Reducing salt in breads and packaged foods could significantly reduce heart disease risk

Reducing salt levels in breads and packaged foods could prevent thousands of deaths and significantly cut rates of heart disease and stroke in France and the UK, according to two major new studies.

Excess sodium intake remains one of the leading dietary risk factors for hypertension, which can lead to heart attack, stroke, kidney disease and dementia. While the World Health Organization recommends adults consume less than 2,000mg of sodium per day, average intake remains far higher across Europe.

The research, published today in Hypertension, an American Heart Association journal, shows that small, industry-led reformulation changes, requiring no effort from consumers, could deliver major public health benefits by lowering average blood pressure across entire populations.

Clémence Grave, M.D., lead author of the French study said:

This approach is particularly powerful because it does not rely on individual behaviour change, which is often difficult to achieve and sustain. Instead, it creates a healthier food environment by default.”

France: Bread reformulation could quietly save lives

In the French study, researchers modelled the potential impact of a voluntary agreement between government and bread producers to reduce salt content in baguettes and other breads by 2025.

Bread is a cultural staple in France and traditionally contributes around 25 percent of total daily salt intake. By 2023, most French breads were already meeting the new sodium standards, indicating reformulation is achievable without disrupting consumer habits.

To understand the potential impact of the agreement on public health, researchers used national data and a mathematical model to estimate how many cases of cardio-cerebrovascular disease, kidney disease and dementia could be prevented if targets were fully met.

The model shows full compliance would cut daily salt intake by 0.35g per person, leading to modest blood pressure reductions across the population.

With 100 percent compliance, the study estimated:

• Annual deaths could decline by 0.18 percent, around 1,186 lives saved
• Hospitalisations for ischemic heart disease could fall by 1.04 percent
• Haemorrhagic stroke admissions could drop by 1.05 percent
• Ischemic stroke admissions could reduce by 0.88 percent

The model suggests men would see the greatest overall benefit, while women aged 55 to 64 would have the highest proportion of preventable cases.

Grave said:

This salt-reduction measure went completely unnoticed by the French population – no one realised that bread contained less salt.

Our findings show that reformulating food products, even with small, invisible changes, can have a significant impact on public health.

These results highlight the need for collaboration between policymakers, industry and health care professionals.”

Grave noted that one limitation of the study, as with all modelling research, is that it is difficult to separate the effects of bread reformulation from other shifts in diet and consumption patterns over time.

UK: Packaged and takeaway targets could prevent 128,000 cases

The second study focused on the UK, examining national survey data to estimate the potential impact if food businesses had fully met the government’s 2024 sodium-reduction targets for retail and out-of-home categories.

The programme set salt targets across 84 packaged grocery categories, including bread, cheese, meat and snacks, and 24 takeaway and foodservice categories such as burgers, curries and pizza.

Researchers found full compliance could have reduced average salt intake from 6.1g to 4.9g per day, a 17.5 percent reduction per person.

Even small reductions in daily intake were projected to generate major long-term benefits.

Over a 20-year period, the model suggested:

• Around 103,000 cases of ischemic heart disease could be prevented
• Approximately 25,000 strokes could be avoided

Across lifetimes, blood pressure improvements could deliver:

• 243,000 additional quality-adjusted life years
• £1 billion in savings for the NHS

Lauren Bandy, D.Phil., lead author and researcher at the University of Oxford explained:

We know that cardiovascular disease is a leading cause of death in the UK – as it is worldwide – so any reductions in salt intake and blood pressure could lead to big benefits.

We also know that the food industry still has a lot of progress to make when it comes to salt reduction, so there’s a lot of room for improvement.”

Bandy added that meeting reformulation goals could deliver substantial health gains without requiring consumers to change behaviour.

If UK food companies had fully met the 2024 salt reduction targets, the resulting drop in salt intake across the population could have prevented tens of thousands of heart attacks and strokes, saved substantially in health costs and significantly improved public health.

All without requiring people to change their eating habits.”

Researchers cautioned that some of the food salt data used may not yet reflect the most up-to-date reformulation progress towards the 2024 targets. They also warned that people self-reported their diets, so surveys may under-estimate salt intake, especially from takeaway meals and food eaten out.

A wider message for manufacturers and foodservice

Experts say the findings are relevant far beyond Europe, particularly in countries where most sodium intake comes from commercially prepared foods.

Daniel W. Jones, M.D., FAHA, chair of the 2025 American Heart Association/American College of Cardiology High Blood Pressure Guideline, said the modelling reinforces the value of national reformulation strategies.

He added:

Both of these modelling studies demonstrate the potential benefit in reducing risk for heart disease and stroke by reducing sodium consumption.

This ‘national’ approach to limiting salt content in commercially prepared foods is a key strategy for countries where a major part of food consumption is from foods prepared outside the home.

Though sodium reduction makes small improvements in blood pressure at the individual level, these small changes in individuals result in major improvements in a large population.”