The food industry may face sodium limits from the U.S. government if it doesn't voluntarily reduce salt content in processed foods, said Thomas Frieden, director of the Centers for Disease Control and Prevention.
"Substantial changes" in food production are needed to improve Americans' health by reducing salt consumption, Frieden, who previously headed New York City's health department, said in an editorial published in the Annals of Internal Medicine. A voluntary reduction of salt by food manufacturers would lower consumption more than a mandatory tax on salt in packaged foods, according to a study in the same journal that Frieden cited.
American adults consume an estimated 3,900 milligrams of sodium a day — more than twice the maximum recommended by U.S. government dietary guidelines, according to a Stanford University study published in the same journal. Excess sodium intake is linked to high blood pressure, raising the risk of heart attacks and stroke, Frieden said in yesterday's editorial.
"Because more than three-fourths of Americans' sodium intake comes from processed foods and restaurant meals, it is extremely difficult for individuals to limit their consumption to healthy levels," Frieden said. If foodmakers don't make those foods less salty, "new regulations on sodium content of processed and prepared foods might be necessary."
The industry already is working to help Americans lower their sodium intake, said Melissa Musiker, senior manager of science policy, nutrition and health at the Grocery Manufacturers of America. Campbell Soup Co., the world's largest soupmaker, and Hormel Foods Corp. are two of the Washington- based group's members that have announced voluntary sodium reductions. The group represents more than 200 food and beverage makers.
Frieden laid the groundwork for New York's push to reduce salt in prepared foods before President Barack Obama picked him last year to head the Atlanta-based CDC. He also banned smoking and trans fats in the city's restaurants during his seven years as health commissioner. New York announced an effort in January to spur food makers and restaurant chains to voluntarily reduce their salt use by 25 percent over five years.
Americans' sodium consumption may be reduced 9.5 percent if U.S. regulators emulated a U.K. initiative by working with the industry to cut salt in packaged foods, the Stanford study found. That would lead to decreases in blood pressure, preventing more than 513,000 strokes and more than 480,000 heart attacks among Americans ages 40 to 85, and save $32 billion in medical costs, according to the report also published yesterday in the Annals.
Food manufacturers "have been working voluntarily, often without the consumer's knowledge, on the reduction of sodium, and they plan to continue doing so," Musiker said yesterday in an interview.
Camden, New Jersey-based Campbell says it has more than quadrupled its lower sodium offerings to more than 110 products from 25 in 2005. The company reduced sodium in more than 90 soups, including its condensed tomato soup and V8 vegetable juice drinks, according to a Jan. 11 statement.
ConAgra Foods Inc., based in Omaha, Nebraska, said in 2007 that its voluntary initiative to cut sodium from products such as Marie Callender's frozen dinners, Orville Redenbacher's popcorn and Chef Boyardee canned ravioli had removed about 2.8 million pounds from Americans' diets annually.
Spam and Jennie-O
Austin, Minnesota-based Hormel, the maker of Spam luncheon meat and Jennie-O turkey, has said it cut more than 560,000 pounds of salt from its products in 2007 and an additional 438,738 pounds in 2008.
Levying a "sodium tax" could decrease U.S. sodium consumption by another percent and save $22.4 billion in medical costs, the study found. No country has imposed such a tax, according to the report.
"After tobacco control, the most cost-effective intervention to control chronic diseases might be reduction of sodium intake," Frieden said in the editorial, written with Peter Briss, the CDC's acting associate director for science. The U.K.'s sodium campaign, which includes voluntary salt- reduction targets for the food industry, helped inspire the study, said Crystal Smith-Spangler, the lead author of the research article.
"Based on our data, it looks like it could be worth doing because it's very cheap and because cardiovascular disease is such a huge problem and hypertension is such a major risk factor for cardiovascular disease," Smith-Spangler, a postdoctoral scholar at Stanford's Center for Health Policy, said yesterday in an e-mail.
The government should conduct a long-term study of the health benefits of a low-sodium diet before "trying it out on the public," said Dick Hanneman, president of the Salt Institute in Alexandria, Virginia. The group represents salt producers such as Chicago-based Morton Salt, a unit of K+S AG. "There's good scientific evidence that calls into question Dr. Frieden's conclusions," Hanneman said yesterday in an interview. "We think the next responsible step is to do a health outcome study of low-sodium diets and also, at this point, to study whether sodium appetite can be modified over a long term."
People are acquiring a taste for salt early in their lives, according to a study published today in the journal Health Affairs. About 27 percent of children's calories come from snacks, researchers at the University of North Carolina-Chapel Hill found, based on data from 2006. The number of snackers has jumped since the late 1970s, with candy and salty products such as chips and pretzels contributing to the increase.