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The voluntary agreement on public health between the government and food companies came under attack today after a report in the BMJ claimed it had led to thousands of deaths from strokes and heart attacks and called for a system of “tobacco style” regulation.

The report, published in the BMJ by Consensus Action on Salt and Health (CASH), accused former health secretary Andrew Lansley of allowing progress on salt reduction made under the FSA to fatally stall after bring in the Responsibility Deal.

CASH attacked what it called the “very poor sign-up” to the 2017 salt targets, with only half of the companies signed up to the 2014 commitment currently having joined.

It named companies including Unilever, McDonalds and Kellogg’s as key absentees, and claimed the delay had disrupted progress in salt reduction.

CASH claimed 6,000 lives a year have been put at risk by what it says was the lost momentum under the FSA’s salt reduction programme, started in 2005.

“This was done by setting up specific salt targets for 86 categories of food, with the aim of re-setting them every 4 years,” it said.

“Whilst the targets remained voluntary, monitoring of the food industry was maintained throughout, ensuring no company lagged behind. As a result, significant reductions in salt intake were made at a population level, consequently reducing blood pressure and resulting in fewer deaths from heart attack and stroke.”

But CASH pointed out no further commitments to salt targets were made until Lansley was replaced by Jeremy Hunt and Anna Soubry, with new targets eventually set in 2014 to be achieved by 2017.

“The delay has meant momentum in salt reduction has been lost, with many companies stopping or slowing down their planned reductions in salt added to foods,” it added.

“The food industry is the biggest and most powerful industry in the world,” said Professor Graham MacGregor, professor of cardiovascular medicine at Queen Mary University of London and lead author of the paper.

“Most of the foods that it currently provides are very high in salt, fat and sugars, causing increased risk of strokes, heart failure and heart attacks, and predisposing to cancer than healthier alternatives,” he added.

“It is therefore imperative that robust mechanisms should be set up immediately to control the food industry in a similar way to the tobacco industry.”

The BRC strongly denied key elements of the report’s claims. A spokesman said: “The first salt targets were in fact developed by retailers and not the FSA, which took them and adopted them as the official national targets. This shows the level of commitment from retailers to salt reduction from the very beginning.

“Progress has not been disturbed; retailers have not stopped reformulating.

”However as we progress, the process becomes more difficult. All the big successes happened at the beginning; subsequent work is constant with smaller steps over lengthier periods of time.”

The spokesman denied four years had been lost. “This is not true. The working plan agreed at the beginning of the process clearly stated when different policies were going to be discussed and agreed through the development of pledges. This priority document was published and is in the public domain.

“Retailers provide consumers with a variety of products, many of which are very low in salt, fat and sugars. The use of front of pack labelling for the last ten years and more recently the adoption of the national FOP recommendation by the whole retail industry, means that consumers can easily identify foods that are high in certain nutrients and make informed choices.”