The calls come after Cappuccio and his colleagues recently published further evidence of social inequality in salt intake and reduction strategies – meaning the health benefits of lower salt foods have not reached those in the most need of them.
Writing in BMJ Open, the UK-based research team this time focuses on analysing socioeconomic and geographic splits in salt intake in Italy – finding that salt intake in the country is significantly higher in less advantaged social groups.
The findings mirror previous findings from Cappuccio and his team, and are something that he says indicates that across Europe people of low socio-economic background eat more salt than those on higher incomes - which can contribute to the lower life expectancy seen in these groups.
"The government can do something about this by discouraging manufacturers from producing cheap, salty food and distributors from selling them. These are the types of foods consumed by those on lower incomes because they are inexpensive but ultimately they have a detrimental effect on your health,” said Cappuccio, who is based at the University of Warwick Medical School.
“We now have convincing evidence in Britain and across Europe that more regulatory actions and mandatory enforcements are needed to deliver a reduced-salt environment for all to benefit from,” he added.
The authors performed the latest study as part of ongoing work to assess the social and geographical differences in salt intakes across Europe.
In the current cross-sectional survey, they analysed data from 3,857 men and women in Italy
Cappuccio and his team measured the amount of sodium in the urine of participants, an indication of salt consumption.
Despite Italy being renowned for its healthy Mediterranean diet the findings suggest that people in the poorer areas of the country, mostly in the south, have more salt in their diets than those in the more affluent north.
Even after taking into account factors such as differences in regional cuisine and salt from sources other than diet, the team found that across Italy there was an association between salt intake and income and educational attainment – for example those in lower skilled jobs had 6.5% more sodium in their urine (high salt consumption) compared to those in top managerial jobs.
There was a similar relationship between education, as those who were educated to just junior school level ate 5.9% more salt that those with university degrees.
“The study shows for the first time that salt intake is significantly higher in less advantaged social groups (both by occupation and by level of educational attainment),” noted the researchers. “This social gradient is independent of age, sex, BMI, hypertension and other behavioural variables.”
They concluded that such social inequalities in terms of salt intake be taken into account and monitored in the implementation of salt reduction programmes in Italy – and throughout Europe.
Source: BMJ Open
Volume 5, Issue 9, doi: 10.1136/bmjopen-2014-007467
"Geographic and socioeconomic variation of sodium and potassium intake in Italy: results from the MINISAL-GIRCSI programme”
Authors: Francesco P Cappuccio, et al