ramaswamy, H.S. and Simpson, B.K. (1990a),
``Developments in food packaging technology.
Part I: processing/cooking considerations'', Trends
in Food Science and Technology, November,
pp. 107-10.
Smith, J.P., Ramaswamy, H.S. and Simpson, B.K. (1990b),
``Developments in food packaging technology.
Part II: storage aspects trends on food science
and technology'', Trends in Food Science and
Technology, November, pp. 111-18.
Stamler, J. (1997), ``The INTERSALT study: background,
methods, findings, and implications'', The American
Journal of Clinical Nutrition, Vol. 65 (Supplement),
pp. 626s-642s.
Tilston, C., Neale, R., Gregson, K. and Bourne, S.
(1993), Salt ± A Challenge to Food Manufacturers
(Food Marketing Research Group, University
of Nottingham), Horton Publishing, Bradford,
pp. 5-37.
Wheelock, V. (1998), ``Salt ± the next major food issue'',
Food Industry News, April, pp. 15-16.
Whitehead, T. (1998), ``Against the grain'', The Grocer,
Vol. 27, pp. 32-3, 35.
Williams, A (1994), ``New technologies in food
preservation and processing: Part II'', Nutrition &
Food Science, No. 1, pp. 20-3.
Wyatt (1983), ``Acceptability of reduced sodium in breads,
cottage cheese and pickles'', Journal of Food
Science, Vol. 48, pp. 1300-2.
173
in processed foods
Joanna Gibson
Gillian Armstrong and
Heather McIlveen
The authors
Joanna Gibson is a PhD Research Student in the
Consumer Studies Division, Gillian Armstrong is a
Lecturer on the Consumer Studies Programme and
Heather McIlveen is Course Director of the Consumer
Studies Programme, all at the University of Ulster,
Jordanstown, Nothern Ireland.
Keywords
Salt, Diet, Processed foods, Food manufacturing
Abstract
Salt is one of the most valuable substances available to
man, with a definitive role in the human body and in food
production. However, the continued use or indeed misuse
of salt has led to adverse effects on health. The increasing
consumption of convenience foods has contributed
greatly to a high salt intake. Highly processed,
convenience foods are known to contain large quantities
of salt to optimise storage stability and flavour
acceptability. Current high salt intakes have therefore
been attributed to processed foods, accounting for 75-85
per cent of total salt intake. Such findings and associated
health implications have prompted a call from health
professionals and food researchers to reduce salt intake.
Effective salt reduction, however, can only be achieved
with the co-operation and commitment of the food
industry in the development of lower-salt processed
foods.
Electronic access
The current issue and full text archive of this journal is
available at
http://www.emerald-library.com
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . pp. 167±173
# MCB University Press . ISSN 0034-6659
Functions of salt
Salt in the human body
Salt is a dietary essential and its role in the
human body is paramount to normal body
functioning. Sodium chloride (NaCl) is the
chemical term given to common salt and it is
the sodium element that is potentially harmful
when consumed in excess. The principal role
of salt in the body is the maintenance of
bodily fluid within close and regulated limits
(American Society for Nutritional Sciences,
1999).
Sodium (Na) is the principal cation in
extracellular fluids in the body. Together with
potassium (K), chloride (Cl) and other ions,
sodium ions maintain the volume of the
extracellular fluid, osmotic pressure, acidbase balance and electrophysiological activity
in muscles and nerves (IFST, 1999). Sodium
chloride is necessary for the creation of
gradients across cells, to enable the uptake of
nutrients, especially from the small intestine
(American Society for Nutritional Sciences,
1999).
Sodium content in the body is controlled by
excretion through the kidneys into the urine.
For this reason, the sodium intake of children
must be carefully monitored and regulated,
since a child's kidneys are not fully developed
and would not be capable of excreting large
quantities of sodium from the body. Sodium is
also excreted from the body in the form of
perspiration. This occurs more intensely in hot
climates and during strenuous exercise,
causing muscular cramps. If body fluids are not
replenished, by increasing fluid consumption,
dehydration may occur. Despite this fact, most
healthy people metabolise sodium normally
and excrete any excess consumed (IFR, 1999).
