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Salt: A Review of its Role in Food Science and Public Health

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290 Current Nutrition & Food Science, 2008, 4, 290-297

Salt: A Review of its Role in Food Science and Public Health

Edel Durack, Mercedes Alonso-Gomez and Martin G. Wilkinson*
Department of Life Sciences, University of Limerick, Castletroy, Limerick, Ireland

Abstract: Salt has been used in food preparation since pre-history and is still routinely added in modern food
manufacturing processes. Salt may be added at the table or during cooking; however a large amount of dietary salt
originates from processed foods (~60-70% of adult daily dietary salt). Excess salt intake is strongly linked to increases in
blood pressure (hypertension) and subsequently pre-disposes individuals to the onset of cardiovascular disease (CVD), a
leading cause of death in developed countries. Excess dietary salt intake has also been linked to the development of
kidney disease, aggravation of asthma conditions and to the onset of osteoporosis. Results from large numbers of human
studies have led to worldwide initiatives being put in place in order to reduce current levels of salt consumption. Hence
there is an urgent need to reduce excess dietary salt intake from processed foods in particular. Current daily consumption
figures can be as high as ~10-12g NaCl per day while an intake of 4g salt per day is sufficient. Therefore a target
reduction to an intake of 6g per day is the goal for a number of public health agencies worldwide. An incremental
reduction in salt content in foods appears to be the best strategy to reduce population blood pressure values. However any
reduction in salt content in processed foods must not impact on product safety or sensory quality. In this review various
public health aspects of salt intake are considered. Additionally, the technological implications of salt reduction in foods
are discussed and the possibilities for replacement of salt by addition of salt replacers, herbs, spices and other food
ingredients to maintain product quality are highlighted.

HISTORY OF SALT evaporation facilities, to advanced, multi-stage evaporation

Salt comprises of both sodium and chloride in which
sodium consists of up to 40% of the molecule. Human
requirements for sodium or chloride must be obtained
through the diet. Salt together with fermentation and
dehydration (air/sun) are classical methods of food
preservation originating from prehistoric times. About 5000
years ago, the Chinese noted that soaking of meat or fish in
saline solutions allowed preservation for extended periods,
subsequently this technique was used to preserve a wide
range of foods [1]. The use of salt in the diet may have been
adopted soon after man started cooking food, as boiling of
food in particular would have removed salt naturally present
in the food [2]. Over the centuries salt became one of the
most traded commodities in the world and indeed one of the
most heavily taxed [3]. In ancient Greece the expression,
"not worth his salt” arose as a means of placing value on
slaves and salt rations "salarium argentum", were given to
Roman soldiers from which the English word "salary" is
derived . Indeed in Classical and Medieval times salt became
so valued as a food preservative that it was used as a form of
currency for goods and services [4].
Salt occurs naturally in sea-water and in rock salt
deposits after an area of sea-water becomes enclosed and the
water evaporated by the heat of the sun. Salt may also be
present with other constituents in certain rocks or become
dissolved in natural brines originating from porous rock or
flowing from salt springs in the ground [2]. Over many
millions of years, other sediments may be deposited above
the salt, leaving the beds of rock salt below the surface.
Almost 100 countries across the world have facilities for
producing white salt, ranging from primitive solar
*Address correspondence to this author at the Department of Life Sciences,
University of Limerick, Castletroy, Limerick, Ireland; Tel: + 353 61
213440; Fax: + 353 61 331490; E-mail: Martin.Wilkinson@ul.ie
processes within purpose-built salt refineries [5] .
SALT IN FOOD MANUFACTURE
The importance of salt in food manufacture arises from
its roles in preservation, and contributions to flavour, texture
and colour. Salt acts as a preservative by lowering the water
activity (aw) content to below that which is required by
various bacterial species for growth. Aw is the ratio of the
vapour pressure of water in a food to the vapour pressure of
pure water at the same temperature and, in essence, is a
measure of the availability of water for enzymatic reactions,
microbial growth and metabolism. Each microbial species
has a minimum aw below which it cannot grow [6]. Highly
perishable foods with an aw of
0.950 including meat, fish,
vegetables, milk, cooked sausages and breads and foods
which contain up to 4 oz (w/w) sucrose or 7% NaCl allows
growth of Pseudomonas, Escherichia, Proteus, Shigella,
Klebsiella, Bacillus, Clostridium perfringens, and some
yeasts. Foods with an aw ~ 0.910 including some cheeses
(Cheddar, Swiss, Meunster, and Provolone), cured meats,
some fruit juice concentrates and foods containing 55%
(w/w) sucrose or 12% NaCl allow growth of Salmonella,
Vibrio parahaemolyticus, C. Botulinum, Serratia,
Lactobacillus, Pediococcus and some moulds. Foods having
an aw ~ 0.870 including fermented sausage (salami), sponge
cakes, dry cheeses, margarine or foods containing 65%
(w/w) sucrose or 15% NaCl allow growth of many yeasts
(Candida, Torulopsis, Hansenula) and Micrococcus. Foods
with an aw of ~ 0.800 including fruit juice concentrates,
sweetened condensed milk, chocolate syrup, maple and fruit
syrups, flour, rice, pulses containing 15-17% moisture, fruit
cake and high sugar cakes allow growth of most moulds
(mycotoxigenic penicillin), Staphylococcus aureus, and most
Saccharomyces species. Foods having an aw of ~ 0.750 such
as jam, marmalade, marzipan, glacé fruits and marshmallows
allow growth of most halophilic bacteria, mycotoxigenic

1573-4013/08 $55.00+.00 © 2008 Bentham Science Publishers Ltd.

