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Assault on the System

Michael Glenwood

Assault on the System (continued)

From Science to Policy

More recent studies have continued to highlight the threat posed by too much salt in our diets, and the need for a strong preventive approach. “The evidence now suggests that if your blood pressure goes up, you’ve already started to incur organ damage,” says Anderson. “If you wait ’til age 50 or 60 to get treatment, irreversible damage may have set in.” 

Skeptics have expressed concerns that a steep and sudden reduction in sodium in the food supply could end up having adverse effects. But even the ambitious 20 percent reduction targeted by NSRI would be gradual and would take us back to the still-excessive levels of the 1970s. “The idea that harm would come from this level of sodium reduction is a myth,” says Appel.

“As far as I and many other public health officials are concerned, the necessary science on this has been done,” says Sonia Angell, MD, a New York City Health Department official who helped set up NSRI, and also sat on the recent IOM sodium-reduction panel. “The World Health Organization, the American Medical Association, the American Heart Association and the U.S. government in their Dietary Guidelines for Americans all have concluded that there’s too much salt in the diet. So I think the challenge that we face now is how to move it out of our food supply.” 

Small-scale studies have shown that the sodium content of many processed foods can be reduced gradually without making diners reach for their saltshakers. And a number of countries, including Finland and the UK, have already found that sodium-reduction programs can work at the population level. 

The UK’s effort began in 2003 and includes progressively tightened targets for sodium reductions by the UK food and restaurant industry. The initiative is voluntary but is clearly backed by the possibility of formal regulations. Its overall goal is to reduce the UK population’s average daily sodium intake to 2,400 mg. Dozens of UK food companies are on board, the average sodium content in many food categories has dropped sharply, and the average UK intake has fallen by 10 percent from 2001. 

“The UK’s model in particular demonstrated to us that there was an effective way to approach this,” says Angell.

As of this April, NSRI had obtained sodium-reduction pledges from 16 U.S.-based food and restaurant companies, including Heinz, Goya, Subway, Starbucks and Kraft. Like the UK initiative, NSRI specifies maximum average sodium levels for different categories of processed foods and restaurant foods. There is an initial set of targets to be met by 2012, and a tighter set for 2014. Kraft, for example, has pledged to meet the specified 2012 targets in half of NSRI categories that cover its foods, including a 17 percent reduction in sodium for its Oscar Mayer bologna.

NSRI aims for an overall 25 percent cut in sodium in America’s processed and restaurant foods by 2014, which, if achieved, should cut Americans’ overall sodium intake by about 20 percent. But for many products, meaningful sodium reductions will reduce palatability and/or shelf life, which could make it hard for companies to comply voluntarily. While the IOM panel encouraged voluntary-based initiatives such as NSRI, its primary recommendation was that “the FDA should expeditiously initiate a process to set mandatory national standards for the sodium content of foods.” 

FDA action could be years away, but the prospect of formal regulation, plus the scientific evidence that now links excess sodium to tens of thousands of excess annual deaths, has gotten the attention of the food industry. Most of the companies that signed up for NSRI had already been gradually and quietly reducing the sodium in their products. 

That’s also the case for companies that haven’t joined NSRI. Campbell’s Soup Company, for example, claims to have reduced the sodium load in its original V8 juice by a third since 2002. During the IOM panel’s deliberations, says Anderson, “a representative of one of the fast-food chains gave a talk, and said that on their own they’d already cut the salt by about 70 percent in one of their menu items—and no one even noticed.” 

“Some in the food industry have dug in their heels on this, but most have been moving in the right direction,” says Appel. “They want to stay ahead of the curve.”

Comments

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  • Adongo Amos Otieno

    Marsabit, Northern Kenya 10/16/2010 04:16:12 AM

    Hi, This indeed is very valuable information. Kenya is already into this trouble. Overweight among young people below 40 years is on the rise probably due to increase in consumption of processed foods. But attention now needs to shift research work towards nomads of Kenya who originally thought to be resistant to Hypertension despite red meat diet. Is there a professor in Johns Hopkins interested in the study of nutrition and public health among nomadic people? Let's be touch.

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