Lowering sodium in packaged and prepared foods could significantly improve cardiovascular health and prevent many cases of heart disease, stroke and deaths in the general population in France and the U.K., according to two new research studies published today in Hypertension, an American Heart Association journal.
Consuming too much sodium is a major risk factor for hypertension, also known as high blood pressure, which can lead to health complications such as heart attack, stroke, chronic kidney disease, dementia and other forms of cardiovascular disease, according to the American Heart Association.
To address the global concern about excessive sodium consumption, many countries have implemented salt-reduction strategies to improve public health and reduce health costs. Two studies — one in France involving salt-reduction targets for baguettes and other bread products in 2025, and the other in the United Kingdom focusing on 2024 goals for takeaway and packaged foods — estimated the potential impact on the general population if those salt-reduction targets were met. The projections calculated in these two studies indicate that minor adjustments in sodium content to some of the most common prepared foods in each country would require no effort from people to change their eating habits, yet may produce significant public health benefits.
“This approach is particularly powerful because it does not rely on individual behavior change, which is often difficult to achieve and sustain. Instead, it creates a healthier food environment by default,” said Clemence Grave, M.D., lead author of the study from France and epidemiologist and public health physician at the French National Public Health Agency.
The World Health Organization recommends adults should consume less than 2,000 milligrams (mg) of sodium per day; however, global intake is much higher. The American Heart Association recommends daily intake of no more than 2,300 mg of sodium a day — equal to about 1 teaspoon of table salt — but also says the ideal limit is no higher than 1,500 mg per day for most adults, especially for those with high blood pressure.
Sodium reduction in bread (France)
In 2019, France set a national public health goal to reduce salt consumption by 30%. In 2022, a voluntary agreement was signed between the government and bread producers to lower salt content by 2025. Bread, especially the baguette, is a culturally and nutritionally central food in France, yet it can be high in salt — traditionally containing about 25% of total daily recommended intake of salt. By 2023, most breads made in France already met the new sodium standards.
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 the salt-reduction targets met full compliance. The analysis found that with bread consumption remaining the same and sodium-reduction targets fully met, less salt in baguettes and bread would decrease daily intake by 0.35 g per person, leading to slightly lower blood pressure across the population. Specifically, the analysis revealed that estimates for 100% compliance to salt-reductions meant deaths are estimated to have declined 0.18% (by 1,186) annually, hospitalizations for ischemic heart disease have dropped by 1.04%, while hospitalizations for hemorrhagic stroke and ischemic stroke have fallen by 1.05% and 0.88% respectively.
The study’s modeling suggests men received the greatest benefits across all age groups, with 0.87% of heart diseases and strokes prevented among men (vs 0.63% among women). Among women, the avoidable proportion is highest among those aged 55 to 64 years old.
“This salt-reduction measure went completely unnoticed by the French population — no one realized that bread contained less salt,” Grave said. “Our findings show that reformulating food products, even with small, invisible changes, can have a significant impact on public health.”
Sodium reduction in packaged foods and take-out meals (United Kingdom)
For the study in the U.K., researchers used national survey data to estimate the amount of salt people consumed from pre-prepared packaged and take-out meals. They then estimated daily sodium intake if all relevant food categories met the 2024 sodium-reduction targets. Sales-weighted average and maximum salt content targets were set for 84 grocery food categories — including bread, cheeses, meats, and snacks — and, for the first time, 24 out-of-home categories such as burgers, curries, and pizza.
The research found that fully meeting the sodium reduction goals could have reduced average salt intake from about 6.1 g to 4.9 g per day — translating to an estimated average of 17.5% less salt consumed per person per day. Men would experience slightly larger reductions than women because they tend to consume more salt in general. Even this small, daily reduction in salt would lower blood pressure modestly across the population, and the improvements could add up. During a 20-year period, the modeling suggests that about 103,000 cases of ischemic heart disease and approximately 25,000 strokes could be prevented in the U.K. Over people’s lifetimes, the blood pressure reductions would translate into roughly 243,000 additional quality-adjusted life years and £1 billion in savings (about $1.3 billion in U.S. dollars) for the U.K.’s National Health Service.
“We know that cardiovascular disease is a leading cause of death in the U.K. — as it is worldwide — so any reductions in salt intake and blood pressure could lead to big benefits,” said Lauren Bandy, D.Phil., the study’s lead author and a researcher in food and population health at the University of Oxford. “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.”
Daniel W. Jones, M.D., FAHA, chair of the 2025 American Heart Association/American College of Cardiology High Blood Pressure Guideline and dean and professor emeritus of the University of Mississippi School of Medicine, said the results are “absolutely relevant” to the U.S. and any country where much of the food consumed is prepared outside the home. “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.”
Study details, background and design for the research in France: The average daily salt consumption was 8.1 g per day in France in 2015, with more than 90% of adults exceeding the recommended daily threshold. Traditional French bread and baguettes contained about 1.7 g of salt per 100 g, contributing around 2 g of salt per day per person, roughly 25% of total daily intake. The French government set a target of reducing salt intake by 30%, and in March 2022 reached a voluntary agreement with the bakery sector to progressively reduce salt in all breads by 2025. To quantify the potential impact, researchers modeled expected reductions in systolic blood pressure and avoidable health conditions under full compliance. The analysis included systolic blood pressure data for adults ages 35 and older and salt intake from a 2014-2016 national survey combined with 2022 statistics from the national claims database.
Study details, background and design for the research in the U.K.: The study’s long-term health modeling was based on the U.K.’s adult population. Researchers collected daily salt intake from the U.K.’s National Diet and Nutrition Survey in 2018-2019 to estimate changes in salt intake if reductions met the specified targets for 2024. The survey collects data on food consumption and nutrient intakes of a representative sample of about 1,000 people using repeated food diaries for a three- to four-day period. The sample for this study included 586 participants ages 18 and older, weighted to be representative of the U.K. population based on midyear estimates for 2017. The participants reportedly ate 2,549 unique foods, of which 1,532 were matched to a salt reduction target category.
Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability.