Salt
aspergilli. An a w as low as 0.600 typically found in foods
such as dried fruits containing 15-20%, moisture, toffees,
caramels and honey permits growth of Xerophilic moulds
(Aspergillis chevalieri, A. candidus, Wallemia sebi) and
Saccharomyces bisporu,. At aw values below 0.500 there is
generally no microbial growth [7].
The mechanism of microbial growth inhibition by salt
appears related to plasmolysis or water loss from the cell.
When the aw of the food is reduced through salt addition,
bacterial cells experience osmotic shock and plasmolysis,
loosing turgor, leading to cessation of growth, death or cells
entering a dormant state. In order for growth to resume, aw
must return to values which allow cells to recover [8]. To re-
establish turgor, microbial cells increase aw by accumulation
and uptake of compatible solutes [9, 10]. Compatible solutes
are small highly soluble, organic molecules including sugars
and polyols or
- and - amino acids that do not interfere
with metabolism, even when accumulated to high concen-
trations [10, 11]. Reducing aw value of foods by salt addition
may lead to an extended lag phase, in which bacterial cells
undergo a period of adaptation to the new environment
before the exponential phase commences. Specifically,
addition of a 3.6% salt solution to grated carrot was reported
to reduce aw sufficiently (0.84) to suppress microbial growth
within the product while maintaining an acceptable taste,
however addition of 4% salt resulted in the product
developing an excessively salty taste [12].
As well as its preservative qualities, salt improves flavour
texture and mouthfeel of many products especially processed
foods. It is one of the four basic flavours (sweet, salt, acid,
bitter) associated with foods and imparts both its own
specific flavour when added to food products, or enhances
the flavour of other ingredients and/or reduces bitterness in
certain products [13]. A unique sodium-related transduction
mechanism exists which does not occur with other anions,
whereby an electrical signal is propagated through the
nervous system to identify the taste of salt, this only happens
for sodium or lithium [14]. Although salt enhancement for
flavour purposes is more commonly associated with savoury
foods, salt can also be used to deliver flavour in sweet
products like chocolate [14]. Salt is a key component of
cheese manufacturing and is added to generate levels in the
final products ranging from ~0.7% (w/w) in Swiss-type
cheese to ~6% (w/w) for Domiati cheese, an Egyptian
variety. In cheese manufacture, salt together with pH and
calcium level have an effect on the extent of para-casein
hydration, or aggregation, which in turn affects the water
binding capacity of the casein matrix, its tendency for
syneresis and the resulting rheological, textural charac-
teristics and cooking properties of the cheese [15]. Salt
controls acidification activity of starter cultures and affects
the activity of various ripening enzymes. The contribution of
salt to the overall flavour profile of varieties such as Cheddar
can be gauged from the fact that low salt cheese is generally
thought to be ‘insipid’, or lacking flavour [16].
In the manufacture of meat and meat products salt has
many functional attributes; activation of proteins to improve
hydration and water binding capacity; increasing binding
properties of proteins to improve texture and increasing the
viscosity of meat thereby facilitating the formation of a
Current Nutrition & Food Science, 2008, Vol. 4, No. 4 291
stable batter [17]. It is also used for colour maintenance [1].
