Health Minister Aaron Motsoaledi wants food manufacturers to use less salt in their products, and they are not best pleased.
A fragile agreement is being brokered between food manufacturers and government, but this one is not about wages or ownership requirements — it's about how much salt is allowed in our bread, potato crisps and other foodstuffs.
Although South Africans currently eat twice the recommended daily amount of salt, the move by government to regulate how much salt manufacturers can add to processed foodstuffs has raised concerns from big businesses and consumer groups about the costs of finding substitutes to preserve food and keep it tasty.
On March 18 Minister of Health Aaron Motsoaledi, signed an amendment to the Foodstuffs, Cosmetics and Disinfectants Act of 1976 stipulating that there would be a maximum amount of sodium allowed in an array of food. The law requires that bread, butter, breakfast cereals, potato crisps, ready-to-eat snacks, processed meat, sausages, soup powder, gravy powder, two-minute noodles, stock cubes and jelly all be lighter on the salt by 2019.
The new restrictions would require a loaf of bread, which currently contains 4.8% sodium, to contain about 4% by 2016 and be down to 3.8% by 2019.
The legislation is part of a bid by the health department to ward off diseases linked to a high salt intake, such as high blood pressure, strokes, heart attacks and vascular dementia.
And the move by the department is statistically justified: according to the South African Medical Research Council, strokes are the third leading cause of death in South Africa, and hypertensive diseases are the seventh.
In 2000 alone, almost 34 000 people died from strokes and almost 17 000 died from hypertensive disease. According to the Heart and Stroke Foundation, about 130 South Africans suffer heart attacks and about 240 have strokes every day.
Notwithstanding the obvious health benefits of restricting the intake of salt, the Consumer Goods Council of South Africa said it was "shocked and disappointed" that the law had been passed. Its biggest concern was about the cost of finding salt substitutes for the affected food products. "Any formulation changes to foodstuffs impact the costs to the system," Ronel Burger, head of the food safety initiative at the council, told the Mail & Guardian. Manufacturers would be forced to find suitable "substitute ingredients" for this alpha-element that boosts flavour, preserves shelf life and is almost as cheap as water.
Pioneer Foods, which operates 17 large-scale bakeries around the country, said the current lack of salt substitutes made the targets unrealistic. Lulu Khumalo, executive of corporate affairs and sustainability at the company, told the M&G: "We fully support the drive to reduce the nondiscretionary daily intake of salt in the diet, through the setting of national targets for specific food categories that are implemented incrementally over a realistic period of time."
However, she said, the company was "currently not aware of commercially acceptable technical solutions — both locally and abroad — that have been successful. We therefore cannot support this very low sodium level."
But Professor Melvyn Freeman, head of noncommunicable diseases at the health department, said the department discouraged the use of substitutes. Instead, it advocated weaning consumers off using too much salt over time.
"We are trying to say to them: 'No, don't use salt replacers unless it's absolutely necessary, because that will keep them used to the salty taste. Rather help to change the palate of the consumers'."
Manufacturers should decrease the salt in their food by increments, he said. "If you use a slow reduction process, you can get them used to less salt in their food over time."
This weaning process, he said, needed only 14 days, rather than the six years the department was allowing. "We are doing this over a very extensive period — until 2019. People have a long time to change their manufacturing processes," he said. "If they're clever, manufacturers will use that time to reduce the content slowly rather than in two batches [in 2016 and 2019 when the requirements take effect]."
The bottom line
But whether salt is reduced or substituted, the change will affect companies' bottom lines, said Burger. It would require shelf life and stability tests, consumer testing and a change of packaging — which could cause higher food prices.
Less salt could mean shorter shelf lives as well, increasing distribution costs.
And although Freeman said that companies could initially decrease the salt in their foods by up to 15% with no impact on taste, he acknowledged that there would be a definite manufacturing cost to so drastically decreasing salt content by 2019.
Nevertheless, the cost to business would be outweighed by the lessened strain on the healthcare system, he said. "We can save about 7 500 lives a year," he said. "Now can you imagine what the expense is in hospitals trying to save the lives of those 7 500 people?"
A combined report by the Medical Research Council and the Wits Rural Public Health Unit pitches the saved cost at R300-million a year if the population decreased its salt intake by a mere 0.85 grams a day.
This only includes hospital fees for nonfatal strokes. It does not take into account the fees of those who die from diseases linked to a high intake of salt and the savings that would be made from less absenteeism as a result of a healthier populace.
"People with lower salt intake will also live longer, and therefore consume more [food] over the course of their lives," said Freeman. "So manufacturers can actually make more money that way. For us it's a bit of a no-brainer."
Regulation vs self-regulation
And yet other countries have not come to the same "obvious" solutions. South Africa appears be the first country to regulate salt addition at a manufacturing level.
Freeman said big businesses opted for this solution during initial engagement sessions as a way "to level the playing field" between large and small companies.
Countries such as Australia and the United Kingdom have opted for self-regulation in the food industry, with limited success.
"The suggested sodium reduction requirements will push food manufacturers into largely uncharted territory," said Khumalo of Pioneer Foods. "We recommend that sodium reduction be regarded as an exploratory process."
Curbing the urge to sprinkle
Of the approximately eight grams of salt consumed by the average South African every day, between 50% and 60% has already been added to bought food — the rest is added by consumers when they sit down to a meal, said Freeman.
Tiger Brands disagrees. "Salt added in cooking and at the table seems to be the dominant source of salt consumption — far more than processed food content," the company said in a statement.
Tiger Brands advocated programmes aimed at behaviour change rather than legislated oversight. "Much global intervention has been to educate and change behaviour, and this seems to be more effective than regulation alone," said the company's nutritional consultant, Stella Papadopoulos-Fenster.
"Although the minister's objective is honourable and well intentioned, at the same time, or even before legislated salt reduction takes place, there needs to be education and behaviour changes."
Freeman acknowledged the need to change behaviour, and referred to the department's new programme to raise public awareness of the dangers of eating too much salt. The Heart and Stroke Foundation has also formed a lobby group called Salt Watch to complement the government's efforts. Overall, the various stakeholders are coming to the table, so to speak: the department received 30 submissions to its draft changes and has altered the final amendment to reflect the input.
"We're not anticipating people will go against this," said Freeman. "We are hoping that they will see it as a partnership towards better health, rather than something to get around."
Rubbing salt into food manufacturers' wounds
Health Minister Aaron Motsoaledi is overseeing a drastic reduction in the amount of salt you eat — and it's all in the name of wellbeing. Through his recent amendment to the Foodstuffs, Cosmetics and Disinfectants Act of 1976, Motsoaledi has limited the amount of salt that is allowed to be added to foodstuffs by manufacturers.
By 2019, the amount of salt in your bread will have been decreased by 30%, the salt in a vienna sausage will be down by 13%, and by 12% in a packet of potato crisps. That may render your food a little blander than before but, according to Motsoaledi, it addresses an urgent health risk.
The average South African eats 8.1 grams of salt a day, "more than two times the physiologically required amount," he told Parliament in 2011.
By lowering the salt content of bread alone, an estimated 6 400 lives could be saved in South Africa every year, a September 2012 study in the SA Medical Journal found.