Proposed guidelines from the F.D.A set targets for the gradual reduction in sodium across a range of both manufactured and restaurant foods. CreditSaul Loeb/Agence France-Presse — Getty Images
The federal government proposed voluntary guidelines for the food industry to reduce salt in the American food supply on Wednesday, a move long sought by public health advocates who said the new standards could eventually help save thousands of lives.
The guidelines came after years of debate, and while voluntary, still set a benchmark by which companies can be measured, something health advocates say is critical to lowering salt levels in the American diet.
More than 70 percent of the sodium consumed in this country is already in food before it reaches the table, according to the Centers for Disease Control and Prevention. The guidelines, put out by the Food and Drug Administration, are intended to help reduce that. They apply to packaged foods like bread, salad dressing, canned soup and cheese, as well as to meals in restaurants.
“While a majority of Americans reports watching or trying to reduce added salt in their diets, the deck has been stacked against them,” the F.D.A. said in a statement. “The majority of sodium intake comes from processed and prepared foods, not the saltshaker.”
Despite efforts over the past several decades to cut down on sodium, a main component of table salt, the average American adult still consumes 3,400 milligrams a day — equivalent to about 1.5 teaspoons of salt. That is nearly 50 percent more than the 2,300 the federal government recommends. Too much sodium can raise blood pressure, which is a major risk factor for heart disease and stroke. One in three Americans have high blood pressure. For blacks, it is one in two.
But there has been some scientific controversy over how much to reduce sodium.
Some scientists say data has emerged showing that dropping below a certain level is actually dangerous, and raised the risk of heart attacks and other bad health outcomes. A 2013 report from the Institute of Medicineconcluded that cutting out too much sodium could be harmful.
David A. McCarron, a research associate in the Department of Nutrition at the University of California, Davis, said a number of studies had shown risks of too little salt.
“Going below 3,000 is dangerous — that’s what the data has shown,” said Professor McCarron, who has consulted for the food industry.
Dr. Thomas Frieden, the director of the C.D.C., argued the current level is too high.
“We understand that there are some researchers who do not agree on the general consensus” of the correlation between sodium and poor health outcomes, he said. But, he added, “We find fatal flaws” in research they cite.
F.D.A. scientists said the health advantages of getting down to the recommended 2,300 milligrams a day were beyond dispute.
“The science has been well vetted,” said Susan Mayne, director of the Center forFood Safety and Applied Nutrition at the F.D.A.
The guidelines are sweeping and set targets for the gradual reduction in sodium in the majority of processed and prepared foods — about 150 categories, including pizza, deli meats, canned soup, snacks, breads and rolls. The reductions would be two-phased, cutting sodium over two years and over 10 years. If the food industry adjusts sodium levels based on the F.D.A.’s targets, the agency said it expected consumption to drop to 3,000 milligrams a day in two years and 2,300 in 10 years.
The guidelines are open to public comment for up to five months.
The voluntary targets would help level the playing field in added sodium in food. There is huge variation in the amount of sodium added to similar products, Dr. Mayne said. For example, salad dressing has 150 milligrams to 2,000 milligrams of sodium per 100 grams (nearly half a cup), and packaged wheat bread has 229 milligrams to 671 milligrams per 100 grams, the measure F.D.A. scientists used in their analysis.
“With that type of variation, it’s clear we can make progress,” she said.
The food industry offered tempered reaction. The Grocery Manufacturer’s Association said in a statement that “we believe additional work is needed to determine the acceptable range of sodium intake for optimal health,” including research that indicates health risks “from consuming too little sodium.” But the group said it would work with the F.D.A. on sodium reduction targets.
Some companies seemed enthusiastic. “Mars applauds F.D.A. for releasing its draft voluntary guidelines on sodium, and we look forward to providing additional comments on the recommendations,” the company said in a statement. It said it had reduced sodium in its products by a quarter from 2007 to 2012, and planned to reduce by an additional 20 percent “across our food portfolio” by 2021.
In an editorial published in The Journal of the American Medical Association on Wednesday, Dr. Frieden wrote that a decrease in sodium intake by as little as 400 milligrams a day could prevent 32,000 heart attacks and 20,000 strokes annually. He pointed out that 39 countries had established sodium targets for foods and meals, with 36 of those voluntary, including Britain, which set voluntary sodium reduction targets in 2003. By 2011, sodium intake had dropped by 15 percent, according to researchers in Britain, average blood pressure declined, and deaths from ischemic heart disease and stroke fell. (Researchers noted that other factors could be at work, too.)
Dr. Frieden argued that the changes in the United States would give consumers the option of eating less sodium because the food supply would be less salty. “It makes the default option the healthier option,” he said on a conference call. “If it’s not salty enough for them, they can choose to add sodium.”
Michael F. Jacobson, the executive director of the Center for Science in the Public Interest, said his group had petitioned the F.D.A. to impose mandatory guidelines but that “they just couldn’t go that far because the food industry would go to Congress and say, shut down this process.”
Dr. Frieden said some companies had already begun to reduce sodium. He named Walmart; Darden, which operates restaurants including Olive Garden; Unilever; PepsiCo; General Mills; and Nestlé.
General Mills said that as of the end of last year, it had reduced sodium in more than 350 products, which it said was one-third of its current American retail sales.