In cured meats, when sodium nitrite is added with the salt,
the meat develops a red, then pink colour. Nitrite reacts with
the meat myoglobin to cause these colour changes, first
converting to nitrosomyoglobin (bright red), then, on
heating, to nitrosohemochrome (a pink pigment) [18]. It also
has a tenderising effect on meat by allowing myofibrils to
swell in the presence of salt (3-9%), therefore enhancing the
water holding capacity (WHC) of the meat. These
concentrations of salt are similar to those generally present
in comminuted meats. The presence of these levels of salt
cause an increase in the amount of protein extracted in the
meat products and forms a salt and protein complex which
binds pieces of meat together. Salt also alters the pH and
ionic environment thus aiding the formation of this cohesive
structure [17, 18] and is essential in the manufacture of
sausages, burgers and ready-to-eat sliced meats [18]. In the
manufacture of bread, salt plays a key role; it enhances the
stability of wheat gluten and makes it less extensible
therefore reducing the sticky texture of bread. It does this by
causing a tightening or binding of the dough. The reasons for
this are thought to be competition for hydrogen binding sites
in the gluten protein molecule by the sodium ions [18]. Salt
also affects the rate of fermentation in bread by reducing the
amount of gas produced, as evidenced by the fact that
inadequate salt levels can lead to excessive yeast fermen-
tation leading to poor loaf structure [13]. Salt is a heavily
utilised ingredient in the manufacture of fermented vege-
tables such as sauerkraut and pickles. Salt controls microbial
growth by allowing outgrowth of beneficial cultures in the
vegetable substrate thus providing the necessary conditions
for a safe fermentation. Subsequent development of acidity
encourages growth of acid tolerant bacteria such as
Lactobacillus plantarum which converts sugars to lactic acid
[18]. Salt content also affects texture in pickled onions as
unbrined pickling onions contain substantial levels of acetic
acid which can form a haze around the product. The
formation of this layer may be prevented by the addition of
salt. Salt can also prevent the pinking which occurs if the
onions are acidified before brining. Salt addition may also
prevent spoilage of acid preserved products, as acid-tolerant
spoilage species are not usually salt-tolerant [13]. In addition
to food processing salt is also used in the manufacture of
soap and glass.
EFFECTS OF SALT ON BACTERIA
The effect of salt on microorganisms is dependant on a
number of factors both intrinsic and extrinsic. Intrinsically,
each microorganism differs in its response to salt [11].
Various reports exist regarding the ability of E. coli to
survive in various osmotic environments with growth
reported in aqueous salt solutions ranging from 0.036%, to
0.18% in the lumen, to much higher concentrations in a food
system [19]. Jenkins et al. [20] reported survival of E. coli in
salt solutions of 2.2 to 2.5 M (~13-15%) following prior
exposure to low non-growth inhibiting salt concentrations of
0.3 to 0.35M (1.8-2.0%). Listeria is capable of surviving and
growing at high salt concentrations; all strains can grow in
complex media containing 10% (w/v) NaCl while some
strains can tolerate 20% (w/v) NaCl and some strains can
remain viable after 1 year in the presence of 16% (w/v) NaCl
at pH 6.0 [21]. Indeed Listeria has been reported to survive
292 Current Nutrition & Food Science, 2008, Vol. 4, No. 4
in 30% NaCl [22]. Faleiro et al. [23] studied the growth of L.
monocytogenes in various broths and found that the bacteria
was capable of growing in nutrient broth up to 10% added
salt and in tryptose soy broth containing 25.5% (w/v) salt for
up to 4 days. In food, L. monocytogenes is capable of
growing in cabbage juice containing 5% salt [24], survival
was detected in a 30% brine solution stored for > 60 days
and in beef immersed in a 22% salt solution stored for 100
days [25]. Lowering aw of the growth media by the addition
of salt creates an unfavourable environment for L.
monocytogenes, which leads to reduced growth rates,
extended lag phases and overall population decline [26].
Growth of L. monocytogenes has been observed at aw of 0.90
in TSB with added salt, and survival has been reported at an
aw of 0.83 [25].
Sutherland et al. [27] reported that 89 % of strains of
Bacillus cereus examined were capable of growth in 7%
NaCl while 10% NaCl appeared to be slightly inhibitory. B.
cereus inoculated into a beef goulash meal containing 3%
added salt, grew by ~2 log units after 18 hours storage at
28ºC. B. cereus exhibits cross protection when exposed to
either physical or chemical stresses. Cross protection takes
place when bacterial cells need to adapt to some
physiological or environmental factors which result in
microbial protection against sublethal treatments, including
stresses to which the microorganisms has not previously
been exposed to [28]. This process triggers the synthesis of
proteins which provide protection from various stresses
including high or low temperature, high or low pH or high
osmolarity arising from the presence of solutes including salt
or sugars [29]. Another way in which bacterial cells adapt to
osmotic stress is by accumulation of compatible solutes [10,
11, 28]. Browne & Dowds [30] showed that pre-treatment of
B. cereus with a 1% salt solution protected the bacteria
against stresses such as heat, ethanol and acid. However, pre-
treatment with 1% salt did not afford protection against salt
concentrations of 10-12% NaCl. In this study, B. cereus
exhibited resistance to 8 or 10% salt during the lag or early
log phase but became more sensitive to these salt levels
during late log phase and did not regain salt resistance in the
stationary phase.
Desmond et al. [31] reported that strains of non-starter
lactic acid bacteria (NSLAB) such as Lactobacillus
paracasei can grow to 108 CFU/g during manufacture and
ripening of cheddar cheese, highlighting the ability of
NSLAB to grow in the presence of salt concentrations
normally present in Cheddar cheese ( ~2.7%, w/w) [32].
