§ Motion made, and Question proposed, That the sitting be now adjourned.—[Charlotte Atkins.]9.30 am
§ Mr. David Tredinnick (Bosworth)
On a point of order, Mr. Deputy Speaker. Has the difficulty of accessing Westminster Hall come to your attention? Some Members experienced particular difficulties in reaching the Chamber this morning, not least because the gates in New Palace Yard are closed and the directions are not clear. Furthermore, access through the centre of the hall, towards the Members' Cloakroom, is also barred. Are you satisfied that Members have been given sufficient notice that they might encounter difficulties as, perhaps, my hon. Friend the Member for Totnes (Mr. Steen) has done in finding his way through the maze, and would you raise the matter with Mr. Speaker?
Mr. Deputy Speaker
Order. The Serjeant at Arms has sent instructions on how to get here to all Members. If some Members have not caught up with them, that is up to them. I apologise for the difficulty. I understand that it is caused by the need to check the roof beams, and that that is being done for the sake of Members' safety. I notice that there is a good attendance this morning, and I am sorry that I have run out of orienteering badges.
§ Mr. Anthony Steen (Totnes)
As we have started one minute late, Mr. Deputy Speaker, I hope that you may allow us to carry on until 11.1 am. I am delighted that Mr. Speaker felt that salt was sufficiently important to be given the prominence that he has conferred on it by granting a one and a half hour debate.
Salt is vital for our health. It is an essential source of sodium, and it keeps our nervous systems working. However, it is also a killer. We eat too much of it, and the health of the nation is paying a terrible toll. Last year, nearly 250,000 people died in the United Kingdom as a result of high blood pressure. Strokes accounted for 50,000 of those deaths as well as for substantial illness and disabilities. High salt intake is overwhelmingly linked to high blood pressure; the evidence is now as stark and dramatic as the evidence that smoking kills. There are warnings on cigarette packets; there should be warnings on food products that contain high levels of salt. The Government should insist that they carry a statement such as, "The food in this packet contains a high concentration of salt, which can damage your health."
The food industry, the Government and the national media all have a responsibility to warn people of the risks posed by a high cumulative intake of salt. The message should be, "This is your wake-up call: cut your daily intake of salt or you will damage your health."
266WH The simple five-a-day fruit and vegetable message has been undermined by a plethora of off-the-peg, well-presented packets of pre-packed processed foods. Most of them contain more salt than one person requires in a single day. The food industry is our second largest industry after defence. It contains very powerful groups and many multinational companies. There are big advantages for them if salt is added to food; it makes people thirsty and more likely to buy a can of soft drink. In fact, PepsiCo produces both soft drinks and Walkers crisps. It is predicted that if the salt in snack foods were reduced, UK soft drink sales would slump by 8 billion cans a year.
How many people are aware that a slice of bread contains almost a gram of salt? Just six slices contain most of the recommended daily intake. If one ate a whole loaf, one would consume two or three times the amount of salt one needs in a day. People should eat bread that contains less salt, but it is very difficult to find. Breakfast cereals also contain high levels of salt—except for Weetabix and Shredded Wheat. If one pours cornflakes into a bowl of water, then takes out the cornflakes, the water tastes like sea water.
Tinned soups are extremely high in salt; even so-called fresh soups in cartons can contain over half the daily salt requirement. However, baked beans take the biscuit. On 27 May, the Daily Mail highlighted the fact that one tin of baked beans contains an entire daily allowance of salt.
A couple of sandwiches—four slices of bread—contain two thirds of the salt requirement for an adult; not to mention the filling, such as beef, cheese or ham, which will probably take the salt consumed above the recommended level. Mr. Deputy Speaker, how many receptions have you attended in the last few weeks where those delicious House of Commons sandwiches are served? We all tuck into them, but they contain a lot of salt. After eating four of them, one has consumed more than half one's daily salt requirement.
Ready meals are increasingly popular, and are fast and easy. However, this year's "Salt and Health" report from the Scientific Advisory Committee on Nutrition shows that many people have very high levels of salt in their body, leaving little room for the salt that we take in from other foods, such as bread and cereals. Convenience should not mean an increased health risk. When products aimed particularly at children contain lots of salt, the damage starts.
The survey of ready meals by the Food Standards Agency published last month shows that 83 per cent. of ready meals contained more than 40 per cent. of the target salt intake for one day. Although "healthy eating" ready meals often contained a little less salt than the standard versions, the differences were small. One meal, Asda's "Good For You" lasagne, contained 60 per cent. of an adult's target daily intake of 6 g a day. However, Asda is committed to reducing salt in its products and will shortly achieve a reduction of up to 18 per cent. in the salt in its products since 1998. Safeway had some of the lowest-salt products; lasagne and chicken korma and rice from its "Eat Smart" range. Heinz "Weightwatchers" and Birds Eye "Less Than 3% Fat" chicken korma were also relatively low in salt.
267WH Salt quite simply makes totally inedible food palatable at little cost. Take cheap sausages as an example. They contain 85 per cent. fat and 5 per cent. meat bound together with a cereal whose concentration of salt is 50 per cent. higher than that of sea water. Those products are cheap to produce and are most profitable. They also tend to be purchased by those on tight budgets who often need to watch their diets closely.
What about children's snacks such as Cheese Strings and Dairylea Lunchables? The amount of salt contained in those products is as high as salt levels in the Atlantic ocean. Once manufactures have managed to titillate children's salt receptors, those receptors become less capable of detecting salt concentration. As a result, children feel the need to consume more and more salt each day than they require. Any food that does not have a high enough salt content tastes bland to them. Nor is it just children who become addicted to salt; adults get hooked on it too. Even those who are aware of the dangers of too much salt in their diet consume large quantities unwittingly because 98 per cent. of the nation's shopping is done at supermarkets, where it is often more convenient for people to buy pre-packed rather than fresh foods.
Why exactly is it so important that salt is a component part of our daily diets? Salt not only confers its own flavour on products, but is used as an enhancer to modify the flavour of other ingredients and reduces the bitterness in some products. Salt is also a preservative mechanism, working via a reduction in water activity. Micro-organisms require water to survive and grow, but salt absorbs water, leaving a reduced amount for them. The Egyptians discovered that 5,000 years ago, when they used salt to keep food from decaying.
The Scientific Advisory Committee on Nutrition makes it clear that people are consuming too much salt and that that has a direct effect on their blood pressure—the more salt eaten, the higher the blood pressure. High salt intake also causes other damage, such as high water retention, and it can contribute to the thinning of the bones, known as osteoporosis, and is closely related to gastric cancer. Salt intake is an important consideration for people with diabetes, especially those who suffer from type 2 diabetes. High blood pressure, or hypertension, is a major risk factor for strokes, heart attacks and kidney failure. In western countries, average blood pressure increases with age. Although often considered normal, such an increase does not occur in traditional, hunter-gather societies, such as the Yanomamo people in Brazil. However, when hunter-gather peoples migrate to urban environments, their blood pressure levels come into line with those of people in industrialised societies.
