Food Industry's Sodium Reduction Efforts Have Failed

Scientists Call for Mandatory, Phased-In Limits on Salt in Food to Prevent Cardiovascular Disease


Food manufacturers did not make much progress between 2005 and 2011 in reducing sodium levels in packaged and restaurant foods, according to a new investigation published online today in the journal JAMA Internal Medicine. Despite industry pledges to cut back, the average sodium content in 402 packaged foods tracked between 2005 and 2011 by the Center for Science in the Public Interest declined by just 3.5 percent. And even though public health officials have been ringing alarm bills about excess sodium's role in promoting high blood pressure, stroke, and heart disease, chain restaurants actually increased sodium slightly in the 78 items tracked by an average of 2.6 percent.

The authors say that voluntary action by the food industry to reduce sodium has failed, and that strong action on the part of the Food and Drug Administration is required to reduce the sodium content of packaged and restaurant foods. Such limits could be achieved gradually over a ten-year period, according to the paper. Its authors are CSPI executive director Michael F. Jacobson, professor of preventive medicine Stephen Havas of the Northwestern University Feinberg School of Medicine, and biostatistician Robert McCarter of George Washington University and Children's National Medical Center. CSPI collected data from Nutrition Facts labels for almost 500 food products in 2005, 2008, and again in 2011.

"The strategy of relying on the food industry to voluntarily reduce sodium has proven to be a public health disaster," said Jacobson. "Inaction on the part of industry and the federal government is condemning too many Americans to entirely preventable heart attacks, strokes, and deaths each year."

"The current high levels of sodium in packaged and restaurant foods, if not reduced, will likely cause at least one million deaths and $100 billion in health-care costs in the coming decade," Havas said. "Action by the FDA requiring the food industry to lower sodium in our food supply is long overdue and should begin without further delay. The Obama administration should take action forthwith."

The average sodium in the 12 varieties of barbecue sauce tracked by CSPI increased by 6.3 percent, the average sodium in 11 varieties of Caesar salad dressing increased by 3.7 percent, and the average sodium in 7 varieties of 100 percent whole wheat bread increased by 3.6 percent. On the brighter side, the categories of fresh or frozen pork, canned diced tomatoes, canned white tuna, vegetable soup, and sliced turkey breast all saw average reductions in sodium of more than 20 percent.

The federal government, the American Medical Association, American Heart Association, American Public Health Association, and World Health Organization have all called for steep reductions in sodium consumption. In 1978 and again in 2005, CSPI petitioned the Food and Drug Administration to set reasonable limits on the salt content of processed foods. A report of the Institute of Medicine backed mandatory limits on sodium in 2010, stating bluntly that four decades of public education and voluntary sodium reduction efforts failed to make a dent in Americans' intakes. Indeed, Americans are consuming more sodium now than 40 years ago.

Researchers estimate that current per-capita sodium consumption is about 3,300 milligrams per day—but perhaps as high as 3,800 mg per day when adjusted for underestimating food consumption and salt added during cooking and at the table. Most of the population—a group comprised of African Americans, middle-aged or older people of any ethnicity, and people with high blood pressure, diabetes, or kidney disease—are advised to limit their consumption to 1,500 mg of sodium per day. The American Heart Association recommends that limit for all people aged two and over. It's almost impossible for Americans to restrict themselves to that amount without large changes on the part of the food industry, the scientists say.

CSPI found that sodium levels varied widely among brands of similar products. One brand of tomato paste had more than five times as much sodium as the brand with the least, and ounce for ounce, McDonald's Quarter Pounder with Cheese had 34 percent more sodium than Burger King's similar Original Whopper with Cheese, for instance. That suggests that companies at the higher end in sodium could easily reduce levels and still have highly marketable foods.

While the sample of 480 foods is broadly representative of the food supply, it is still a small percentage of the tens of thousands of foods in grocery stores and restaurants, the authors caution. And since 2011, most large companies have begun lowering sodium levels further, prompted in part by new research and development, as well as the National Salt Reduction Initiative led by New York City. McDonald’s, Taco Bell, Kraft, and Pepperidge Farm all claim reductions of more than 10 percent in recent years, and General Mills and ConAgra have pledged to reduce sodium by 15 percent, and Walmart by 25 percent, by 2015.

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