I tried the UK's 'saltiest' sandwich - here's what I learned

James Gallagher Health and science correspondent

This week, it was reported that a particular chicken sandwich contains as much salt as five McDonald's cheeseburgers, leading it to top a list of over 500 analyzed sandwiches. The sandwich, offered by the bakery chain Gail's, boasts a staggering 6.88g of salt, exceeding the UK's daily recommended limit of 6g and the World Health Organization's 5g guideline. Therefore, it clearly ranks as an unhealthful option.

Despite this, I decided to set aside my packed lunch and taste the sandwich myself, eager to explore the implications of consistently consuming too much salt on our health.

As I ventured out before the lunch crowd, my initial thought was, "this sandwich is massive," quickly followed by a realization of its hefty price – £8.90 for a single sandwich.

Upon unwrapping my meal, I found a 1,000-calorie triple-decker containing three slices of bread with two layers of filling: one featured a thick cut of bacon paired with salad and the other contained smoked chicken and coleslaw.

Part of me anticipated disliking it, imagining I would be overwhelmed by its saltiness. However, I found it to be delicious. The presence of salt was unmistakable, yet its flavor profile was satisfying, highlighting the reason for salt’s prevalent use in our food.

Though I couldn't finish the entire sandwich, plenty of colleagues in the newsroom were eager to assist in finishing it.

However, this week’s updates on salt from the World Health Organization made for sobering reading. Dr. Luz Maria De Regil, the organization's nutrition director, warned that "excess salt consumption remains among the top preventable drivers of death globally," attributing 1.7 million deaths each year to this dietary issue.

As I considered the sodium intake from my meal, I began to reflect on the effects of salt consumption on the body and the reasons behind our excessive salt intake.

The chemistry of salt

From a chemical perspective, table salt is composed of sodium chloride. The human body requires a certain amount of sodium to maintain essential functions, and sodium is present in nearly every cell in the body. It plays a crucial role in facilitating nerve communication and helping regulate water balance within the body.

According to Sonia Pombo, a researcher at Queen Mary University of London and head of research at Action on Salt and Sugar, "the amount we need is actually very, very small in the grand scheme of things," particularly when compared to our actual salt consumption.

Health impacts of excess salt

The implications of excessive salt consumption on health are extensive, with the most pronounced impact observed in blood pressure regulation. The sodium we consume enters the bloodstream, drawing in additional water and increasing blood volume. As a result, the heart must work harder to circulate this volume, which subsequently elevates blood pressure—akin to tightening the tap on a garden hose.

High blood pressure, often referred to as "the silent killer," can go unnoticed until it leads to severe health events such as strokes or heart attacks due to ruptured blood vessels.

Beyond blood pressure, excessive salt consumption stiffens blood vessels, increasing their risk of damage. It also adversely affects the kidneys—the organs responsible for blood filtration—and may leach calcium from bones, thus weakening them. Additionally, high salt intake has been linked to various health conditions, including vascular dementia, stomach cancer, and may even influence the immune system.

While my lunch left me with some concern, I acknowledged that one sandwich wouldn't have a significant impact on my long-term health. Pombo reassured me, stating, "Having a one-off, high-salt meal isn't going to impact your long-term health," acknowledging that the gradual increase in blood pressure occurs over many years.

Although I strive to maintain a healthy diet, the statistics regarding our collective salt consumption indicate many of us likely exceed the recommended 6g daily limit.

How much salt do we actually eat?

The UK National Diet and Nutrition Survey employs 24-hour urine monitoring to assess salt intake among the population. The most recent data from 2019 reveals that men consume about 9.2g of salt per day, while women average 7.6g. The disparity is partially attributable to men consuming more food overall. Alarmingly, these figures have remained static since 2008.

Pombo challenges common misconceptions regarding balancing salt intake, pointing out that you cannot simply "sweat it out" unless you are an elite athlete or mitigate it by drinking excessive water. A diet rich in fruits and vegetables, as opposed to a heavy reliance on ultra-processed foods, can provide potassium, which helps mitigate some effects of salt. However, she emphasizes, "that doesn't make it OK; one doesn't cancel out the other."

Where is all the salt coming from?

Salt is predominantly found in the foods we consume rather than being solely a condiment we add ourselves (though many argue there’s no valid excuse for not salting your fish and chips).

Pombo notes, "It's in pretty much everything," including foods that don't particularly taste salty. Bread, in all its varieties, is especially significant due to its widespread consumption.

Consumers can make healthier choices by selecting products with lower salt content, provided they are diligent in reading labels. However, given the ubiquity of salt in our diet, many advocates argue that the onus of reducing sodium levels should fall on food manufacturers.

Salt serves a dual purpose in food: it helps preserve goods by preventing bacterial growth while also contributing to profit margins. Professor Francesco Cappuccio from the University of Warwick emphasizes, "salt can be taken out" of products, yet manufacturers are reluctant due to its low cost.

He draws attention to the strategic use of salt in settings like pubs, where salted peanuts encourage patrons to purchase additional beverages, showcasing salt's role in enhancing food appeal.

Industry response

We reached out to Gail's regarding the salt content in their sandwiches but did not receive a response. A representative from the Food and Drink Federation stated that their members’ products now contain "nearly a third less salt" than in 2015, asserting that significant investments have been made to innovate healthier offerings.

Kate Nicholls, chair of UKHospitality, remarked that hospitality venues prioritize nutrition and healthy eating, providing customers with the best options when dining out.

The verdict

So, will I return to the bakery next week for another chicken caesar sandwich? I conclude that it should be regarded as an occasional indulgence, and I will revert to my usual packed lunches.