It is indisputable that salt has an important
function in the human body and careful
attention must be given to the regulation of salt
intake in order to sustain good health.
Salt in food
Salt is a valuable commodity which is used
extensively in food processing. It is a cheap
and versatile product (MacGregor, 1998;
Whitehead, 1998) and its role in the food
industry is twofold:
(1) functionality; and
(2) palatability.
The benefits of using salt in food
manufacturing are far-reaching, for the food
industry and the consumer alike.
167
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
Joanna Gibson, Gillian Armstrong and Heather McIlveen
In food processing, salt is primarily used as
a preservative, to reduce water activity and
maintain food safety. Salt is essential in bread
manufacturing, particularly for fermentation
regulation and gluten formation in dough
(Whitehead, 1998). It has important binding
properties, in that it facilitates water
absorption, which in turn leads to increased
yield, especially in meat products. This
contributes to higher product volume and,
ultimately, increased sales and profit.
The palatability of food has long been
attributed to the flavouring properties of salt
and the additional ability of salt to enhance
other flavours within a product. Salt is
particularly important in processed foods,
which rely heavily on this substance to replace
other flavours which may have been lost
during manufacturing. MacGregor (1998)
has commented that high salt concentrations
are necessary in processed foods because
many food items would otherwise be inedible.
Salt has been reported to have an effect on
other product attributes, such as texture,
consistency, appearance and mouthfeel
(James et al., 1987). The specific effect of
reducing salt on product attributes is,
however, not fully understood.
In reducing salt content, the functionality
and palatability of processed foods will
ultimately be affected. The health benefits to
be gained, however, are potentially more
important for consumers suffering from, and
those currently at risk of, hypertension. To
appreciate and understand the implications of
salt on health, salt consumption must be
quantified and considered in view of
recommended daily intakes.
(European Commission's Scientific
Committee for Food, 1993, cited by IFR,
1998).
The most startling fact arising from salt
research is that between 75 and 80 per cent of
our salt intake comes from processed foods.
The remaining 20-25 per cent has been
suggested to come from discretionary salt
(table salt and salt used in cooking) and salt
naturally present in food (IFST, 1999). At
present many consumers are unaware of
current high salt intakes and, in particular,
those foods which are contributing to high salt
consumption. Therefore, there is a need for a
clearer understanding of the main sources of
salt in the diet.
Sources of salt
Current high salt intakes have been attributed
to the increase in consumption of processed
convenience foods. It is now known that the
largest proportion of consumers' salt intake
comes from widely used processed foods
(Halliday and Ashwell, 1994). These include
bread, cereal products, savoury snacks, soups,
sauces, cured meats, ready meals, pizza and
processed frozen foods (see Table I).
It is apparent that the current salt content of
many processed foods is beyond the
requirements for food safety and flavour.
Food manufacturers must therefore take
responsibility for the current state of the
nation's diet, as regards excessive and/or
unnecessary salt content in processed foods.
Health implications
Current salt intake
It is widely acknowledged that current salt
intakes are in excess of recommended daily
intake values, with the greatest amount
coming from processed foods. National
dietary surveys have quantified salt
consumption as an average intake of 10.1g per
day for men and 7.7g per day for women
(Halliday and Ashwell, 1994; Godlee, 1996).
A reduction in salt intake to 6g per day has
been recommended (COMA, 1994, cited by
American Society for Nutritional Sciences,
1999). However, the body only requires 1.5g
per day to ensure normal body functioning
and regulation of extracellular fluid
The association of high salt intake with
hypertension and the associated risk of
cardiovascular disease is at the forefront of
salt research. It is suggested that blood
pressure may be raised as a result of high salt
consumption. The Intersalt Cooperative
Research Group (1988) also outlined the
association between high salt intake and
elevated blood pressure, with increasing age.
Results of the study highlight that habitual
high salt intake is a major risk factor for
cardiovascular disease and, perhaps more
importantly, is one which can be prevented
(Stamler, 1997).
