The UN must make reducing salt intake a global health priority, say UK scientists.
Writing in the British Medical Journal they say a 15% cut in consumption could save 8.5 million lives around the world over the next decade.
The report says practical steps to reduce consumption should be drawn up without delay.
If voluntary measures do not work, the food industry should be compelled to cut salt levels, it says.
The report – by researchers at the Universities of Warwick and Liverpool – says that after cutting tobacco consumption, getting people to eat less salt would be the most cost effective way to improve global health.
The researchers say there is a “consistent, direct relation between salt intake and blood pressure”. High blood pressure in turn is linked to heart disease, stroke and kidney problems.
They point to the US, where cutting salt intake by a third would save tens of thousands of lives and save up to $24 billion annually in health care costs.
But with 70% of deaths from strokes and heart attacks occurring in developing countries, the report says the impact of reduced intake would be global.
However, the researchers warn that both widespread education and engagement with the food industry will be needed to limit the salt content of processed foods.
One of the report authors, Professor Francisco Cappucio, of the University of Warwick, said the food industry had a “huge responsibility” to take action.
He said: “The reformulation of food in their hands could deliver a massive impact to public health in the same way that at the moment it is contributing to a huge burden of disease.
“They train your taste buds – the more salt you eat the less salt you taste the more salt you want, to get that saltiness.
“It is quite a vicious circle, and these circles create profit and it is important that these profits are balanced against the health of the population.”
But Morton Satin, a vice president at the industry body, the Salt Institute, rejected the report out of hand.
He said: “The salt reduction agenda has become an urban myth – far more based upon populist ideology than objective science.”
Mr Satin said there had been a number of studies in the past year that have questioned the prevailing wisdom on the health damage caused by salt.
He said: “This compulsion to regulate is being pushed by a gaggle of activist ideologues who have long ago abandoned science to take up the salt-bashing cudgel.”
Professor Cappucio pointed to successful salt reduction programmes in Finland, Portugal and Japan which all showed substantial reductions in blood pressure following cutbacks in salt consumption.
He has little time for the efforts of the food and salt industry to re-open the debate on health effects.
“It’s no surprise that there has been some antagonism from the food industry, trying to create some false feeling of controversy to confuse consumers.
“There is a covert approach to protect their profits at a time where a reduction in salt intake might erode some of them.”
The latest report comes ahead of a UN high level meeting on non-communicable diseases in September which will draw up plans to fight heart disease, diabetes and other ailments over the next decade.