“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,” Health and Human Services Secretary Sylvia Burwell said in a statement. “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.”
The agency said that many food companies — including General Mills, Mars and Nestle — already have cut back on salt but that the overall level in the food supply remains too high. After a lengthy analysis, the FDA created 150 categories of foods and set targets for sodium reductions. When asked why they are voluntary rather than mandatory, Susan Mayne, director of the agency’s Center for Food Safety and Applied Nutrition, said officials “believe we really need to have a dialogue with industry about what the appropriate targets will be.”
Final guidelines won’t be issued until after public comment periods.
Studies have shown that high salt intake increases blood pressure and that high blood pressure raises the risk of heart attack, stroke and other cardiovascular problems. Overall, about a third of Americans have high blood pressure; the proportion is about 50 percent for African Americans and about 10 percent for children ages 8 to 17.
Thomas Frieden, the director of the Centers for Disease Control and Prevention, who participated with FDA officials in a media call, said the evidence was clear: Reducing sodium in the food supply will “save lives, reduce health-care costs and save money.”
But some researchers don’t think it's a good idea to drive down salt consumption. One of the leading skeptics is Andrew Mente, an associate professor of clinical epidemiology and biostatistics at McMaster University in Hamilton, Ontario, who was the lead author of a salt study recently published in the Lancet.
Mente said Wednesday that his analysis of four international studies found that low-salt diets — below 2,300 mg a day — might actually increase the risk of heart disease compared with average salt consumption. The only people who need to worry about reducing sodium are those with high blood pressure and high salt consumption, he said.
Lori Roman, the president of the Salt Institute, a trade association that represents salt producers, echoed Mente’s views that the FDA guidelines disregard scientific evidence, are counterproductive and could be dangerous. “It’s malpractice,” she said.
But the Grocery Manufacturers Association, which represents the makers of food, beverage and other consumer products, had a more moderate response. Leon Bruner, chief science officer, said its member companies “look 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.”
CDC’s Frieden dismissed arguments that science doesn’t support lower salt consumption, saying there’s a “very robust body of evidence that supports the health benefits.” He said studies that don’t show such benefits have serious methodological problems. “We don’t see this as there are two sides with similar levels of evidence,” he said. “The more rigorously done trials ... show the relationship.”
Jim O’Hara, the director of health promotion policy for the Center for Science in the Public Interest, agreed with Frieden. Experts at his organization and other health groups say skeptics such as Mente “are simply getting it wrong,” he said.
CSPI, which has long pushed the FDA to take steps to reduce salt in the food supply, sued the agency last fall, seeking action on a 2005 petition asking for government action.
President Michael Jacobson said Wednesday that while the group had pressed for mandatory standards, the FDA's voluntary action will nevertheless provide clear goals “by which companies can be held accountable.” The guidelines would help “level the playing field for those companies that are already trying to use less salt in their foods.”