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FDA Sodium Reduction Effort Long Time Coming

We can hope for meaningful food supply-wide sodium reduction 50 years after the scientific evidence for the need had become convincing. In the meantime, the subtle but devastating effects of high-sodium diets will continue to take the lives of tens of thousands of people and waste billions of dollars annually.
06/01/2016 02:20pm ET | Updated June 2, 2017
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1978 was a big year for change.

The U.S. Senate ratified the treaty transferring sovereignty of the Panama Canal to Panama with Republican Senate Minority Leader Howard Baker supporting the Carter Administration in that effort.

Sony produced the Walkman.

The Dallas Cowboys defeated the Denver Broncos in SuperBowl XII in New Orleans, the first American football championship played in a domed stadium and also played in primetime.

On the other hand, change has come much more slowly in public health than in politics, technology and professional sports. Our organization, the Center for Science in the Public Interest, petitioned the Food and Drug Administration (FDA) in 1978 to set limits on sodium in foods and to require sodium labeling on packaged foods.

Even then, the science was compelling. Excessive consumption of sodium, mainly from salt in foods, leads to hypertension, increasing the risk of fatal heart attacks and strokes. So, today's announcement by the FDA that it is releasing draft guidance for industry of voluntary targets for sodium levels in processed and restaurant foods is a modest step forward, albeit an important one. That is why one should take with more than a grain of salt any sky-is-falling rhetoric from some food manufacturers and a few academic outliers.

The draft guidance will now be open to public comment, and then the agency will have to review those comments before it publishes a final guidance. And remember, it will still be voluntary. Moreover the ultimate targets for industry to achieve are 10 years down the road, meaning 2027 or 2028 depending on how fast the FDA works.

In short, we can hope for meaningful food supply-wide sodium reduction 50 years after the scientific evidence for the need had become convincing. In the meantime, the subtle but devastating effects of high-sodium diets will continue to take the lives of tens of thousands of people and waste billions of dollars annually. And that is tragic, because so much of those costs are preventable.

Over the decades, advocates and public health leaders have had to fight for every inch of progress, whether in the form of sodium disclosures on Nutrition Facts labels, local nutrition standards, sodium-reduction targets for school meals, or the National Salt Reduction Initiative launched by the New York City Department of Health and Mental Hygiene in 2010.

A number of major companies -- Walmart, General Mills, Nestle, to name just a few -- have shown leadership by reducing sodium in their own products. A few, such as Mars and Nestle, have even supported release of the FDA targets. But industry trade associations have repeatedly retreated to the lowest common denominator in this public policy debate as seen in the National Restaurant Association's recent legal challenge to a New York City rule requiring that ultra-high-sodium dishes be labeled with a health warning.

The latest stalling tactic being offered by industry is the claim that FDA action is premature because the establishment of a new recommended sodium consumption level for healthy individuals, called a Dietary Reference Intake, is underway. Never mind that the current sodium DRI only dates from 2005; in other words, it's very current and was affirmed in the 2015-2020 Dietary Guidelines for Americans. Also, the new DRI is likely to be ready by 2020 at the latest, and so any adjustment to the FDA's voluntary regimen could easily be accommodated.

The industry nay-sayers apparently are pinning their DRI hopes on a handful of scientific studies that have been published in recent years that claim sodium reduction can be harmful. Those studies have been widely faulted by cardiovascular-disease experts for their seriously flawed methodologies. More to the point, they have not swayed public health authorities in countries around the world. For instance, Argentina and South Africa mandated sodium reduction targets in 2013 for their countries.

Currently, Americans consume the equivalent of just under two teaspoons of salt a day, and three quarters of that comes from the salt that the food industry puts into processed and restaurant foods. The change we are talking about is roughly half of that added salt. But the payoff in reduced premature deaths and medical costs would be enormous.

Imagine if industry and government action had started reducing sodium 38 years ago!