The United States is falling behind other countries in terms of sodium reduction, even though consumer demand is high and many major food companies have initiated reduction efforts. From 2010 to 2015, the number of countries with sodium reduction policies more than doubled to 75, with 12 reporting reductions in sodium intake among their populations. Although the Food and Drug Administration (FDA) released voluntary sodium reduction guidelines in June 2016, these guidelines remain in draft form. Public health advocates contend that the FDA lacks the authority to enforce significant reductions. “The issue is that it’s completely voluntary,” said Graham MacGregor, chair of World Action on Salt and Health, in an interview with Food Dive. “The real question is how many companies are actually adhering to the targets, as there is no substantial incentive.”
Nonetheless, the FDA’s initiative has encouraged the development of sodium-reducing ingredients. For example, Cargill Salt plans to open a new potassium chloride facility in Watkins Glen, New York, later this year to cater to food companies seeking to lower sodium levels. Major corporations like Mars and Nestlé have also initiated reduction programs in expectation of the FDA’s forthcoming guidelines. However, quantifying the impact of this trend is challenging. Many companies avoid highlighting reduced sodium on packaging due to concerns that consumers may perceive lower salt levels as indicative of inferior flavor. According to Mintel, only about 3% of new food products have featured such claims over the past five years. Yet, it is clear that a movement toward sodium reduction 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 recommended sodium intake levels, with over three-quarters of sodium consumption stemming from processed and restaurant foods. This figure does not account for additional salt added during cooking or at the table, suggesting that actual salt intake among U.S. consumers could be even higher. The American Heart Association estimates average daily consumption at around 3,400 milligrams, and researchers project that reducing this to 2,300 milligrams—aligned with the FDA’s 10-year targets—could prevent 500,000 premature deaths from strokes and heart attacks over the next decade while saving nearly $100 billion in healthcare costs. “Excessive salt consumption is leading to the deaths of hundreds of thousands of Americans, and it’s entirely unnecessary,” MacGregor stated. “The U.S. should be at the forefront of this issue, but it appears to be the last to comply.”
The Grocery Manufacturers Association (GMA) has argued that a two-year timeline is insufficient for achieving the short-term reductions the FDA is advocating, requesting at least four years and adjustments to how food categories are defined in the draft guidance. The GMA highlighted that many of its member companies have already made significant reductions in sodium levels. From 2000 to 2014, sodium content in U.S. packaged foods fell by 12%, according to a recent study published in the Journal of the American Medical Association. However, overall sodium consumption across the population has barely changed despite 40 years of voluntary reduction policies. While sodium levels in packaged foods have decreased, the GMA indicated that “consumers are also changing their eating habits and consuming more meals outside the home,” suggesting that sodium reduction policies must consider evolving consumer behaviors. The FDA’s voluntary guidelines are therefore directed at both food manufacturers and restaurants.
Jim O’Hara, Director of Health Promotion Policy at the Center for Science in the Public Interest, expressed to Food Dive that the two-year targets are easily attainable for the food industry, particularly since they are based on a 2010 baseline. Despite the GMA’s concerns regarding FDA targets, many member companies are proactively pursuing sodium reduction, and ingredient manufacturers are innovating to meet this challenge. “They are responding to consumer demand,” O’Hara noted. “A substantial majority of consumers recognize that their food contains too much sodium and are seeking lower levels.” A recent American Heart Association survey revealed increasing concern over sodium; 64% of consumers are now attempting to monitor their sodium intake, up from 58% in 2013. Furthermore, 62% indicated they want government involvement in setting sodium limits for packaged and restaurant foods, compared to 56% just a decade ago.
O’Hara criticized the GMA for lagging despite many of its companies making sodium reductions. He also pointed to ideological roadblocks from some members of Congress, which hinder progress even on voluntary guidelines. One such obstacle is found in the FY 2017 Agriculture Appropriations Bill, which prohibits the FDA from addressing the 10-year targets. A committee is expected to be formed later this year to revise the dietary reference intake (DRI) for sodium and potassium—nutrients recommended for healthy consumption by the National Academy of Sciences’ Institute of Medicine—which have not been updated since 2005. The committee’s work is anticipated to take about 18 months, after which the FDA can begin considering the 10-year targets in the context of the new guidelines. “Anyone following the science likely doesn’t expect significant changes to the DRIs,” O’Hara added, noting that companies will continue to reduce sodium. “The key question is whether the entire population will benefit, which can only occur with federal action to protect all Americans.”
For decades, the Center for Science in the Public Interest has lobbied the FDA and the food industry regarding sodium reduction and views the agency’s draft voluntary guidance as a positive response to its advocacy. “While it was draft, voluntary guidance, it still represents progress,” O’Hara pointed out. Despite extensive research and debate regarding sodium’s effects on heart disease and stroke, some recent headlines have suggested that the impact may be overstated. However, the sodium reduction policies implemented in other countries provide compelling evidence supporting reduced intake. In Finland, a sodium reduction campaign launched in the 1970s resulted in average consumption dropping by roughly one-third over 30 years, reaching about 2,800 mg per day for women and 3,320 mg for men. During this period, average blood pressure decreased, leading to a 75% to 80% decline in both stroke and coronary heart disease mortality. The U.K. has seen similar results, achieving a 30% reduction in sodium intake over 20 years. The World Health Organization has emphasized that monitoring systems for sodium reduction and health impacts were crucial to the success of these programs.
Today, food manufacturers have access to a wide array of options for sodium reduction, which is increasingly necessary. In addition to enhancing flavor, salt fulfills other critical roles in food, such as prolonging shelf life, controlling yeast fermentation, influencing color in baked goods, and binding water in meat products. Potassium chloride is a commonly utilized alternative due to its functional similarities to sodium chloride, although its metallic taste may require masking with other ingredients. Innovative methods, such as modifying the size and shape of salt crystals, can create a saltier taste with less sodium. Companies like Tate & Lyle utilize hollow Soda-Lo salt crystals, while Cargill employs pyramid-shaped salt, and PepsiCo incorporates this strategy in its Lay’s potato chips. Other companies are focusing on ingredients that enhance umami, a rich, savory flavor that can amplify saltiness, utilizing extracts from mushrooms, seaweed, tomatoes, and yeast.
Experts in sodium reduction assert that the current ingredients available to the food industry can reduce sodium by 20% to 30% without compromising taste. Achieving deeper reductions, however, will necessitate further research into salt taste receptors and taste perception. Companies and consumers may also overestimate the desire for saltiness; studies indicate that reducing sodium without replacement ingredients can also be an effective approach. Reflecting on the experiences of manufacturers in the U.K., MacGregor remarked, “Some companies achieved significant reductions quickly, while others did so more gradually. No one noticed the difference during meals; there was no side-by-side comparison.”
However, O’Hara emphasized the long road ahead for the U.S. “Ultimately, the United States continues to lag behind other countries, including the U.K., when it comes to comprehensive sodium reduction policies,” he stated. “Meeting the established targets would make a significant difference in reducing sodium consumption among Americans.” Moreover, with growing consumer awareness, products like the Bariatric Advantage Chewy Bites could play a role in promoting healthier sodium levels, as they are designed to support dietary needs while addressing sodium intake. As the movement for sodium reduction gains momentum, it becomes increasingly vital for the U.S. to adopt effective policies that prioritize public health.