High blood pressure is also known to be the
main cause of strokes and the major cause of
168
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
Joanna Gibson, Gillian Armstrong and Heather McIlveen
Table I Salt and sodium contents of common processed foods
Food product
Salt/serving (g)
Weetabix
Pringles (sour cream and onion)
White bread (thick sliced)
Gravy
Savoury crispy pancakes
Mature cheddar cheese
Cornflakes
0.25
0.4
0.5
0.5
0.75
0.9
1.0
Garlic bread
Chicken supreme with rice
Chicken tikka masala with rice
Baked beans
Tomato sauce for bolognese
Southern fried chicken
Cream of tomato soup (tinned)
Lasagne
Pizza
1.25
1.75
1.75
1.9
1.9
2.25
3.0
3.0
5.75
Sodium/serving (g)
0.1/37.5
0.17/30
0.2/slice
0.2/50ml
0.3/pancake
0.35/50
0.4/30 serving with 125ml
semi-skimmed milk
0.5/half baguette
0.7/meal
0.7/meal
0.75/150
0.75/150
0.9/portion
1.2/300
1.2/meal
2.3/180 serving
heart attacks, which are two of the most
common causes of death and morbidity in the
UK (CASH, 1998). To a lesser extent, high
salt consumption has also been correlated
with asthma, osteoporosis, stomach cancer
and stroke, conditions which are also
recognised for the serious implications on
health status (Wheelock, 1998). The IFST
(1999) have reported an association of high
salt intake with heart failure, cirrhosis,
nephrotic syndrome and idiopathic and
cyclical oedema.
The comprehensive range of illnesses
related to high salt intake emphasises the
severe implications of high salt consumption
and illustrates the need for research into salt
reduction strategies.
A call for salt reduction
The compelling need for a reduction in salt
consumption is warranted by the risk of
hypertension and cardiovascular disease,
which has also been confirmed by extensive
medical research. Research has established
that reducing salt consumption lowers blood
pressure significantly (Law et al., 1991a;
Cappuccio et al., 1997; Elliot, 1997). Law et
al. (1991b) reported that blood pressure
varies according to sodium intake.
Consequently, the effect of universal
moderate dietary salt reduction on mortality
may be more substantial and perhaps even
Lowest salt content
!
Highest salt content
greater than the effects of treating blood
pressure with drugs.
Recent recommendations to reduce salt
intake have formalised the calls for salt
reduction and the need to improve the health
of consumers. National and international
health organisations have recommended a
daily salt intake of 6g per day (Tilston et al.,
1993; IFST, 1999), which would entail a
reduction of 30 per cent on current salt
intakes. However, many salt reduction
programmes to date have focused on
encouraging a reduction in discretionary salt
usage and have been problematic; for
example, Law (1995) reports that, whilst one
individual could be motivated to reduce salt
intake by 3g per day, it is impossible to expect
a whole population to achieve such a
reduction. Following many failed attempts to
reduce discretionary salt usage, a well coordinated and workable salt reduction
programme still needs to be implemented.
Salt reductions on a population-wide scale
can only be achieved successfully by reducing
salt in processed foods. Food researchers have
been consistent in their call for a concerted
response from the food industry. Similarly,
the demand for manufacturers to reduce salt
has been supported by the Nutritional
Aspects of Cardiovascular Disease Review
Group. The Review Group (1994) (cited by
de la Hunty, 1995) have recognised that the
recommended reduction in salt intake can
only be achieved through compositional
changes in the salt content of processed foods.
169
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
Joanna Gibson, Gillian Armstrong and Heather McIlveen
In doing so, it is expected that the long-term
health benefits of a co-ordinated salt
reduction programme would be much greater
than those of individual efforts (James et al.,
1987).
Pressure on food manufacturers to reduce
salt in processed foods is undoubtedly
increasing. Some workers (Nan et al., 1995)
have suggested a combined approach to salt
reduction. This approach would involve
alterations in food preparation and product
formulation, in conjunction with changes in
the diet (Adams et al., 1995; North and
Neale, 1995). Clearly, a reduction in salt
intake is dependent on both changes in
individual behaviour and, more importantly,
changes in product formulation. However,
individual behavioural changes are difficult to
achieve and, therefore, in the initial stages at
least salt reduction may depend primarily on
the food manufacturer (Anonymous, 1996).
