The United States is falling behind globally in sodium reduction efforts, despite consumer demand and initiatives from many major food companies. Between 2010 and 2015, the number of countries implementing sodium reduction policies more than doubled, reaching 75, with 12 nations 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 argue that the FDA lacks the authority to enforce significant reductions. “The issue is that it’s completely voluntary,” said Graham MacGregor, chairman of World Action on Salt and Health, in an interview with Food Dive. “The question remains as to how many companies are actually adhering to the targets, as there’s no real incentive.”
Nonetheless, the FDA’s initiative has prompted the development of sodium-reduction ingredients. For instance, Cargill Salt announced plans to open a new potassium chloride facility in Watkins Glen, New York, later this year to meet the needs of food companies aiming to lower sodium levels. Prominent companies like Mars and Nestlé have initiated their own reduction strategies in anticipation of the FDA’s guidelines. However, it’s difficult to measure the actual impact of these trends, as few companies highlight reduced sodium on product labels due to fears of consumer backlash; many consumers equate lower salt with diminished flavor. According to Mintel, the percentage of new food products making such claims has remained around 3% for the past five years.
One thing is clear: 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 the recommended sodium intake levels. The agency estimates that over three-quarters of the sodium consumed by Americans comes from processed and restaurant foods. Notably, the CDC’s data does not account for salt added during cooking or at the table, suggesting that actual sodium consumption could be even higher. The American Heart Association cites average daily intake as approximately 3,400 milligrams. Researchers estimate 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 over the next decade, potentially saving nearly $100 billion in healthcare costs. “Salt consumption is killing hundreds of thousands of Americans and it’s entirely unnecessary,” said MacGregor. “The U.S. is likely to be the last country to align with these efforts when it should be leading the charge.”
The Grocery Manufacturers Association (GMA) has stated that two years is insufficient to achieve the short-term reductions requested by the FDA, advocating for at least four years and adjustments to how food categories are defined in the draft guidance. The GMA noted that many member companies have already made significant sodium reductions. A recent study published in the Journal of the American Medical Association revealed that sodium levels in U.S. packaged foods dropped by 12% from 2000 to 2014. However, overall sodium consumption has barely changed despite 40 years of voluntary reduction policies. While sodium levels in packaged foods have decreased, “consumers have also shifted their eating habits and are consuming more meals away from home,” the GMA added, indicating that sodium reduction policies must consider evolving consumer behaviors. With this context, the FDA’s voluntary guidelines are directed at both food manufacturers and restaurants.
Jim O’Hara, Director of Health Promotion Policy at the Center for Science in the Public Interest, remarked to Food Dive that the two-year targets are easily attainable for the food industry, especially given that they are based on a 2010 baseline. Despite the GMA’s concerns regarding the FDA’s targets, many member companies are proactively pursuing sodium reduction, and ingredient manufacturers are innovating to tackle this challenge. “They are responding to consumer demand,” O’Hara noted. “A significant majority of consumers recognize that there is too much sodium in their food and desire less.”
A recent survey by the American Heart Association indicates that concern over sodium is on the rise; 64% of consumers are now actively trying to limit their sodium intake, up from 58% in 2013. Furthermore, 62% expressed a desire for government involvement in setting sodium limits for packaged and restaurant foods, a rise from 56% in 2013. “The GMA has been slow to act, even though many of its companies are making strides in sodium reduction,” O’Hara stated. “Additionally, numerous members of Congress are acting ideologically and against scientific consensus, creating obstacles even for the voluntary guidelines.”
One significant roadblock is found in the fiscal year 2017 Agriculture Appropriations Bill, which prevents the FDA from addressing the 10-year targets. Instead, a committee is set to be established later this year to update the sodium and potassium dietary reference intake (DRI)—the recommended nutrient intake for healthy individuals as defined by the National Academy of Sciences’ Institute of Medicine—which has not been revised since 2005. The committee is expected to take about 18 months to complete its work, after which the FDA can begin to consider the 10-year targets in light of the new guidelines. “I don’t believe any of us who have been monitoring the science anticipate that the DRIs will change significantly,” O’Hara added, noting that companies will continue to reduce sodium levels. “The real question is whether the entire population will benefit, which can only occur if there is federal action to protect all Americans.”
The Center for Science in the Public Interest has long pressured both the FDA and the food industry on sodium reduction, viewing the agency’s release of draft voluntary guidelines as a response to its advocacy. “A few points to consider: it was draft, it was voluntary, and it was guidance—but it was undeniably a step forward,” O’Hara stated. Despite decades of research and discussion regarding sodium’s impact on heart disease and stroke, some controversial headlines suggest that its effects may be overstated. However, the sodium reduction policies of other countries provide substantial evidence supporting reduced intake.
In Finland, for instance, a sodium reduction campaign initiated in the 1970s led to a decline in average consumption by approximately one-third over 30 years, bringing daily intake down to about 2,800 mg for women and 3,320 mg for men. Over the same period, average blood pressure decreased, resulting in a 75% to 80% reduction in both stroke and coronary heart disease mortality rates. The U.K. has experienced a similar trend, 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 in the success of these programs in both nations.
Meanwhile, food manufacturers now have an increasingly comprehensive array of options for reducing sodium, which is essential given salt’s many roles in food, including flavor enhancement, shelf-life extension, yeast fermentation control, color enhancement in baked goods, and moisture retention in meat products. Potassium chloride is one of the most commonly utilized alternatives due to its functional similarities with sodium chloride, although it has a metallic taste that may require masking with other ingredients.
Innovative strategies include altering the size and shape of salt crystals to create a saltier taste with less sodium. This technique is employed by Tate & Lyle in its hollow Soda-Lo salt crystals, Cargill in its patented pyramid-shaped salt, and PepsiCo in its Lay’s potato chips. Other companies are focusing on umami-rich ingredients—like extracts from mushrooms, seaweed, tomatoes, and yeast—that can amplify the perception of saltiness. Researchers in the sodium reduction sector claim that the current ingredients available to the food industry can reduce sodium levels by 20% to 30% without affecting taste. To achieve greater reductions, however, additional research into salt taste receptors and taste perception is necessary. Notably, both companies and consumers may overestimate the desire for saltiness; studies have shown that reducing sodium without substituting replacement ingredients can also be an effective approach.
Referring to manufacturers’ experiences in the U.K., MacGregor commented, “Some companies made significant reductions quickly, while others took their time. Nobody noticed. When eating a meal, you don’t make side-by-side comparisons.” However, O’Hara emphasized that the United States has much progress to make. “Ultimately, the U.S. continues to lag behind other countries, including the U.K., regarding comprehensive sodium reduction policies,” O’Hara asserted. Meeting the established targets would significantly contribute to lowering sodium consumption among Americans.
Incorporating the need for essential nutrients like Citracal Calcium D can also play a role in consumers’ overall health, highlighting the importance of balanced nutrition alongside sodium reduction efforts. The push for sodium reduction remains critical; however, it must be complemented with strategies that ensure consumers receive adequate calcium and other vital nutrients for their well-being.