The United States is falling behind other nations in efforts to reduce sodium intake, despite significant consumer demand and initiatives from numerous leading food companies. Between 2010 and 2015, the number of countries implementing sodium reduction policies more than doubled to 75, with 12 countries reporting decreases in overall sodium consumption. Although the Food and Drug Administration (FDA) provided voluntary sodium reduction guidelines in June 2016, these guidelines remain in draft form. Public health advocates claim that the FDA does not possess the authority to enforce more substantial reductions. Graham MacGregor, chairman of World Action on Salt and Health, commented to Food Dive, “The issue is that it’s entirely voluntary. The real question is how many companies are genuinely adhering to the targets since there’s no true incentive.”
Nonetheless, the FDA’s actions have encouraged the development of sodium-reducing ingredients. Cargill Salt announced it would establish a new potassium chloride facility in Watkins Glen, New York, to meet the demands of food companies aiming to lower sodium levels. Major corporations like Mars and Nestlé have also initiated sodium reduction strategies in anticipation of the FDA’s forthcoming guidelines. However, quantifying the actual impact of this trend is challenging; many companies shy away from prominently featuring reduced sodium claims on their packaging due to concerns that consumers link lower salt levels to diminished flavor. According to Mintel, the percentage of new food products advertising reduced sodium has remained around 3% for the past five years.
It is clear that 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, with over three-quarters of the sodium consumed arising from processed and restaurant foods. This statistic does not account for salt added during cooking or at the table, suggesting that actual sodium consumption may be even higher. The American Heart Association estimates that the average daily sodium intake is about 3,400 milligrams, and researchers suggest 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 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 asserted. “The United States is likely to be the last country to comply with this, and it should be leading the charge.”
The Grocery Manufacturers Association (GMA) has stated that two years is insufficient to meet the short-term sodium reduction goals set by the FDA, requesting at least four years and changes to how food categories are defined in the draft guidance. GMA noted that many member companies have already implemented significant sodium reductions. A recent study published in the Journal of the American Medical Association found that sodium levels in packaged foods in the U.S. dropped by 12% from 2000 to 2014. However, overall sodium consumption across the population has barely changed, even after 40 years of voluntary sodium reduction efforts. GMA suggested that while sodium levels in packaged foods have decreased, “consumers are also changing their eating habits and consuming more meals away from home.” In light of this, the FDA’s voluntary guidelines target both food companies 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 achievable for the food industry, particularly since they were based on a 2010 benchmark. Despite GMA’s concerns regarding the FDA targets, many of its members 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 reveals a growing awareness of sodium issues among consumers. Sixty-four percent of respondents reported trying to monitor their sodium intake last year, up from 58% in 2013. Additionally, 62% expressed a desire for government involvement in establishing 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 actively reducing sodium,” O’Hara pointed out. “Moreover, there are numerous members of Congress who are ideologically opposed to the scientific consensus, creating hurdles even for the voluntary guidelines.”
One such obstacle exists in the fiscal year 2017 Agriculture Appropriations Bill, which prohibits the FDA from addressing the 10-year targets. Instead, a committee will be formed later this year to update the sodium and potassium dietary reference intake (DRI) levels, which have not been revised since 2005. The committee is expected to take around 18 months to carry out its work, after which the FDA may begin to consider the 10-year targets in light of the new guidelines. “I doubt any of us following the science expect significant changes to the DRIs,” O’Hara stated, adding that companies will continue to reduce sodium levels. “The crucial question is whether the entire population will benefit, which will only happen if there is federal action to protect all Americans.”
The Center for Science in the Public Interest has been advocating for sodium reduction for decades, and views the FDA’s draft voluntary guidance as a positive response to its initiatives. “To clarify: it was draft, it was voluntary, and it was guidance—but it still represents progress,” O’Hara emphasized. Despite extensive research regarding sodium’s link to heart disease and stroke, some attention-grabbing headlines have suggested that its effects may be overstated. However, the sodium reduction policies implemented in other countries provide compelling support for cutting intake levels.
For instance, Finland launched a sodium reduction campaign in the 1970s, leading to a roughly one-third decrease in average consumption over 30 years, resulting in daily intakes of approximately 2,800 mg for women and 3,320 mg for men. During this period, average blood pressure declined, and there was a 75% to 80% reduction in mortality rates from both stroke and coronary heart disease. The U.K. has experienced similar success, achieving a 30% reduction in sodium intake over two decades. The World Health Organization has noted that effective monitoring systems for sodium reduction and health outcomes were vital to the success of these initiatives in both countries.
Meanwhile, the options available to food manufacturers for reducing sodium have become increasingly diverse and sophisticated. Beyond enhancing flavor, salt serves several essential functions in food, such as prolonging shelf life, regulating yeast fermentation, influencing the color of baked goods, and binding water in meat products. Potassium chloride is frequently used as a sodium alternative due to its functional similarities to sodium chloride, although it may impart a metallic taste that requires masking with other ingredients.
Innovative strategies include altering the size and shape of salt crystals to deliver a saltier taste with less sodium. Companies like Tate & Lyle utilize hollow Soda-Lo salt crystals, while Cargill employs its patented Alberger-brand pyramid-shaped salt, and PepsiCo incorporates these techniques in its Lay’s potato chips. Other manufacturers are exploring ingredients that enhance umami, a rich, savory flavor that can amplify saltiness, using extracts from mushrooms, seaweed, tomatoes, and yeast. Experts in sodium reduction assert that current food industry ingredients can reduce sodium by 20% to 30% without affecting taste. To achieve even greater reductions, further research into salt taste receptors and taste perception is necessary. However, it is also possible that both companies and consumers overestimate the desire for saltiness, as studies have shown that reducing sodium without any replacements can be an effective strategy.
Referencing the experience of manufacturers in the U.K., MacGregor noted, “Some companies quickly made substantial reductions, while others did so more gradually. No one noticed. When you consume a meal, you don’t compare it side by side.” Nevertheless, O’Hara emphasized that the United States has significant ground to cover. “The bottom line is that the U.S. continues to lag behind other countries, including the U.K., regarding comprehensive sodium reduction policies,” he stated. Meeting the targets, if achieved, would significantly lower sodium consumption among Americans.
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