However, reducing salt in processed foods
presents limitations for the food
manufacturer. The main disadvantage is loss
of flavour, which continues to pose a problem
for food manufacturers. It has been proposed
that a gradual reduction in the salt content of
processed foods offers an achievable means of
successfully reducing salt intake, without
adversely affecting taste and ultimately
consumer acceptability (Antonios and
MacGregor, 1997). Many believe that a
gradual reduction of sodium in existing
products could be achieved without greatly
changing food habits (Engstrom et al., 1997).
Nestle food expert, Professor David
Richardson (cited by Whitehead, 1998), has
commented that stepped reductions in salt
content allow consumers to acclimatise to any
taste variation. As salt intake is reduced, the
salt taste receptors become much more
sensitive, and highly salted food becomes
unpleasant (Antonios and MacGregor, 1997).
For this reason, gradual salt reductions enable
consumers to acquire a taste for less salt and
develop a preference for low-salt foods.
Universal studies have shown little or no
decrease in consumer acceptability for lowsalt produce (Wyatt, 1983; Norton and
Noble, 1991; Rodgers and Neale, 1999).
In addition, the food industry has been
reluctant to reduce salt content because of its
preservative effects, even though many
technological developments have helped to
reduce or eliminate such dependence (Smith
et al., 1990a; 1990b; Williams, 1994).
Fundamental developments such as
refrigeration, packaging developments and
improved standards of food hygiene have
contributed to the somewhat reduced need
for salt as a food preservative.
Reducing salt in processed foods, therefore,
appears to be a critical part of the ongoing
need to improve the health of the population.
Reducing the amount of salt added to
processed foods would lower blood pressure
considerably and prevent some 70,000 deaths
a year in the UK, as well as reducing many
other disabilities (Law et al., 1991a).
However, despite the evidence to support a
reduction in dietary salt intake, there has been
little concerted effort to reduce sodium intake
in western countries (MacGregor and Sever,
1996). The UK has been slow in its
development of salt reduction in processed
foods, unlike Australia, where research has
been ongoing for many years and is well
established; for example, breakfast cereal
manufacturer, Kelloggs, has significantly
reduced the salt content of their products in
the Australian market. Following such
successful product developments, the UK
breakfast cereal market could surely be
encouraged to adopt a similar approach.
Food industry perspective
With growing concern surrounding high salt
consumption, a response from the entire food
industry is imperative (Hegsted, 1991;
Cappuccio et al., 1997; Elliot, 1997). A report
in the British Medical Journal (Anonymous,
1996) reported that, given the large quantities
of salt in processed foods, there was clearly a
role for food manufacturers to reduce salt
content in food. However, to date, the food
industry has been reluctant to reduce salt in
processed foods (Anonymous, 1996).
Food producers and the salt industry have
opposed the reduction of salt in processed
foods because of potential loss of flavour and
eventual loss of revenue (MacGregor and de
Wardener, 1998). Furthermore, salt
contributes significantly to product yield,
which in turn generates high product volume
and profit. Any arbitrary reductions in salt
content would undoubtedly entail a risk of
losing market share for many food
manufacturers (Matz, 1996).
In opposing salt reductions in processed
food, manufacturers have highlighted their
170
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
Joanna Gibson, Gillian Armstrong and Heather McIlveen
concerns regarding research findings to date.
The food industry demands firm evidence
relating salt and hypertension rather than
suggested relationships. However, as The
Intersalt Cooperative Research Group (1988)
shows, evidence of the relationship between
salt and blood pressure is becoming stronger
(MacGregor and Sever, 1996). A reduction in
salt consumption strongly indicates a
significant reduction in blood pressure (Forte
et al., 1989). Despite re-analysis of results,
food manufacturers have continued to
discredit evidence linking salt to high blood
pressure (Liebman, 1996). Some food
manufacturers have adopted desperate
measures to try and stop government
recommendations on salt reduction.
Manufacturers have lobbied governments,
refused to co-operate with expert working
parties and have encouraged misinformation
campaigns, rather than concentrating on
product reformulation (Godlee, 1996).
