Decreasing sodium content in processed and ready-to-eat foods has the potential to significantly enhance cardiovascular health and avert numerous heart attacks, strokes, and early deaths in countries like France and the United Kingdom. These insights emerge from two recent investigations published in Hypertension, an esteemed publication from the American Heart Association.
Small Food Changes With Large Public Health Impact
Excessive sodium intake stands as a primary driver of hypertension, commonly referred to as elevated blood pressure. The American Heart Association highlights that high blood pressure substantially increases the likelihood of severe health issues, such as heart attacks, strokes, chronic kidney disease, dementia, and various other cardiovascular disorders.
Given that overconsumption of sodium represents a pervasive challenge in public health, numerous nations have implemented strategies aimed at cutting back on salt. Sodium, a key component of salt, is predominantly ingested via routine dietary items. Implementing reductions in salt at a societal scale is regarded as an effective method to boost enduring health results and simultaneously decrease expenditures on healthcare.
The latest research encompasses two distinct modeling analyses. The first, centered on France, evaluates anticipated sodium cuts in baguettes and similar bread varieties targeted for 2025. The other scrutinizes the United Kingdom’s sodium diminishment objectives for 2024, focusing on packaged products and meals obtained from takeaways.
Each investigation projected outcomes assuming complete adherence to these sodium benchmarks. The forecasts indicate that even minor diminutions in sodium within frequently consumed items could yield substantial advantages for public health. Crucially, such modifications would not necessitate any shifts in consumers’ dietary preferences or habits.
“This strategy proves especially effective since it bypasses the need for personal behavioral adjustments, which are frequently challenging to initiate and maintain over time. Rather, it fosters a more healthful food landscape automatically,” explained Clémence Grave, M.D., the primary author of the French research and an epidemiologist alongside a public health specialist at the French National Public Health Agency located in Saint-Maurice, just outside Paris.
The World Health Organization recommends that adults limit their sodium consumption to under 2,000 milligrams (mg) daily, yet global averages far surpass this guideline. The American Heart Association advocates for no more than 2,300 mg per day—equivalent to roughly one teaspoon of table salt—and suggests an optimal limit of 1,500 mg daily for most adults, especially individuals managing high blood pressure.
Sodium Reduction in Bread (France)
In 2019, the French government outlined a nationwide objective to slash salt consumption by 30%. This initiative culminated in a voluntary pact in 2022 between authorities and bread manufacturers to decrease salt concentrations in bread products by 2025. Bread, particularly the iconic baguette, forms a cornerstone of French cuisine but also serves as a significant sodium source, historically providing around 25% of the suggested daily allowance. By 2023, the majority of bread manufactured in France had already aligned with the updated sodium criteria.
To gauge the prospective health implications of this pact, scientists employed nationwide statistics and a sophisticated mathematical framework. They calculated the potential avoidance of cardio-cerebrovascular diseases—those impacting the heart and cerebral blood vessels—along with kidney ailments and dementia, contingent on achieving the sodium goals entirely.
The evaluation revealed that, with steady bread consumption patterns and full target attainment, per-person daily salt ingestion would decline by 0.35 grams. Such a decrease would prompt moderate yet impactful reductions in population-wide blood pressure levels.
Estimated Health Benefits in France
In a full-compliance projection, the team forecasted the following:
- Yearly mortality rates would drop by 0.18%, equating to 1,186 fewer deaths.
- Hospital admissions for ischemic heart disease would reduce by 1.04%.
- Admissions for hemorrhagic stroke and ischemic stroke would diminish by 1.05% and 0.88%, respectively.
- Males would derive the most comprehensive gains, with 0.87% of heart disease and stroke incidents averted versus 0.63% for females. For women, the highest preventable share appeared in the 55-to-64 age bracket.
“This salt-lowering initiative passed entirely under the radar of the French public—no one noticed the reduced salt in their bread,” noted Grave. “Our results demonstrate that reformulating foodstuffs, even through subtle, imperceptible alterations, can profoundly influence public well-being.”
“These outcomes emphasize the importance of partnership among policymakers, the food sector, and healthcare experts,” she continued. “Integrating personal guidance with broad-scale tactics can yield deeper cuts in cardiovascular hazards and foster sustained health advancements.”
