The United States is falling behind other nations in sodium reduction efforts, despite significant consumer demand and initiatives from numerous major food corporations. Between 2010 and 2015, the number of countries implementing sodium reduction policies more than doubled, reaching 75, with 12 reporting reductions in sodium intake across their populations. Although the Food and Drug Administration (FDA) issued voluntary sodium reduction guidance in June 2016, it remains in draft form. Public health advocates contend that the FDA lacks the authority to enforce substantial reductions, with Graham MacGregor, chairman of World Action on Salt and Health, stating, “The problem is that it’s entirely voluntary. The question is how many companies are actually meeting the targets since there’s no real incentive.”
Nonetheless, the FDA’s actions have sparked the development of sodium reduction ingredients. Cargill Salt plans to open a new potassium chloride facility in Watkins Glen, New York, in response to the food industry’s push to lower sodium levels. Major companies like Mars and Nestlé have also initiated reduction plans in anticipation of the FDA’s guidelines. However, quantifying the impact of this movement is challenging. Many companies hesitate to advertise reduced sodium on packaging due to concerns about consumer perceptions, as lower salt levels are often linked to diminished flavor. According to Mintel, only about 3% of new food products have highlighted reduced sodium on their labels over the past five years.
One thing is clear: this movement is crucial for the health of American consumers. Data from the Centers for Disease Control and Prevention (CDC) reveals that 90% of children and 89% of adults exceed recommended sodium intake levels. The agency estimates that more than three-quarters of the sodium consumed by Americans comes from processed and restaurant foods. Notably, this data does not account for salt added during cooking or at the table, suggesting that actual sodium intake could be even higher. The average consumption is approximately 3,400 milligrams per day, as reported by the American Heart Association. Researchers estimate that reducing intake to 2,300 milligrams—aligned with the FDA’s 10-year targets—could prevent around 500,000 premature deaths from stroke and heart attack over the next decade and save nearly $100 billion in healthcare costs.
MacGregor emphasized, “[Salt consumption is] killing hundreds of thousands of Americans and it’s entirely unnecessary. The United States is likely to be the last country to adopt these measures, when it should be a leader.” The Grocery Manufacturers Association (GMA) has pointed out that two years may not be sufficient to achieve the short-term reductions requested by the FDA, advocating for at least four years and adjustments to food category definitions in the draft guidance. They noted that many member companies have already made significant sodium reductions. A recent study published in the Journal of the American Medical Association indicated that sodium levels in U.S. packaged foods decreased by 12% from 2000 to 2014, yet overall population sodium intake has changed little despite decades of voluntary reduction initiatives.
While sodium levels in packaged foods have decreased, the GMA noted that “consumers were also shifting their eating patterns and consuming more foods away from home.” This indicates that sodium reduction policies must account for evolving consumer behaviors. With this understanding, the FDA’s voluntary guidelines focus on both food manufacturers and restaurants. Jim O’Hara, Director of Health Promotion Policy at the Center for Science in the Public Interest, remarked that the two-year targets are easily attainable for the food industry, given they are based on a 2010 baseline.
Despite the GMA’s concerns regarding the FDA’s targets, many of its members are proactively pursuing sodium reduction, and ingredient manufacturers are continuously innovating to meet this challenge. O’Hara noted, “They are responding to consumer demand. A significant majority of consumers recognize that their food contains excessive sodium and are seeking less.” A recent American Heart Association survey revealed that concern over sodium is on the rise, with 64% of consumers attempting to monitor their sodium intake last year, an increase from 58% in 2013. Additionally, 62% expressed a desire for government involvement in setting sodium limits for packaged and restaurant foods, up from 56% in 2013.
O’Hara criticized the GMA for its slow progress, stating, “The GMA has dragged its feet even though many of its companies are reducing sodium.” He also noted that some members of Congress are ideologically opposed to scientific consensus, creating obstacles even for voluntary guidelines. An example of such an obstacle is the fiscal year 2017 Agriculture Appropriations Bill, which restricts the FDA’s ability to implement the 10-year targets. Instead, a committee is to be established later this year to update the sodium and potassium dietary reference intake (DRI)—the recommended nutrient amounts for healthy individuals as determined by the National Academy of Sciences’ Institute of Medicine—which have not been revised since 2005. This committee is expected to take about 18 months to complete its work, after which the FDA can reassess 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 commented, adding that companies will continue to reduce sodium levels. The crucial question remains whether the entire population will benefit, which can only happen with federal action to safeguard the health of all Americans. The Center for Science in the Public Interest has been advocating for sodium reduction for decades, viewing the FDA’s draft voluntary guidance as a response to its ongoing efforts.
Despite extensive research and debate over sodium’s impact on heart disease and stroke, some media headlines have suggested that the dangers may be overstated. However, successful sodium reduction policies in other countries strongly support lowering intake levels. In Finland, for instance, a sodium reduction campaign initiated in the 1970s resulted in average consumption dropping by about one-third over 30 years to approximately 2,800 mg per day for women and 3,320 mg for men. Concurrently, average blood pressure fell, leading to a 75% to 80% reduction in mortality from both stroke and coronary heart disease. The U.K. experienced a similar trend, achieving a 30% reduction in sodium intake over 20 years. The World Health Organization has emphasized that monitoring systems for sodium reduction and health outcomes were vital to the success of these programs.
Meanwhile, food manufacturers have access to an increasingly comprehensive set of options for reducing sodium, which is essential. Beyond enhancing flavor, salt plays crucial functional roles in food, such as extending shelf life, controlling yeast fermentation, affecting the color of baked goods, and binding water in meat products. Potassium chloride is one of the most widely used alternatives due to its functional similarity to sodium chloride, although it possesses a metallic taste that may require masking with other ingredients.
Innovative strategies include altering the size and shape of salt crystals to deliver a saltier taste with less sodium. Companies like Tate & Lyle utilize hollow Soda-Lo salt crystals, Cargill employs pyramid-shaped Alberger-brand salt, and PepsiCo incorporates this technique in its Lay’s potato chips. Other companies are exploring ingredients that enhance umami flavor, which intensifies the perception of saltiness. Potential umami-rich ingredients include extracts from mushrooms, seaweed, tomatoes, and yeast.
Experts in sodium reduction assert that the existing ingredients available to the food industry can effectively lower sodium content by 20% to 30% without compromising taste. To achieve more substantial reductions, however, further research into salt taste receptors and taste perception is necessary. Additionally, companies and consumers might overestimate the desire for saltiness; studies have shown that reducing sodium without any replacements can also be an effective strategy. Reflecting on the experiences of manufacturers in the U.K., MacGregor noted, “Some companies made substantial reductions quickly, while others proceeded more slowly. Nobody noticed. When you are eating a meal, you don’t compare it side by side.”
However, O’Hara emphasized that the U.S. still has much progress to make. “The bottom line is that the United States continues to lag behind other countries, including the U.K., in terms of comprehensive sodium reduction policies. Meeting the targets would significantly contribute to reducing sodium consumption among Americans.”