Western medical researchers are now proposing a ‘salt tax’ for developing countries, in order to reduce deaths from cardiovascular disease (CVD).  Is this just a ‘nanny state’ measure, or has the ‘Western doctor knows best’ attitude got the better of common sense and political wisdom?

Nudge nudge, wink wink

The idea that targeted taxation can prompt people to act more in their own interests, and those of society at large – so-called ‘nudge theory’ – is currently highly fashionable.  Proposed taxes on ‘unhealthy’ foods, like saturated fats and sugar, are obvious consequences of this thinking.

Return of the salt tax

Researchers at Harvard University in the USA recently presented an analysis claiming that higher taxes on salt, along with voluntary industry reductions in salt levels, would reduce CVD.

Fair enough, you might think. But the researchers are talking about developing countries, countries that have a wide range of different diets, lifestyles and nutritional needs. In many parts of the world, the decimation of indigenous diets and their replacement with staples like maize (corn), wheat and rice, have led to numerous problems with lack of nutritional diversity. There is rarely a solid scientific platform on nutritional intakes and requirements in developing countries. Simply assuming needs and intakes are similar to more intensely studied western, industrialised populations could be a grave error. One example that delineates the type of problems with a proposed salt tax relates to the difference in sodium requirement for rural subsistence farmers who spend large parts of the day in the baking sun, as compared with those working in city, air-conditioned offices.  

If we’re going to look at minerals, it’s almost certainly the issue of mineral balance that is at the heart (excuse the pun) of the problem. This means it’s less about the total sodium intake and more about sodium/potassium balance, and magnesium intake. In relation to other minerals, many people in developing countries simply don’t eat enough vegetables, and these are often the most importance source of trace minerals in the diet.

But there are also other considerations. How are the poorest in these developing societies meant to afford a hike in the price of salt-containing foods? And anyway, what are cossetted Western medical researchers doing recommending tax increases for distant countries?

Education not taxation

For us, by far the best way to change people’s behaviour is to educate them about the health consequences of their food choices. Educational strategies in developing countries are years behind those in the industrialised world. Accelerating educational programmes – in a sensible direction – would surely be infinitely preferable to making poor people even poorer and taxing certain foods out of their reach.

Call to action

• Be careful how much salt you add to your food, taste it before salting and try to accustom your palate to lower amounts of salt over time. If you do use salt, use salt that contains a full spectrum of minerals, such as a good, sea salt or Himalayan salt
• Avoid processed foods and ready meals, as these tend to contain high levels of salt
• To increase you trace mineral intake and assist mineral balance in your body, eat a wide variety of vegetables that are soil-grown, as opposed to being hydroponically (plants grown in a mineral solution without soil) cultivated. In Western countries, many salad vegetables such as tomatoes, cucumbers and peppers, are grown hydroponically in very limited nutrient solutions. Most organically-certified salad vegetables are grown in the soil.
• Consider taking good quality mineral supplements if you think your diet might be low in trace (and ultra-trace) minerals. Consult a qualified and experienced nutritional practitioner if you need individualised advice.

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