According to a report in the British Medical Journal in 1996, people who consume large amounts of salt are at greater risk of suffering from strokes and cardiovascular disease. The recent Intersalt study measured the salt intake of more than 10,000 people in 32 countries and found that a difference of only 6 g of salt a day can result in a dramatic difference of systolic and diastolic blood pressure. Researchers at Leuven university in Holland reviewed the dietary habits of 268WH people in 24 countries and discovered that high salt intake can significantly increase the risk of stomach cancer. There is no laboratory evidence that that is the case, and it is more likely that diets consisting of highly salted, spicy foods are often associated with low intake of fresh fruit and vegetables, which might contribute to the development of cancer.
In 1995, the effects of sodium intake on the bone density of 124 women who had been post-menopausal for more than 10 years were studied. A 50 per cent. reduction in the intake of dietary sodium was as effective in reducing bone loss in the hip and the ankle as supplementing the diet with calcium. Professor Graham MacGregor from the pressure group Consensus Action on Salt and Health has done much pioneering work in the field. Recently, he linked salt with calcium when he brought together several research papers on decreased bone density and reduction of calcium retention. He concluded that reductions in salt intake would reduce mobilisation of calcium from bone in post-menopausal women.
New salt targets for children highlight the fact that children's salt intake is higher than that of adults in relation to their body weight, and that approximately 75 per cent. of their salt intake is from processed foods, usually bought from supermarkets. A snapshot of the salt content of children's ready meals shows that some ready meals aimed at children have levels of salt as high as in standard adult meals, while some supposedly healthy option meals contain more than half a whole day's target intake. Marks & Spencer and Asda are pioneering a salt reduction programme for that group.
In 1994, the Government recommended that people reduce their daily salt intake. However, scientific evidence for the conclusion that daily over-consumption of salt is linked to serious health problems has come to the fore only recently. The Department of Health and the Food Standards Agency recommended that everybody should cut the amount of salt that they eat from the current average of 10 to 12 g of salt a day, which is equal to two teaspoonfuls, to 5 to 6 g a day, which is equal to one teaspoonful or less. In 1994, the Department of Health published a report entitled "Nutritional Aspects of Cardiovascular Disease", which recommended that the figure should be lower still-4.1 g. Other European countries are trying to achieve similar ends. It is not a British problem, but a western problem.
The salt that one adds in cooking or at the table is only about one quarter of the salt intake over which we have any control. As hidden salt lurks in processed foods, people are completely unaware of how much salt they consume. It is that hidden salt that is the killer. Everyone is consuming salt that they do not know they are consuming and which they would not necessarily consume if they had the choice.
Nutritional information on food packaging labels is confusing. Only a scientist—there are some here today—would understand it. Why does the law insist on having sodium levels on the packet, but not salt levels? Six out of 10 people say that it is important to look for salt when trying to eat healthily, but only two in 10 say the same about sodium. Only one in three think that salt and sodium are the same, and four in 10 have no idea 269WH whatever about the relationship. CASH feels that information about salt, not sodium, should be on the label, because 99 percent. of sodium consumed in this country is from salt. The term "sodium" means little to the consumer. Of course, there are salt alternatives, but I shall not discuss those this morning.
Information on food labels must be rethought to make them clearer and more consumer-friendly. Marks & Spencer has devised a simple but effective panel that explains the ingredients of a product extremely well, and I commend that idea to the Minister and will send her an example. As I said, the panel is extremely effective, but Marks & Spencer tells me that it is illegal for it to display the panel, because it is supposed to include merely sodium levels, not salt levels. It is a wonderfully simple table that explains a product's contents in a moment. Furthermore, the information on the labels for Marks & Spencer's "Count on us" range makes admirable sense. It contains the information that one needs in order to lose weight, the amount of salt in the product and, most importantly, the amount recommended for consumption each day by adults. The fact that Marks & Spencer sells £100 million worth of that range each year demonstrates only too well that the public are acutely aware of their health and the way in which it is affected by what they eat.
Will the Minister say whether the Government are prepared to legislate so that, alongside each nutrition label, there is a list outlining the exact amount of each nutrient in a way that people can understand? Consumers could check that at a glance and make an informed but simplified choice without having to spend hours doing sums. Whatever the Minister says, my constituents and I do not understand the current labelling, and I doubt whether her constituents do. In fact, the information is printed so small that one cannot read it anyway.
Professor Alan Jackson, the chairman of the Scientific Advisory Committee on Nutrition, states in his "Salt and Health" report, which was published in April:It is for the Government to consider the action required to achieve the recommended reductions in the salt intake of the population. Achieving these targets will not be easy. Key to achieving a sustained salt reduction for public health benefit is the engagement of the food industry (manufacturers, retailers and caterers).Renowned chefs such as Nick Coiley of the highly acclaimed Agaric restaurant in Ashburton, Devon—formerly of the Carved Angel in Dartmouth, which happens to be in my constituency—recognise that the public expect modern chefs to respond not only to fashion, but to health requirements. Fine food, he says, can be produced using a range of fresh herbs as salt alternatives that can bring out flavours in keeping with the demand for healthier food. However, House of Commons catering still relies far too much on salt. In one outlet last week, I commented on how delicious the roast lamb was and was told that salt is rubbed into it, which brings out the flavour. Yesterday, the baked potatoes were beautifully crisp. I discovered why: the skins had been rubbed with salt.
There is reluctance among the 40 or so chefs in this great Palace to reduce the amount of salt to what is considered good practice in a healthy diet. Who will change that? Some 3,000 people work in the Palace. I wonder how many people have higher blood pressure as 270WH a result of the food that they eat here. I am convinced that the Government should issue guidance to restaurants, cafés, and other food outlets to indicate beside each item on the menu whether it is high or low in salt, or how much salt a portion might contain. There is no reason why that should not happen. It could be done as a voluntary code. It would focus the minds of the caterers and chefs as well as making the public aware of the issue.
Food is usually prepared and cooked behind closed doors in restaurants, and since more and more people eat out, especially city dwellers and younger people, it should be incumbent on restaurants to help raise the level of health consciousness. It is essential that the salt content per serving be stipulated. The Government could take a lead, which would fit in nicely with their long-term health plans to stimulate a pattern of healthy eating and diet awareness.
Why is the Government's NHS label so complicated? Supermarkets must pay£100 a licence for each product, and the logo looks like an MOT testing station logo. Hon. Members may have seen it. It is supposed to support healthy living but can be used only on fruit and vegetable products. I gather that Marks & Spencer believe it to be a complete waste of time. I should mention that I am a shareholder of Marks & Spencer, in which I declare an interest. I spent a morning going round one of its stores with its nutritional team, and was slightly infected, and affected, by its approach, which I found encouraging. It says that the NHS logo is a red herring—expensive, irrelevant and without credibility or recognition. Will the Minister explain why the labels have not been brought up to date or abandoned?
Salt in our diet is a matter of life and death. The Bible exhorts us to "seek life", and as a nation we are more aware than ever before of our health and vulnerability, and of the need to be kind to our bodies and to respect our diet if we are to enjoy quality of life in the years that we have left. Our new lifestyles, including the liberation of women, have resulted in a change in our cooking and eating patterns. The nuclear family has been replaced by a number of independent units in the same household. Processed foods have become part of the armoury of any home, and children eat separately from adults, mostly on the hoof, between computer games. Traditional sit-down, freshly cooked and prepared meals have all but disappeared.