Studies investigating the stress protection responses of
Lb. acidophilus have found an increase in population follo-
wing incubation in the presence of 2% salt, but a decrease in
the presence of salt over the range 4-18% [33]. Lactobacilli,
however, do not produce the same osmoprotectant proteins
as Listeria or Bacillus species.
PUBLIC HEALTH ASPECTS OF SALT INTAKE
Excessive intake of salt by consumers has been related to
development of hypertension and consequently the higher
risk of development of cardio-vascular disease (CVD)
especially for sub-groups such as hypertensives (individuals
with raised blood pressure) and in older or black individuals
Wilkinson et al.
[34]. As far back as the 18th century, the Chinese observed
that a “hard pulse” indicating high blood pressure was linked
to a high intake of salt and associated this “hard pulse” with
stroke incidence. However, it was not until 1904 that the
Western world made the correlation between high salt intake
and hypertension [35]. According to the Irish Heart
Foundation, CVD is the most common cause of death in
Ireland with over 10,000 deaths annually accounting for 37%
of all deaths, including 24% of all premature deaths below
the age of 65 [36, 37]. In the UK figures are similar, with
CVD causing about 40 per cent of deaths while ~40 per cent
of people aged 55-64 exhibit symptoms of heart disease [38].
Hypertension or high blood pressure is extremely
common in developed countries such as UK and USA [39].
The term blood pressure refers to the force of blood pressing
against the walls of the arteries, as the heart pumps blood
around the body [39] and is measured in millimetres of
mercury (mmHg). In the seventh report of the Joint National
Committee (JNC VII) on Prevention, Detection, Evaluation
and Treatment of High Blood Pressure (2003) normal blood
pressure was defined as <120/80mmHg expressed as systolic
over diastolic pressure where systolic refers to pressure on
contraction of the cardiac muscle. In JNC VII hypertension
or high blood pressure refers to individuals whose blood
pressure is
140mmHg systolic or
90 mmHg diastolic.
JNC VII also introduced a new term “prehypertension”
which refers to individuals with blood pressure ranging from
120-139mmHg systolic and/or 80-89 mmHg diastolic [3,
40]. Blood pressure in the body is regulated by the
requirement of the kidneys to excrete or conserve enough
sodium to maintain normal sodium content and blood
volume. Therefore, excess sodium is generally excreted. Any
increase in blood volume caused by excess salt increases
arterial pressure, glomerular filtration rate and renal
perfusion leading to increased water and sodium excretion
[3, 39]. However, there is an upper limit to the amounts
which may be excreted and therefore excess salt can lead to
increased water retention and if retention exceeds water
excretion this may in turn lead to tissue damage and
hypertension [34, 39]. In the UK the COMA report states
that “The Health of the Nation” target is to reduce average
systolic blood pressure by 5mm Hg. In order to achieve this
target, reduction in alcohol consumption, obesity and
excessive salt consump-tion are seen as factors which must
be controlled [38]. The COMA report highlighted the need to
effect an incremental reduction in blood pressure across the
entire population rather than targeting a large reduction in
blood pressure in selected groups e.g. hypertensive
individuals. The rationale behind this approach is that it may
result in a greater reduction in overall disease rates. The most
successful dietary approach with which to lower blood
pressure appears to be that of DASH (Dietary Approaches to
Stop Hyper-tension) in the US. DASH trials were carried out
on 412 random individuals on two diets, firstly a regular
American diet (control diet) and secondly, a diet rich in
fruits, vegetables and low-fat dairy products (DASH diet).
Within each dietary group, individuals were maintained at
three different daily salt intake levels at 4, 6 or 8 g [3, 41].
An overall reduction in blood pressure was found for
individuals on the DASH diet while the greatest reductions
in blood pressure were observed for individuals where the
Salt
DASH diet included the lowest daily salt intake (4g). This
latter diet resulted in a reduction in blood pressure by an
average of 8.9mm Hg systolic and 4.5mm Hg diastolic
below the control diet and where a high daily salt intake (8g)
was maintained [42].
Other illnesses associated with excess salt intake include
the development of kidney stones, kidney disease, and
ultimately kidney failure. Higher incidences of stomach
cancer have also been found in individuals with a high salt
intake and high salt intakes may aggravate asthma
conditions. Additionally, dietary salt significantly influences
calcium excretion and may be a major contributor to the
onset of osteoporosis [35] . Increased salt in the diet may
lead to both increased sodium and calcium excretion in urine
and various studies have shown that an increase of 100 mmol
of sodium/day (equivalent to 5.8 g NaCl/day) causes an
additional urinary excretion of ~0.6 mmol calcium per day in
young men and women. As about one-third of the skeleton is
calcium and phosphorus, sustained high losses of calcium
can lead to decreased bone density [43]. The National
Osteoporosis Society in the UK recommend avoiding adding
salt to the diet for people who may be affected by osteo-
porosis [44]. He et al. [41] reported that in the UK children
and adolescents who eat less salt, drink less sugar-sweetened
drinks lower their chances of developing obesity, high blood
pressure, heart attack and strokes in later life, a finding also
reported by CASH [45].
