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 in Hypertension, an American Heart Association journal. The studies estimate the potential public health impact if national salt-reduction targets for specific food categories were fully met, highlighting a population-level strategy that does not rely on individual behavior change.
The French study focused on a 2022 voluntary agreement between the government and bread producers to lower salt content in all breads by 2025. Bread, especially the baguette, is a central food in France and traditionally contributed about 25% of the total daily recommended salt intake. Researchers used national data and a mathematical model to estimate health outcomes if these targets achieved full compliance. The analysis found that reducing salt in baguettes and other breads would decrease daily salt intake by 0.35 grams per person, leading to slightly lower blood pressure across the population.
Specifically, the modeling suggested that 100% compliance could result in 1,186 fewer deaths annually, a 0.18% reduction. Hospitalizations for ischemic heart disease could drop by 1.04%, while hospitalizations for hemorrhagic stroke and ischemic stroke could fall by 1.05% and 0.88%, respectively. Men were projected to receive the greatest benefits across all age groups. "This salt-reduction measure went completely unnoticed by the French population - no one realized that bread contained less salt," said Clemence Grave, M.D., lead author of the study and an epidemiologist at the French National Public Health Agency. "Our findings show that reformulating food products, even with small, invisible changes, can have a significant impact on public health."
The U.K. study examined the potential impact of meeting 2024 sodium-reduction targets 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. Using national survey data, researchers estimated that fully meeting these goals could reduce average salt intake from about 6.1 grams to 4.9 grams per day, a 17.5% decrease per person. Men would experience slightly larger reductions due to generally higher salt consumption.
The long-term modeling projected that over a 20-year period, these modest daily reductions could prevent approximately 103,000 cases of ischemic heart disease and about 25,000 strokes in the U.K. Over lifetimes, the blood pressure reductions could translate into roughly 243,000 additional quality-adjusted life years and £1 billion in savings for the U.K.'s National Health Service. "If U.K. food companies had fully met the 2024 salt reduction targets, the resulting drop in salt intake across the population could have prevented tens of thousands of heart attacks and strokes, saved substantially in health costs and significantly improved public health," said Lauren Bandy, D.Phil., the study's lead author and a researcher at the University of Oxford.
Both studies reinforce the importance of coordinated efforts among policymakers, the food industry, and health professionals to strengthen and enforce sodium-reduction programs globally. Consuming too much sodium is a major risk factor for hypertension, which can lead to heart attack, stroke, chronic kidney disease, dementia, and other cardiovascular diseases. The World Health Organization recommends adults consume less than 2,000 milligrams of sodium daily, while the American Heart Association recommends no more than 2,300 milligrams, with an ideal limit of 1,500 milligrams for most adults.
Daniel W. Jones, M.D., chair of the 2025 American Heart Association/American College of Cardiology High Blood Pressure Guideline, noted the relevance of these findings to the U.S. and other countries where much food is prepared outside the home. "This 'national' approach to limiting salt content in commercially prepared foods is a key strategy," he said. "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." The research underscores that systemic changes in food production, rather than reliance on individual dietary adjustments, offer a powerful pathway to substantial public health gains.