Despite the lack of co-operation from many
areas of the food industry in reducing salt,
there have been plausible efforts with regard
to salt labelling. In response to public
demands and government pressure, many
food retailers have included the salt/sodium
content of products in their nutritional
information. This has been an important step
forward for the industry and must be duly
acknowledged. However, the emphatic need
for salt reduction in processed foods still
remains the fundamental issue.
The way forward
The way forward for successful salt reduction
is clearly through co-operation between
government, health professionals, food
researchers and food manufacturers (CASH,
1998). It is surely timely to reach a consensus
to support a reduction in dietary salt intake
and seek to improve the diet and health of the
population nation-wide. Government
intervention in the salt debate is particularly
welcomed, and it is anticipated that
government recommendations on salt
reductions are imminent (Whitehead, 1998).
Such a response would certainly be a positive
move forward and prove valuable in reducing
dietary salt intake.
Consumer demand for reduced-salt
produce is essential in persuading
manufacturers to develop products that
consumers actually want (Hegsted, 1991;
CASH, 1998). Consequently, consumers
must lobby the government and food
manufacturers to reduce the current high salt
content in processed foods and provide more
low salt alternatives. However, it is
anticipated that only consumers who are well
informed and concerned about diet and
health will go to such lengths to secure a
better quality of life for themselves.
In the UK, the major food retailers have
responded positively to concerns surrounding
the high salt content of processed foods. It
could be said that the leading food retailers
have been proactive in seeking to reduce the
salt content of their own brand products.
Heading the developments for ``lower'' salt,
has been ASDA. ASDA initiated salt
reductions by announcing a reduction of 25
per cent on the current salt content in many
of their own brand products. This reduction
has been increased to 40 per cent in a wide
selection of ready meals and processed
poultry products. Following closely in salt
reductions has been the Co-op. The Co-op
has focused on the use of the low sodium
product, ``Lo-Salt''. Recent product
developments and re-formulations have
involved salt reductions by as much as 10 per
cent in standard white bread. Other retailers,
however, have been slower in their response
to the salt issue. Tesco have introduced the
``salt calculator'' information leaflet, to enable
consumers to convert sodium content to salt
content. With this information, it is hoped
that consumers will be able to quantify their
salt intake and adjust it accordingly.
However, it could be argued that the
conversion chart would only benefit the wellinformed, health conscious consumer, trying
to reduce salt intake, as opposed to benefiting
those consumers most at risk of high blood
pressure and cardiovascular disease. In view
of this, it would appear that the way forward is
clearly through a gradual reduction in the salt
content of processed foods. A collaborative
approach, involving food retailers and
manufacturers, may be the only way to
successfully reduce dietary salt intake and
improve the health of the entire population.
Successful salt reductions in processed
foods have been confirmed by numerous
studies (Wyatt, 1983; Ruusunen et al., 1999;
Rodgers and Neale, 1999). These workers
have reported little or no differences in taste,
preference or consumer acceptability of
171
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
Joanna Gibson, Gillian Armstrong and Heather McIlveen
reduced salt products, as revealed from
sensory analysis testing. Such findings
support the feasibility of reducing salt in
processed foods; however, it is important that
initial reductions are small and gradual to
allow consumers to become accustomed to
any changes in taste. With continued
consumption of low salt foods, taste receptors
adapt to less salt and eventually consumers
should acquire a preference for foods lower in
salt. The health benefits to be achieved from
reducing salt in processed foods are
immeasurable. Consumers suffering from
hypertension and those at risk of hypertension
will benefit significantly.
Given the success of existing salt reductions
in processed food and efforts by food retailers
to reduce salt, it is imperative that the food
industry in general responds immediately to
the quest for lowering salt intake. Calls for salt
reduction reinforce the seriousness of the
situation and the severity of the risks to
health. However, effective salt reductions can
only be achieved if food manufacturers adopt
a proactive approach to salt reduction and if
realistic salt reduction programmes are
implemented. Salt reduction strategies must
also have the support of government, health
professionals and dietary advisers, to ensure
complete and effective implementation and,
more importantly, improved health among
the population.