Salt has become man's enemy because of the quantity consumed. What is good in small quantities can become bad in large quantities. It is not only food that is over-salted; I wonder how many people have considered the amount of sodium in bottled mineral water, which as mineral water, not spring water, goes through rocks. I will not mention brands that contain high levels of sodium. Far from being superior to tap water, mineral water contributes to the daily intake of too much salt.
The Government have a huge task to educate, legislate, advise, cajole, and lead by example. The debate is meant to send a signal to the country's caterers, retailers and food manufacturers of the national concern about the amount of salt in our diet and its impact on our health. This is, of course, an individual matter that everyone in the country must address. It is for everyone to decide what they eat, how much they eat 271WH and where they buy their food. We enjoy immense choice, and our farmers produce some of the best food in the world. However, we no longer eat food fresh. If we did, salt intake could be halved, which would save thousands of lives in this country alone. I hope that the debate will light a beacon of awareness that will continue beyond 11 am today.
Mr. Deputy Speaker
Order. I see five Members standing. If they do the mathematics as quickly as I can, they will see that if they restrict their time voluntarily, they may all get in. I have no powers to restrict their time.
§ Mr. Kerry Pollard (St. Albans)
I congratulate the hon. Member for Totnes (Mr. Steen) on securing the debate. I am pleased that he invited me to take part in it to discuss this vitally important issue. I also welcome the Under-Secretary of State for Health, my hon. Friend the Member for Welwyn Hatfield (Miss Johnson), to her new post. She is an old friend of mine and represents a neighbouring constituency. I know that she takes the issue seriously.
Salt is vital for life, and I shall give an example of that from my own family. My second son, Adam, is diabetic and has epilepsy, and therefore his salt balance is critical. If he loses salt, he goes into a coma and has to go into hospital to have his salt level rebalanced. Within minutes, he is bright and breezy again and back home with his family.
I agree with what the hon. Member for Totnes said. I have had to change my speech, because much of what he said, I had intended to say, and I am sure that that will be the case for other hon. Members. That will certainly help, Mr. Deputy Speaker, in cutting down on the length of our contributions.
It is not universally accepted that we consume too much salt in our diet, and one of our big challenges is to get that message across. We are going on a journey similar to that taken on tobacco a number of years ago. Some 40 years ago, when I was 15 or 16, starting to smoke was a rite of passage. We all did it and accepted it—that was the way things were.
I am pleased to say that I did not take to smoking, and do not smoke now—I have not smoked for donkey's years. I did not like it, and it did not like me, and that has saved me thousands of pounds. I am also pleased to say that my wife does not smoke, and nor do any of my seven children. I hope that none of my seven grandchildren will either. However, the journey that we are taking now is similar.
§ Chris Grayling (Epsom and Ewell)
I am concerned by the hon. Gentleman's comments, because he draws a parallel between tobacco which, in any shape or form, is directly linked to disease, and salt which, as my hon. Friend the Member for Totnes (Mr. Steen) pointed out, is of concern only in excessive intakes rather than in a 272WH balanced diet. Surely the hon. Gentleman does not want to see us go down the same route of significant regulation that has been necessary for tobacco?
§ Mr. Pollard
The hon. Gentleman makes a good point, but the only parallel that I could think of with reducing salt consumption was the journey that we went on in raising awareness of the dangers of tobacco.
As the hon. Member for Totnes said, Professor MacGregor has been a pioneer in making everyone aware of the dangers of salt. A few years ago, when he started his campaign, he was castigated by many of his colleagues, and looked on as a little cranky. I am pleased that he remained cranky, and that he has carried the campaign forward. I have been a member of Consensus Action on Salt and Health for five years and have worked closely with Professor MacGregor. He now has a national reputation in the field, and people accept that what he says is true. The CASH awareness campaign has had some success, in that many of our supermarkets and others who add salt to food are gradually reducing it. However, that success has been insufficient.
In March 2000, I tabled early-day motion 558, which stated that high salt intake leads to high blood pressure, causing more strokes and heart attacks—the two commonest causes of death in the United Kingdom. It also stated thatthree-quarters of people's salt intake … comes from … processed food.I received 28 signatures in support of that motion. The hon. Member for Bosworth (Mr. Tredinnick) tabled a similar early-day motion this year, which attracted 53 signatures. That might indicate greater awareness among Members of Parliament that salt can be dangerous, although it is vital to life.
Professor MacGregor and the CASH team have organised three annual events on salt awareness day. I sponsored one, which was attended by Raymond Blanc, the internationally known chef. He regaled us with tales of the amount of salt that he puts in his restaurant food. In his restaurant, he said, people had become used to a lower level of added salt and their taste buds had adjusted accordingly. I said that I would pop into his restaurant and have a meal with him one day, not realising that there is almost a year's waiting list and that dining there is more or less by invitation only—it is like going to Buckingham Palace. I have not yet been to see Raymond Blanc, but he uses less salt in cooking and evangelises about it around the country.
Anton Edelman, another renowned chef, came along to a salt awareness day. He, too, is well aware that adding too much salt is dangerous. As the hon. Member for Totnes and others have said, salt added to processed food and bread is the real killer. I have twice met representatives of the Federation of Bakers, who are trying their best to cut the amount of salt they put in their products; they have made some progress but nowhere near enough. It is a matter of taste; we need to persuade, bully or, if necessary, force a reduction in salt intake. The story could then have a happy ending for tens of thousands of babies, who will not die prematurely, suffer crippling strokes or have a poor quality of life. We must not fail children, who are vulnerable and innocent victims being force-fed too much salt. Action now will save lives.
§ 10 am
§ Dr. Richard Taylor (Wyre Forest)
The hon. Member for Totnes (Mr. Steen) has outlined the problem before us very clearly. Those of us from the northern half of the country know that there is a dialect word for food that is short of salt: it is "wallow", which has nothing to do with a hippopotamus in mud. The Oxford English Dictionary, which has about 10 volumes, includes the word and gives the meaning as "tasteless, insipid and sickly". That is why we will have such a battle to reduce salt consumption—it is what makes some food worth while.
I shall quickly whiz over some of the things that the medical profession have been told in the last few years. I am not a nutritionist; I am a retired physician who is probably out of date and therefore I shall speak with caution.
In 1995, a document entitled "Health of the Nation" was sent to all hospital doctors. It stated that the average intake of salt per day was 9 g, which should be cut to 6 g, which alone would reduce average blood pressure by 2 to 3 mm of mercury. At that time, the aim was to reduce blood pressure by 5 mm of mercury, because that would reduce strokes by 34 per cent. and heart attacks by 21 per cent.
In 2000, the national service framework for coronary heart disease was issued. It described the reduction of risk factors and encouraged healthy eating. There was not much specific mention of salt and sodium, but the healthy eating advice recommended a balanced diet—increasing fruit, vegetables and oily fish, and decreasing fat, saturated fat and salt. I should be interested to know from the Minister how milestone 3 in the NSF is being achieved. It states thatby April 2002 every local health community will have quantitative data no more than 12 months old on the implementation of the policieson promoting healthy eating, among other things.
