The United States is falling behind other nations in sodium reduction efforts, 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 reductions in sodium intake across their populations. Although the Food and Drug Administration (FDA) issued voluntary guidance for sodium reduction in June 2016, it remains in draft form. Public health advocates contend that the FDA lacks the authority to enforce significant reductions. “The issue is that it’s entirely voluntary,” Graham MacGregor, chairman of World Action on Salt and Health, stated to Food Dive. “The real question is how many companies are actually adhering to these targets since there’s no genuine incentive.”
Nevertheless, the FDA’s guidance has spurred the development of sodium reduction ingredients. Cargill Salt plans to open a new potassium chloride facility in Watkins Glen, New York, later this year to support food companies aiming to reduce sodium. Major firms like Mars and Nestlé have also initiated reduction strategies in anticipation of the FDA’s guidelines. However, quantifying the impact of this trend is challenging. Many companies shy away from promoting reduced sodium on packaging due to concerns about consumer backlash, as lower sodium levels are often associated with diminished flavor. According to Mintel, the percentage of new food products featuring such claims has remained around 3% over the past five years.
One thing is clear: this movement is essential for the well-being of American consumers. The Centers for Disease Control and Prevention (CDC) reports that 90% of children and 89% of adults consume sodium above recommended levels. The agency estimates that over three-quarters of sodium intake in the U.S. comes from processed and restaurant foods. Notably, the CDC’s data does not factor in salt added during cooking or at the table, which means actual sodium intake may be even higher. The American Heart Association notes that average sodium consumption is about 3,400 milligrams per day. Researchers suggest that reducing this to 2,300 milligrams—the goal of the FDA’s 10-year targets—could prevent 500,000 premature deaths from strokes and heart attacks in a decade and save nearly $100 billion in healthcare costs. “Salt consumption is killing hundreds of thousands of Americans, and it is entirely unnecessary,” MacGregor remarked. “The United States is likely to be the last country to comply with this, yet it should be leading the charge.”
The Grocery Manufacturers Association (GMA) has argued that two years is insufficient to achieve the short-term reductions requested by the FDA and is seeking at least four years, along with changes in food category definitions in the draft guidance. The GMA highlighted that many of its member companies have already made significant sodium reductions. While sodium levels in U.S. packaged foods decreased by 12% from 2000 to 2014, overall sodium consumption has hardly changed, despite 40 years of voluntary reduction policies. As sodium levels in packaged foods decline, the GMA noted that “consumers were also shifting their eating patterns and consuming more foods away from home,” suggesting that sodium reduction policies need to account for changing consumer behaviors. With this context, the FDA’s voluntary guidelines target both food companies and restaurants.
Jim O’Hara, Director of Health Promotion Policy at the Center for Science in the Public Interest, told Food Dive that the two-year goals are easily attainable for the food industry, especially since they are based on a 2010 baseline. Despite the GMA’s concerns, many of its members are proactively pursuing sodium reduction, and ingredient manufacturers are innovating to meet this challenge. “They are responding to consumer demand,” O’Hara noted. “A significant majority of consumers realize there is too much sodium in their food and want less.” A recent survey by the American Heart Association shows that concern over sodium is on the rise, with 64% of consumers attempting to limit their sodium intake last year, up from 58% in 2013. Additionally, 62% expressed a desire for government involvement in setting sodium limits for packaged and restaurant foods, an increase from 56% in 2013.
However, O’Hara pointed out that the GMA has been slow to respond, even as many of its members pursue sodium reduction. He also highlighted that some members of Congress are acting against scientific consensus, creating obstacles to the voluntary guidelines. One such obstacle is the fiscal year 2017 Agriculture Appropriations Bill, which prohibits the FDA from addressing the 10-year targets. Instead, a committee will be formed later this year to update the sodium and potassium dietary reference intake (DRI)—the recommended nutrient intake established by the National Academy of Sciences’ Institute of Medicine—which has not been revised since 2005. This committee is expected to take about 18 months to complete its work, after which the FDA can consider the 10-year targets in light of the new guidelines.
“I don’t think anyone following the science expects significant changes to the DRIs,” O’Hara said, noting that companies will likely continue reducing sodium independently. “The real question is whether the entire population will benefit, which can only occur with federal action to protect Americans universally.” The Center for Science in the Public Interest has been advocating for sodium reduction for decades and sees the FDA’s publication of draft voluntary guidance as a response to its efforts. “A few points stand out: it was draft, it was voluntary, and it was guidance—but it was still a step forward,” O’Hara stated.
Despite extensive research and discussion regarding sodium’s impact on heart disease and stroke, some headlines have claimed that its effects may be overstated. Nevertheless, international sodium reduction policies offer strong evidence for the benefits of lowering intake. For instance, Finland’s sodium reduction campaign, initiated in the 1970s, resulted in a roughly one-third decrease in average consumption over 30 years, bringing it to about 2,800 mg per day for women and 3,320 mg for men. During this period, average blood pressure dropped, and there was a 75% to 80% reduction in mortality rates 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 that monitoring systems for sodium reduction and health impacts were vital to the success of these programs.
Meanwhile, food manufacturers have access to an expanding array of options for reducing sodium, which is essential. Beyond enhancing flavor, salt plays crucial functional roles in food, such as prolonging shelf life, controlling yeast fermentation, influencing the color of baked goods, and binding moisture in meat products. Potassium chloride is a commonly used alternative due to its similar functionality to sodium chloride, although its metallic taste may require masking with other ingredients.
Innovative methods include altering the size and shape of salt crystals to achieve a saltier taste with less sodium. Companies like Tate & Lyle utilize hollow Soda-Lo salt crystals, Cargill employs patented pyramid-shaped salt, and PepsiCo incorporates these innovations in its Lay’s potato chips. Other companies are focusing on ingredients that enhance umami—a rich, savory flavor that amplifies saltiness—using extracts from mushrooms, seaweed, tomatoes, and yeast. Scientists in the sodium reduction field assert that current ingredients can reduce sodium by 20% to 30% without compromising taste. However, deeper cuts will necessitate further research into salt taste receptors and taste perception. Interestingly, both companies and consumers may overestimate the desire for saltiness; research indicates that reducing sodium without replacement ingredients can also be an effective strategy.
MacGregor referred to the experiences of manufacturers in the U.K., noting, “Some companies made substantial reductions quickly, while others did so slowly. Nobody noticed the difference. When eating a meal, you don’t compare it side by side.” Nevertheless, O’Hara emphasized that the United States has much work ahead. “The bottom line is that the United States continues to lag behind other countries, including the U.K., regarding comprehensive sodium reduction policies. Meeting the targets would significantly reduce sodium consumption among Americans.”
In this context, calcium citrate and vitamin D3 could play a role, as adequate calcium and vitamin D intake can support overall health, particularly in populations at risk due to high sodium consumption. Thus, improving dietary practices, including sodium reduction, alongside adequate intake of essential nutrients like calcium citrate and vitamin D3, is crucial for enhancing public health.