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Lowering Sodium in the Food Supply

The Problem

The majority of sodium consumed comes from processed and prepared foods, not the salt shaker. This makes it difficult for all of us to control how much sodium we consume.

Some companies have reduced sodium in certain foods, but many foods continue to contribute to high sodium intake, especially processed and prepared foods, including foods eaten away from home.

Public Health Need

Americans consume on average 3,400 milligrams (mg) of sodium per day—nearly 50 percent more than the 2,300 mg limit recommended by federal guidelines.

Most children and adolescents also eat more than is recommended, ranging from 2,900 mg per day for children 6 to 10 years of age to 3,700 mg per day for teens ages 14 to 18 years.

Too much sodium can raise blood pressure, which is a major risk factor for heart disease and stroke.

One in three Americans adults has high blood pressure, and that number increases to almost one in two for African American adults. Additionally, one in 10 children has high blood pressure.

Reducing sodium intake has the potential to prevent hundreds of thousands of premature deaths and illnesses in a decade.

The Science

The totality of scientific evidence, as reviewed by many well-respected scientific organizations, supports lowering sodium consumption from current levels.

High blood pressure, which has been linked to diets high in sodium, is a major risk factor for heart disease and stroke.

FDA's goal to reduce sodium intake is consistent with the 2015 Dietary Guidelines Advisory Committee (DGAC) report, Healthy People 2020, and the two Institute of Medicine reports on sodium.

In addition, some but not all studies have found that a higher sodium intake is associated with a higher risk of cardiovascular disease and that a lower sodium intake is associated with lower risk of cardiovascular disease. ,Analyses of intervention trials of sodium reduction aimed at blood pressure have observed fewer events of cardiovascular disease as well.

The science supporting the relationship between sodium reduction and health is clear: When sodium intake increases, blood pressure increases, and high blood pressure is a major risk factor for heart disease and stroke – two leading causes of death in the U.S. (CDC has compiled a number of key studies, which continue to support the benefits of sodium reduction in lowering blood pressure. In some of these studies, researchers have estimated lowering U.S. sodium intake by about 40 percent over the next decade could save 500,000 lives and nearly $100 billion in healthcare costs.)

FDA Approach

FDA is issuing for public comment draft voluntary targets for reducing sodium in commercially processed and prepared food both in the short-term (2 year) and over the long-term (10 year).

The FDA wants to work with food companies and restaurants to gradually adjust sodium levels in food.

Voluntary guidelines provide FDA with greater flexibility to adjust these guidelines as new information becomes available and as the food supply evolves.

FDA’s approach supports sodium reduction efforts already made by industry, provides common targets for defining and measuring progress, and provides companies with the flexibility and time to innovate using emerging science on sodium reduction technologies.

Based on estimates using National Health and Nutrition Examination Survey (NHANES) data, if the food industry adjusts sodium levels in food based on FDA’s targets, we expect the short-term (2 year) targets for sodium content in food would reduce sodium consumption to about 3,000 mg per day, and that the long-term (10 year) targets would reduce sodium consumption to about 2,300 mg per day.

FDA is providing 90 days for comment on the short-term targets and 150 days for comment on the long-term targets.

There are 16 overarching categories with individual targets for about 150 subcategories of food in recognition that a one-size approach does not fit all.

To achieve a significant impact, the FDA is especially encouraging adoption by food manufacturers whose products make up a significant proportion of national sales in one or more categories and restaurant chains that are national and regional in scope.

The targets take into consideration the many functions of sodium in food, including taste, texture, microbial safety, and stability. FDA is seeking input from the industry on challenges posed by sodium reduction given the many functions of sodium in foods.

FDA's approach encourages a level playing field by setting voluntary targets for both processed and restaurant foods.

The targets do not address naturally occurring sodium or salt that individuals add to their food.

Read & Comment on the Draft Guidance for Voluntary Sodium Reduction Goals

Frequently Asked Questions on FDA's Sodium Reduction Strategy

1. What is FDA doing?

Every day, Americans are getting too much sodium in their diet, and the majority comes from processed and prepared foods, not the salt shaker. That is why we have developed draft guidance with sodium reduction targets to encourage industry to gradually reduce sodium in a wide range of foods. We are recommending both voluntary short term (2 year) and long-term (10 year) targets.

2. Which foods are highest in sodium?

Sodium is added to almost all processed foods. Some foods are known to be high in sodium, but what’s also important is how much and how often the food is consumed. Certain frequently consumed foods such as pizza, sandwiches, deli meats, pasta dishes, snacks, breads and rolls are known to contribute significantly to sodium intake. On the other hand, some high-sodium foods, such as dried fish, do not contribute as much to overall sodium intake because they typically aren’t consumed in large quantities, or as often.

3. Why is sodium added to food?

Sodium is added to processed food for a wide variety of reasons. For example, it is used to control microbial growth, which can cause food to spoil and to cause illness. Sodium also is used for taste and for texture, leavening, and fermentation. While sodium is necessary for many reasons, today’s food supply contains too much sodium.

4. Why is reducing sodium in foods important?

Too much sodium contributes to high blood pressure, which can lead to strokes and heart attacks. Americans now consume on average about 3,400 milligrams (mg) of sodium each day, while federal guidelines recommend less than 2,300 mg for the general population. Reducing sodium in foods will prevent hundreds of thousands of premature deaths and illnesses over a decade.

