The United States is falling behind other nations in sodium reduction efforts, despite significant consumer demand and initiatives from major food corporations. Between 2010 and 2015, the number of countries implementing sodium reduction policies more than doubled, reaching 75, with 12 of these nations reporting reductions in overall sodium intake. Although the Food and Drug Administration (FDA) issued voluntary sodium reduction guidelines in June 2016, these guidelines remain in draft form. Public health advocates argue that the FDA lacks the authority to enforce stricter 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 adhering to the targets because there’s no real incentive.”
Nonetheless, the FDA’s actions have catalyzed the development of sodium reduction ingredients. Cargill Salt has announced plans to open a new potassium chloride facility in Watkins Glen, New York, later this year, in response to food companies seeking to lower sodium levels. Major brands like Mars and Nestlé have also initiated reduction programs in anticipation of forthcoming FDA guidelines. However, quantifying the impact of this trend is challenging, as many companies avoid highlighting reduced sodium on product labels due to concerns about consumer backlash, as lower salt levels are often linked to diminished flavor. Mintel reports that the proportion of new food products advertising reduced sodium has remained around 3% over the last five years.
This movement is essential for improving the health of American consumers. According to the Centers for Disease Control and Prevention (CDC), 90% of children and 89% of adults consume sodium levels exceeding recommendations. The CDC estimates that over three-quarters of the sodium in American diets comes from processed and restaurant foods. Notably, these figures do not account for salt added during cooking or at the table, suggesting that actual sodium intake may be even higher. The American Heart Association cites average consumption at approximately 3,400 milligrams per day. Researchers estimate that reducing this to 2,300 milligrams, which aligns with the FDA’s 10-year targets, could prevent 500,000 premature deaths from strokes and heart attacks over a decade, potentially saving nearly $100 billion in healthcare costs. “Salt consumption is killing hundreds of thousands of Americans, and it’s entirely unnecessary,” MacGregor emphasized. “The United States is likely to be the last country to align with sodium reduction efforts when it should be leading the charge.”
The Grocery Manufacturers Association (GMA) argues that two years is insufficient time to meet the FDA’s short-term sodium reduction goals and has requested a minimum of four years, along with revisions to how food categories are defined in the draft guidance. The GMA also noted that many member companies have already made significant sodium reductions. While sodium levels in U.S. packaged foods decreased by 12% from 2000 to 2014, population-wide sodium consumption has barely changed, despite 40 years of voluntary reduction policies.
Although sodium levels in packaged foods have declined, GMA points out that consumers are shifting their eating habits, increasingly choosing foods away from home. Therefore, the FDA’s voluntary guidelines aim to address 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 achievable for the food industry, especially given that they are based on a 2010 baseline.
Despite GMA’s reservations about the FDA targets, many of its members are proactively pursuing sodium reduction, and ingredient manufacturers are developing innovative solutions to tackle the challenge. “They are responding to consumer demand,” O’Hara noted, pointing out that a significant majority of consumers recognize the excessive sodium in their food and desire less. A recent survey by the American Heart Association revealed that concern about sodium is on the rise, with 64% of consumers trying to monitor their sodium intake last year, up from 58% in 2013. Additionally, 62% expressed a desire for government involvement in setting sodium limits in packaged and restaurant foods, an increase from 56% in 2013.
O’Hara criticized the GMA for dragging its feet, despite many companies taking action on sodium reduction. He also mentioned that some members of Congress are acting against scientific consensus, creating obstacles for even the voluntary guidelines. One such obstacle is found in the fiscal year 2017 Agriculture Appropriations Bill, which prohibits the FDA from addressing the 10-year targets. Instead, a committee is expected to be formed later this year to update the sodium and potassium dietary reference intake (DRI), which has not been revised since 2005. It will take about 18 months for the committee to complete its work, after which the FDA can consider the 10-year targets in light of the new guidelines.
“I don’t think any of us following the science expect the DRIs to change significantly,” O’Hara remarked, adding that companies will continue to reduce sodium levels. “The real question is whether the entire population will benefit, which can only be achieved through federal action to protect all Americans.”
The Center for Science in the Public Interest has long pressured both the FDA and the food industry for sodium reduction, viewing the agency’s draft guidance as a response to these efforts. “A few points to note: it was draft, it was voluntary, and it was guidance — but it was still progress,” O’Hara stated.
Despite decades of research and debate regarding sodium’s impact on heart disease and stroke, some sensational headlines suggest that its effects may be overstated. However, the sodium reduction policies of other countries provide compelling evidence for decreasing intake. In Finland, a sodium reduction campaign initiated in the 1970s led to a reduction of average consumption by about one-third over 30 years, reaching approximately 2,800 mg per day for women and 3,320 mg for men. Concurrently, average blood pressure decreased, resulting in a 75% to 80% drop in both stroke and coronary heart disease mortality. The U.K. has achieved similar results, cutting sodium intake by about 30% over 20 years. The World Health Organization emphasizes that monitoring systems for sodium reduction and health impacts were crucial to the success of these programs in both countries.
As food manufacturers explore various options to lower sodium levels, their toolbox has expanded significantly. Besides its flavor contribution, salt plays essential functional roles in food, such as extending shelf life, controlling yeast fermentation, influencing baked goods’ color, and binding water in meat products. Potassium chloride is frequently used as a sodium alternative due to its similar functionality, 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 achieve a saltier taste with less sodium. This technique is utilized by companies like Tate & Lyle, Cargill, and PepsiCo. Other companies have concentrated on ingredients that enhance umami, an intense savory flavor that can amplify saltiness, using extracts from mushrooms, seaweed, tomatoes, and yeast. Scientists in the sodium reduction sector assert that current ingredients available to the food industry can achieve sodium reductions of 20% to 30% without affecting taste. However, achieving deeper reductions necessitates further research into salt taste receptors and taste perception. Interestingly, both companies and consumers may overestimate the desire for saltiness, as research indicates that reducing sodium without any replacement ingredients can also be effective.
Reflecting on manufacturers’ experiences in the U.K., MacGregor noted, “Some companies made significant reductions quickly, while others did so gradually. Nobody noticed; when dining, you don’t compare meals side by side.” However, O’Hara emphasized that the U.S. still has considerable work to do. “The bottom line is that the United States continues to lag behind other countries, including the U.K., in implementing comprehensive sodium reduction policies. Meeting the targets could significantly lower sodium consumption among Americans.”
As the conversation around sodium reduction continues, it’s worth noting the potential benefits of incorporating alternatives such as rugby calcium citrate 950 mg into diets, which might help in managing sodium intake while still providing essential nutrients.