Nov. 29, 2007 -- A scientific watchdog group is asking the government to cut the amount of sodium Americans consume, while regulators consider whether such a move would have widespread health benefits.
The group is calling on the FDA to set new standards limiting the sodium content of food. Americans on average consume far more that the recommended amount of sodium, a fact thought to play a key role in high rates of hypertension and cardiovascular disease.
Most of the sodium Americans eat is from packaged food or restaurant meals. The group, the Center for Science in the Public Interest (CSPI), says voluntary industry efforts to curb the use of salt have not gone far enough. The CSPI petitioned the FDA to compel more cuts.
"We have a health crisis on our hands, and history suggests that more certain and more permanent measures are needed," Michael Jacobson, PhD, the group's executive director, said at FDA hearings on the petition.
Cardiovascular disease, including strokes, heart attacks, and heart failure, is the No. 1 killer of Americans. Hypertension, or abnormally high blood pressure, is a major risk factor for cardiovascular disease.
Cutting Sodium Levels
The hearings mark the first time in 25 years that the FDA has considered measures to cut sodium levels in food. The agency concluded in 1982 that voluntary industry efforts were sufficient to protect the public's health.
Americans' average sodium intake did not drop appreciably, while rates of cardiovascular disease have gone up.
"I think the FDA's optimism about voluntary changes has proved unwarranted ... and many tens of thousands of people have died unnecessarily," Jacobson said.
Agency officials called Thursday's hearing an information-gathering session and said they have not determined when or if they will move to curb sodium in the food supply. The agency could enact new limits on the amount of sodium companies can add to food or come up with stricter labeling standards warning consumers about the dangers of sodium.
"There is a lot of research for us to consider," Barbara Schneeman, PhD, director of FDA's office of nutrition, labeling, and dietary supplements, told WebMD.
Much of that research has been done since the agency last considered salt levels in food.
Lawrence Appel, MD, a professor of medicine and epidemiology at Johns Hopkins Medical Institutions, said three studies since 2001 have linked cutting dietary sodium to a reduction in cardiovascular events like heart attack.
The latest, published last April in BMJ, showed that adults who cut their dietary sodium levels reduced their changes of a heart attack or stroke by 30%.
"This is truly a public health epidemic," Appel said of hypertension.
Appel led an Institute of Medicine panel that in 2004 urged adults to limit sodium intake to 2,300 milligrams per day, the amount present in one teaspoon of table salt. But most sodium intake is from processed foods.
Voluntary Cuts in Sodium
Representatives of the food industry said companies have succeeded in voluntarily cutting unnecessary sodium out of their products. They warned that consumers were driven away from products when companies previously experimented with quickly removing salt.
"Improvement in the health of Americans is best achieved through education to modify behaviors ... rather than single policies on individual ingredients," said Robert Earl, senior director of nutrition policy for the Grocery Manufacturers Association -- Food Products Association.
Jacobson said that industry efforts to cut sodium have occurred but that they have been too gradual. The CSPI tracked 71 grocery store products and found that they dropped about 0.5% per year between 1984 and 2004. At that rate, Jacobson said it would take 100 years to cut average sodium intake by 50%.
Several government and private groups, including the American Medical Association, have recommended such a cut take place over the next decade.
"I don't think we have that long to wait," Jacobson said.