From Our 2007 Archives

FDA Mulls Cutting Salt in Processed Foods

By Steven Reinberg
HealthDay Reporter

THURSDAY, Nov. 29 (HealthDay News) -- U.S. Food and Drug Administration officials opened a public debate Thursday on just how much salt is too much in the processed foods Americans eat.

The hearing was called in response to a request made in 2005 by the consumer advocacy group Center for Science in the Public Interest (CSPI), asking the agency to make changes to the regulatory status of salt, to require limits on salt levels in processed foods, and to require health messages related to salt and sodium on food labels.

"Very few people dispute that Americans get way too much salt from processed and restaurant foods, and that an excess promotes hypertension, stroke, heart attacks, kidney failure, and early death," CSPI executive director Michael F. Jacobson said in a statement. "While the FDA has historically declined to challenge companies to lower high sodium levels, it is increasingly hard for FDA officials to ignore the calls to action made in recent years by the medical community."

Testifying at the meeting, Dr. Stephen Havas, the American Medical Association's vice president for science, quality and public health, said that "the need for action is clear. The deaths attributed to excess salt consumption represents a huge toll - the equivalent of a jumbo jet with more than 400 passengers crashing every day of the year, year after year."

In a statement, Havas said that cutting the amount of salt in the American diet in half over the next decade could save 150,000 lives annually.

"Americans don't consume large amounts of salt because they request it," he said, "but often do so unknowingly because manufacturers and restaurants put it in food."

Not everyone agrees that regulation is the way to go, however.

"Americans consume too much salt," agreed Milton Stokes, a spokesman for the American Dietetic Association, which represents the nation's nutritionists. "But I don't think the idea of a sodium warning would be effective. People are confused enough. It makes people almost afraid to eat."

One food industry representative also opposes new regulation.

"The issue is really more about individual's dietary patterns and food choices," said Robert Earl, senior director of nutrition policy at the Food Products Association (FPA), a food industry lobbying group.

"We think an alternative to strict regulation of salt as a food additive [is] that you can achieve public health benefit by encouraging industry to continue its efforts to reduce salt in food products and at the same time encourage American consumers to eat according to [the federal government's] Dietary Guidelines for Americans," Earl said.

Currently, the FDA categorizes salt as "generally recognized as safe." So far, the agency has refused to change this categorization.

But at the hearing, the AMA called for the agency to revoke that status and develop regulatory measures to limit sodium in processed and restaurant foods.

The FDA is also looking for input on whether mandated product labeling is called for and whether that would, in fact, be effective.

Stokes does support limiting the amount of sodium in foods; however, he believes consumer pressure, not new FDA rules, is the most effective way to do so.

Consumers might not even notice the change, he said, especially if food companies very gradually lowered the amount of salt in their products. "It's a matter of cutting back slowly," he said.

Another expert believes things won't change until regulators take action.

"The evidence has been building up over the years about the effects of salt on blood pressure and cardiovascular disease," said Nancy Cook, an associate professor of medicine at Harvard Medical School in Boston. "FDA action is probably the only way you can achieve a reduction in sodium."

Other countries, including Finland and the United Kingdom, have had success in reducing the amount of salt in processed foods, Cook pointed out. "Food manufacturers aren't going to do it on their own," she said.

Stokes said it's not too hard to improve the American diet. "You could start by adding one more serving of fruit or vegetable a day and take the salt shaker off the table," he said. "You can also rinse canned vegetables before using -- that removes up to 40 percent of the salt."

U.S. Dietary Guidelines recommend that Americans limit their salt intake to 2,300 milligrams a day. But half the population -- blacks, middle-aged or elderly people, and those with high blood pressure -- are at special risk and are advised to use only 1,500 milligrams a day.

However, the average salt intake for most Americans is about 4,000 milligrams a day, according to the CSPI.

Only a little of that salt comes from the salt shaker or home cooking. About 77 percent comes from processed and restaurant foods, the group says. Many restaurant dishes have more than one or two days' worth of salt on a single plate, according to the CSPI.

But food industry spokesman Earl said consumers can choose low-sodium options, since many products are already labeled as "low salt" or "no added salt."

"There are a variety of tools to communicate salt content," he said. "There is also a lot of effort that has gone on over decades related to slow, incremental reductions in salt content."

But salt reduction is happening in other countries, the Associated Press reported. For example, McDonald's Chicken McNuggets in the United States has more than twice as much salt as the same product in the United Kingdom, and Kellogg's Special K in the United States has 58 percent more salt in than it does in the United Kingdom, CSPI noted.

Getting rid of just a few dashes of salt a day will boost Americans' health, another expert said.

"There is no doubt that most Americans consume too much salt, and no doubt sodium excess contributes to high blood pressure, stroke and the rate of premature death," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine.

"I strongly favor reductions in the sodium content of processed foods, and labeling that makes it easier for all of us to gauge and control our sodium intake," Katz said.

Still, he has his reservations when it comes to regulatory intervention. "I am less enthusiastic about reclassifying a nutrient because of the failings of the food supply at large," Katz said.

SOURCES: Milton Stokes, R.D., spokesman, American Dietetic Association; Nancy Cook, D.Sc., associate professor, medicine, Harvard Medical School, Boston; David Katz, M.D., M.P.H., director, Prevention Research Center, Yale School of Medicine, New Haven, Conn.; Robert Earl, M.P.H., R.D., senior director, nutrition policy, Food Products Association, Washington, D.C.; Nov. 29, 2007, statement, American Medical Association; Associated Press

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