Healthy eating advice is to eat more of the good things and less fat, saturated fat and salt. The hon. Member for Totnes made the good point that we must convince the food industry, because food marketing affects what people eat. The hon. Gentleman said that if companies sell both crisps and drink, they are doing themselves a lot of good. However, Walkers are producing crisps in the old-fashioned way, which most of us will remember, with a separate little packet of salt that one can choose to tip on to the crisps or not. Perhaps the message is getting through.
§ Mr. Steen
I thank the hon. Gentleman for his comments, and it was a chat on the steps outside that resulted in his being here. When he was in general practice—it was not that long ago, although he may think so—did he raise the issue with patients, or is it only just coming on the radar screen now?
§ Dr. Taylor
I must correct the hon. Gentleman—I was a hospital physician not a general practitioner. However, the issue was certainly covered in the list of advice that we gave patients with blood pressure problems. We were well aware of the issue in 1995.
I was about to tell hon. Members about the tremendous battle that has gone on with the food industry and the salt manufacturers. As recently as 274WH 2001, the Salt Manufacturers Association appealed to the Governmentto open up the debate on dietary sodium consumption and promote a policy on salt consumption based on sound scientific evidence.It added:We do not believe this has happened to date.It also produced a very persuasive, lengthy paper, which it sent to the Food Standards Agency's Scientific Advisory Committee on Nutrition. The paper states:Specifically, since 1994 new evidence has emerged that … defines far more precisely any blood pressure relationship with salt restriction in normal and hypertensive persons… provides critical new data on the blood pressure benefits of improving the overall quality of the diet as opposed to simply restricting salt … shows that salt sensitivity is not the primary contributor to premature cardiovascular events, but simply a surrogate marker for a poor quality diet … argues that the 1994 … recommendation on dietary sodium intake should be reconsidered.Sadly, I have not had that long to prepare for the debate, and I have been unable to find out whether the Food Standards Agency replied, although I hope that the Minister has the facts.
On 8 March, the British Medical Journal reported that the World Heath Organisation had concludedthat a diet low in saturated fats, sugar, and salt and high in fruit and vegetables, together with an hour a day of exercise, can counter cardiovascular diseases, cancer, diabetes, and obesity.That is certainly the gold standard recommendation at the moment. However, to convince the food industry, and the salt manufacturers, in particular, we must find out whether the association's paper was considered.
How do we tackle the issue? To be honest, the NSF on coronary heart disease contains only platitudes. It says that we should improve access to healthy foods, make them affordable and ensure that public agencies makea variety of healthy foods readily available to staff".Contrary to my usual experience of House of Commons potatoes, those in the Terrace Cafe never have enough salt on them, so perhaps some of the chefs have got the message.
§ Dr. Taylor
I thank the hon. Gentleman very much.
It is essential to raise awareness about the importance not only of the issues around salt, but of food labelling. Like other hon. Members, I have taken the trouble to look at a few food labels. The sandwich that I ate yesterday—in Portcullis House—contained 1.9 g of sodium. while the dietary information on another sandwich was in very small letters. I am lucky in that I can take my glasses off and see things close to, but I could not have read the information on that sandwich otherwise.
I emphasise that there must be balance in everything. One must balance one's diet, but one must also strike a balance between dietary considerations on the one hand, and exercise and weight loss on the other. I am very lucky in having an office in Portcullis House. I have discovered that it is exactly a quarter of a mile between my office and the voting Lobbies. Yesterday I made 275WH eight journeys two ways, which means that my exercise quota is being reached quite easily. I am pleased about that.
I shall certainly try to avoid convenience foods. There are terrible stories of other contaminants of salted peanuts in pubs, which I am sure all members have heard—I shall never eat any of those. I shall concentrate on crisps with separate salt. I shall finish with the hope that the Minister will give us some definitive answers, particularly on how we should persuade the food industry—the salt producers—that it must market products containing less salt, that will yet be attractive and encourage people, particularly the young, to buy them.
§ Dr. Howard Stoate (Dartford)
I congratulate the hon. Member for Totnes (Mr. Steen) on securing this important debate, and on his huge background research, which has informed the House and shows how much interest he takes in this important subject. Members should be able to reduce the lengths of our contributions; most of the points that I was going to raise have been well covered by the hon. Gentleman.
As we have heard, salt is necessary for life. It is in virtually all living organisms and it is therefore contained in everything we eat. As with many foodstuffs, too little is dangerous and too much is dangerous. It is similar in many respects to the other major food groups such as fat, protein and sugar, all of which have consequences if we eat too much or too little of them.
So what is the problem? As we have heard from hon. Members on all sides, we all eat too much salt on average. That is undoubtedly having a significant effect on our overall health. The reason why it is such a difficult problem comes down to the difference between epidemiology, which is the study of disease in populations, and individual health care, which is the study of disease in individual people. The public fully understand the effect of eating too many calories, too much fat—particularly saturated fat—and too much sugar. It goes without saying that most people will be able to tell us that if we eat too much, we get fat, and that if we eat too much fat, we are likely to get heart disease and will certainly put on weight.
What is more significant is that most people understand that if one reduces one's calorie or fat intake, one can reverse the health effects rapidly. The diet industry, which is now worth£2 billion a year, is testimony to the fact that most people realise that limiting food has a direct personal effect on their health. The difficulty is that that does not apply to sodium and salt. As the hon. Member for Wyre Forest (Dr. Taylor) said, if everyone reduced their sodium intake to the recommended level, we could probably see a 2 or 3 mm reduction in blood pressure across the population. On an individual basis, that would have a vanishingly small effect, but the effect on the whole population would be enormous. As the hon. Gentleman pointed out, it would save tens of thousands of lives a year.
276WH The problem remains that individuals have little control, because modifying one's sodium intake does not make a great difference: people do not look or feel different if they change the amount of salt they take in. We have to look more at what Government, manufacturers and the industry can do to limit the sodium people take in their diet, which is clearly far too much at the moment. That will be difficult.
It would be easier to say, for example, to manufacturers, "There's too much salt in the food. Reduce it". That would be nice, but there are good reasons why they will not do that. The main reason is that salt is incredibly cheap. It is also a good preservative and flavour enhancer. It alters the texture of food, and it is therefore a valuable commodity. It is a cheap way of producing flavoursome, well preserved, safe food.
Unfortunately that has consequences, particularly for children. I recently went to a healthy eating talk at Sainsbury's, organised by the National Obesity Forum, BUPA and Sainsbury's. A tour is offered, and one can go around the larger Sainsbury's stores with a nutritional adviser who will point out which foods are good for one and which are not. A good range of foods is available in Sainsbury's. I would not deny what it is trying to do; it is very positive, but I looked at the con tent of food in a so-called healthy eating range, and it still contained far too much salt. Admittedly, there was less than there was in the standard range, but only a bit less. The manufacturers concentrated far more on calories, saturated fat and sugar, all of which are important, and were taking insufficient interest in salt. The reason is simple. If salt is reduced, people do not like the food and do not eat it; anyone who has eaten salt-free baked beans knows that they are disgusting. There is pressure on manufacturers to use salt to make their food more palatable.
