The US Food and Drug Administration (FDA) held its first public hearing on limiting the amount of salt in processed food, yesterday, 29th November, at agency premises in College Park, Maryland.

The non profit nutrition watchdog, the Center for Science in the Public Interest (CSPI) and other public health bodies and pressure groups urged the FDA to bring in restrictions on the amount of salt and sodium in processed foods, arguing that to do so would save thousands of lives every year and help Americans avoid high blood pressure, strokes, heart disease and kidney failure.

Halving the amount of salt added in the American diet could reduce deaths in the US by 150,000 a year, said the American Medical Association (AMA), who also testified at the hearing.

The CSPI has been lobbying the FDA on this issue for nearly 30 years. It has filed petitions and even brought lawsuits against the agency, the second of which was filed in 2005, where it accused the FDA of “not making good on its Reagan-era promises to press food companies to voluntarily reduce salt content in foods”.

Both the CSPI, the AMA and other advocates of public health urged the FDA to take immediate action to reduce the excessive amount of salt in food. They want the FDA to set strict limits on how much salt manufacturers are allowed to put in processed food and to educate the public about the advantages of a low sodium diet.

Executive director of the CSPI, Michael F Jacobson, said that:

“While the FDA has historically declined to challenge companies to lower high sodium levels, it is increasingly hard for FDA officials to ignore the calls to action made in recent years by the medical community.”

Dr Stephen Havas, AMA Vice President for Science, Quality, and Public Health, said the number of people who die because they eat too much salt represents a “huge toll”, and suggested that many people don’t realize how much salt is in their food:

“Americans don’t consume large amounts of salt because they request it, but often do so unknowingly because manufacturers and restaurants put it in food,” said Havas.

He said the number of deaths per year attributed to excess salt was:

“The equivalent of a jumbo jet with more than 400 passengers crashing every day of the year, year after year.”

The AMA estimate that most Americans consume two to three times the amount of sodium that is considered healthy, with an estimated 75 to 80 per cent of it coming from processed and restaurant food.

“The FDA has an opportunity to inform the public of the hazards of salt through better labeling and provide increased incentives for the industry to reduce the amount of salt added to food,” said Havas.

According to the CSPI, although the American dietary guidelines recommend a daily limit of 2,300 milligrams of sodium a day, with half of Americans advised to consume even less, more like 1,500 mg a day (these are African Americans, the elderly and people with high blood pressure), the average American sodium intake is around 4,000 mg a day, nearly double the recommended maximum.

The CSPI also said that “very little sodium actually comes from the salt shaker or home cooking”, and according to one small study they cited, 77 per cent of it comes from processed and restaurant food, agreeing with the AMA. The CSPI’s own analysis is that many dishes consumed in restaurants supply one or two days’ worth of sodium intake in a single dish.

Examples of restaurant and processed food dishes containing one or more days’ worth of recommdend intake of sodium cited by the CSPI included:

  • Marie Callender’s Classic One Dish Chicken Teriyaki (2,200 mg, nearly the total recommended daily amount).
  • An order of beef and cheese nachos with sour cream and guacamole (2,430 mg, the same as the total recommended daily amount).
  • A typical Reuben sandwich (3,270 mg, one and half times recommended daily amount).
  • Denny’s Lumberjack Slam Breakfast (4,460 mg, nearly twice recommended daily amount).
  • Swanson’s Hungry Man XXL Roasted Carved Turkey (5,410 mg, over twice recommended daily amount).

There are many other ways that salt creeps into the daily American diet often without consumers realising it. For example, foods thought not to be particularly salty actually contain high amounts of salt, said the CSPI. They gave further examples such as salty bread and cheese, which contribute 10.7 and 5.5 per cent of daily sodium intake respectively.

Giving another example of how the public may be unaware of where their salt intake comes from, the CSPI cited McDonald’s meals. Most people probably think the French fries will have the largest amount of salt, but in fact, it is the burgers. A large order of fries contains about 330 mg of sodium, whereas a small burger has 520 mg, they said.

The CSPI gave other examples of wide variations in sodium content among different food brands, and they also pointed to international comparisons of the same food. In the UK and Finland, where salt regulation has been a top public health priority, manufacturers have responded. In the UK for example, an order of McDonald’s Chicken McNuggets has only half the amount of sodium of the US version. Kellogg’s Special K cereal has 58 per cent more sodium in the US version than in the UK version.

Under the current system, the FDA approves labelling such as “low sodium” to inform the public about salt.

The health groups want the FDA to strengthen labelling, and change salt’s current status as “generally recognized as safe”, so it is controlled as a food additive. The AMA for instance wants labelling to appear at the front of packaging, and for the FDA to impose stricter limits on claims about “low sodium” content. More incentives are needed to make manufacturers respond said the AMA.

Jacobson said the FDA should change salt’s status from generally recognized as safe to “generally recognized as dangerous”.

According to a report in Reuters, the Grocery Manufacturer’s Association (GMA), also present at the hearing, did not agree. They want to keep the current system, and said people would find food too bland if manufacturers were forced to cut salt. They also said the research was not sufficiently rigorous on the health risks. A senior policy director at the Grocery Manufacturers of America, a trade group for the food industry, said that salt had been used in food “since antiquity”.

Other food manufacturing groups said they might support some limited changes.

Click here for Center for Science in the Public Interest (CSPI).

Click here for American Medical Association (AMA).

Click here for Grocery Manufacturers Association (GMA).

Written by: Catharine Paddock