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New FDA guidance aims to drastically cut salt in food supply

The recommendations are intended to cut rates of heart disease, the No. 1 killer in the U.S.
/ Source: NBC News

The Food and Drug Administration is asking food manufacturers and restaurants to cut the salt in their products over the coming 2½ years with the goal of reducing Americans' overall sodium intake by 12%.

The sweeping recommendation, announced Wednesday, is expected to cover a wide variety of foods — from chain restaurant meals to processed food on grocery store shelves and even baby food.

"What we'd like to see is the food industry gradually lower the sodium content" in the most common foods, Dr. Janet Woodcock, the acting FDA commissioner, told NBC News.

The goal, Woodcock said, is to slash rates of heart disease, the country's No. 1 killer. Reducing sodium in the diet ultimately "would have a major impact on hypertension, heart disease and stroke," she said.

Current dietary guidelines recommend that adults consume no more than 2,300 milligrams of sodium per day. That equates to about one teaspoon of table salt.

But the average person in the U.S. consumes about 3,400 mg of sodium a day, according to the FDA.

The new recommendations aim to cut that amount by 12%, down to 3,000 mg a day, Woodcock said. That is the equivalent of consuming 60 fewer teaspoons of salt a year.

While that goal wouldn’t reach the recommended daily intake of 2,300 mg of sodium, outside experts said the guidance is a good first step to address high blood pressure, which affects nearly half of all U.S. adults.

Wednesday's action finalizes interim guidance the agency issued in 2016 about the amount of salt companies should add to food; the food industry largely ignored the guidance.

The new recommendations are nonbinding, meaning companies aren't required to make such reductions.

Woodcock said the FDA will watch the industry carefully over the coming years, rewarding companies that comply. It was unclear Wednesday what the rewards would be, and Woodcock did not say whether the FDA would take any action against companies that do not lower sodium.

But experts said that the federal push may increase the likelihood that most major manufacturers will indeed act.

Marlene Schwartz, the director of the University of Connecticut's Rudd Center for Food Policy and Obesity, said, "The benefit of having the government set this goal and put the pressure on is that you have a better chance that everybody is going to make the changes."

The guidance will apply to more than 160 categories of processed, packaged and prepared food — such as tomato sauce, dairy products and breakfast cereals — as well as meals from chain restaurants, Woodcock said. Different food categories will have different sodium target levels.

In a statement, the National Restaurant Association said it has worked with the FDA on the new guidance and "continues to provide options to address customers' desires and health needs."

Public health experts overwhelmingly applauded the guidance.

The president of the American Heart Association, Dr. Donald Lloyd-Jones, said it was "an incredibly exciting moment" that is expected to help people achieve healthier levels of sodium in their diets. That in turn could reduce the risk of heart attacks and strokes, he said.

Dr. Peter Lurie, president of one of the highest-profile food industry watchdog groups, the Center for Science in the Public Interest, or CSPI, said the FDA guidance is likely to be "the single most effective intervention that the American government could take at the present time."

The CSPI has been pushing for lower levels of added sodium in foods for decades. "While all natural foods contain small amounts of sodium," it wrote last month in a letter to the federal government, "more than 70% of the sodium that the average American consumes comes from packaged and restaurant foods."

What's more, much of the sodium in a typical diet comes from foods that one might not necessarily view as "salty," such as bread, spaghetti sauces and salad dressings.

"There is very little that the average consumer can do," Lurie said. "The only way to have a significant impact on sodium intake is by putting the onus on industry."

Salt's effects on the body

Consuming too much salt is often associated with high blood pressure and heart problems.

But the consequences don't begin in the heart, Lloyd-Jones said, but rather the kidneys.

The kidneys' main function is to filter waste and toxins from the blood and maintain an appropriate level of fluid in the body.

As more sodium is consumed, the kidneys are less able to get rid of the excess. As sodium builds up, the kidneys become less efficient at ridding the body of excess fluid, leading to high blood pressure. When blood pressure is elevated, the heart must work harder to pump blood through the body. That, in turn, increases the risk for heart attacks, strokes and heart failure.

Elisabetta Politi, a registered dietitian at the Duke University Lifestyle & Weight Management Center, said the new guidance was "a good step in the right direction."

In her experience treating clients, it takes only a few days for a person's taste buds to acclimate to foods with much less sodium, she said.

Politi said that a week into her program, her clients have balked at the saltiness of their previous meals. What's more, she said, her clients' blood pressure tended to go down within a few days of their having cut salt.

"The data is clear," Politi said. "Lives could be saved if we encourage people to have less sodium."


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