SODIUM IN FOOD: SHAKING OUT CHANGES

COELI CARR

SALT HAS BECOME A CONSTANT in the American diet. It's in just about every prepared food item in today's supermarket; from frozen dinners to canned soup, salt is the food industry's preservative and flavor enhancer of choice.

Over the years, a number of consumer groups have raised alarm over Nutrition Facts panels that reflected sodium levels creeping up into the thousands of milligrams. Right now, federal dietary guidelines cap daily recommended intake at 2,300 milligrams for most people, though many products contain much more than that.

Scientific studies have linked ingesting too much sodium to high blood pressure, which in turn can lead to coronary disease and stroke. Excess sodium has also been associated with edema and migraine headaches. Many people are aware of the risks of too much sodium in the diet, but limiting intake in a world driven by a need for convenience is not always easy.

At its most basic, sodium is an elemental mineral, and an electrolyte that plays an important role in regulating the balance of pH and water in the body, as well as nerve function. Too little sodium consumption can cause cells to malfunction. Sodium is essential to human life.

Over the years, though, sodium has been adopted by food manufacturers to flavor and brighten the taste of food, or to preserve it.

“But sodium can get into our food in other ways,” cautioned David Katz, director of the Yale Prevention Research Center, noting ingredients like sodium bicarbonate and monosodium glutamate. “All these are potential sources of sodium, and sodium from any source is sodium.”

The consequences of immoderate use of the substance — some would call it an epidemic — are so serious that the normally reticent American Medical Association felt compelled to take a stand. In June 2006, the physicians' group urged the Food and Drug Administration to revoke the GRAS, or “generally recognized as safe” status of salt. The AMA also called for a minimum 50% reduction in the amount of sodium in processed foods over the next decade.

It's easier to understand the urgency of the matter if what the experts advise is compared with what food products actually contain. The government's 2005 Dietary Guidelines for Americans recommend that young adults consume less than 2,300 milligrams — that's no more than one teaspoon — of sodium per day. The guidelines are even more stringent for specific populations, such as those suffering from hypertension, African Americans, and middle-aged and older adults. They are advised to consume no more than 1,500 milligrams of sodium per day and to meet certain potassium recommendations.

The shock is that many food products greatly exceed these amounts. A package of Swanson's Hungry Man XXL Roasted Carved Turkey contains 5,410 milligrams of sodium, more than double the recommended allotment for the general population, and more than triple the recommended limit for those on restricted diets. At the lower end, one bowl of Uncle Ben's Teriyaki Chicken Rice Bowl contains 1,450 milligrams of sodium.

One of the key movers in bringing awareness to the public about the dangers of excess salt consumption is the Center for Science in the Public Interest, a Washington-based, nonprofit health advocacy organization. Early in 2005, CSPI published “Salt: The Forgotten Killer and FDA's Failure to Protect the Public's Health.” The publication, written by Michael F. Jacobson, the organization's executive director, addressed many topics of concern. Jacobson cited annual surveys sponsored by the Food Marketing Institute, the supermarket industry's trade association, showing that people's concern about the harmfulness of salt has diminished. Not only did the percentage of people who said they were eating less salt/sodium drop from 13% in 1996 to 5% in 2004, but only 7% of shoppers looked at the sodium content of foods when reading labels.

“Salt: The Forgotten Killer” also focused on how tough it is to reduce sodium content in foods. A taste for salt is instinctive, which makes it difficult to give up. And when companies do try to provide food products with less or no salt — often herbs, spices and other ingredients are used as replacements — consumers often find them tasteless, he wrote.

CSPI followed up its initial report in August 2005 with “Salt Assault: Brand-name Comparisons of Processed Foods.” This addendum underscored previous findings that the culprit is not usually overuse of the salt shaker but rather the sodium present in processed and restaurant foods; the latter accounts for more than three-quarters of all sodium ingested. “Salt Assault” also noted that wide variations in sodium content exist among brands. Both publications can be downloaded from the organization's website, www.cspinet.org.

With deaths related to high blood pressure reaching 150,000 annually and individuals' daily consumption of sodium averaging about 4,000 milligrams, CSPI is quick to note food manufacturers that are taking steps to turn the tide. In 2006, CSPI praised Campbell Soup Co. for significantly reducing sodium levels in some of its best-selling products and for introducing a number of lower-sodium versions, and expressed hope that other manufacturers will follow. Packaged Facts, the publishing division of MarketResearch.com., noted in a recent report that General Mills' Progresso soup line extensions were introduced in 2006 with 50% less sodium, at 450 milligrams per serving.

The report also referred to previously published information that ConAgra Foods had reduced the sodium content of several product lines in the past year — Kids Cuisine by 18%, Chef Boyardee by 14% and Banquet frozen dinners by 10%.

Consumers can also help themselves by becoming more familiar with the federal government's several sodium-related label definitions, which vary considerably. For example, “sodium-free” means fewer than 5 milligrams per serving, while “low-sodium” means 140 milligrams or fewer per serving.

What's the prognosis for the consumer? Datamonitor's Productscan statistics show that the percentage of new foods (not including beverages) in the United States that claim to be no- or low-salt, or no- or low-sodium, is slowly rising. The figure for 2007 to date is 4.3%, up from 3.1% in 2006.

Another encouraging sign is that in April 2007, the World Health Organization published a report endorsing strategies that cut back on salt consumption as a cost-effective way to reduce serious health problems like heart disease and stroke.

The report also urged governments around the world to reduce average sodium consumption to 2,000 milligrams daily. In the U.K., one government agency initiated a vigorous campaign urging consumers to choose lower-sodium foods and to pressure the food industry to decrease sodium levels in their products.

CSPI would like the U.S. government to take a stronger stance on this issue. Like the AMA, the group also recommends changing salt's regulatory status from GRAS to “food additive,” which would give the FDA the authority to establish stricter regulatory limits.