SALT INTAKE AND DIET
Sodium plays an important role in the body by regulating
fluid balance. It also transmits nerve impulses, assists muscle
relaxation and contraction, and transports nutrients to cells
[1, 46]. Over 90% of the sodium in the diet occurs in the
form of sodium chloride (salt) and 1g of sodium is
equivalent to 2.54g of salt [47]. Pre-agricultural diets of
humans may have been low in salt and have been estimated
at a daily sodium intake of 768mg [48], equivalent to 1.92 g
of salt. An adult daily intake of 4g salt is sufficient to meet
the physiological needs of 97.5% of the population [47].
However the actual salt intake for the average adult is much
higher, at approximately 10g per day in Ireland [47] and the
UK [39] and may be as high as 12 g a day in some European
countries [34]. The UK National Diet and Nutrition Survey
carried out on adults aged 19 to 64 years, found that mean
daily intake of salt was ~3g higher in males compared with
females [49]. In the US, a report carried out by the
Department of Health and Human Services (HHS) and the
US Department of Agriculture (USDA) recommended a
daily adult intake of <2.3g, of sodium per day or 5.75g salt.
Individuals with hypertension, black people, middle aged
and older adults were recommended to consume no more
than 1.5g of sodium per day or 3.75g salt [50]. The National
Research Council of the National Academy of Sciences in
Washington, D.C., similarly recommended a minimum daily
amount of 1.25g salt per day with an upper limit of 6g salt
per day [51]. In the case of infants and children the
recommended daily allowance (RDA) for salt is much lower.
A report by the Scientific Advisory Committee on Nutrition
(SACN) in the UK suggest a reference nutrient intake of salt
for children to be in the range of 0.6 grams per day for
Current Nutrition & Food Science, 2008, Vol. 4, No. 4 293
newborns, 1.8 grams per day for 4-6 year olds and 4.08
grams per day for 11-14 year olds [39].
In Ireland, the average daily salt intake in children aged
4-6 years and 7-10 years exceeds 5g and 6g, respectively
[47]. In the UK, reference nutrient intakes (RNI) recommend
average salt intakes for children of 0.5g – 0.7g per day for
children aged 1 to 6, and 0.7g – 1.6g per day for children
aged 7 to 14 [39]. A National Children’s Food Survey
carried out by Irish Universities Nutrition Alliance (IUNA)
in 2005 compiled data from 594 children from 28 primary
schools in the Republic of Ireland. A food diary recorded by
the children allowed the following intake classifications: 5-6
year olds 4.6 g per day (with a target total salt intake of 3 g
per day), 7-10 year olds 5.3 g per day (with a target total salt
intake of 5 g per day), 11-12 year olds 5.9 g per day (with a
target total salt intake of 6 g per day) [52].
Approximately 15% of total dietary sodium is naturally
occurring, a further 15-20% is discretionary i.e. salt added by
the consumer to foods when preparing, cooking and eating
meals, while 65-70% is non-discretionary derived from
processed foods [39, 47]. Busy modern lifestyles with longer
working hours, greater number of working mothers, decline
of family meal times and more time being spent on out of
home activities have resulted in an increase in consumption
of processed meals [53]. The National Diet and Nutrition
Survey in the UK highlighted foods contributing signifi-
cantly to excess salt intake. Cereals and cereal products
provided 35% of mean intake. White bread alone provided
14% of mean daily intake, breakfast cereals 5%, and biscuits,
buns, cakes and pastries 4%. Overall, meat and meat
products provided 26%, with bacon and ham, contributing
8%, and chicken (including coated chicken) and turkey
dishes, providing 5%. All other food groups were respon-
sible for less then 10% of the daily intake. This data high-
lights the requirement to target sodium reduction strategies
in particular towards the processed foods sector [49]. This
survey also found that ~73% of respondents reported that salt
was usually added to their food during cooking. In the US,
members of the American Medical Association may
recommend that the Food and Drug Administration (FDA)
revoke the “generally regarded as safe” (GRAS) status of
salt and instead implement regulatory measures limiting the
amount of salt added to processed or canteen foods [54].
HUMAN STUDIES
The 1970s saw the first human studies into the adverse
effects of salt intake on health. One such study looked at the
haemodynamic and hormonal effect of short-term manipu-
lations of sodium chloride intake over the physiologic range
in both normotensive and hypertensive subjects. In the same
decade the Surgeon General's report was also published
which labelled salt as a clear cause of high blood pressure.
