It's time to regulate salt, government panel says

Citing 40 years of failed efforts to voluntarily reduce the amount of salt in food, an advisory panel Tuesday recommended that the government regulate sodium for the first time, gradually setting limits that could save 100,000 lives and billions of dollars in medical costs a year.

The proposals outlined by the Institute of Medicine envision step-by-step efforts that would both ratchet back Americans' desire for salt and mandate the maximum amount that could be added to various types of foods.

"If done correctly," IOM panel chair Jane E. Henney told reporters, consumers "will practically notice no change in taste."

It is a tricky proposition. Remove too much salt too fast, and Americans could lose interest in the plate in front of them.

But numerous health groups have for years urged strong measures. About one-third of Americans have high blood pressure, which is a risk factor for stroke, heart attack, and kidney disease. Increasing levels of sodium are linked with high blood pressure.

Both have risen steadily in recent decades - the average person now consumes 50 percent more than the recommended maximum - as people have eaten more processed food and taken more meals in restaurants, which often serve large portions of salty fare.

Various efforts to change consumer behavior have made little difference. Only 15 percent of people get less than the recommended maximum 2,300 mg.

At Chili's, for example, not a single taco or burger platter on the menu contains less than this daily total, according to its Web site.

With the exception of Philadelphia, which this month became the first major jurisdiction in the nation to require that chains list sodium and other nutritional information on printed menus, it is difficult for consumers to tell what is in their food. One recommendation by the panel is that Congress consider putting sodium on menus.

But the key recommendation is that the Food and Drug Administration begin to mandate a series of incremental reductions in the maximum amount of salt - mainly sodium - that can be added to foods and beverages. Anything above the maximum would be illegal.

The food agency already has the authority to regulate salt, the panel said, as part of its powers to approve food additives unless they fall under a category known as generally recognized as safe.

"However, rather than revoke the status of salt as a GRAS food substance, the committee recommends activities to modify the conditions under which salt added to foods can remain GRAS," the panel wrote.

For example, the FDA might mandate maximum amounts of sodium per serving in food categories - say, bacon - in 2015, then slightly less in 2018, and finally reaching the goal in 2024.

"It must be done very thoughtfully," said panel chair Henney, a former FDA commissioner and now a medical professor at the University of Cincinnati. Pickles, for instance, "are very high in salt content but are not eaten that often," she said, "so what you get with pickles might be quite different than something that is eaten more frequently, like bread, or cereal."

The gradual implementation would be intended to wean Americans off their salt habit. "It is a little bit like coming in from bright light to a darkened room," said panel member Gary Beauchamp, who researches taste as director of the Monell Chemical Senses Center in Philadelphia. "If you do it gradually, people probably won't notice it much."

Beauchamp and others said a key reason to make sodium limits mandatory was to get the food industry "on a level playing field," so manufacturers and restaurants don't use salt to compete for customers.

Another panel recommendation is to clarify current daily limits. Although the maximum is 2,300 mg, a footnote in nutrition guidelines says that people with hypertension, black adults, and everyone over 50 - well more than half the U.S. population - should consume no more than 1,500 mg.

The panel suggested making 1,500 mg the ceiling for everyone.

The food industry has long argued that it didn't have tasty ways to replace sodium if it made deep cuts. But reaction from the industry on Tuesday was mixed.

Campbell Soup Co., which has greatly expanded its lower-sodium offerings in recent years, said it would gradually lower sodium levels while still appealing to consumer tastes.

McDonald's Corp. said it was waiting to see details of the report.

But the head of the salt lobby blasted efforts to curb salt consumption as an unwarranted and overly broad assault. "It's not scientifically sound," said Lori Roman, president of the Salt Institute. "They could be harming people."

The proposed government mandate goes beyond attempts launched this year by New York City to persuade industry to voluntarily reduce salt in restaurants and packaged foods.

The United Kingdom's extensive voluntary program has managed to cut sodium consumption by only about 10 percent since 2004.

The risks of high blood pressure vary among populations. Blacks and the elderly are far more likely to be diagnosed with hypertension than other groups.

While about a quarter of all adults in the suburban counties of Southeastern Pennsylvania told interviewers that they had high blood pressure, according to the 2008 Household Health Survey, more than 35 percent of Philadelphians did. Among people age 60 and over, about half of suburban residents and nearly two-thirds in Philadelphia had high blood pressure.