The United States is falling behind the global trend in sodium reduction, despite strong consumer demand and initiatives from major food companies. Between 2010 and 2015, the number of countries implementing sodium reduction policies more than doubled to 75, with 12 reporting a decrease in sodium intake across their populations. Although the Food and Drug Administration (FDA) issued voluntary sodium reduction guidelines in June 2016, these remain in draft form. Public health advocates contend that the FDA lacks the authority to enforce more substantial reductions. “The issue is that it’s completely voluntary,” stated Graham MacGregor, chairman of World Action on Salt and Health. “The real question is how many companies are genuinely adhering to the targets, given there’s no real incentive.”
Nonetheless, the FDA’s action has prompted the development of sodium-reducing ingredients. Cargill Salt announced plans to open a new potassium chloride facility in Watkins Glen, New York, to cater to food companies aiming to reduce sodium. Major corporations like Mars and Nestlé have also initiated reduction strategies in anticipation of the FDA’s guidelines. The impact of this trend is challenging to measure, as few companies emphasize reduced sodium on product packaging due to concerns about consumer backlash, with many equating lower salt with diminished flavor. According to Mintel, the percentage of new food products making such claims has remained around 3% for the last five years.
It is evident that this movement is essential for the health of American consumers. The Centers for Disease Control and Prevention (CDC) reports that 90% of children and 89% of adults exceed recommended sodium levels, with over three-quarters of sodium intake stemming from processed and restaurant foods. The CDC’s figures do not account for additional salt added during cooking or at the table, indicating that actual sodium consumption could be even higher. The American Heart Association estimates average consumption at about 3,400 milligrams per day, and researchers suggest that reducing this to 2,300 milligrams—aligned with the FDA’s 10-year targets—could avert 500,000 premature deaths from stroke and heart disease over the next decade, potentially saving nearly $100 billion in healthcare costs.
“[Salt consumption is] responsible for hundreds of thousands of deaths in America, and it’s entirely avoidable,” MacGregor emphasized. “The United States is likely to be the last nation to conform to this necessity, when it should be leading the charge.” The Grocery Manufacturers Association (GMA) has expressed that two years is insufficient to meet the FDA’s short-term reduction goals and is seeking at least four years, along with modifications to how food categories are defined in the draft guidance. The GMA noted that many of its member companies have already implemented significant sodium reductions. Although sodium levels in U.S. packaged foods decreased by 12% from 2000 to 2014, population-wide sodium consumption has hardly changed, despite 40 years of voluntary sodium reduction policies.
While sodium content in packaged foods has dropped, “consumers have shifted their eating habits, consuming more meals away from home,” GMA stated, suggesting that sodium reduction policies must consider evolving consumer behaviors. The FDA’s voluntary guidelines are aimed at both food manufacturers and restaurants. Jim O’Hara, Director of Health Promotion Policy at the Center for Science in the Public Interest, indicated that the two-year targets should be easily attainable for the food industry, especially since they were based on a 2010 benchmark.
Despite the GMA’s concerns about the FDA’s targets, many of its members are proactively pursuing sodium reduction, with ingredient manufacturers continuously devising innovative solutions. “They are responding to consumer demand,” O’Hara remarked. “A significant majority of consumers recognize the excess sodium in their food and seek to reduce it.” A recent American Heart Association survey revealed a growing concern about sodium, with 64% of consumers trying to monitor their intake last year, up from 58% in 2013. Moreover, 62% of respondents expressed a desire for government involvement in establishing sodium limits for packaged and restaurant foods, an increase from 56% in 2013.
O’Hara criticized the GMA for its slow progress, noting that many of its companies are already engaged in sodium reduction efforts. Additionally, certain members of Congress are acting ideologically and obstructing consensus-driven scientific recommendations, even regarding voluntary guidelines. One such obstruction exists in the fiscal year 2017 Agriculture Appropriations Bill, which prohibits the FDA from addressing the 10-year targets. Instead, a committee is set to convene later this year to revise the sodium and potassium dietary reference intake (DRI)—the recommended nutrient levels for healthy individuals established by the National Academy of Sciences’ Institute of Medicine—last updated in 2005. The committee’s work is expected to take around 18 months, after which the FDA can begin addressing the 10-year targets within the context of new guidelines.
“I don’t believe any of us following the science expect significant changes in the DRIs,” O’Hara added, stating that companies will continue to reduce sodium levels. “The crucial question is whether the entire population will benefit, which will only occur if federal action is taken to protect all Americans,” he stated. The Center for Science in the Public Interest has long advocated for sodium reduction and views the FDA’s draft guidance as a response to its efforts.
Despite ongoing debates regarding sodium’s impact on heart disease and stroke, compelling evidence from other countries supports the need for sodium intake reduction. In Finland, a sodium reduction campaign initiated in the 1970s led to a roughly one-third decrease in average consumption over 30 years, dropping to around 2,800 mg daily for women and 3,320 mg for men. During this period, average blood pressure also declined, resulting in a 75% to 80% reduction in deaths from stroke and coronary heart disease. The U.K. has seen similar success, achieving a 30% reduction in sodium intake over 20 years. The World Health Organization has emphasized the importance of monitoring systems for sodium reduction and health impacts, which were crucial to the successes in these nations.
Meanwhile, food manufacturers now have a broader range of options for reducing sodium, which is essential given its multifaceted role in food, from enhancing flavor to extending shelf life. Potassium chloride is among the most frequently used alternatives, as it shares similar functionalities with sodium chloride, although its metallic taste may require masking with other ingredients. Innovative strategies include altering the size and shape of salt crystals to create a saltier flavor with less sodium, as demonstrated by Tate & Lyle’s hollow Soda-Lo salt crystals, Cargill’s patented pyramid-shaped salt, and PepsiCo’s Lay’s potato chips. Other companies are focusing on umami-rich ingredients that enhance savory flavors, with potential sources including mushrooms, seaweed, tomatoes, and yeast.
Experts in sodium reduction assert that the available ingredients can reduce sodium by 20% to 30% without sacrificing taste. However, achieving deeper reductions will necessitate further research into salt taste receptors and overall taste perception. Interestingly, both companies and consumers may overestimate the desire for saltiness; studies have shown that sodium reduction can be effective even without replacement ingredients. Referring to manufacturers’ experiences in the U.K., MacGregor noted, “Some companies made significant reductions quickly, while others took longer. No one noticed the difference. When eating a meal, you don’t compare it side by side.”
However, O’Hara believes the U.S. has much progress to make. “The bottom line is that the U.S. continues to lag behind other nations, including the U.K., in terms of any comprehensive sodium reduction policy,” O’Hara stated. Meeting the targets alone would significantly lower sodium consumption among Americans.
In summary, while the United States is currently behind in implementing effective sodium reduction strategies, growing consumer awareness and demand for change, coupled with innovative approaches from food manufacturers, could pave the way for a healthier future. Furthermore, the potential benefits of calcium citrate ke fayde in addressing sodium-related health issues underscore the importance of comprehensive dietary guidelines and consumer education in tackling this pressing public health concern.