These findings paved the way for National Health policies to
be put in place [55]. However, most of these studies were
only concerned with role of salt in blood pressure control.
Results from a much larger systematic, organised
international study were published in 1988. This study was
the Intersalt study funded by the National Heart, Lung, and
Blood Institute (USA) [56] and involved measurement of
electrolyte excretion (sodium) in individuals across the globe
and how this was related to blood pressure. Results showed a
294 Current Nutrition & Food Science, 2008, Vol. 4, No. 4
vast difference in sodium excretion ranging from 0-2
mmol/24 h (Yanomamo Indians, Brazil) to 242 mmol/24 h
(North China). This study found that in those populations
who had a daily salt intake below 50 mmol, there was also a
direct relationship between 24 h urinary sodium excretion
and blood pressure. In general, populations with low sodium
excretion had low incidences of hypertension with a very
low increase in blood pressure with age. Another large study,
the National Health and Nutrition Examination Survey
(NHANES I), showed similar findings where a percentage of
cardiovascular related deaths which occurred in a large
population of monitored subjects were related to urinary
sodium excretion [57]. However, the definitive clinical trial
in this area is the Dietary Approaches to Stop Hypertension
(DASH) study also carried out in the US. As discussed
earlier, this study found that the greatest reductions in blood
pressure were observed in individuals on the DASH diet
where salt intake was low salt (4g) [42]. Migration studies
carried out were reported by MacGregor (1997) [58]. This
study investigated the movement of a population of Kenyans
from a rural background to an urban setting. The rapid
increase in blood pressure following migration was mainly
associated with an increase in dietary salt intake. The results
of these trials have lead to the development of worldwide
initiatives to reduce the amount of dietary salt consumed by
various methods, which include consumer education and
reduction in salt added during food manufacture.
WORLDWIDE INITIATIVES TO REDUCE SALT
CONSUMPTION
Increasingly governments worldwide have initiated
campaigns to reduce the average daily salt intake of the
general population. In Ireland and the UK, government
policy to reduce salt consumption to specific target intakes
are being implemented by national health agencies, food
agencies, local authorities and food companies acting
together. Typically these initiatives involve informing the
public about the dangers of excess salt consumption and how
they may subsequently undertake sodium reduction through
dietary choices. Pressure is also being put on the producers
of processed foods, where the majority of dietary salt comes
from, to reduce the levels of salt present in these products.
The Food Safety Authority of Ireland (FSAI) are working
closely with the food industry to bring about a reduction in
salt intake and have recently announced that they are on
target to reduce the level of salt to 6g per day by 2010 [47].
This voluntary salt reduction programme currently involves
75 food businesses, and their representative groups, involved
in the manufacturing of bread, cereals, meat products,
savoury sauces, snack foods and confectionery [47, 59]. In
the UK, the Food Standards Agency (FSA) has agreed a two-
stage target to reduce average salt intake by 10% (approx 1g
per day) by 2005 or 2006 and as a longer term goal, to
reduce average salt intake by 33% by 2008 [60]. An action
group, CASH (Consensus Action on Salt and Health) has
been set up to lobby for lower salt content in processed
foods. CASH holds an annual National Salt Awareness week
and in 2008 the key focus was on highlighting the growing
problem of excess salt in children’s diet. CASH have
highlighted that some children’s food products can contain
more than half the daily limit for a 6 year old in a single
serving [45]. CASH also draw attention to high levels of salt
Wilkinson et al.
in new products or recipes, however, they note that the
average salt content of supermarket ready meals has been
reduced by 45% since 2003. Hence, the FSA target of
reducing salt levels in processed foods by 2010 seems quite
achievable. The targets cover 85 categories of processed
foods, including foods such as bread, bacon, ham, breakfast
cereals and cheese, and convenience foods such as pizza,
ready meals, savoury snacks, cakes and pastries. CASH
claims that a one-third reduction in fatal strokes and a one-
quarter reduction in mortality from heart disease could be
achieved if a new daily salt intake limit of 3g for adults
could be attained. This figure of 3g is not unrealistic and the
US National Heart, Lung and Blood Institute have
recommended a daily average intake of 3.75g. In the UK,
The Food and Drink Federation (FDF) claims that the UK
leads the world in the campaign for salt reduction [45]. In a
global context, the World Action on Salt and Health
(WASH) has similar aims and activities to CASH and to date
71 countries have joined this initiative. From a public health
perspective, salt reduction should be an easy strategy to carry
out since 80% of all salt is found in, processed, canteen,
restaurant and fast food. A strategy of incremental reductions
in salt of 10-20%, which are below taste threshold levels and
which do not cause technological problems, may be achieved
in a wide range of foods which contain added salt. If such
incremental reductions were repeated every 1-2 years, salt
intake in the UK could be reduced by about 6g per day [45].
Bertino et al. [61] found that preferred levels of salt in food
is dependant on the amount of salt consumed by individuals.
