Salt or sodium chloride (NaCl) is a crystalline compound consisting of sodium (Na) and chloride (Cl). One gram of salt contains about 0.4 g of sodium and 0.6 g of chloride. Likewise, in the context of salt content or intake, one gram of sodium equals approximately 2.5 g salt (EU 2011).
Salt used as an ingredient for food, either directly sold to consumers or used for food manufacturing, shall not be less than 97% of sodium chloride (FAO/WHO 2006), on a dry matter basis, exclusive of additives. Depending on the origin and the method of production of the salt (obtained from the sea, from underground rock salt deposits or from natural brine), it may contain varying traces of other minerals. For public health reasons salt may also be fortified e.g. with iodine, iron or fluoride (FAO/WHO 2006).
The words salt and sodium are often used interchangeably (WHO 2016). Most sodium is consumed in the form of sodium chloride and the public understands the term salt better than sodium. EU Regulation 1169/2011 (EU 2011) on food information to consumers requires the declaration of the salt content calculated as salt equivalents from the sodium content of a product (see Paragraph 3). Also, the High Level Group on nutrition and physical activity experts refer to salt and not sodium (EC 2012b). For the purposes of this brief, both terms will be used according to the the context and the source used.
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Salt (sodium chloride) is commonly used as a food ingredient or condiment. The main purposes for the usage of salt are for enhancing taste and preserving the product (EFSA 2005). At the EU level, it is estimated that 95% of sodium is consumed in the form of salt (EC 2012b).
Most of the sodium intake (70-75%) comes from processed foods, while 10-15% comes from naturally occurring sodium in unprocessed foods and 10-15% from discretionary sodium added during cooking or eating (EFSA 2006). Besides salt, other examples of sodium containing compounds added to foods are sodium nitrate, monosodium glutamate and sodium phosphate.
The quantity of intrinsically occurring sodium in unprocessed foods is very low, compared to processed foods (WHO 2012, Kloss 2017); Table 1 gives examples of the sodium content of the same food in unprocessed and processed states.
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The main food groups responsible for salt intake in Europe are bread and bakery products, cereal products, meat and meat products as well as cheese and dairy products. Other important groups are ready meals and soups (EC 2012b
, Kloss 2017)
. Bread, cereals and bakery products are the most important sources of salt in many national diets, bread alone contributing to around 20% or more of the total salt intake. In the US, most (71%) of the salt intake comes from sodium added to foods consumed outside home (Harnack 2017)
. According to USDA Scientific Report of the 2015 Dietary Guidelines Advisory Committee (DGAC 2015)
, mixed dishes, especially burgers and sandwiches, are the main contributors to intake of salt in American diets.
In the EU, Regulation (EU) 1169/2011 (EU 2011) on food information to consumers requires the mandatory nutrition declaration of the salt content in prepacked foods. To ensure that the final customer easily understands the labelling, it is appropriate to use 'the term salt instead of the corresponding term of the nutrient sodium'. Therein, 'salt means the salt equivalent content calculated using the formula: salt = sodium × 2,5'. The unit of measurement to be used is g per 100 g of product. The daily reference intake for salt is 6 g for adults, and the salt content can be expressed as a percentage of the reference intake per 100 g or per 100 ml.
Under Regulation (EU) 1924/2006 (EC 2006) on nutrition and health claims made on foods, the following salt-related nutrition claims are permitted:
- Low sodium/salt claims, 'may only be made where the product contains no more than 0.12 g of sodium, or the equivalent value for salt, per 100 g or per 100 ml. For waters, other than natural mineral waters falling within the scope of Directive 80/777/EEC, this value should not exceed 2 mg of sodium per 100 ml.'
- Very low sodium/salt claims, 'may only be made where the product contains no more than 0.04 g of sodium, or the equivalent value for salt, per 100 g or per 100 ml. This claim shall not be used for natural mineral waters and other waters.'
- Sodium-free or salt-free claims, 'may only be made where the product contains no more than 0.005 g of sodium, or the equivalent value for salt, per 100 g.'
- Reduced salt claims, 'may only be made where the reduction in sodium is at least 25 % compared to a similar product.'
- No added sodium/salt (EC 2012a) claims, 'may only be made where the product does not contain any added sodium/salt or any other ingredient containing added sodium/salt and the product contains no more than 0.12 g sodium, or the equivalent value for salt, per 100 g or 100 ml.'
- 'Where appropriate, a statement indicating that the salt content is exclusively due to the presence of naturally occurring sodium may appear in close proximity to the nutrition declaration' (EU 2011).
If food is at least as low in salt as referred to in the claim low sodium/salt presented above, the following health claim is permitted:
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- 'Reducing consumption of sodium contributes to the maintenance of normal blood pressure' (EU 2012).
Sodium is an essential nutrient and is necessary for normal cell function and for neurotransmission (WHO 2012). From a public health perspective, a number of national and international institutions have examined the impact of salt intake on health, focusing on effects on blood pressure, cardiovascular disease, stomach cancer and renal functions. The statements or opinions of these institutions are shown in Table 2.