'Forgotten Killer' Salt Kills 150,000 a Year, Says CSPI Report

Too much salt in the diet is boosting Americans’ blood pressure and is prematurely killing roughly 150,000 people each year, according to a new report issued today by the nonprofit Center for Science in the Public Interest (CSPI). Despite the pleas of health experts to cut back, salt consumption has drifted upward over the past 30 years to the point where Americans are now consuming about 4,000 milligrams of sodium per day—about twice the recommended amount. CSPI is filing a lawsuit against the Food and Drug Administration (FDA) in federal court to compel the agency to classify salt as a food additive. Presently, FDA classifies salt as GRAS, or Generally Recognized as Safe, which means that it is not closely regulated.

CSPI is also urgently recommending that consumers choose lower-sodium foods, and is proposing that the FDA phase in reasonable limits on the salt content of foods that provide the most salt to the diet.

“Americans spend more than $15 billion each year on drugs to treat hypertension, yet the government spends almost nothing to reduce salt consumption,” said CSPI executive director Michael F. Jacobson. “And taking its cue from indifferent regulatory agencies, the food industry has done little to lower sodium levels in processed and restaurant foods.”

The 2005 Dietary Guidelines for Americans recommends that young adults consume less than 2,300 mg of sodium per day. People with hypertension, African Americans, and middle-aged and elderly people—almost half the population—are advised to consume no more than 1,500 mg per day. Nevertheless, sodium intake has increased steadily since the 1970s.

“The medical community has reached a consensus that diets high in sodium are a major cause of high blood pressure as well as pre-hypertension, or blood pressure just short of high blood pressure,” said Dr. Stephen Havas of the University of Maryland School of Medicine and a leading sodium expert. Havas also represents the American Public Health Association on the National Institutes of Health’s advisory committee on the prevention and control of hypertension. “High blood pressure and pre-hypertension significantly increase the risk of having a heart attack or stroke. Today roughly 65 million Americans have high blood pressure and another 45 million have pre-hypertension. Unfortunately, a lifetime of eating too much salt is putting Americans’ lives in jeopardy.”

Processed foods and restaurant foods contribute almost 80 percent of sodium to the diet, according to the 32-page report. Thousands of processed foods, such as frozen dinners and soups, contain between 500 and 1,000 mg of sodium per serving. Some Swanson Hungry Man XXL dinners contain more than 3,400 mg of sodium per package, and one, the Roasted Carved Turkey, contains 5,410 mg. A package of Maruchan Instant Lunch ramen noodles with vegetables contains 1,400. And although a few companies offer reduced-sodium product lines (most notably ConAgra’s Healthy Choice products), CSPI says those are the exception rather than the rule.

Among different brands of similar foods, CSPI found wide variances in sodium content. A two-tablespoon serving of Ken’s Light Caesar salad dressing has 600 mg of sodium, while the same amount of a similar product, Morgan’s Caesar, has 170. Progresso Vegetable soup has 940 mg of sodium per serving, while Healthy Choice Garden Vegetable has 480 mg. Ragu Traditional Old World Style pasta sauce has 756 mg of sodium per serving while Classico Tomato and Basil has 310 mg. Another pasta sauce, Enrico’s All Natural No-salt-added, has just 25 mg per serving.

Unlike packaged foods available in grocery stores, restaurant foods are not yet required to provide any nutrition labeling, and no major restaurant chain discloses sodium content on menus. Plenty of restaurant meals, including many Chinese entrées, deli sandwiches, and breakfasts, provide more than a whole day’s worth of sodium. Denny’s Lumberjack Slam breakfast has 4,460 mg of sodium and a typical order of General Tso’s chicken with rice has 3,150 mg, according to the report.

The bulk of Americans’ salt intake is not coming from the salt shaker. Only about 11 percent percent of sodium in the diet comes from salt added while eating or cooking.

“The high sodium content of the American diet—mostly from processed foods—represents an enormous health problem,” said Dr. Claude Lenfant, president of the World Hypertension League. “If we could reduce the sodium in processed and restaurant foods by half, we could save about 150,000 lives per year.”

CSPI first sued the FDA over salt in 1983, when it asked a federal district court to direct the FDA to declare sodium a food additive—a declaration that would have given the agency the authority to set limits for salt in foods. The FDA, though, had just begun requiring sodium labeling on some packaged foods and convinced the court that that measure should be given a chance to work. FDA told the court “if there is no substantial reduction in the sodium content of processed foods … the FDA will consider additional regulatory actions, including proposing a change in salt’s GRAS status.”

CSPI’s new lawsuit, filed in the United States Court of Appeals for the District of Columbia, contends that since salt content in foods hasn’t declined, the court should order the agency to finalize a decision on salt’s regulatory status.

“There is no way the FDA can look at the science and say with a straight face that salt is ‘generally recognized as safe,’” Jacobson said. “In fact, salt is generally recognized as unsafe, because it is a major cause of heart attacks and stroke. The federal government should require food manufacturers to gradually lower their sodium levels.”

In addition to setting limits on sodium, CSPI also recommends that government:

• require front-label symbols to identify high-sodium foods
• require chain restaurants to disclose sodium (and other nutrients) on menus and in brochures
• prod food manufacturers to use less salt
• establish within FDA a Division of Sodium Reduction
• mount other initiatives to prevent cardiovascular disease, including major campaigns to promote diets rich in vegetables, beans, fruit, nuts, and other healthful foods

CSPI points out that several foreign governments employ some of those strategies. Most dramatically, the British government is waging a vigorous campaign to reduce sodium consumption by one-third. As a result, Heinz has reduced sodium in baked beans by 30 percent and McDonald’s has lowered the sodium content of a typical Happy Meal by 20 percent. While Kraft has lowered the sodium of the Lunchables sold in Great Britain, the sodium in American Lunchables remains unchanged.

“When high-salt diets are turning so many Americans’ hearts into ticking time bombs, American health policymakers are acting more like Keystone Kops than the bomb squad,” Jacobson said.

CSPI says that the best way for consumers to cut back on salt is to eat more fresh fruits and vegetables (which are practically sodium-free) and fewer processed foods and restaurant meals.

Note: Salt: The Forgotten Killer is available for free at www.cspinet.org/salt or by sending $8 per copy to CSPI, 1220 L St., NW, Washington, DC 20005.