• by Thom Forbes  @tforbes, June 2, 2016

The U.S. Food and Drug Administration yesterday issued a draft guidance proposing reductions in the amount of sodium in nearly 150 categories of prepared foods, from bakery products to soups. It wants “to help the American public gradually decrease” salt intake from an average 3,400 milligrams a day to 3,000 mg in two years and 2,300 mg in a decade.

The self-described “practical, gradual, and voluntary approach” proposed by the FDA is open to public comment for 90 days for issues one through four in the draft and for 150 days for issues five through eight.

“Today we’ve achieved a historic breakthrough,” said Michael Jacobson, president and co-founder of the Center for Science in the Public Interest, citing its 39-year effort to reduce the amount of sodium used in packaged and restaurant foods. The only downside to the action, he said in an email and release, is that the targets are not mandatory.

Pointing out that its members have introduced more than 6,500 product choices with reduced sodium, since 2002, the Grocery Manufacturers Association said that it looks forward “to working with the agency to ensure the best and most recent science is taken into account when determining sodium intake levels for optimal health for all Americans” in a statement attributed to its chief science officer, Leon Bruner.

“Like others inside and outside of government, we believe additional work is needed to determine the acceptable range of sodium intake for optimal health. This evaluation should include research that indicates health risks for people who consume too much sodium as well as health risks from consuming too little sodium,” the GMA statement concludes.

Measured words aside, The Wall Street Journal’s Heather Haddon tells us that the fight between regulators and the food industry “is escalating” with critics maintaining the government’s “moves are based on sometimes-conflicting scientific evidence, and could inflate food costs and ruin the flavors and textures consumers prefer.”

The GMA “estimated that it would take six to 18 months and cost $500,000 to $700,000 to reformulate a product with less salt to meet the guidelines, assuming alternatives were available,” Haddon writes.

The feds’ rationale for reducing sodium consumption were made clear in both the subhed — “to prevent premature illnesses and deaths” —and the second paragraph of the FDA news release announcing the action: “Americans consume almost 50% more sodium than what most experts recommend. One in three individuals has high blood pressure, which has been linked to diets high in sodium and is a major risk factor cause of heart disease and stroke. That number climbs to one in two African Americans and even includes one in 10 children aged 8-17.”

Government officials across several federal agencies are framing the action as empowering consumers, who can, of course, still use a shaker to add as much salt to a dish as their palates desire. And the heads of the health departments in New York City, Chicago, Houston, Los Angeles, and Philadelphia issued a joint statement to “applaud the FDA” for the new targets, pointing out that 75% of sodium in the American diet comes from packaged and restaurant foods.

Indeed, “many Americans want to reduce sodium in their diets, but that’s hard to do when much of it is in everyday products we buy in stores and restaurants,” said Health and Human Services secretary Sylvia Burwell in the FDA release. “Today’s announcement is about putting power back in the hands of consumers, so that they can better control how much salt is in the food they eat and improve their health.” 

In a The New England Journal of Medicine op-ed cited by NPR’s Allison Aubrey, four researchers including Centers for Disease Control director Thomas Friedan claim that cutting the average sodium intake by just 400 mg per day could potentially prevent as many as 28,000 deaths annually. 

“Most of the sodium consumed is already in the foods we purchase and cannot be removed by consumers,” the article states.

But Andrew Mente, an associate professor of clinical epidemiology and biostatistics at McMaster University in Hamilton, Ontario, tells the Washington Post’s Laurie McGinley that “his analysis of four international studies found low-salt diets — below 2,300 mg a day — might actually increase the risk of heart disease compared to average salt consumption.”

Mente and colleagues recently published those findings in The Lancet. “The only people who need to worry about reducing sodium are those with high blood pressure and high salt consumption,” he told McGinley. Lori Roman, the president of the Salt Institute, “echoed Mente's views that the FDA guidelines disregard scientific evidence, are counterproductive and could be dangerous,” McGinley writes. “‘It's malpractice,’ she said.”

On the other side, the CSPI points out that the Institute of Medicine, Dietary Guidelines for Americans, American Heart Association, American College of Cardiology, and the World Health Organization all recommend that companies reduce sodium levels in their products and that people eat lower sodium diets.