The team acknowledged that results hinge on modeling premises and data availability. “Directly isolating the effect of bread salt reduction proves unfeasible, as it coincides with other influences like lifestyle shifts or fluctuating bread intake, which we can’t precisely quantify here,” Grave clarified.
Furthermore, the review covered a single-year timeframe. Extending forecasts would demand further premises and datasets.
Sodium Reduction in Packaged Foods and Take-out Meals (United Kingdom)
In the U.K. analysis, experts reviewed national survey information to quantify salt derived from packaged goods and takeaway options. They subsequently computed shifts in sodium uptake if every pertinent category complied with the 2024 national targets.
Authorities set sales-weighted averages and upper salt thresholds for 84 supermarket categories, encompassing bread, cheeses, meats, and snacks. Notably, for the first instance, 24 out-of-home categories—like burgers, curries, and pizzas—were incorporated. The simulation assessed repercussions for heart disease, stroke incidence, life quality, and medical expenses.
Complete target fulfillment would lower average daily salt from approximately 6.1 grams to 4.9 grams, marking a 17.5% per-person decline. Males were anticipated to see marginally greater reductions, reflecting their higher baseline consumption.
These incremental daily drops were poised to subtly ease blood pressure population-wide, with advantages compounding longitudinally.
Long-Term Health and Cost Benefits in the U.K.
Across two decades, the simulation predicted averting around 103,000 ischemic heart disease cases and approximately 25,000 strokes in the U.K.
Over full lifespans, the blood pressure drops were expected to yield about 243,000 extra quality-adjusted life years—a key metric for health gains—and conserve £1 billion (roughly $1.3 billion USD) for the National Health Service.
Researchers deemed the results consistent with prior knowledge. “Cardiovascular disease ranks as a top killer in the U.K., mirroring global trends, so curbing salt and blood pressure promises substantial gains,” stated Lauren Bandy, D.Phil., principal author of the U.K. paper and a food and population health researcher at the University of Oxford in England. “The food industry retains considerable scope for salt cuts, indicating ample opportunity ahead.”
“Had U.K. firms achieved the 2024 targets fully, the population-level salt decline could have forestalled tens of thousands of heart attacks and strokes, trimmed healthcare spending markedly, and elevated public health markedly—all sans dietary habit changes,” she asserted. “Bolstering and upholding salt policies domestically and internationally could realize these gains.”
Limitations included potential outdated salt data near 2024 and self-reported survey intakes, which often understate sodium, especially from eateries and takeaways.
Relevance for the United States and Beyond
Daniel W. Jones, M.D., FAHA, who chairs the 2025 American Heart Association/American College of Cardiology High Blood Pressure Guideline and serves as dean and emeritus professor at the University of Mississippi School of Medicine in Jackson, Mississippi, affirmed the studies’ wide applicability.
“These models vividly illustrate sodium cuts’ power to mitigate heart disease and stroke risks,” he observed. “This nationwide tactic for curbing salt in commercial foods is vital where much consumption stems from external preparation. Individual blood pressure tweaks may seem minor, but aggregated across masses, they drive profound population-level progress.”
Study Details: France
France recorded an average 8.1 grams of daily salt intake in 2015, with over 90% of adults surpassing guidelines. Classic French breads and baguettes held about 1.7 grams of salt per 100 grams, supplying roughly 2 grams per person daily—or 25% of total.
Aiming for 30% salt reduction, France forged a voluntary bakery accord in March 2022 for phased cuts in all breads by 2025.
Investigators simulated systolic blood pressure drops and linked outcomes under full compliance, factoring varied responses in hypertensive versus normotensive groups.
The framework drew on systolic data for adults 35+, salt from a 2014-2016 survey via three 24-hour recalls, merged with 2022 claims data covering hospitalizations, outpatient services, and deaths in France’s system.
Study Details: United Kingdom
U.K. modeling targeted adults, probing sodium cuts’ effects on ischemic heart disease, strokes, quality-adjusted life years, and costs.
Drawing from the 2018-2019 National Diet and Nutrition Survey, it gauged 2024 target impacts using three-to-four-day diaries from ~1,000 representatives.
The cohort comprised 586 adults 18+, weighted to 2017 demographics. They logged 2,549 unique items, 1,532 aligning with target categories.
