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The largest organization of public health professionals in the world is calling on the Food and Drug Administration to begin regulating the amounts of salt and other sodium-containing ingredients used in processed foods with an eye toward reducing sodium in the food supply by 75 percent.
In a resolution passed unanimously today at the American Public Health Association’s 139th annual meeting, the group called on the FDA to “remove or modify” salt’s official status as a Generally Recognized as Safe (or GRAS) food ingredient—a status that allows unlimited amounts of sodium in foods.
The resolution calls on the FDA to begin regulating sodium in the food supply within one year and to establish a timetable for gradually reducing sodium in the food supply by 75 percent within 10 years. The resolution also recommends that all Americans consume no more than 1,500 mg of sodium daily.
The evidence that high sodium intake raises blood pressure is clear and convincing, according to the resolution.
The relationship between blood pressure levels and the risk of developing cardiovascular disease is “strong, continuous, graded, consistent, independent, and etiologically significant,” says the group, and that “reducing the amount of sodium added in the manufacturing and commercial preparation of food is a prudent and safe public health intervention, and the single most effective means of reducing the sodium intake of Americans.”
The APHA resolution was praised by the nonprofit Center for Science in the Public Interest (CSPI), which has been calling on the FDA to regulate and limit sodium in packaged foods since 1978.
“Salt, in the amounts presently used in processed foods, is the single deadliest ingredient in the food supply, contributing to the premature deaths of tens of thousands of Americans each year,” says CSPI Executive Director Michael F. Jacobson. “This has been widely acknowledged in the medical community for many years, but has been mostly ignored by food manufacturers and regulators. I hope that the American Public Health Association’s powerful recommendation spurs the Food and Drug Administration to act—at last.”
In 2010, the American Heart Association and the U.S. Dietary Guidelines Advisory Committee made 1,500 mg per day their recommended sodium limit for all Americans.
The APHA resolution now also makes the same recommendation. The Institute of Medicine has recommended that the FDA regulate sodium in the food supply to help Americans limit their consumption of sodium.
According to the government’s dietary advice, only people with hypertension, people who are middle-aged and older, and African Americans should consume fewer than 1,500 milligrams of sodium daily. People in those groups represent about 70 percent of adults.
The rest should consume no more than 2,300 mg of sodium per day, about a teaspoon of salt. However, Americans are consuming close to 4,000 mg of sodium per day—an amount that “far exceeds current recommendations and physiologic need,” according to the APHA resolution.
And that excess sodium doesn’t occur naturally and isn’t coming from the salt shaker: between 75 and 80 percent comes from salt added to processed and restaurant foods.
“In the United States, more than 400 people die prematurely every day and many more are becoming disabled due to the excessive sodium in our food supply,” says Stephen Havas, MD, author of the APHA resolution and adjunct professor of preventive medicine at Northwestern University, Feinberg School of Medicine. "Their failure to prevent this toll of death and disability is inexcusable. We must do better.”
CSPI first petitioned the FDA in 1978 to reduce salt in processed foods. Since then, it has filed a lawsuit against the agency for failing to take action, and in 2005 filed a new regulatory petition asking the FDA to revoke the GRAS status of salt and set limits on sodium.
The FDA held a public hearing on CSPI’s petition in 2007, but since then, the industry has only made minimal progress in reducing sodium, and sodium consumption remains at harmful levels. The FDA is holding a public meeting on sodium on Nov. 10.
“The Institute of Medicine concluded last year that industry’s voluntary efforts over the past 40 years to reduce sodium levels have utterly failed and that the FDA needed to set limits,” Jacobson says. “Presumably to fend off binding regulations, several large companies have said they would lower sodium modestly over the next several years. But even partial industry efforts are bound to falter without the level playing field provided by government regulations. It’s high time that the FDA acted.”
Jacobson, CSPI’s director, will receive the APHA’s prestigious David P. Rall Award for Advocacy in Public Health at a ceremony tonight.
The Center for Science in the Public Interest is a nonprofit health advocacy group based in Washington, D.C., that focuses on nutrition and food safety policies.