Best known for deciding whether medications are safe and effective, the Food and Drug Administration is weighing whether to crack down on plain old salt, which doctors say is harmful in the quantities most Americans consume.
At a hearing today, the agency will begin collecting expert testimony on the role excess salt in the diet plays in causing high blood pressure, heart disease and strokes. An increasingly vocal medical community has joined consumer groups to demand government intervention, and the review could lead to federal limits on the salt content of processed foods such as canned soups and breakfast cereals.
FOR THE RECORD:
Regulating salt: An article in Thursday's Section A about a possible federal crackdown on sodium in processed foods incorrectly said that Contadina tomato paste had higher levels than Hunt's. Contadina has 20 milligrams of sodium per 2-tablespoon serving; Hunt's has 95 milligrams. —
In a carefully calibrated response, the food industry has acknowledged a problem but has called for voluntary solutions rather than government regulation. More than 75% of the salt the average American consumes comes from processed foods and restaurant meals.
At issue is whether the FDA should change its official classification of salt as "GRAS" -- Generally Recognized as Safe -- and instead declare it a food additive subject to limitations.
The Bush administration, often loath to impose new regulations, may have an added incentive to act in this case: It is planning to launch a national campaign against obesity, particularly among children. And salty foods contribute to the problem, because people often wash down their hot dogs and potato chips with beverages rich in sugar.
"Normally they're not drinking water, they're drinking soda," said Dr. Stephen Havas of the American Medical Assn., citing estimates that soft drinks, beer and wine consumed with salty foods add about 280 calories a day to the American diet. "That's huge," he said.
FDA officials say they view excess salt in the diet as a serious public health issue, but the agency is keeping its options open.
"We certainly recognize that it's a big problem for a lot of people, and consumers should have choices if they want to reduce their salt intake," said Laura Tarantino, director of the FDA's office of food additive safety, who is taking a leading role in the agency's review.
The agency's involvement is long overdue, some activists say.
"For the first time in 25 years, the FDA is showing an interest in lowering sodium levels in the food supply," said Michael F. Jacobson, executive director of the Center for Science in the Public Interest, a consumer group that petitioned the agency to take action.
Jacobson's group had been waging a campaign to get the FDA's attention, but prospects for action improved markedly after the AMA made it a top priority last year. "We came to the conclusion that the evidence is overwhelming," Havas said.
Too much sodium has been linked in scientific studies to high blood pressure, a major risk factor for heart disease and stroke.
The National Academy of Sciences recommends that adults consume no more than 2,300 milligrams of sodium daily, roughly the amount in a teaspoon of salt. The target is lower -- 1,500 milligrams -- for people at higher risk for high blood pressure, including those over 50 and African Americans.
Americans typically consume about 4,000 milligrams of sodium daily.
The AMA cites estimates that 150,000 lives could be saved annually if the nation were to reduce its sodium consumption by 50%, a goal the doctors' group says can be attained within a decade.
It probably can't happen without the cooperation of the food industry, and producers are skeptical.
"Claims about [low] salt are often a turnoff for consumers," said Robert Earl, senior director of nutrition policy for the Food Products Assn., a trade organization. "Consumers automatically think it means the food isn't going to taste good."
But Jacobson said his group's research shows that the sodium content of the same types of packaged foods can vary dramatically. For example, Contadina tomato paste has 237% more salt than Hunt's -- although Contadina tomato sauce has 33% less sodium than Hunt's. Such findings suggest there's room to lower sodium levels without affecting taste, Jacobson said.
Regulators in other industrialized countries already have begun grappling with the problem. In Finland, government and industry have collaborated to bring about a 40% decrease in sodium consumption since the late 1970s, according to the AMA. In the United Kingdom, government regulators set voluntary sodium reduction targets for about 70 kinds of processed foods.
U.S. consumers seeking low-sodium foods complain of few choices and higher prices. For example, canned soups are considered a good alternative for people who are interested in cutting down on fatty foods. But many soups are high in sodium, and the low-salt versions often cost more.
Earl, the industry expert, said the FDA should consider ways to entice companies to lower sodium content instead of imposing requirements.
For example, the agency could create a new category of lower-sodium foods, one that does not require a steep initial cut in salt content.
"Carrots will be more effective than sticks, and incentives to continue to gradually reduce the sodium content over time are going to be more effective than a very abrupt reduction," he said.
"Voluntary action is very important, and it could bring sodium levels down more quickly than regulation," Jacobson said. "But not every company will do it. And voluntary action can be easily reversed. Regulation is more durable."
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