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Assault on the System

Michael Glenwood

Assault on the System

Decades of meticulous science proved that a low-sodium diet could reduce your blood pressure.
Now comes the tricky part: extracting salt from the food supply.

On a Monday morning last January, New York City Mayor Michael R. Bloomberg stepped in front of cameras and reporters at City Hall to announce a new public health campaign of astounding ambition: The Mayor and his health department, supported by more than 50 other city and state governments and health associations, intended to cut Americans’ average salt intake by 20 percent over the next five years, by targeting the excess salt in processed foods and restaurant foods. The National Salt Reduction Initiative (NSRI) would rely on the voluntary cooperation of food companies and restaurant chains, but it aimed to affect hundreds of commonly consumed items, from Kraft bacon to Heinz ketchup and Subway subs—not just in New York City but across the country. “We have been able to accomplish something that many thought was impossible: setting concrete, achievable goals for salt reduction,” Bloomberg said.

Previous salt-reduction efforts have been aimed at individual consumers. For decades, doctors have advised their patients with high blood pressure to cut the salt, and more recently the federal government has begun encouraging all Americans to do the same. Yet our salt intake has been rising, and our epidemic of hypertension—now afflicting about a third of all American adults—has been worsening. According to the most recent national survey, we consume about 3,400 mg of sodium per day on average (sodium being the salt ingredient of chief concern), while a healthy sodium intake for most of us would be at or below 1,500 mg per day—roughly the amount in two-thirds of a teaspoon of salt.

Our sodium intake is high because excess sodium is basically baked into our food supply. Nearly 80 percent of the sodium we consume comes from processed and restaurant foods—compared to only about 11 percent from our saltshakers. Some products these days can push our intake over the healthy limit in a few bites. A McDonald’s Big Breakfast with Hotcakes, for example, delivers more than 2,000 artery-thumping milligrams of sodium. Even seemingly healthy, non-salty-tasting foods are a potential hazard; one can easily get half the daily recommended sodium limit from a few slices of store-bought whole wheat bread.

“Sodium is in almost everything we eat, so we don’t have as much control over our intake as we’d like to think,” says Lawrence Appel, MD, MPH ’89, a professor of Medicine, Epidemiology and International Health and a faculty member of the Bloomberg School and the School of Medicine’s Welch Center for Prevention, Epidemiology and Clinical Research.

Thus, NSRI moves away from the old, demand-side emphasis on consumer education and takes aim instead at the supply-side of salt. Similar efforts have begun recently in other countries, and an Institute of Medicine (IOM) panel, which included Appel and Welch Center epidemiologist Cheryl Anderson, PhD, MPH, MS, concluded in April that the Food and Drug Administration (FDA) should eventually make sodium reductions in food mandatory, not voluntary.

“Now, really for the first time, sodium reduction has become a high priority within the FDA,” says Michael Jacobson, PhD, whose Center for Science in the Public Interest, in Washington, D.C., has been urging the agency to regulate sodium since 1978.


This forum is closed
  • 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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