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In Canada, nearly 80 per cent of the sodium we eat is added to our food before we take the first bite.Jiri Hera/Getty Images/iStockphoto

More than one in five Canadians have high blood pressure. Among 60 to 79 year olds, that figure shoots up to more than 50 per cent. Elevated blood pressure is a leading risk factor for heart disease, stroke – some of the leading killers in Canada – and other chronic health conditions.

Sodium is a major contributor to high blood pressure. And over all, Canadians consume more than double the sodium they need each day. In fact, the average toddler, teen and adult in Canada consumes well over the maximum recommended safe limit every day.

Because the bulk of the sodium Canadians consume is added by manufacturers and restaurants – nearly 80 per cent of the sodium Canadians eat is added to our food before we take the first bite – it's very difficult to significantly reduce intake. (Only about 11 per cent of the sodium in our food is added by consumers themselves.) Even seemingly "healthy" items, like whole-wheat bread, low-fat dressing, sauces, soups and canned vegetables, can all contain high amounts of salt.

For this reason, Canadians should be concerned about the results of a recently released study that found restaurant chains have made little progress in reducing the sodium levels in many of their menu items. In some cases, restaurants have even added sodium to menu items, according to the results of the study, which examined restaurant offerings in 2010 and 2013. More than 20 per cent of the menu items included in the survey contain more than a day's worth of sodium.

It's worth noting that many people now dispute the need to reduce sodium, after the publication of several studies that seemed to refute the link between high blood pressure and sodium. In fact, some researchers suggest that cutting salt is actually bad for health.

But, in reality, the majority of those studies have some fairly major flaws – such as looking at a relatively young group of people over a short period of time, which one study did in 2011. The study found that people who ate a low-sodium diet were more likely to die of heart disease. But the total number of overall deaths was small and the study period was short. The authors concluded that low sodium intake was linked to their deaths – an irresponsible leap, considering the size and duration of the study. The journal Heart has since retracted one meta-analysis (a review of multiple studies) refuting the link between high sodium and ill health after determining that data from two of the six studies used to draw conclusions were duplicated.

Restaurants Canada, the industry organization representing the food-service industry, says that sodium levels in the Canadian food supply remain high because that is what consumers want.

We are biologically geared to enjoy the taste of salt, and the restaurant industry knows it – and is afraid it will lose business if it scales down sodium levels in some of the offerings.

What that means, in essence, is that restaurants – and food manufacturers – are putting business ahead of the health of Canadians. That's understandable: After all, they are businesses, not health charities. And consumers are free to choose where and what they eat.

But on the other hand, the vast majority of packaged, processed and prepared food is overloaded with sodium. What that means is that by and large, the food industry actually has a lot of influence over how much sodium Canadians eat. From a public-health standpoint, there is an undeniable case for the food industry to reduce sodium levels.

It has pledged to do so, many times.

The federal government has so far decided to leave any action on that front up to the industry – despite the fact that a federally appointed task force recommended in 2010 that the Canadian government set maximum limits for sodium that could be added to various foods, and monitor those levels to ensure they were met over time.

And if they weren't met, the task force recommended considering making such changes mandatory.

Instead of adopting that plan, the government disbanded the task force and left the industry in charge of sodium reduction.

Is it any surprise that the industry has so far failed to take meaningful action that will improve Canadians' health?

Meanwhile, Britain, which has perhaps the most aggressive government-led sodium-reduction campaign in the world, has seen sodium intake levels come down by 10 per cent. The British Food Standards Agency has set new reduction targets for the food industry to meet by 2017, and notes that so far, salt levels in many foods have been slashed by 50 per cent or more. And research has found that from 2003, when the campaign began, to 2011, stroke deaths were reduced by 42 per cent and heart disease deaths by 40 per cent. Although it might be optimistic to conclude that reduction was entirely the result of reduced sodium consumption, it's hard to deny that some connection exists.

Britain's food industry has been working with the government agency hand-in-hand. The reduction targets are voluntary, which means that it might not be necessary to legislate such public-health campaigns. But it does help to have the institutional backing of a government that can continuously push for change.

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