Rx for Salt: Cut It Out
The American Medical Association (AMA) is turning up the heat on the food and restaurant industry to serve products with less sodium.
Last week, the AMA's House of Delegates passed a resolution calling for a 50 percent reduction in sodium content of processed foods, fast foods and restaurant meals over the next 10 years. The AMA, which represents a quarter-million U.S. physicians, also urged the Food and Drug Administration to revoke salt's status as a food ingredient "generally recognized as safe."
More than 30 percent of adults, an estimated 65 million Americans, already have high blood pressure, a condition that increases the risk of stroke, kidney disease and heart problems. Since blood pressure rises with age, the numbers are expected to grow as the baby boomer population edges past 60.
Blood pressure increases are also fueled by inactivity, obesity, alcohol consumption and sodium intake. Bottom line: U.S. adults 55 and older have a 90 percent lifetime risk of high blood pressure -- yes, that means that nine out of 10 are poised to develop hypertension.
The good news: They all don't have to.
In the few remaining cultures where salt consumption is much lower, so are rates of high blood pressure. Even so, salt sensitivity varies from person to person -- a fact that has fueled debate about the benefits of reducing sodium intake. But in recent years, new analyses of scientific studies have been strong enough to prompt the World Health Organization and health groups in Great Britain, Australia, New Zealand, Finland and the United States to urge significant reductions in sodium. In addition to the AMA, the American Public Health Association, the American Heart Association and the National Heart, Lung, and Blood Institute have called for reductions.
The latest U.S. Dietary Guidelines set the daily intake of sodium at 2,300 milligrams or less for adults 50 and younger. That's equal to about a teaspoon of salt daily. For older adults, African Americans and people who already have high blood pressure, the recommended daily intake is 1,500 milligrams or less, about the amount found in a cup of canned chicken noodle soup and a slice of frozen cheese pizza. (Pepperoni and sausage boost sodium higher.)
"And remember, these are the daily maximums, not what you should aim for," notes Edward Roccella, director of the National High Blood Pressure Education Program at the National Heart, Lung, and Blood Institute.
Tell that to American adults, whose average consumption is 4,000 milligrams of sodium per day for every 2,000 calories consumed. The AMA found that 95 percent of American men and 75 percent of women aged 31 to 50 regularly ingest more than the upper daily limit for sodium.
Nor is hiding the salt shaker likely to help. The U.S. Dietary Guidelines Advisory Committee noted that nearly 80 percent of the sodium consumed comes from processed food and meals at restaurants and fast-food outlets.
"Many doctors have recommended to hypertensive patients to cut down on sodium and not use salt in cooking or at the table," says Stephen Havas, vice president of science, quality and public health for the AMA and a co-author of the resolution on sodium. "So the patient is left thinking that they're doing something about it when [in fact] they're not addressing the major source of sodium."
In addition to challenging restaurants and fast-food establishments to cut the sodium, the AMA also asked for warning labels on high-sodium grocery items. A frozen entree, for example, "may contain one to two teaspoons of salt," Havas said. "And it doesn't necessarily taste salty. You don't realize that you are being exposed to that salt load."