There is a particular problem in respect of children. If we do not do something radical about their salt intake, we will face a major problem. I recently wrote a pamphlet for the Fabian Society on obesity in children. In the course of the research, it became obvious that salt was a major problem. Because of children's smaller body mass, the amount of salt that they take proportionately is worryingly high. The other difficulty is that most of the foods that children like, particularly crisps, nuts and pizzas, contain far too much salt. It is not an exaggeration to say, as I concluded in my Fabian pamphlet, that if we do not do something radical about children's nutrition, we shall raise a generation of children who predecease their parents. In that case, I was talking more about obesity and its effect on type 2 diabetes and heart disease, but the same could easily apply to salt. Much more research is needed.
I call for radical measures. Telling people, "eat less salt" will not work. It is not an easy message to get across, and the average member of the public will not understand it. If it does not have a direct effect on their appearance or their well-being, people will not do it. With other Members, I am calling for far more controls on advertising to children, on snack machines in schools, and on sponsorship, particularly by fast food manufacturers. That is where the problems lie. On children's television, 97 per cent. of food advertisements are for foods that are high in fat, sugar, salt or other things that children should not eat to excess. Kids are 277WH bombarded with advertisements for the most damaging foods, so we should take stringent measures. I do not believe that a voluntary code, or advising people to take in less salt, will work.
I appreciate the difficulty that the Minister and the Government will be in if she starts talking about punitive measures against manufacturers and advertisers. However, if we do not do something drastic, we will face a major health problem. It must not be underestimated. Today's debate shows that people are aware that if we do not do something radical, soon and far reaching, the consequences will be huge.
I am pleased to have had an opportunity to take part in the debate and I congratulate the hon. Member for Totnes on securing it.
§ Mr. David Tredinnick (Bosworth)
It is always a great privilege to follow my hon. Friend the Member for Totnes (Mr. Steen), who has campaigned for many years on the issue. When I say many years, I mean it—
§ Mr. Tredinnick
My hon. Friend is very generous, but he is wrong: he has represented his current constituency for 20 years and, before that, Liverpool, Wavertree for 10 years, so he has unbroken service of 30 years in the House.
I welcome to her post the Under-Secretary of State for Health. She succeeds the hon. Ladies who are now, respectively, the Minister for Crime Reduction, Policing, and Community Safety, and the Under-Secretary of State, Office of the Deputy Prime Minister. I wish her well. I see that she was instrumental in the banning of carcinogenic asbestos products and took a lead in issues relating to lead in paint, so she is well placed to consider this subject. I notice also that she has opposed ageism in employment, so those of us who are over 50 are glad to know that she will not object to our extended tenure in the House.
Like everyone else, I find that most of my arguments have already been made. However, I should like to say a little more about children, and to make some international comparisons. The worst example of salt poisoning that I have ever come across was in the Gaza strip in Palestine. Due to the extraction of water under Israeli Government policies, the salination of drinking water means that the Gaza strip has the highest level of renal failure in the world. That illustrates how serious the issue can be.
The hon. Member for St. Albans (Mr. Pollard) mentioned the early-day motion that I tabled in February, and mentioned other motions on sugar intake and omega oil supplements. The Government must look at diet much more seriously. Much could be done to improve the health of the nation by gently warning people of the effects of food consumption. The hon. Member for Dartford (Dr. Stoate) mentioned taste; he said that bland beans were not much fun. I see the tin of beans belonging to my hon. Friend the Member for Totnes. It is not bland; it has lots of salt in it.
If one examines Elizabethan cookery books to see what was in people's diets, one can see that tastes were quite different. People did not have the taste for sugar 278WH that we have today. We must try to reduce progressively consumption of salt by persuading the food industry to take action. The arguments made by the hon. Member for Wyre Forest (Dr. Taylor) were absolutely spot on. The industry has tried to mount a defence with quite spurious arguments in many cases. We need to secure a gentle reduction that will coincide with a change in taste, as the hon. Member for Dartford said.
My hon. Friend the Member for Totnes mentioned children, and the marketing of foods that are aimed at them. Children have been subjected to phenomenal marketing campaigns, which have coincided with the food industry's expansion of salty foods. Consumption of all the new crisps, the little circles, ringlets and so on that our children try to persuade us to buy for them at motorway service stations—"Daddy, may I try Doritos?"—peaked in the 1980s. Those consumption levels are starting to decline, but far too little has been done in that respect. The Minister must pay attention to that.
Another important issue that was raised by my hon. Friend the Member for Totnes is labelling. Labelling is confusing; I would like to know what percentage of the population know what sodium is. I imagine that a large proportion think that it is quite different from salt. The Minister must take that point on board. How small is the small print? What percentage of the population can read a label without glasses? That would be an interesting statistic. We need clearer labelling. There have been motions in the House over the years—certainly over the bur Parliaments in which I have served—that have addressed the labelling issue.
A related issue, which the Minister must address, is that of food supplements. The Minister will be aware that the Food Supplements (England) Regulations 2003 have been laid before the House. It has become apparent from discussions with food industry representatives at the Food Standards Agency that the setting of maximum permitted levels of nutrients in food supplements by the European authorities is likely to lead to very low permissible levels, reflecting outdated concepts of nutritional need rather than safety. That is a battle that the Minister must fight and win. The risks of excess sodium consumption are well documented and well known, but the documentation and information available on that subject far exceeds the information available on the known risks from excessive consumption of vitamins. However, the Government are proposing to accept European legislation that will remove a whole raft of very valuable nutrients and minerals from our diets. The point was made about the use of herbs rather than salt. If we are going to use the natural products of this country, we do not wish to see effective species elimination by the European Union.
§ The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson)
§ Mr. Tredinnick
The Minister shakes her head, but that motion has been prayed against and may be the subject of a Supply day debate. The Minister should be aware that one of the well-known experts in the industry, Patrick Holford, is making a presentation to the House on 7 July. He is the founder of the Institute for Optimum Nutrition. Before the Minister says that that is bound to be an industry organisation, it is a not- 279WH for-profit educational trust that accepts no funding from vested interests, including vitamin, food or drug companies. Patrick Holford and that organisation are clearly at odds with the Food Standards Agency and its interpretation. The FSA says that limiting B6 is wrong and that the EU directive on vitamins and minerals will be had for one's health.
The Minister should be aware that there is massive opposition in the industry. She should also get a grip on the problems with the food supplements directive and the traditional herbal medicines directive, and on what we are trying to achieve in this country through preventive medicine, an improved diet, more and better labelling, and reduced sugar and salt intake—the whole package. The hon. Lady's predecessor accepted a delegation of industry manufacturers who said afterwards that they believed that they had been misled. They had been promised that the criteria used would be different, but they believed that the Government had caved in. I urge the Minister to reconsider the issue.