Individuals with a high salt intake appear to require a higher
salt concentration to obtain the same taste sensation as those
less sensitive to salt. This finding would support the strategy
of a gradual incremental reduction of salt contained in
processed foods as being the most effective way of reducing
dietary salt intake, especially non-discretionary salt.
LABELLING OF SALT OR SODIUM CONTENTS IN
FOODS
A key issue related to public health salt reduction
campaigns is the labelling of sodium or salt contents in
foods, especially pre-packed foods, i.e. frozen or chilled
ready meals, pizzas, soups and snacks. In the EU, nutritional
labelling is not compulsory unless a nutritional claim is
being made for the food. When a nutritional claim is being
made on a food product labelling is mandatory and must
include energy value, amount of protein, carbohydrates, fat,
saturates, sugar, fibre and sodium [62]. In Ireland it is
mandatory for pre-packed foods to include a label which
includes a list of ingredients along with other essential
information [63]. Due to increased awareness on health
implications of a healthy diet, consumers are more likely to
check ingredient listings and nutritional labelling on
products, especially pre-packed processed foods. Currently,
many food labels or declarations are confusing to the
consumer and actual amounts of salt in the product can be
difficult to figure out. Some food products list grams of salt
or sodium, other list grams per 100g and others grams per
serving which can be up to 375-400g. Current EU legislation
states that only sodium content is required to be labelled,
however many food manufacturers declare the amount of salt
in the product [64]. Sharp [65] states that food labels should
include salt content (not sodium content) per serving and per
Salt
100g and also the recommended daily amount (RDA). Sharp
highlighted the anomalies that can occur in food labelling
where, for instance, a can of organic beans can claim to
supply one of the recommended five daily servings of fruit
and vegetables and contain no artificial colourings or
preservatives; yet one serving may contain 2.5g salt. Many
food manufacturers have, in addition to nutritional
information, included Guideline Daily Amounts (GDA)
derived from recommendations of Government and health
agencies to assist consumers achieve a balanced healthy diet
and for salt these are based on an intake of 6g per day [64].
In the UK the FSA have recommended a “traffic light”
labelling system where the consumer instantly knows after
looking at a food label whether it contains high, medium or
low amounts of fat, saturated fat, sugars and salt. A red label
indicates high levels, an amber label indicates medium levels
and green suggests the food contains low levels of a
particular nutrient [66]. To date, the European Commission
(EC) have not backed this method of labelling, considering it
to “oversimplify” the situation, by giving a narrow view
about a particular food and not educating consumers about
the benefits of a balanced, healthy diet [64]. The EC have
however, tabled legislation requiring pre-packed foods to
clearly display nutritional information on the front of the
pack. This information would include; energy values, fat,
saturated fats and carbohydrate content per 100 ml or 100g
or per portion with specific reference to sugar and salt
content [67]. The proposed changes in labelling should assist
consumers’ dietary choices especially in relation to obesity
and high salt intake [68]. In Australasia, manufacturers pay
for the right to display the healthy option logo, “Pick-the-
Tick”, provided they meet standards laid down by the
National Heart Foundation [65]. This scheme appears to be
quite successful and in New Zealand was reported to cause
the removal of 33 tonnes of salt from food products in a
single year. The FSA have also outlined a basic labelling
method to immediately inform consumers as to whether a
product is high or low in salt content, greater than 1.5g salt
per 100g or 0.3g salt per 100g, respectively [69].
In order for a food to bear a claim that it is low in
sodium/salt, the product should contain no more than 0.12g
of sodium, (equivalent to 0.3g of salt, per 100g or per
100ml). For a product to claim very low sodium/salt content,
the product must contain no more than 0.04g of sodium
(equivalent to 0.1g salt, per 100g or per 100ml). In order to
make a claim of sodium-free or salt-free the product must
contain no more than 0.005g of sodium (equivalent to
0.0125g salt per 100g) under the EU Directive 80/777/EEC.
In order for a product to claim that it is sodium/salt reduced
it must contain sodium, or the equivalent value for salt, at a
level of 25% less than a similar product under the EU
Directive 90/496/EEC [70].
REDUCTION OR REPLACEMENT OF SALT IN
FOODS
As already outlined, salt plays a key role in providing
typical textural and organoleptic characteristics in a range of
foods and hence its removal and/or replacement may have
major impacts on quality and processing. There are two main
alternatives to salt available to the food technologist, namely,
salt enhancers or salt replacers. Salt enhancers are
Current Nutrition & Food Science, 2008, Vol. 4, No. 4 295
ingredients that enhance the perception of saltiness or of a
salt-tasting compound without having any saltiness itself.
