Lowering the amount of salt in processed foods or choosing low-salt alternatives can lead to substantial health benefits when it comes to cardiovascular disease. It can cause a maximum reduction of heart attacks by 5% and over 7% less strokes. These are the results of PhD research by Marieke Hendriksen at RIVM and Wageningen University. Considerable effort by both consumers and the food industry is required to achieve the calculated health benefits.

A high salt intake affects blood pressure and thus the risk of cardiovascular diseases. In the Netherlands, cardiovascular diseases are among the diseases with the highest disease burden. Lowering salt intake leads to lower blood pressure  levels and thereby to fewercases of cardiovascular disease. Salt intake in the Netherlands is well above the recommended maximum intake of 6 grams a day. Approximately 80% of daily salt intake comes from processed foods. Hendriksen examined for the first time the impact of salt reduction on public health in the Netherlands and Europe.

Reducing sodium levels 

When reducing sodium levels in processed foods by half (the technologically feasible minimum levels), the daily salt intake from processed foods decreased by 2.1 gram (women) or 2.9 gram (men), a reduction of respectively 37% and 38%. In this scenario, almost 30,000 heart attacks and over 53,000 strokes could be prevented in the next twenty years (a reduction of respectively 4.4% and 6%). Such a reduction would require  an enormous effort from the food industry. Salt reduction initiatives between 2006 and 2010 have not yet lead to a lower daily salt intake. At the beginning of 2014 Minister Schippers of Health, Welfare and Sports signed an agreement with sector associations in the food business to lower salt, saturated fat and sugar in foods in the Netherlands

Low-salt alternatives

When replacing food with low-salt alternatives, the salt intake can decrease with 2.7 to 3.6 grams (a reduction of 47%). By lowering the daily salt intake through low-salt alternatives in the next twenty years approximately 35,000 heart attacks could be prevented (a decrease of 5.3%), as well as 64,000 strokes (a decrease of 7.2%). To achieve such a decrease in salt intake through low-salt alternatives, consumers will have to make a big adjustment to their current diet.

European level

Hendriksen also calculated the health impact of salt reduction in nine European countries. In other European countries, salt reduction would also result in a considerable reduction in cardiovascular disease. The health impact differs between countries; the expected health gain is lowest in Finland and highest in Poland.


These effects in different scenarios for salt reduction were assessed using the RIVM Chronic Disease Model. Also data from the Dutch Food Consumption Survey 2007-2010 and the Dutch Food Composition Database 2011 were used. The research was conducted at RIVM, together with Wageningen University, TNO and the WHO Collaborating Centre for Nutrition at RIVM.