References and further reading
Adams, S.O., Maller, O. and Cardello, A.V. (1995),
``Consumer acceptance of foods lower in sodium'',
Journal of the American Dietetic Association,
Vol. 95 No. 4, pp. 447-53.
American Society for Nutritional Sciences (1999), available
at: http://www.nutrition.org.uk (accessed 15 August
1999).
Anonymous (1996), ``A salty issue'', British Medical
Journal, Vol. 312 No. 7041a, p. 1237.
Antonios, T.F.T. and MacGregor, G.A. (1996), ``Salt ± more
adverse effects'', The Lancet, Vol. 348 No. 9022,
pp. 250-1.
Antonios, T.F.T. and MacGregor, G.A. (1997), in Pearson,
A.M. and Dutson, T.R. (Eds), Production and
Processing of Healthy Meat, Poultry and Fish
Products ± Advances in Meat Research Series
Vol. 11, Blackie Academic and Professional, London,
pp. 84-100.
Cappuccio, F.P., Markandu, N.D., Carney, C., Sagnella,
G.A. and MacGregor, G.A. (1997), ``Double-blind
randomised trial of modest salt restriction in
older people'', The Lancet, Vol. 350 No. 9081,
pp. 850-4.
CASH (Consensus Action on Salt and Hypertension)
(1998), available at: http://www.sghms.ac.uk
(accessed 17 January 2000).
de la Hunty, A. (1995), ``The COMA report on nutritional
aspects of cardiovascular disease: the scientific
evidence'', British Food Journal, Vol. 97 No. 9,
pp. 30-2.
Elliot, P. (1997), ``Lower sodium for all'', The Lancet,
Vol. 350 No. 9081, pp. 825-6.
Engstrom, A., Tobelmann, R.C. and Albertson, A.M.
(1997), ``Sodium intake trends and food choices'',
American Journal of Clinical Nutrition, Vol. 65
(Supplement), pp. 704s-707s.
Forte, J.G., Pereira Miguel, J.M., Pereira, M.J., de Padua,
F. and Rose, G. (1989), ``Salt and blood pressure: a
community trial'', Journal of Human Hypertension,
Vol. 250, pp. 370-3.
Godlee, F. (1996), ``The food industry fights back'', British
Medical Journal, Vol. 312 No. 7032a, pp.1239-40.
Halliday, A. and Ashwell, M. (1994), ``Salt in the diet'',
The British Nutrition Foundation Briefing Paper,
pp. 3-19.
Hegsted, D.M. (1991), ``A perspective on reducing salt
intake'', Hypertension, Vol. 17 (Supplement I),
pp. 1201-4.
IFR (Institute of Food Research) (1998), ``The salt debate'',
position statement.
IFR (Institute of Food Research) (1999), available at:
http://www.ifr.bbsrc.ac.uk (accessed 29 September
1999).
IFST (Institute of Food Science and Technology) (1999),
``Salt'', IFST Current Hot Topics, position statement.
Intersalt Cooperative Research Group (1988), ``Intersalt:
an international study of electrolyte excretion and
blood pressure. Results for 24-hour urinary sodium
excretion and potassium excretion'', British Medical
Journal, Vol. 297 No. 644, pp. 319-28.
James, W.P., Ralph, A. and Sanchez-Castillo, C.P. (1987),
``The dominance of salt in manufactured food in the
sodium intake of affluent societies'', The Lancet,
Vol. 8530, pp. 426-9.
Law, M.R. (1995), ``Salt and blood pressure'', British Food
Journal, Vol. 97 No. 9, pp. 33-4.
Law, M.R., Frost, C.D. and Wald, N.J. (1991a), ``By how
much does dietary salt reduction lower blood
pressure? III ± analysis of data from trials of salt
reduction'', British Medical Journal, Vol. 302,
pp. 819-24.
Law, M.R., Frost, C.D. and Wald, N.J. (1991b) ``By how
much does dietary salt reduction lower blood
pressure? I ± analysis of observational data among
populations'', British Medical Journal, Vol. 302,
pp. 811-15.