I am mindful of your warning about time, Mr. Deputy Speaker, and of my desire to help other colleagues. I want to talk briefly about the situation overseas. In the United States, about 50 million adults have high blood pressure or hypertension, about 700,000 die from heart disease each year, and 166,000 die from strokes. It is estimated that the average American blood pressure would drop by 5 mm Hg if US food manufacturers were to reduce by half the levels of sodium in their products over a 10-year period. As a result, the country would experience a 20 per cent. reduction in high blood pressure, a 14 per cent. reduction in death from strokes and a drop in overall deaths of 7 per cent. Such a change in sodium content would save 150,000 lives a year.
The World Health Organisation has been mentioned. Its teams evaluated the cost-effectiveness of 17 measures aimed at preventing cardiovascular disease worldwide, including what it calls non-personal measures such as media messages about the importance of blood pressure, body weight, cardiovascular disease and cholesterol counts, and personal measures such as being screened and, if necessary, being treated for high blood pressure and elevated cholesterol. The WHO found that the measures, which include moves to cut salt from the food supply, could be very cost-effective. The Minister should take note of its conclusion that Government action to reduce salt appears to be more effective than voluntary efforts. The WHO is behind us on the issue.
The Food Standards Agency wrote a letter to me that was addressed, "Dear Colleague." I thought for a moment that the chairman had been elected to the House of Commons, because we use that form of address in the House. The letter said that the agency was taking action. I would not say that my early-day motion in February had influenced that decision, but as my hon. Friend the Member for Totnes knows, early-day motions are tabled and press releases can be issued. Nevertheless, the Food Standards Agency has committed itself to achieving a 10 per cent. reduction in average salt intake. That is welcome, although 6 g a day is still too high. Some progress has been made, but not a lot.
280WH I am a great fan of Westminster Hall. The debates are often very good and we have a range of expertise here this morning. What we have heard so far must give us all hope. We know that we are dealing with a serious issue that must be addressed. I look forward to hearing further contributions.
Mr. Deputy Speaker
Order. I will call the hon. Member for Angus (Mr. Weir) if he promises to take no more than three or four minutes.
§ Mr. Michael Weir (Angus)
Much of what I would have said has already been said, so I shall be brief.
It has long been recognised that Scotland has a health problem because of poor diet, and salt is a contributing factor in the high incidence of heart disease and cancer. A Scottish health survey of 1998 reported that 33 per cent. of men and 28 per cent. of women suffered from high blood pressure. However, there are huge variations in that overall statistic. The figure for men in the younger age group of between 17 and 24 years of age is much lower: it is only 10 per cent. The figure for those in the older age group of 16 to 74 rises to about 76 per cent. Women showed the same general trend.
Those of us who have passed the mid-point of our 40s will be all too familiar with general practitioners regularly taking our blood pressure and advising us to reduce our salt intake. Most of us have probably taken that advice and at least moved to low-sodium alternatives. However, that will do us no good if a lot of the food that we eat is heavy in salt or sodium. We could, of course, stop eating pre-prepared food, bake our own bread and so on, but for practical purposes that is impossible in the lives that we lead.
A serious problem that concerns me as a father and which has been mentioned by other hon. Members is the effect on children. It is not easy to cut down on children's salt intake. Most children, and not a few adults, are over-fond of potato crisps, some of which are very salty indeed. For example, I stopped buying a certain brand of crisps advertised by the former captain of the England football team—I hasten to add that that had nothing to do with my decision—because they tasted very salty indeed. I instead bought the brand with the separate little blue bag of salt that the hon. Member for Wyre Forest (Dr. Taylor) mentioned. Those crisps have been about for many years under a different name, but, ironically, are made by the same firm, Walkers crisps. Interestingly, when my daughter was given those crisps, she ate them but did not put the little blue bag of salt on them and was quite happy to eat them without the salt, which gives rise to the question whether the salt is required in the first place. That is a small victory, but shows that perhaps the cause is not lost and that reduced salt can work if we push at it.
I am one of those perhaps deeply sad persons who goes round supermarkets looking closely at the labels on the products that they buy. As has been mentioned, one needs a degree in food science to understand much of what is on the labels. It is also worth recalling that it is not always clear from the labels what the salt or sodium content of a product is. Someone with high blood 281WH pressure might want to know the salt content, but it may be listed as sodium. The salt level in any food might be around two and a half times the listed sodium level, and even then not all sodium may be apparent, because it can come from ingredients other than salt. That is highly important, because, as has been mentioned, 75 per cent. of our daily salt intake is hidden in the food that we eat, which contributes to a large number of strokes. If we reduce that proportion, 50 per cent. of those may be avoided.
Conscious of your constraints, Mr. Deputy Speaker, I shall finish on that point.
§ Mrs. Patsy Calton (Cheadle)
Most of the points that I wanted to make have already been made, but I hope to add a small amount of extra value.
Most people consume more salt than is absolutely necessary; the average is 12 g as compared with the average daily requirement of 6 g. Some 75 per cent, of our salt comes from processed foods, which makes it more difficult for people to understand exactly what they are taking in. Salt comes from ready meals, and canteen, restaurant and fast foods. I would particularly single out restaurant and fast foods rather than ready meals, because at least when one buys something from a supermarket there is a label on the packet if one cares to look for it. However, all of us over 50 suffer from a problem with labels in that we have considerable difficulty in reading the text if it is in 6 or 5 point type, and usually have to take our glasses off to do so.
There are large quantities of salt in foods; for example, the hon. Member for Wyre Forest (Dr. Taylor) said, I think, that there was 1.9 g of sodium in the sandwiches that he had for lunch yesterday, which represents 76 per cent. of his recommended daily intake. It is worrying if we can buy or are enticed into buying such food in this place. The figures in the hon. Gentleman's example probably included the filling, because I checked the bread that I used to make toast this morning and it had less than 0.1 g of sodium, so I thought, "Well, that's okay then." I can usually control my salt intake until lunchtime, but once lunchtime comes in this place it goes haywire. When I was preparing for the debate I first thought that I would check how much salt I eat in a day. I was doing well until lunchtime, but my husband got to the Red Lion pub ahead of me and ordered me a cheese and bacon sandwich, which threw the whole thing out for that day. I was also very much aware of the extra water that I needed to drink for the rest of the day.
The Food Standards Agency and the Department of Health have proposed a reduction of 25 per cent. in salt levels in processed foods as a first step. We should strongly support that recommendation. We need a staged process that deals not only with salt, but with a healthy, balanced diet and exercise as part of our lifestyle. It is not sufficient to talk simply about salt and sodium. However, we must be careful not to overstate the case. It has been recognised in the past few years that one problem with diet is that once officialdom recognises one issue—body mass, for example—some people go to the opposite extreme and we see all the difficulties of eating disorders, such as anorexia and bulimia. We do not want people to try to cut salt out of their diet completely. That would be a great shame.
282WH The Scientific Advisory Committee on Nutrition has concluded that the evidence for a direct link between salt intake and high blood pressure is now much stronger. The hon. Member for St. Albans (Mr. Pollard) said that the way in which we grew in knowledge of this issue was similar to what happened with tobacco. There is a link in terms of public perception. We now believe that there is a direct link between salt and blood pressure, but we have not quite got the final piece of information. What we do know is that people who suffer from hypertension will reduce their blood pressure by reducing their salt intake. That is important research, important information for us to have and a good pointer in the right direction. Although there is evidence that does not show a direct link between salt intake and blood pressure, the information that we have indicates that reducing our salt intake would do most of us no harm and some of us a great deal of good. It would be sensible to ensure that we move forward on that basis.
