Reducing Americans' excessive sodium consumption requires establishing new federal standards for the amount of salt that food manufacturers, restaurants, and food service companies can add to their products, says a new report by the Institute of Medicine.
Because the vast majority of people's sodium intake comes from salt that companies put in prepared meals and processed foods, this regulatory strategy would make it easier for consumers to eat lower, healthier amounts of salt, said the committee that wrote the report.
The committee has asked the U S Food and Drug Administration to gradually step down the maximum amount of salt that can be added to foods, beverages, and meals through a series of incremental reductions. The goal was not to ban salt, but rather to bring the amount of sodium in an average American's diet below levels associated with the risk of hypertension, heart disease, and stroke, and to do so in a gradual way that would assure that food remains flavourful to the consumer, the committee said.
Regulatory action was necessary because four decades of public education campaigns about the dangers of excess salt and voluntary sodium cutting efforts by the food industry had generally failed to make a dent in Americans' intakes, the committee said.
The industry's voluntary efforts have fallen short because of lack of a level playing field for all products. Companies have feared losing customers who could switch to competing products or brands with higher salt content. Also, salt is so widespread and present in such large amounts in grocery store and menu items --- including many foods and drinks that people do not think of as salty-- that it is difficult for people who want to reduce their sodium intake to succeed.
"For 40 years we have known about the relationship between sodium and the development of hypertension and other life threatening diseases, but we have had virtually no success in cutting back the salt in our diets," said committee chair Jane E. Henney, professor of medicine, University of Cincinnati, College of Medicine, Cincinnati.
"The report submitted by IOM outlines strategies that will help in effectively lowering sodium consumption to healthy levels. The best way to accomplish this was to provide companies the level playing field they need so that they are able to work across the board to reduce salt in the food supply.
Lowering sodium by the food industry in a stepwise, monitored fashion will minimise changes in flavour and still provide adequate amounts of this essential nutrient that are compatible with good health.
On an average, Americans consume more than 3,400 milligrams of sodium -- the amount in about 1.5 teaspoons of salt -- each day. The recommended maximum daily intake of sodium -- the amount above which health problems appear -- is 2,300 milligrams per day for adults, about 1 teaspoon of salt. The recommended adequate intake of sodium is 1,500 milligrams per day, and people over 50 need even less.
Americans' salt consumption has been shaped in part by changes in eating habits as people consume more processed foods, dine out more frequently, and prepare fewer meals from basic, raw ingredients in the home. People's tastes can be reset to prefer less salty flavour through subtle reductions over time, studies show.
Salt has been treated as "generally recognised as safe," and there were no regulatory limits on its use as an additive. But studies connecting high intakes of sodium to high blood pressure, heart attacks, strokes, kidney disease, and other debilitating and deadly conditions show that salt is safe only up to a certain amount. FDA will need to gather and assess an ample body of data to determine what limits to set on the mineral's use in processed foods and prepared meals and what the incremental decreases should be. The committee acknowledged that establishing the process will take significant time, staffing, and funding.
FDA issues statement on IOM’s sodium report<
The FDA has clarified its reaction to the report submitted by the Institute of Medicines on cutting down the sodium intake of the Americans. It said that it has not made a decision to regulate sodium content in foods at this time.
Over the coming weeks, the FDA will more thoroughly review the recommendations of the IOM report and build plans for how the FDA can continue to work with other federal agencies, public health and consumer groups, and the food industry to support the reduction of sodium levels in the food supply. The Department of Health and Human Services will be establishing an inter-agency working group on sodium at the Department that will review options and next steps
The FDA said that success in reducing sodium intake would require coordinated national action, with participation of all. It was encouraged by the fact that some food manufacturers have already begun or announced their commitment to reduce sodium levels in their products. The FDA has asked the consumers to start lowering sodium intake by purchasing foods low in sodium, asking grocer to carry more low-sodium products, and asking for low-sodium options at restaurants.