In a strongly-worded submission to the Food Safety and Inspection Service (FSIS), as part of its probe into sodium reduction, the AHA said there was “overwhelming evidence” that lowering sodium improved cardiovascular outcomes.
It also called on the government to impose mandatory low-sodium targets, set a daily value for sodium of 1,500mg/day for labeling purposes and to change the GRAS status of salt.
Its comments came as the Grocery Manufacturers Association (GMA) filed comments with FSIS arguing that “results from a growing number of published research studies dispute the conventional wisdom that sodium reduction will universally lead to health-promoting outcomes”.
Instead, said the GMA, ”the data show that sodium reduction may lead to unintended health consequences such as increased all-cause and cardiovascular disease mortality.”
We ‘strongly disagree’ with Salt Association statements
But AHA president Dr Gordon F. Tomaselli said the “overwhelming evidence shows that reductions in sodium consumption are linked to improvements in blood pressure and a reduced risk for a number of chronic diseases”.
He added: “Despite the abundance of studies showing the benefits of lowering sodium consumption, there are some who question the science and argue that sodium reductions will hurt rather than improve health.
“The salt industry has, for example, claimed that ‘there may indeed be very negative consequences if the diet limits sodium to the range of 1,500 - 2,300mg/day as recommended in the Dietary Guidelines’ and that ‘there are more medical studies that caution against population-wide salt reduction than support it… and could result in mass illnesses’.”
He said: “We strongly disagree with these statements – they are not supported by the science. We also question studies that the salt industry has used to show that reductions in salt intake do not result in improved cardiovascular outcomes.”
Mandatory sodium targets, daily value of 1,500mg/day and a change to salt’s GRAS status
Meanwhile, although most food manufacturers advocate a voluntary approach to sodium reduction, the AHA says mandatory targets are the only way to tackle excess sodium intakes.
All voluntary sodium reduction programs “have one element in common”, claimed Tomaselli. “They all lead to some degree of sodium reduction.
“But the programs are limited in scope and do not have the ability to require sodium reductions in the entire food supply. To achieve widespread sodium reductions, a mandatory nationwide standard will be required.”
Given the difficulty for food manufacturers presented by sodium reduction, AHA “recommends that the FDA use a step-wise process to reduce sodium content over time”, said Tomaselli.
“The FDA could establish intermediate sodium limits designed to reduce overall sodium consumption to 2,300mg by 2015. Final limits reducing sodium consumption to 1,500mg could take effect in 2020.”
CSPI: Voluntary approach has failed
His comments were echoed by the Center for Science in the Public Interest, which said “many food manufacturers and restaurants, when acting voluntarily, have failed to reduce sodium content to acceptable levels”.
It added: “In addition to setting ceilings for sodium in foods, the FDA could also … alert consumers to high sodium levels by requiring the word ‘high’ adjacent to the word ‘sodium’ on Nutrition Facts labels.
“It also could require on bulk packages of salt a statement such as ‘Salt promotes heart disease. Try using half as much salt as recipes call for’.”
General Mills: Mandatory targets are unrealistic and unsustainable
However, Kathryn L. Wiemer, director and fellow at the General Mills Bell Institute of Health and Nutrition, said mandatory ceilings for sodium were “unrealistic” and “not sustainable.
“If the food industry is faced with overly aggressive, mandatory sodium reduction targets and not given adequate time to address these technological challenge", she argued, "we will not be able to adequately formulate food products to consumer expectations and the FDA’s efforts will be for naught.”
Meanwhile, Campbell Soup’s decision to add sodium back to selected soup lines last year was a “cautionary tale” that “illustrates the point that food manufacturers cannot help improve dietary sodium intakes if our solutions are not viable in the marketplace”, she added.
Finally, she urged all government agencies to “conduct a thorough review of the emerging evidence describing the potential unintended consequences of reducing sodium intake”.