There are three areas in which we can do something about this issue. However, it is complex, and several steps must be taken into account. We need to worry about what is happening with children. Baby foods and the amount of salt in them are already strictly controlled. The problem arises when children move to the next stage of nutrition and start to eat normal adult foods. That is when they are likely to be overloaded with salt.
I shall conclude shortly, because I am aware that other hon. Members want to speak. As I suggested, there are three areas in which we must work much harder. First, we need a standard food labelling system to make it clear to consumers exactly how much salt is in a product. I accept that we are talking about whole populations, but when populations are examined, we see that it is the activities of individuals that make a difference. Individuals must therefore be able to work out exactly what they are taking into their body and take informed decisions about that.
Secondly, manufacturers should gradually reduce the salt content of foods. That should be encouraged by whatever means the Government have at their disposal. Thirdly, steps must be taken to increase public awareness of the potential risks of an excessive salt intake, with an emphasis on the importance of a healthy, balanced diet combined with physical activity.
Together, those three steps would enable the public to make an educated choice and perhaps assist them in preventing the ill health resulting from strokes and so on that is likely to come later, and the premature deaths that could well occur as a result of raised blood pressure, which an increased salt intake is thought to produce. We need to be slightly careful about assuming that there is a direct link, because we do not know that yet.
With hon. Members' indulgence, I should like to conclude by thanking my temporary researcher, Helen Kearney. She is a student on work experience and she is here today. I thank her for the work that she has done on this issue and I hope that she found it interesting. I praise her school for producing such an interested and interesting student.
§ Chris Grayling (Epsom and Ewell)
I congratulate my hon. Friend the Member for Totnes (Mr. Steen) on securing the debate and on making a powerful speech. Judging by the speeches from both sides of the Chamber, there is general concern about the issue, as well as a general awareness that we must deal with it if we are to improve the food environment.
My hon. Friend made some important points. He said that salt had taken a terrible toll on the health of the nation, and he set out some reasons for that. His remarks encapsulated very well the public health problems that we face, and he gave practical examples. He talked about salt in cornflakes, lasagne and even mineral water, although, judging from the contents label on the bottles in the Chamber, we would have to drink 20 to 25 cases to reach our daily allowance. I do not think, therefore, that mineral water poses an imminent health threat.
My hon. Friend hoped that the debate would act as a beacon of awareness to the nation. I would like to think that many people outside are listening with rapt attention, but I suspect that we shall all have to do much more work to build awareness of the problems.
My hon. Friend referred to developing ideas that could help to tackle those problems. He talked about labelling, and his comments were echoed by the hon. Member for Cheadle (Mrs. Calton). There is general agreement that labelling must be smarter and more effective, and that the message must be clearer for consumers who do not fully understand the health issues around salt. In that respect, I sense consensus in the Chamber that improved food labelling is a non-controversial way of educating shoppers who buy products that contain excess salt. It is also a way of encouraging the industry to look for ways to reduce salt.
My hon. Friend talked about the possibility of low-salt items being highlighted on menus in restaurants. Clearly, there is increasing labelling on menus nowadays. It started with vegetarian food, and vegan foods are now sometimes labelled, too. It is even becoming commonplace to see gluten-free items. I see no reason why restaurants should not be free to put low-salt items on their menus as well. However, I suspect that that is not really the answer and that we need lower salt levels across the board rather than in just some dishes.
The hon. Member for St. Albans (Mr. Pollard) made a thoughtful contribution, which was clearly based on his experience. I was glad that he clarified his position on the comparison with tobacco, a point also raised by the hon. Member for Cheadle. There is a danger in pursuing such an analogy too far. The important difference is that tobacco is a direct contributor to ill health, whereas salt is an essential part of our daily diet. Too much may be bad for us, but too little is equally bad. If we create the sense that salt is a demon like tobacco, we shall do people a disservice.
§ Mr. Pollard
I was trying to make the point that we and our children are being force-fed salt and have no control over that. A distinction can be made as regards tobacco, because people can choose whether to light a 284WH cigarette and put it in their mouths. That was the point made by my hon. friend the Member for Dartford (Dr. Stoate).
§ Chris Grayling
I accept that point and the desirability of reducing salt in food. However, salt is part of a balanced diet, and we do not want the consumer to believe that it must be avoided at all costs. As with fatty foods and other foods about which there is a health issue, we need balance not prohibition. That is why I raised concerns about some comments that have been made.
§ Chris Grayling
That is a fair point. Public education should get that message across, just as it has done with fatty foods. I shall return to education in a moment.
The hon. Member for Wyre Forest (Dr. Taylor) made the extremely important point that in an age of industrial production, food is often tasteless and needs additives to pep it up and make it attractive to the consumer. I want greater expansion of organic farming, and more use of traditional methods, although I recognise that in a modern, industrial society we cannot wholly leave behind industrial farming methods and it would be wrong to do so. However, the agricultural sector has a duty to explore ways of ensuring that the products of industrialised forms of farming have the taste that makes it less necessary to put salt in food.
The hon. Member for Dartford gave his views on banning advertising to children. He and I have debated the issue before; I have great anxiety about taking the route of regulation rather than education. The hon. Member for St. Albans mentioned using force, and I have genuine concerns about that, although I shall not rehearse the arguments at length. I understand the motivation for wanting to pursue the issue, but in an era of 24-hour news channels, multichannel satellite television and a variety of marketing ways to reach consumers, enforcing a ban and defining the territory in which it would apply would be difficult.
§ Dr. Stoate
The hon. Gentleman and I do not see eye to eye on the matter because manufacturers of processed foods that are high in salt have huge advertising exposure and make large profits, but there is no profit in healthy and natural foods. Therefore, the advertising that kids are exposed to is completely unbalanced. I am merely calling for balance.
§ Chris Grayling
My view is that we should try to educate consumers. The trend in recent years has been for manufacturers to start producing healthier options. They have taken a step along the way, although there may be further to go. The more they can see the benefit of responding to genuine market need, the more likely it is that there will be a change in consumers' behaviour. I am not persuaded that telling people what to do or cutting them off from a section of marketing will deliver that objective; only education can do so. The difficulty is in deciding where to draw the dividing line if bans or restrictions are to be imposed in marketing foods—for 285WH example, when is a food healthy? Who decides whether it is appropriate to market a food? Legislating in that respect would be extremely difficult.
§ Mr. Pollard
The hon. Gentleman is talking about choice, but as I said, people do not have a choice: they are being force-fed the stuff. That is why legislation may be necessary.
§ Chris Grayling
It is my hope and belief that the retailers and manufacturers are taking steps in the right direction, as the hon. Member for Dartford and my hon. Friends the Members for Totnes and for Bosworth (Mr. Tredinnick) said. There may be a long way to go, but the retailers and manufacturers deserve credit for the improvements that have been made. We need to go further; society is afflicted by obesity and is becoming aware of the problems caused by excessive salt intake. These are not the only issues relating to food and nutrition. The food industry must play a core role in helping to address some of the problems. However, we will solve them only in an environment in which the consumer wants a healthier product and there is money to be made in delivering it. We must start the process with public health education.