Examples include; glycine, glycerine monoethyl ester, L-
lysine, L-argine, lactates, mycoscent, trehalose, L-ornithine,
O-aminoacyl sugars, alapyridaine and glutamates such as
monosodium glutamate (MSG) [71]. One of the most
common types of salt enhancer in use is monosodium
glutamate (MSG), which contains high levels of glutamic
acid and imparts a particular “umami” type taste to enhance
the palatability and acceptability of savoury foods [71, 72].
Umami is a Japanese term which refers to a savoury, meaty
or broth-like flavour note. The main advantage in using
MSG for salt replacement in foods is that it contains only
one-third the amount of sodium as salt (13 % as opposed to
40 %) [73]. However, MSG consumption has been
associated with so-called ‘Chinese Restaurant Syndrome’
which may cause headaches, swelling and weakness [1].
Salt replacers are ingredients where the sodium cation
has been replaced by ions such as potassium, calcium or
lithium. Potassium chloride (KCl) is probably the most
widely used salt replacer in the food industry and its use
enables significant reduction in salt content. Sodium
reduction by potassium substitution of 25-30% is generally
recommended and while up to 50% substitution may be
achieved in certain food products, inclusion beyond this
level of KCl may lead to the development of bitter or
metallic off-flavours [71, 74]. Colmenero et al. [75] reported
that potassium has the opposite effect of sodium through
lowering of blood pressure. As well as lowering systolic
blood pressure, a diet high in potassium has been shown to
prevent the development of renal damage in rats. In humans,
increased potassium intake is important in the management
of hypercalciuria (abnormally high levels of calcium in
urine) and in reducing the risk of kidney stone formation
[41]. However, it has been reported that potassium chloride
may be harmful to people with certain medical conditions
[76]. Studies on the antibacterial effect of KCl have shown
similar effects to NaCl in terms of growth rates, death rates,
lag phase duration and overall population when L. monocy-
togenes was grown in Tryptone Soy Broth supplemented
with 0.5% yeast extract. An equivalent reduction in aw to that
achievable by salt addition was obtained by addition of KCl.
A range from 0 to 1.4mol NaCl and KCl was added and in
both cases aw was reduced from 0.999 to ~0.950 [26]. Other
salt replacers used include other potassium salts, calcium
chloride, magnesium sulphate and metal ions [71].
Substitution of NaCl with a mixture of chloride salts in dry
fermented sausages resulted in increased solubilisation and
binding capacity of meat proteins [77, 78]. Blocker
ingredients may be used in conjunction with salt replacers to
mask bitterness, an example of these is adenosine 5’-
monophoshate (AMP), a compound which reduces taste cell
activation by bitter compounds [79].
Some manufacturers directly reduce salt in foods and do
not replace it with a substitute. Indeed CASH claim that a
10-20% reduction in salt content is undetectable by human
salt-taste receptors [45]. Another option for reducing salt in
foods involves the inclusion of herbs and spices as salt
replacers. The use of these food ingredients offers many
advantages. Firstly, from a microbiological aspect they are
widely known to possess antimicrobial properties, and
296 Current Nutrition & Food Science, 2008, Vol. 4, No. 4
studies documenting these properties have been carried out
for a range of spices and their essential oils including cinna-
mon, oregano, thyme, clove and garlic [8, 80-82]. Herbs and
spices can also impart desirable flavour, colour and texture
to the finished product thus minimising any flavour deficits
arising from salt reduction [83-85]. It is clear that food
manufacturers need to investigate their applications in more
detail and incorporate these ingredients into their formu-
lations as part of an ongoing salt reduction strategy in
processed foods.
CONCLUSION
Extensive worldwide public health research has conti-
nued to highlight the adverse effects of a diet high in salt in
population groups ranging from children to the elderly, men
or women and in various racial groups. Therefore Govern-
ment and health agencies have recognised that a reduction in
the amount of daily dietary salt is urgently required. Such a
reduction is especially desirable in the processed food sector
as these foods are recognised as contributing more than any
other food group to dietary salt intake. Therefore it is
imperative that food manufacturers continue their efforts to
reduce or replace salt in these food products. However, in
this review we have outlined the key functional roles that salt
has in food manufacture including imparting flavour notes,
texture development, maintenance of colour and inhibition of
spoilage and pathogenic microorganisms. Hence, to the food
technologist salt reduction is not a straightforward process
and must be underpinned by research to understand the
effects of a salt/sodium reduction strategy on product quality
and safety. By reducing dietary salt intake the incidences of
cardiovascular disease, stroke, hypertension, and other
kidney related disease should fall and benefit the general
population with a reduced burden on public health services.
It is therefore imperative that Government initiatives con-
tinue in order to educate the consumer regarding levels of
salt or sodium in certain foods enabling informed dietary
choices. For the food manufacturer, the challenge is to
provide the consumer with high quality low or reduced
sodium product alternatives especially processed meals.
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Received: July 30, 2008 Revised: September 9, 2008 Accepted: October 2, 2008

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