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Salt limits recommended for processed foods

The average American consumes more than twice the amount of salt recommended by the American Heart Assn.

By Christine S. Moyer — Posted May 5, 2010

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Table salt accounts for about 6% of Americans' daily sodium intake, according to the Centers for Disease Control and Prevention. The remaining salt consumed each day comes largely from processed foods and restaurant meals.

The Institute of Medicine is calling on the Food and Drug Administration to gradually decrease the amount of salt that food manufacturers and restaurants add to their products. An incremental reduction would prevent people from noticing a difference in taste, the IOM said.

In a report released in April, the IOM said the goal is to reduce the public's sodium consumption to 2,300 mg -- approximately one teaspoon of salt -- or less a day. In doing so, the institute hopes to lower risks of hypertension, heart disease and stroke (link).

One in three adults has hypertension, and another 25% of adults have pre-hypertension, according to the CDC.

There is no deadline for implementing the new levels, but the IOM anticipates that the process will take years.

"For 40 years, we have known about the relationship between sodium and the development of hypertension and other life-threatening diseases, but we have had virtually no success in cutting back the salt in our diets," according to a statement by Jane Henney, MD, chair of the IOM Committee on Strategies to Reduce Sodium Intake, which wrote the report.

"This report outlines strategies that will enable all of us to effectively lower our sodium consumption to healthy levels," said Dr. Henney, professor of medicine at the University of Cincinnati College of Medicine.

The FDA has not decided whether it will regulate salt intake. Agency officials are, however, examining ways to continue supporting the reduction of sodium in the food supply. The Dept. of Health and Human Services is expected to establish an interagency working group on sodium to review options and next steps.

The average American consumes 3,400 mg of sodium, or about 1½ teaspoons of salt, each day, according to the IOM. The American Heart Assn. recommends 1,500 mg or less a day.

The IOM is encouraging restaurants and food manufacturers to voluntarily reduce sodium in their products while the FDA considers developing and implementing a new regulatory process.

Supporting salt limits

The American Medical Association supports the IOM's recommendation to limit salt in processed foods and restaurant meals. The AMA adopted a policy in 2006 calling for a stepwise reduction in sodium of at least 50% in processed foods, fast food products and restaurant meals over the next decade.

"Lowering the amount of sodium in processed foods is an important step toward a healthier America," AMA President J. James Rohack, MD, said in a statement.

Hershey, Pa., internist Paul Haidet, MD, MPH, said he also backs the salt reductions. "It's a great idea. ... To change people's behavior you have to change the conditions" in their environment, said Dr. Haidet, director of medical education research at Penn State College of Medicine.

The Salt Institute, however, calls the idea "reckless and flawed." It is urging HHS to conduct clinical trials on the health effects of a salt reduction before any action is taken. Salt levels that are too low can lead to impaired cognitive function, and impaired growth and development, the institute said.

But the IOM's recommendation to limit salt has garnered support from some food and consumer advocacy groups, including the Grocery Manufacturers Assn. "We are looking forward to working with the [FDA] to develop a national sodium reduction strategy that will help consumers," the association said in a statement.

Sen. Tom Harkin (D, Iowa), chair of the Senate Committee on Health, Education, Labor and Pensions supports the FDA's effort to reduce sodium in processed and restaurant foods. "When sodium is so clearly linked to heart disease and strokes, it's time to give Americans more information and better control over their daily intake. This is good common sense and it's a wise investment in our public health too," he said.

In a statement released on his Web site, Harkin said he requested the IOM report in 2008.

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