Liebman, B. (1996), ``Salt: the pressure is on'', Nutrition
Action Health Letter, September, p. 8.
MacGregor, G.A. (1998), ``Salt: blood pressure, the kidney,
and other harmful effects'', Nephrology, Dialysis and
Transplant, Vol. 13, p. 2471.
MacGregor, G.A. and Antonios, T.F.T. (1996), ``Pep(pery)
talk on salt'', The Lancet, Vol. 348 No. 9039,
p. 1453.
MacGregor, G.A. and de Wardener, H.E. (1998), Salt, Diet
and Health ± The Uses and Abuses of Salt
throughout Human History and its Contribution to
Disease in Today's Consumer Societies, University
Press, Cambridge, pp. 193-217.
172
Joanna Gibson, Gillian Armstrong and Heather McIlveen
A case for reducing salt in processed foods
Nutrition & Food Science
Volume 30 . Number 4 . 2000 . 167±173
MacGregor, M.A. and Sever, P.S. (1996), ``Salt ±
overwhelming evidence but still no action: can a
consensus be reached with the food industry?'',
British Medical Journal, Vol. 312 No. 9012,
pp. 1287-9.
Matz (1996), Formulating and Processing Dietetic Foods
Pan-Tech International Inc., Texas, pp. 229-45.
Nan, Y., Tian, H-G., Shao, R-C., Hu, G., Dong, Q-N.,
Pietinen, P. and Nissinen, A. (1995), ``Assessment of
sodium and potassium in processed foods in an
urban area in China'', European Journal of Clinical
Nutrition, Vol. 49 No. 4, pp. 299-306.
North, S.L. and Neale, R.J. (1995), ``Knowledge, attitudes
and eating habits of teenagers with respect to salt
in their diet'', British Food Journal, Vol. 97 No. 5,
pp. 3-11.
Norton, V.P. and Noble, J.M. (1991), ``Reduced-sodium
bakery products: consumer acceptance'', Journal of
Foodservice Systems, Vol. 6 pp. 61-8.
Nutritional Aspects of Cardiovascular Disease (1994),
Report of the Cardiovascular Review Group,
Committee on Medical Aspects of Food Policy,
HMSO, London, pp. 1-186.
Rodgers, A. and Neale, B. (1999), ``Less salt does not
necessarily mean less taste'', The Lancet, Vol. 353
No. 9161, p. 1332.
Ruusunen, M., Sarkka-Tirkkonen, M and Puolanne, E.
(1999), ``The effect of salt reduction on taste
pleasantness in cooked `Bologna-type' sausages'',
Journal of Sensory Studies, Vol. 14, pp. 263-70.
Smith, J.P., Ramaswamy, H.S. and Simpson, B.K. (1990a),
``Developments in food packaging technology.
Part I: processing/cooking considerations'', Trends
in Food Science and Technology, November,
pp. 107-10.
Smith, J.P., Ramaswamy, H.S. and Simpson, B.K. (1990b),
``Developments in food packaging technology.
Part II: storage aspects trends on food science
and technology'', Trends in Food Science and
Technology, November, pp. 111-18.
Stamler, J. (1997), ``The INTERSALT study: background,
methods, findings, and implications'', The American
Journal of Clinical Nutrition, Vol. 65 (Supplement),
pp. 626s-642s.
Tilston, C., Neale, R., Gregson, K. and Bourne, S.
(1993), Salt ± A Challenge to Food Manufacturers
(Food Marketing Research Group, University
of Nottingham), Horton Publishing, Bradford,
pp. 5-37.
Wheelock, V. (1998), ``Salt ± the next major food issue'',
Food Industry News, April, pp. 15-16.
Whitehead, T. (1998), ``Against the grain'', The Grocer,
Vol. 27, pp. 32-3, 35.
Williams, A (1994), ``New technologies in food
preservation and processing: Part II'', Nutrition &
Food Science, No. 1, pp. 20-3.
Wyatt (1983), ``Acceptability of reduced sodium in breads,
cottage cheese and pickles'', Journal of Food
Science, Vol. 48, pp. 1300-2.
173