06 May, 2015 Last updated: 15 May, 2015

It might be hard to swallow for the habitual salt grinders among us but the extra salt in our diet is killing us.

Every night around the dining table or in restaurants and fast food outlets, too many Victorians are risking their lives eating too much salt, and many don’t even know it. New research estimates that each year 1.65 million global deaths are a direct result of eating too much salt.7

Salt is made up of sodium and chloride. Too much sodium increases risk of high blood pressure, which is the leading cause of heart attacks and stroke. One in four Victorians have high blood pressure.5

Around 75% of salt in the Australian diet comes from processed foods. People are unaware of the recommended daily amount and how much salt they’re eating. Daily intake of salt should be no more than one teaspoon (about 5g).8 Currently Victorians are eating almost twice this amount, at about 8 grams a day.6

Tackling salt reduction is a highly cost-effective strategy for improving population health, and for this reason reducing salt in the Victorian diet is a key initiative of VicHealth’s healthy eating strategic imperative for the next three years.

Together with The George Institute for Global Health, the Heart Foundation and other partners, VicHealth is responding to the alarming scale of salt-related health hazards. 

VicHealth's aim is to achieve consensus and commitment on salt reduction action from government, industry and the general public leading to a 1 gram reduction in average salt intake by 2018.

 
Professor Bruce Neal from The George Institute at the University of Sydney says the harmful effects of salt on blood pressure and the very close link between blood pressure and cardiovascular disease are well established. 

"Governments worldwide have agreed to intervene and reduce the terrible toll on human life. Processed foods account for 75% of the salt Australians eat and this salt is being added to the food supply for purely commercial purposes," said Professor Neal. 

The Heart Foundation’s spokesperson Kellie-Ann Jolly agrees and says reducing our intake of salt from processed foods by just 15% over 10 years would avert 5800 heart attacks and 4900 strokes a year. 

"Consumers need to be aware of the hidden salt in processed foods we eat every day, like bread, breakfast cereals, processed meats, cheese, sauces and spreads," said Ms Jolly.

A recent review of the range and impact of current national, international and community salt reduction interventions, funded by VicHealth, provides the rationale and identifies the opportunities for action. The Case for State Action on Salt in Australia, prepared for VicHealth by The George Institute for Global Health made recommendations for state-level action that incorporates strategic partnerships, policy development, public debate, and research. The review also found that existing state and federal government initiatives to reduce salt in Australia are unlikely to achieve the WHO target of a 30% reduction in the population’s salt intake by 2025.

Reducing salt intake in Australia by 30% to achieve the global targets committed to would save around 3400 Australian lives a year.2 Modelling conducted by The George Institute predicts that if a 3g/day reduction in average salt intake in Victoria was achieved, about 800 deaths from stroke and heart disease would be prevented each year with potential savings of millions of dollars in annual health care costs.2,4 

There is a need for greater state-level action on salt reduction, and increased support for effective evidence-based national salt reduction initiatives. 

On our side is the fact that Victoria is a recognised leader in innovation and health. We know there is the capacity to reach the necessary targets.

 
To further address Victoria’s dangerously high salt intake, VicHealth has established a Salt Reduction Partnership Group, which includes The George Institute for Global Health, the Heart Foundation, Deakin University, and the Victorian Department of Health and Human Services. The group has developed a three-year action plan for salt reduction in Victoria. Consultations with additional stakeholders is the next step to expand the Partnership and the reach and impact of the action plan. (See box for the Strategic Partnership Group members).

Existing programs are already available and the intention is to build on and strengthen these. The Food and Health Dialogue established by the Australian Government as a voluntary reformulation scheme aims to reduce the content of sodium and other adverse nutrients in commonly consumed foods. Another, The George Institute’s Food Policy Division, was designated as a World Health Organization Collaborating Centre for Population Salt Reduction in 2013 with a remit to support member states achieve the global target. In addition, the Heart Foundation, the Victorian Department of Health and Human Services and Deakin University all have useful policies, campaigns and research to influence our population’s salt intake. 

Dr Bruce Bolam, Executive Manager of Programs at VicHealth, says there are a range of salt reduction initiatives currently being undertaken in Australia and Victoria, including activities led by Salt Reduction Taskforce partners. 

"We have a group of partners all committed to salt reduction in Victoria and making important contributions. That’s a strong foundation from which to build coordinated action," said Dr Bolam. 

The action plan to reduce Victoria's salt consumption will be coordinated over the next three years. Our first year will be focused on consultation and research, and development of a Victorian State of Salt Report. Implementation of a range of salt reduction activities will occur in the second and third year of the plan, thereby building a comprehensive program to achieve an improved food supply and increased public awareness of the need to eat less salt. The program will include social marketing strategies, direct support for industry action, and trials of innovative approaches to reduce salt and ultimately cut the level of related chronic disease among Victorians.

Vichealth Salt Reduction Strategic Partnership Group

  • Dr Bruce Bolam: Executive Manager – Programs, VicHealth
  • Veronica Graham: State Public Health Nutritionist, Victorian Department of Health and Human Services
  • Dr Carley Grimes: Heart Foundation Postdoctoral Research Fellow, Deakin University, Centre for Physical Activity and Nutrition Research (C-PAN)
  • Kellie-Ann Jolly: Director, Cardiovascular Health Programs, Heart Foundation – Victoria
  • Professor Bruce Neal: Senior Director, Food Policy Division and Chair of the Australian Division of World Action on Salt and Health, The George Institute for Global Health
  • Professor Caryl Nowson: Chair in Nutrition and Ageing, Deakin University, Centre for Physical Activity and Nutrition Research (C-PAN)
  • Jen Reimers: Principal Program Officer – Healthy Eating, VicHealth
  • Colin Sindall: Director, Prevention & Population Health, Victorian Department of Health and Human Services
  • Dr Jacqui Webster: Centre Director, World Health Organization Collaborating Centre on Population Salt Reduction, The George Institute for Global Health

1 Better Health Channel 2014, Salt, accessed 30 January 2015
2 He FJ, MacGregor GA. How far should salt intake be reduced? Hypertension. 2003. 42(6): 1093-9 
3 Based on 2013 Victorian population figures and average salt intakes.
4 Nichols M, Peterson K, Alston L, Allender S. Australian heart disease statistics 2014. Melbourne: National Heart Foundation of Australia, 2014. Accessed 10.02.15.
5 Victorian Department of Health 2012, Victorian Health Monitor Food and Nutrition report, accessed 5 February 2015
6 Jeffery, P, Riddell, L, Land, M-A, Shaw, J, Webster, J, Chalmers, J, Smith, W, Flood, V & Neal, B 2012, ‘Quantifying salt and potassium intake in Victoria adults’, Journal of Hypertension, vol. 30, no. 1118. 
7 Global Burden of Diseases Nutrition and Chronic Diseases Expert Group 2014, ‘Global Sodium Consumption and Death from Cardiovascular Causes,’ New England Journal of Medicine, 371, pp. 624–634. 
8 World Health Organization 2012, Sodium intakes for Adults and Children: Guideline, accessed 12 February 2015