Reducing dietary sodium could reduce cardiovascular disease rates and probably save the health care system about $2 billion a year, said Dr. Norman Campbell. (Larry Crowe/Associated Press)

Sodium kills more Canadians each year than any other chemical substance, a report released Thursday suggests.

The Centre for Science in the Public Interest, a non-profit nutrition and food safety advocacy group, published the report, called Salty to a Fault, online. The group is calling on governments and food manufacturers to do more to manage the risks posed by excess sodium consumption, saying labelling is not enough.

"We've previously called it public health enemy number one," said Bill Jeffrey, national co-ordinator for the centre in Ottawa.

Food manufacturers are using too much salt in foods from soup to hamburger buns, he said, based on the group's survey of about 320 processed and restaurant foods. Sodium in french fries, for example, ranged from a low of 40 milligrams in a 70 gram serving at Swiss Chalet to a high of 550 milligrams for a similar sized serving at Harvey's.

The recommendations call for:

• Health Canada to set sodium reduction targets for key categories of food, as the United Kingdom has done.
• Food companies and restaurants to reduce sodium in foods while Health Canada develops a sodium reduction strategy.
• Grocery stores and chain restaurants to press suppliers to reduce sodium levels.
• Governments to revise standards for sodium substitutes in staple foods.
• The setting of sensible sodium criteria targets for buying foods for RCMP, military facilities, government cafeterias, penitentiaries, and other government venues and government sponsored events, including the upcoming 2010 Olympic Games.
• The closure of loopholes in nutrition labelling regulations that exempt in-store bakeries, delis, and butcher shops.
• High-sodium warning labels where necessary.
• Consumers to read labels carefully.
• Health Canada to require simpler nutrition labels on the front of packages using a symbolic or numerical rating.

The group's claim is backed by research that suggests almost one third of all hypertension cases are a result of consuming excess salt, said Dr. Norman Campbell, an internationally recognized expert in hypertension and the president of Blood Pressure Canada.

75% of sodium not added at stove or table

Reducing dietary sodium would prevent 11,500 Canadians from having a stroke, heart attack or heart failure each year, Campbell said, adding that could probably save the health-care system about $2 billion a year.

The challenge is, it's nearly impossible for people to limit their salt consumption to a healthy dose since so much is added in prepared and packaged foods, Campbell said.

More than three-quarters of the salt in Canadians' diets is added by manufacturers or at restaurants, said Dr. Ross Feldman, a hypertension specialist at the University of Western Ontario and a past president of the Canadian Hypertension Society.

Health Canada has a sodium working group looking at reducing salt content in the food supply, but Feldman is frustrated by the slow progress.

"Canadians are in effect being held hostage to high sodium intakes by eating processed foods," Feldman said.

Salt should be available in grocery stores, but it should be up to consumers to add it if they wish, rather than food processors' doing so, he said.

The World Health Organization said mandating reduced sodium is a government's cheapest option for improving the health of its population.