The hon. Member for Dartford said that people are aware of the personal impact of eating less, being slimmer and having a healthier diet. We must extend that awareness to salt consumption; parents need to know that if they allow their children to consume excessive amounts of salt, they will be less healthy. Parents must want to take the purchasing decisions in the supermarket on a Saturday morning that will deliver healthier products to their children. That must be our priority.
There should be a national debate about salt, and better public health education about the implications of excessive salt consumption. An effective partnership with the industry would encourage it to push at the margins of the market to persuade consumers to try new products. Providing better labelling and information would mean that consumers were better able to take rational decisions by looking at the side of the pack and saying, "I want that, but not that". That is where the Government's priorities should lie.
I commend all hon. Members for their contributions to this extremely important public health debate. I hope the process will continue. I stand by the view "educate, not regulate", and I call on the Government to put real effort into the "educate" part.
§ The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson)
I congratulate the hon. Member for Totnes (Mr. Steen) on his success in securing this important debate. I also welcome the contributions of all who have participated.
High blood pressure, also known as hypertension, is common in the UK. It is a major risk factor for cardiovascular disease, stroke and premature death and a contributory factor in more than 170,000 deaths a year in England. The Government are committed to reducing deaths from heart disease. The recent World Health Organisation project on the burden of disease indicated 286WH that 50 per cent. of deaths and disability could be prevented by national and individual action to reduce major risk factors such as high blood pressure.
Reducing average salt intake is likely to decrease the burden of high blood pressure and improve public health. Our action to reduce the population risk of developing high blood pressure is multi-pronged. It touches on the contributions of a number of hon. Members, because it includes cutting the level of salt in the diet along with encouraging children and adults to eat more fruit and vegetables, maintain a healthy weight and be physically active. All those are needed, and education plays a role.
Sodium is an essential nutrient, and salt is the major source of sodium in our diet. Most people, however, consume more sodium than is required. The latest available data show, as hon. Members have said, that habitual levels of salt intake are high for both adults and children. For adults, average intake is two and half times the amount required, averaging about 9 g a day instead of 6 g. Although accurate data are not available for children, conservative estimates suggest that some children have intakes higher than those of adults.
There is one reassuring fact. Responses to the Food Standards Agency's consumer attitude survey of 2002 showed that 51 per cent. of consumers recognised that they should eat less salt. I shall come on to the point about how salt and sodium are identified in people's minds, but the points made by my hon. Friends the Members for Dartford (Dr. Stoate) and for St. Albans (Mr. Pollard), have been recognised, and that is important.
About 75 per cent. of dietary salt intake comes from processed foods, with the remainder added during cooking and at the table, under consumers' own control. The main sources of salt include cereals and cereal products and meat products, which together contribute more than 50 per cent. of the average salt intakes. I should make a point about the figures on what people buy and eat. One thing that has emerged from my discussions is that it is important to be aware of how much of certain things one eats. Although salt in bread has been reduced, bread can still be an issue because we eat a lot of it. Conversely, although some products contain a high concentration of salt, if one eats a small amount of them the fact that they are very salty might not matter.
Our target is a reduction from 9 g to 6 g a day, as recommended in the 1994 report by the Committee on Medical Aspects of Food and Nutrition Policy. A large body of opinion favours a general reduction in salt consumption, which we recognised in the White Paper "Saving Lives: Our Healthier Nation" and in the NHS Plan. We made a commitment in the plan to work with the food industry and the Food Standards Agency to improve the overall balance in the diet of salt, fat and sugar. That was endorsed by the Chief Medical Officer, and, in 2001, the Scientific Advisory Committee on Nutrition, which replaced the Committee on Medical Aspects of Food and Nutrition Policy, also made recommendations for children. Its report on salt and health was published on 15 May 2003. It concluded that the target intake of 6 g of salt per day for adults, set by the Committee on Medical Aspects of Food and 287WH Nutrition Policy, remained valid, and that the evidence that salt intake was directly associated with blood pressure was even stronger.
The Scientific Advisory Committee on Nutrition also concluded that lowering the average salt intake of the population would proportionately lower average blood pressure and confer significant health benefits. However, I understand that if someone lowers their salt intake, that will lower their blood pressure, but having had a higher salt intake will already have done some damage; they will not return to the levels that they might have done, had they had a lower salt intake throughout their diet.
For infants and children, significant health benefits would be gained from a reduction in average salt consumption. The Government accept the Committee's recommendations and have taken action to bring the report to the attention of all the stakeholder organisations known to have an interest in salt as a public health issue, including the European Food Safety Authority and all the EU food agencies.
The required reduction in average salt intake by one third is substantial and will need concerted action by all, including the food industry—manufacturers, retailers and caterers, all of whom have been well represented in contributions to the debate—and consumers, and will need support from a range of stakeholders including the Government.
The Government are taking action on three fronts: encouraging people to reduce the salt that they add to their food, encouraging them to reduce the salt content of the foods that they buy, particularly processed foods; and providing consumers with helpful information on food labels.
Labelling was raised by several hon. Members. I understand why that topic is important, although, judging by some hon. Members' remarks, I would guess that they have not often done the family shopping. I am an expert on doing the shopping, so I know a great deal about what is to be found in various stores and their labelling arrangements.
The current labelling arrangements require sodium, rather than salt, to be specified. We are making representations to the European Commission on changing those arrangements, which would need to be done on a single market basis. That would allow us to 288WH label products as containing salt rather than sodium. Negotiations are under way, but have not yet reached a conclusion.
§ Mrs. Calton
There is a problem with the term "salt". Perhaps "salt equivalent" would need to be used. Sodium ions cause the dietary problems, and if "salt" alone was used, sodium from other sources might be missed.
§ Miss Johnson
I thank the hon. Lady for her remark and for her contribution to the debate. It is also possible to use a separate labelling panel to indicate salt content, as several retailers and others have already done. We would be in favour of the salt content of foods being made clearer to consumers, and it is not currently illegal to use a separate labelling panel to do that. However, I accept that people have a problem in linking the sodium and salt contents. It is good news that people recognise that salt is an issue, but we need to make the link to sodium as strongly as we can.
§ Miss Johnson
Many aspects can be included in labelling, but there is a problem with continually adding things to labels. One problem with reading labels in supermarkets is that they contain a lot of information, and the more that is included, the less space there is to include detail, particularly on smaller products.
Since 1998, the salt content of bread has been reduced by between 7 per cent. and 21 per cent., depending on the product. The largest salt reduction has been in white loaves—21 per cent.—and the salt in wholemeal bread has been reduced by 10 per cent. Considerable achievements have therefore been made. However, I agree with hon. Members that more work must be done on all those fronts. That is why the Government are pursuing the strategy of examining ways to reduce the salt content of individual foods, and to ensure that labelling, consumer education and healthy eating are at the top of our agenda.
Mr. Deputy Speaker
Order. May I ask hon. Members who do not wish to stay for the next debate to leave quickly and quietly? I hope that hon. Members can find their way back to the Central Lobby.