WHO Report Favors Cutting
Salt from Food Supply

NEW YORK (Reuters Health) - Government actions to cut salt in processed foods, as well as other measures to lower blood pressure and cholesterol, could cut the global rate of cardiovascular disease by up to 50%, UN health officials said Thursday.

Researchers with the World Health Organization (WHO) estimate that public-education campaigns and legislation to lower the salt content of processed foods, along with individuals' own efforts to cut their blood pressure and cholesterol, could help prevent heart disease and stroke in all regions of the world.

Responding to the report, Michael Jacobson, executive director of the US-based nonprofit group Center for Science in the Public Interest said WHO "should be praised for making sound dietary recommendations and urging consumers to cut back on foods high in calories, saturated fat, salt, and added sugars."

The international team evaluated the cost-effectiveness of 17 measures aimed at preventing cardiovascular disease worldwide. The tactics zeroed in on controlling people's blood pressure and cholesterol levels, as high blood pressure and high cholesterol are major risk factors for heart attack and stroke.

"Non-personal" measures included media messages about the importance of blood pressure, cholesterol counts and body weight in cardiovascular disease and either government or voluntary action to reduce salt in processed foods. High sodium intake is a risk factor for high blood pressure.

"Personal" measures involved getting screened and, if necessary, treated for high blood pressure or elevated cholesterol.

Dr. Christopher J.L. Murray and his colleagues found that the population-wide efforts, including moves to cut salt from the food supply, were potentially "very" cost-effective--with government action to reduce salt looking more effective than voluntary efforts.

Treating high blood pressure and cholesterol in people whose risk of cardiovascular disease exceeds 35% over the next 10 years was also deemed a cost-effective way to prevent millions of cases worldwide.

"The combination of personal and non-personal health interventions evaluated here could lower the global incidence of cardiovascular events by as much as 50%," Murray and his colleagues conclude.

The researchers stress that their findings counter the perception that preventing heart disease and stroke is primarily "the concern of the very wealthy."

Cardiovascular disease is a growing problem in developing nations, and recent developments--such as the availability of an off-patent cholesterol-lowering statin--mean that preserving heart health could become a more global concern, according to the researchers.

But they point out that the cost of combination medicines to prevent cardiovascular disease is still beyond the reach of poor nations. This is why, they add, WHO has argued for "massive injections of resources for health from richer countries that could be used to reduce the burden of disease among the poor."

SOURCE: The Lancet 2003;361:717-725.

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