As the final reporting period for Australia’s scheme looms, a UK model has been released, showing the population health outcomes had their targets been met.
Had the UK reached its salt reduction targets for 2024, there would have been 103,000 fewer cases of ischemic heart disease and 25,000 fewer cases of stroke over the following 20 years, according to researchers.
The UK, like Australia, had a voluntary salt reduction scheme for manufacturers and suppliers to opt into which would reduce the sodium content of food products over time. The program began in 2003, with updated targets released every few years.
If the 2020 update, which included industry targets for 2024, had been met, individual salt intake would have reduced by 1.12g per day, according to a modelling study of the potential health outcomes from the salt reduction program.
The model showed 243,000 quality-adjusted life years would have been saved, and a net financial saving for the NHS of £1 billion (approximately $1.9 billion AUD) over the remaining lifetime of the adult population.
Data for the model was taken from the National Diet and Nutrition Survey (NDNS), a rolling annual cross-sectional survey of food and nutrient consumption. The NDNS uses a representative sample of roughly 1000 adults and children who complete food diaries for several days.
The data is adjusted for age, sex, region, nurse’s visits and blood sample collection. A total of 586 adult participants in the NDNS were included in the model, using a sample weighted to be representative of the population of 2017.
The salt reduction program intended to reduce the salt content of food and drink gradually, allowing consumers to adjust to the change in taste and reduce potential impact to sales. It set out clear targets for sodium content 84 grocery food categories, such as bread, cereal, cheese, meat etc.
The scheme appeared to be working initially; population intake fell by 15% between 2003 and 2011, from 9.5g/d to 8.1g/d. Over that time, the population’s blood pressure fell by 1.4mmHg systolic and 3mmHg diastolic, which researchers said contributed to an estimated 42% and 40% reduction in stroke and ischemic heart disease mortality, respectively.
The 2017 industry targets, as set out in the 2014 government update, were reached. However, the momentum of the program appeared to be stalling.
Between 2015 and 2020, very little reduction in salt content was seen in leading grocery categories. A 2020 Public Health England report on the food industry’s progress in salt reduction found that only half of the grocery targets were being met.
Population salt intake went from 8.1g/d in 2011 to 8.4g/d by 2018, and the goals for 2024 were not reached. It is unclear whether the UK government intends to introduce new targets, as the 2020 framework remains the most recent version released.
“Reformulation programs are very appealing programs for improving diet quality, disease incidence, and burden as they do not rely on changes in behaviour by the public. Instead, the onus is on food companies, either through voluntary adherence to set targets or compulsory through legislation,” Dr Kaitlin Day, Research Associate of the Department of Nutritional Sciences, Kings College London, told The Medical Republic.
“The UK has been much more active in implementing these types of approaches (for example the Soft Drink Industry Levy), whereas Australia is more reluctant to follow this route, in general. You can see this in the wording of the Aus reformulation program, which uses very gentle language.”
The Australian voluntary scheme, which began in 2020, set sodium reduction targets for 27 food categories and saturated fat reduction targets for five. This expanded a year later to include sodium reduction in five further food categories and sugar reduction for nine categories.
A two-year follow-up ABS report found the average sodium content decreased by 3% across all participating products, with one in 10 participating products recording a decrease in sodium content. Half of these were from products which were initially exceeding targets.
A similar report, which looked at ABS data of only the five categories that had been added to the sodium reduction program in 2021 (ready meals, ready-to-eat cereals, puffed/flaked/extruded cereals, cereal biscuits and popcorn), found that fewer than one in six recorded a decrease in sodium within two years.
The overall proportion of these products which did not meet their respective sodium targets dropped from 29% to 27% over the two years. Targets were not met by 42% of popcorn products in 2023 (up from 33% in 2021), 31% of ready meals in 2023 (down from 35% in 2021) and 8.8% of breakfast cereals in 2023 (down from 10.5% in 2021).
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The latest available ABS report, released in July 2025, looked at sodium targets from the initial program rollout (without the additions from 2021) over four years. While a third of the products met their targets, 12% recorded an increase in their sodium content over this period.
Across all food categories, the average sodium content of participating products was 4.3% lower in 2024 compared to 2020. The greatest relative reductions were seen across gravies and sauces, crumbed and battered fish, sweet bakery products, processed meat, sausages and savoury snacks.
The four-year review from the Healthy Food Partnership Reformulation Program showed that overall, 82% of participating products were meeting their sodium targets. However, 69% were already meeting them at baseline.
“One of the biggest issues that underlines any development of national, or state-level nutrition policies is the lack of regular up to date data on Australian diets,” said Dr Day.
“The last national nutrition survey was conducted in 2023 and took two years for data to be available, the one before that was conducted in 2011-12. It’s very hard to develop the type of modelling necessary to set salt reduction targets and then monitor their effectiveness with more than 10 years between surveys.
“My understanding is there isn’t a big appetite at state or government level for nutrition policies like this at the moment. There was a lot of advocating a few years ago for a soft drink levy with no uptake. Whether this will change as people start analysing the latest national nutrition survey is hard to predict but I hope so.”
The final reporting period for the reformulation program ends on 30 June 2026.
