Nine out of 10 Americans are eating way too much salt, according to a report this week from the Centers for Disease Control and Prevention (CDC).
The government’s current dietary guidelines advise Americans to consume less than 2,300 mg of sodium — about a teaspoon’s worth — per day. People who are at higher risk for heart problems, including middle-aged and older adults, blacks and those with high blood pressure, should restrict sodium to 1,500 mg a day.
But based on 2005-2006 data from an ongoing federal survey, CDC researchers found that just 5.5% of people in the high-risk group, which accounts for 70% of the U.S. population, met that goal, while 19% of all other adults stayed within their daily 2,300-mg limit.
On average, Americans take in more than 3,400 mg of sodium per day, which experts say is contributing to higher rates of heart disease and stroke.
But reducing dietary sodium is no easy proposition. Salt is everywhere, hidden in virtually every packaged food, from soup and salad dressings to breakfast cereals and chocolate chip cookies. (Click here for a revealing New York Times graphic about foods with a surprising amount of salt.) Considering that nearly 80% of the salt we consume comes not from the tabletop shaker but from processed and restaurant-prepared foods, it would take the coordinated effort by the food manufacturing and service industries to reduce Americans’ sodium intake.
In January, New York City Mayor Michael Bloomberg launched a nationwide siege on salt, with the goal of getting food manufacturers and restaurant chains to reduce the amount of salt in their products by 25% over the next five years. In April, the Food and Drug Administration announced plans for a similar effort — the Washington Post reported that the government intends to work with the food industry to reduce salt gradually over a period of years to adjust the American palate to a less salty diet. “The initiative, to be launched this year, would eventually lead to the first legal limits on the amount of salt allowed in food products,” the paper reported.
In the meantime, several companies and food retailers — including Conagra, General Mills, Kraft Foods, Pepsico, Sara Lee and the supermarket A.&P. — have already pledged to bring down the salt in many of their products.
The health benefits of these efforts could be significant, according to some scientists. A study published in January in the New England Journal of Medicine concluded that the cardiovascular benefits of lowering salt intake would be on par with the benefits reaped from population-wide reductions in smoking, obesity and cholesterol levels.
The study found that if Americans consumed about half a teaspoon less sodium (1,200 mg) per day, there would be between 54,000 and 99,000 fewer heart attacks each year and between 44,000 and 92,000 fewer deaths. New cases of heart disease would drop by between 60,000 and 120,000 each year and cases of stroke would be reduced by between 32,000 and 66,000. The savings to the health care system would be in the tens of billions. The NEJM study suggested that all Americans would benefit from eating less salt, but that the high-risk group — people with hypertension, older adults and blacks — would be helped most.
Still, not all experts agree with the findings, contending that salt is crucial for good health and that universal reductions in salt intake may have wide-ranging effects beyond just lowering blood pressure — not all them beneficial nor uniform in all people. In a 2008 randomized trial of heart-failure patients, for instance, patients placed on a sodium-restricted diet (1,840 mg a day) were more likely to die or end up re-hospitalized than people eating normal amounts of salt (2,760 mg of sodium per day), as observed in a February commentary in the Journal of the American Medical Association.
The JAMA article, written by Dr. Michal Alderman of Albert Einstein College of Medicine in New York City, went on to note that out of 11 other observational studies of normal salt intake in adults, five found no association between salt consumption and clinical heart outcomes. A 2003 review of the literature by the Cochrane Collaboration similarly concluded there was little evidence to support a “general recommendation to reduce sodium intake.” Lowering salt across the board — “for countries like the United States, this means changing the diet of all its residents by reducing the sodium content of prepared foods,” Alderman wrote — would amount to an uncontrolled experiment on the health of unwitting volunteers, the JAMA paper suggested.
Stay tuned for the government’s new dietary guidelines, which are expected to be made official in the fall. The proposed revisions to the 2005 Dietary Guidelines for Americans issued by a panel of scientists and nutritionists appointed by the Department of Agriculture and the Department of Health and Human Services, call for lowering the maximum daily amount of sodium to 1,500 mg per day.