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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 May 12; 334(7601): 967.
PMCID: PMC1867876
Reduced Salt Intake

Health protection requires legislation

M Justin S Zaman, clinical research fellow in epidemiology

Glasziou (previous letter) pleads for a description of what clinicians and patients need to do. It is not simply about adding salt at the dinner table but about understanding the considerable role that players such as the food industry play in public health.1 Health protection through national fiscal and legislative policies should have a higher priority than health promotion interventions applied to general, primary care, and workforce populations.

The high risk strategy, the traditional medical approach to prevention, identifies individuals at high risk of subsequent cardiovascular disease events who are then offered behavioural or pharmacological interventions. In contrast, the population strategy seeks to control the determinants of incidence in the population as a whole.2

Public health policies need to take into account the role that agriculture, trade, education, the physical environment, town planning, and transport have on cardiovascular disease aetiology. Political action is needed to change urban planning, education, and policies on the agriculture, food, and tobacco industries.3 Until then, interventions such as salt reduction campaigns and pleading to patients to throw away the salt cellar in afternoon surgery will make little difference to population salt levels.


Competing interests: None declared.


1. Cappuccio FP. Salt and cardiovascular disease. BMJ 2007;334:859-60. (28 April.) [PMC free article] [PubMed]
2. Rose G. Sick individuals and sick populations. Int J Epidemiol 1985;14:32-8. [PubMed]
3. Pekka P, Pirjo P, Ulla U. Influencing public nutrition for non-communicable disease prevention: from community intervention to national programme—experiences from Finland. Public Health Nutr 2002;5:245-51. [PubMed]

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