Experts call for regulation and gradual tightening of added salt, us

Experts call for regulation and gradual tightening of added salt, us

The US Food and Drug Administration (FDA) should regulate salt as a food additive and gradually tighten the limit on the amount that manufacturers, restaurants and food service providers can add to processed foods and prepared meals, said experts in a new report this week. They base the recommendation on a review of past efforts to reduce sodium intake in the US, which has not changed much in the last 40 years, despite it being a top national health priority.

You can read the report, titled Strategies to Reduce Sodium Intake in the United States, online as a pre-publicaton edition. It comes from the Institute of Medicine (IOM), an independent body established under the charter of the National Academy of Sciences to advise health professionals, policymakers, the private sector, and the public. This particular report was requested by Congress and supported by a number of federal health agencies.

Since the 1970s, reducing sodium intake has been, and still is, an important public health goal for the US, yet despite an array of public health interventions, national standards and guidelines, Americans still consume more sodium than is good for their health, putting individuals at higher risk for blood pressure and related diseases, write the authors.

Also, American eating habits have changed significantly in the past few decades. Where once, much of the sodium consumed came from salt added during home cooking of meals prepared from fresh ingredients or at the table via the salt shaker, for the vast majority of Americans today, dietary sodium comes from the salt that manufacturers, restaurants and food service companies add to processed foods and prepared meals.

Since salt has been added to food for centuries, it is generally recognized as safe, so currently the FDA does not regulate it as a substance that has the potential to harm public health: to do so would be a completely new thing for the FDA.

But the IOM authors argue that there is enough evidence of the harm it can do when intake goes over a certain limit: studies have linked high sodium intake to high blood pressure, heart attacks, strokes, kidney disease, and other serious and fatal conditions.

They recommend that the FDA gathers and reviews the research evidence and decide what the limits should be on the use of salt as an additive to processed foods and prepared meals.

Americans have gradually become accustomed to consuming more salt every day, as the amount of salt in the nation's food supply has gone up over the years. However, research shows that people can get used to eating food with less salt, if it is done gradually: people's tastes can be reset to less salty flavors, wrote the authors.

Thus they recommend that rather than jump straight to a low limit of added salt, the FDA should do it step by step, gradually bringing the limit down so that people get used to the flavor of processed and prepared foods with less salt in it.

The goal is not to ban salt altogether, wrote the authors, but phase it down to below the levels associated with risk of high blood pressure and related diseases.

First author Jane E Henney, professor of medicine at the University of Cincinnati College of Medicine, and chair of the committee that did the research and wrote the IOM report, told the press that the report outlines ways we can all effectively reduce our sodium intake to healthy levels:

"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."

She said the best way for us to reduce our salt intake is to:

"Provide companies the level playing field they need so 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 minimize changes in flavor and still provide adequate amounts of this essential nutrient that are compatible with good health," she explained.

The average American consumes 3,400 grams of sodium a day, which is roughly that contained in 1.5 teaspoons of salt. The 2005 Dietary Guidelines for Americans recommends a maximum intake of 2,300 grams for adults, or about 1 teaspoon of salt. Above this level, and there is a higher risk of developing health problems.

The IOM suggests that 1,500 milligrams per day is adequate for adults, and people over 50 need even less.

The authors also recommend that the percentage of Daily Value for sodium figure shown on food packaging, which tells the consumer how much of their recommended daily intake of sodium is in the product, should change to express the amount as a percentage of the adequate level, rather than the maximum level, as the latter mistakenly implies that this is a recommended intake. They also point out that the current figure is based on an earlier maximum limit of 2,400 grams.

"Strategies to Reduce Sodium Intake in the United States."

Jane E. Henney, Christine L. Taylor, and Caitlin S. Boon.

The National Academies Press, prepub PDFs, and online versions published 20 April 2010.

Sources: IOM.

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