The United States is falling behind other countries in efforts to reduce sodium intake, despite increasing consumer demand and initiatives from major food corporations. Between 2010 and 2015, the number of countries implementing sodium reduction policies more than doubled to 75, with 12 reporting nationwide reductions in sodium consumption. Although the Food and Drug Administration (FDA) issued voluntary guidance for sodium reduction in June 2016, it remains in draft form. Public health advocates assert that the FDA lacks the authority to enforce more substantial cuts. As Graham MacGregor, chairman of World Action on Salt and Health, stated to Food Dive, “The issue is that it’s entirely voluntary. The real question is how many companies are actually adhering to these targets since there’s no significant incentive.”
Nevertheless, the FDA’s initiative has led to the development of sodium-reducing ingredients. Cargill Salt plans to open a new potassium chloride facility in Watkins Glen, New York, later this year to assist food companies in lowering sodium levels. Major companies like Mars and Nestlé have also announced their sodium reduction strategies in anticipation of the FDA’s guidelines. However, quantifying the impact of this trend is challenging. Many companies hesitate to advertise reduced sodium on their packaging due to concerns that consumers may associate lower salt levels with diminished flavor. According to Mintel, only about 3% of new food products have highlighted reduced sodium on their labels over the past five years.
One thing is clear—this movement is crucial 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. The CDC estimates that over three-quarters of the sodium consumed by Americans comes from processed and restaurant foods, and the data does not account for additional salt added during cooking or at the table, suggesting that actual salt intake may be even higher. The average daily consumption is approximately 3,400 milligrams, according to the American Heart Association. Researchers estimate that reducing this to 2,300 milligrams—the target set by the FDA—could prevent 500,000 premature deaths from stroke and heart attack over the next decade and save nearly $100 billion in healthcare costs. “Excess salt consumption is leading to the deaths of hundreds of thousands of Americans, and it’s entirely unnecessary,” MacGregor remarked. “The U.S. should be at the forefront of this initiative, not lagging behind.”
The Grocery Manufacturers Association (GMA) has expressed concern that two years is insufficient time to meet the FDA’s short-term sodium reduction targets, requesting at least four years and changes to how food categories are defined in the draft guidance. While the sodium content in U.S. packaged foods decreased by 12% from 2000 to 2014, population-wide sodium consumption has barely changed, despite 40 years of voluntary sodium reduction policies. Although sodium levels in packaged foods have decreased, GMA noted that consumers have shifted their eating habits, consuming more meals away from home, which must be considered in sodium reduction policies. 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, believes the two-year targets are easily achievable for the food industry, especially since they are based on 2010 figures. Despite GMA’s concerns, many of its members are proactively pursuing sodium reduction, and ingredient manufacturers are developing innovative solutions for this challenge. “They are responding to consumer demand,” O’Hara stated. “A significant majority of consumers recognize that there is too much sodium in their food and desire less.”
A recent American Heart Association survey indicated a growing concern over sodium intake, with 64% of consumers actively trying to limit their sodium consumption last year, up from 58% in 2013. Additionally, 62% of respondents expressed a desire for government involvement in setting sodium limits for packaged and restaurant foods, an increase from 56% in 2013. “The GMA has been slow to act, even though many of its companies are working on sodium reduction,” O’Hara noted. “Moreover, some members of Congress are acting contrary to scientific consensus and creating barriers even to the voluntary guidelines.”
One such barrier is found in the FY 2017 Agriculture Appropriations Bill, which restricts the FDA from addressing the 10-year sodium reduction targets. Instead, a committee will be formed later this year to update the dietary reference intake (DRI) for sodium and potassium—the recommended nutrient intake for healthy individuals—last revised in 2005. The committee’s work is expected to take around 18 months, after which the FDA can examine the 10-year targets in light of the new guidelines. “I don’t anticipate significant changes in the DRIs,” O’Hara commented, noting that companies will continue to reduce sodium levels. “The essential question is whether the entire population will benefit, which can only happen with federal action to safeguard Americans collectively.”
The Center for Science in the Public Interest has been advocating for sodium reduction for decades, viewing the FDA’s draft voluntary guidance as a response to its efforts. “It was a draft, it was voluntary, and it was guidance—but it was still a step forward,” O’Hara remarked. Despite years of research and debate regarding sodium’s contribution to heart disease and stroke, some provocative headlines have suggested that its effects may be overstated. However, the successful sodium reduction policies in other countries provide strong evidence for cutting intake levels.
In Finland, for instance, a sodium reduction campaign commenced in the 1970s, resulting in a roughly one-third decrease in average sodium consumption over 30 years to about 2,800 mg per day for women and 3,320 mg for men. During this period, average blood pressure also dropped, leading to a 75% to 80% reduction in mortality from both stroke and coronary heart disease. The U.K. experienced a similar trend, achieving a 30% reduction in sodium intake over 20 years. The World Health Organization emphasized that effective monitoring systems for sodium reduction and health impacts were vital to the success of these programs.
Food manufacturers now have a diverse toolbox of options available for reducing sodium, which is essential given salt’s critical roles in food beyond flavor, such as extending shelf life and influencing fermentation. Potassium chloride is a commonly used substitute due to its similar functionality to sodium chloride, although its metallic taste may require masking with other ingredients. Innovative strategies include altering the size and shape of salt crystals to enhance saltiness perception with less sodium. Companies like Tate & Lyle, Cargill, and PepsiCo have explored these techniques in their products.
Additionally, some companies are focusing on umami-rich ingredients, such as extracts from mushrooms, seaweed, tomatoes, and yeast, which can enhance the perception of saltiness. Experts in sodium reduction claim that current ingredients can achieve a 20% to 30% reduction in sodium without compromising taste. To make deeper cuts, further research into salt taste receptors and perception is necessary. Interestingly, both companies and consumers may overestimate the desire for saltiness, and studies have shown that reducing sodium without substitutes can also be effective.
Drawing from manufacturers’ experiences in the U.K., MacGregor observed, “Some companies made significant reductions quickly, while others took their time. No one noticed the difference because, when eating a meal, you don’t compare it side by side.” Nevertheless, O’Hara emphasized that the United States still has significant progress to make. “The bottom line is that the U.S. is continuing to lag behind other countries, including the U.K., in implementing comprehensive sodium reduction policies,” he stated. Achieving the targets set forth could greatly contribute to lowering sodium consumption among Americans.
Furthermore, it’s essential to explore how ingredients like perque choline citrate can fit into the broader sodium reduction narrative, as they may provide alternative pathways for enhancing flavor while reducing sodium levels. The integration of such innovative ingredients can play a pivotal role in addressing this public health challenge.