Salt Lamps

FDA Aims to Cut Sodium in Prepared Foods by 12%

It only took five years. But then, the U.S. government has been through a lot in those five years. Yesterday the FDA finally released voluntary guidelines aiming to cut sodium in prepared foods by 12 percent over the next two and a half years. In a joint statement, Acting Commissioner Janet Woodcock and CFSAN Director Susan Mayne explained their modest goals:

“We know that even these modest reductions made slowly over the next few years will substantially decrease diet-related diseases.

“The final guidance outlines short-term goals that we’re recommending the food industry work to meet as soon as possible to help optimize public health. We will continue our discussions with the food industry as we monitor the sodium content of the food supply to evaluate progress. In the future, we plan to issue revised, subsequent targets to further lower the sodium content incrementally and continue to help reduce sodium intake.”

This guidance targets food manufacturers, chain restaurants and food service operators.

Goldilocks Dilemma

Quite naturally, some people think this is great. Others think it’s too little, too slow. And then you can also be sure that some will be dragging their feet and trying to undermine this methodical approach. Responding to this news, Director Larry Appel of the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research said:

“This is a good start because there hasn’t been much guidance on sodium reduction from the FDA in many years. But I would have preferred stronger guidance that is closer to mandatory. Voluntary measures just kick the can down the road.”

Appel’s thought that voluntary measures might not be enough have basis for credibility in data from a 2017 paper in PLOS One. This systematic review found a “effectiveness hierarchy” for different policies to address sodium consumption. In this analysis, mandatory reformulations were almost twice as effective as voluntary measures.

Nonetheless, voluntary measures such as FDA announced yesterday are at the higher end of effectiveness in this hierarchy. And of course, it would be foolish to discount the political advantages of voluntary approaches in the current political climate.

Potential for Real Benefits

Sodium reduction is not a panacea. Population-wide efforts need to consider trade-offs for many different individuals at different levels of consumption. Nonetheless, it is clear that Americans are eating too much salt. So even modest reductions have potential to improve the health of the whole population.

Finland has been working on this for decades now with considerable success. By reducing sodium intake 30 percent, they brought down deaths from stroke and heart disease by 75 to 80 percent.

Thus it’s pretty easy to conclude that FDA’s announcement yesterday is good news. It puts us on a path to reduce the burden of disease from excessive sodium in the food supply.

Click here for the FDA announcement, here, here, and here for further reporting. For more studies on approaches to sodium reduction and their effectiveness, click here, here, and here.

Salt Lamps, photograph by Andrew Bossi, licensed under CC BY-SA 2.5

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October 14, 2021