While weight-conscious consumers often obsess about fat and carbohydrates, a lawsuit newly filed by the Center for Science in the Public Interest (CSPI) puts another popular ingredient in the spotlight: salt.
CSPI is suing the Food and Drug Administration to put more muscle into salt regulation. The lawsuit would change the status of salt from generally recognized as safe (GRAS) to an official food ingredient that would subject it to much stiffer regulation by the FDA. In issuing a report last week on the health dangers of salt, the consumer advocacy group noted that salt consumption has slowly risen over the past 30 years and, by its estimate, accounts for nearly 150,000 premature deaths annually in the United States. Most of those deaths are linked to complications of high blood pressure, or hypertension.
"Americans spend more than $15 billion each year on drugs to treat hypertension, yet the government spends almost nothing to reduce salt consumption," said CSPI executive director Michael F. Jacobson, author of the report.
The latest national nutritional surveys suggest that Americans consume about a third more than the 2,300 milligrams per day limit advised by the federal government's 2005 Dietary Guidelines for adults up to age 45. (Those older than 45, as well as African Americans and people who have already been diagnosed with elevated blood pressure, are advised to consume no more than 1,500 milligrams of sodium daily. That's the amount found in about a cup and a half of many canned soups.)
And, no, removing the salt shaker from the dining table likely won't be enough. An expert committee that helped develop the revised guidelines reported in August that as much as 80 percent of sodium intake comes from processed and restaurant foods.
Even so, the food industry points to major improvements and the growing number of reduced-sodium and no-salt-added products. "Over the past 40 years, there has been a dramatic reduction in the use of sodium in processed foods," said Robert Earl, senior director of nutrition policy at the National Food Processors Association, an industry group. "Various new techniques in canning and freezing have reduced the amount of sodium needed" to extend shelf life of foods.
But those reduced-sodium products must appeal to consumers, which "is not a simple task," as Earl notes.
"There's a tradeoff here," concedes James O. Hill, director of the Clinical Nutrition Research Unit at the University of Colorado Health Sciences Center in Denver, noting that salt is important for taste. "I know where CSPI is coming from. . . . But salt is used for a reason, and it plays a role in allowing consumers to like products. So I'm a big fan of getting the food industry to gradually reduce sodium over time so that the consumer doesn't notice it."
In the meantime, here's what you can do to reduce your sodium intake:
Don't bother doing the milligram math. The answers are already in plain sight on nutrition food labels. Pay attention to percent daily value of sodium. "The rule of thumb is to choose foods that have less than 5 percent of the daily value for sodium" per serving, said Eva Obarzanek, a research nutritionist at the National Heart, Lung, and Blood Institute (NHLBI) .
Eat more fruit and vegetables. Studies suggest that these potassium-rich foods can help counter the effects of high sodium intake.
DASH. No, not the 40-yard kind, but the Dietary Approaches to Stop Hypertension, an eating plan that has been proven to lower blood pressure as much as some medications. DASH is low in total fat, saturated fat and cholesterol, and rich in fruit, vegetables and low-fat dairy products. Get a free copy at www.nhlbi.nih.gov/health/public/heart/hbp/dash/ or from the NHLBI Health Information Center, P.O. Box 30105, Bethesda, MD 20824-0105, or by calling 301-592-8573.
Cut back on sodium gradually. Since the taste for salt develops over time, "it's not a good idea to go cold turkey," said Alice Lichtenstein, professor of nutrition at Tufts University and chairwoman of the American Heart Association's Nutrition Committee. "Introduce a few lower-sodium products, substitute herbs for salt and just begin ratcheting down. That's what really works."
Choose reduced-sodium or no-salt-added foods. Harvard University's Meir Stampfer, a professor of nutrition and epidemiology, snacks on unsalted peanuts and skips sodium-loaded pretzels and chips. Lichtenstein uses low-sodium chicken broth to whip up homemade soups in minutes for her family. Or just swap "natural" peanut butter with no added salt for more-processed brands, which have 6 percent of the daily value per two tablespoons.
Beware of hidden sodium. Besides restaurant fare and canned food, leading sources of sodium include many of the items that the new guidelines suggest should be consumed in greater quantities: whole-grain bread, crackers and ready-to-eat cereals, and dairy foods, especially cheese.
Other high sodium sources: frozen food with sauces; macaroni and cheese with flavor or seasoning packets; salad dressings; condiments, snack foods, luncheon meats, hot dogs and processed tomato products, from juice and ketchup to salsa and sauce. Smart low-sodium choices include: oatmeal, plain shredded wheat, whole-wheat matzoh, brown rice as well as nonfat milk and yogurt. Use vinegar and oil instead of prepared salad dressings. Rinse canned beans and other vegetables to reduce sodium. Choose herbs and spices for flavoring instead of . . . well, you know.
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