5. How strong is the science on the benefits of sodium reduction?

The totality of scientific evidence, as reviewed by many well-respected scientific organizations, continues to support lowering sodium consumption from current levels. For example, the 2013 IOM report concluded, after reviewing the latest scientific literature, that evidence supports efforts to lower excessive dietary sodium intakes. The 2015 Dietary Guidelines Advisory Committee recently considered the 2013 IOM report and other evidence and concluded that sodium intakes should be less than 2,300 mg per day. Recent studies have investigated the direct relationship between sodium intake and heart disease and there is controversy about some findings from observational studies. The limitations of some of these studies have been carefully reviewed and critiqued (Cobb, 2014). For example, in some studies the method used to assess sodium intake (a single morning spot urine sample on one day rather than multiple 24 hour urine samples over time) was a limitation that may have affected the results.

6. What if I don’t have these health problems?

One in three adults has high blood pressure, and you are more likely to have high blood pressure as you get older. This tendency for blood pressure to rise with age is seen mostly in western countries where sodium intakes are high. Children and adolescents also are more likely to have increased blood pressure with higher sodium intakes, and studies suggest that the preference for sodium is affected by early life consumption habits. Children who consume higher sodium foods tend to continue to consume higher sodium foods later in life.

7. Can’t people just check the labels on foods in the supermarket?

Consumers can, and should, check labels when they are available, but not all foods are labeled; an example is deli meats you buy at a counter. Even with labeling, consumers still have a difficult time eating the recommended amount of sodium because sodium levels in today’s marketplace are just too high. The majority of the sodium we eat comes from processed and prepared foods before we add salt at the table or during cooking.

8. Why are you including restaurant foods?

Americans eat about one-third of their food calories and spend about half of their food dollars outside the home so it’s important that restaurants are part of the solution, along with the rest of the food industry. Including restaurant foods is necessary to achieve sodium reduction goals and for people to adapt their taste buds whether they are eating at home or outside the home.

9. Won’t foods with less sodium taste bad?

The sodium in your diet comes from a lot of different types of foods—especially mixed dishes that have a lot of components and sauces. Our approach is to encourage reductions in a variety of products—not just ones that are really high in sodium. This way, we aren’t recommending drastic reductions that will significantly affect the taste of food, and you won’t have to give up your favorites. We carefully studied the range of popular foods in today’s marketplace to see what reductions are possible based on what some companies are already doing.

We also know that people usually don’t notice small reductions (about 10 to 15 percent) in sodium. Over time, taste buds get used to even larger changes, especially if they are made gradually. In addition, there are other ways companies can reformulate, or change, certain foods while still making them tasty to consumers. Examples include adding savory herbs and spices, salt blends, or other flavorings and innovations that enable salt reduction

10. Haven’t many companies already come out with lower sodium foods?

Yes, some food companies are making progress already and we applaud their leadership. But even with these efforts, the sodium content of the food supply remains high. Part of the problem has been the focus on making a few foods very low in sodium, instead of making most foods a little lower in sodium. We want to give the industry common targets across a broad range of foods.

11. When will I see changes in sodium in the foods I buy?

We are encouraging companies to meet short-term targets in two years (note that some foods already meet the short-term targets). We expect that if the food industry reaches these initial targets more broadly, it would reduce average sodium intake to about 3,000 mg per day. We expect the long-term, 10-year targets would lower sodium in the food supply to reduce average sodium intake to close to 2,300 mg per day.

12. Are other countries making similar efforts to reduce sodium in foods?

Yes. There are 75 countries working to reduce the sodium intake and 39 have set sodium target levels for one or more processed foods The World Health Organization has recommended a global reduction in sodium intake that is close to what our targets would achieve. It is difficult to compare countries in terms of progress because sodium intake varies worldwide, and different approaches may be needed based on foods typically eaten. But many countries, such as the United Kingdom and Canada, have made efforts to reduce sodium in their foods.

13. How will you know if companies are making progress in reducing sodium?

A key part of FDA’s long-term plan is to monitor progress toward our goals on a regular basis to understand changes that are occurring. We will work with other government agencies such as the U.S. Department of Agriculture and the Centers for Disease Control and Prevention on these monitoring efforts.

Consumer Information on Reducing Sodium Intake

Additional Resources

History of Actions on Sodium Reduction

On September 13, 2011, the Department of Health and Human Services, with several key initial partners, launched Million Hearts, an initiative that aims to prevent one million heart attacks and strokes over the next five years. As one component of this initiative, the U.S. Food and Drug Administration (FDA) and the Food Safety and Inspection Service (FSIS) launched efforts to identify opportunities to reduce sodium in food in order to put more control into consumers' hands. Excess sodium is a contributory factor in the development of hypertension, which is a major risk factor for heart disease and stroke.

September 2011: FDA and FSIS seek comments on sodium reduction

FDA and FSIS established dockets to obtain comments, data, and evidence relevant to the dietary intake of sodium as well as current and emerging approaches designed to promote sodium reduction.

October 2011: Public Meeting

FDA and FSIS, along with the Centers for Disease Control and Prevention and USDA's Agricultural Research Service and Center for Nutrition Policy and Promotion, sponsored a public meeting to provide interested persons an opportunity to discuss the topics raised in the September 15, 2011 Federal Register Notice. The sponsoring agencies provided multiple opportunities for individuals to actively express their views by making presentations at the meeting, participating in breakout sessions, and submitting written comments to the designated docket(s) by January 27, 2012. We recognize ongoing efforts by a number of members of the restaurant and packaged food industries to reduce sodium and appreciate the complexities of reducing sodium in foods. Input and support from industry and other stakeholders are important to support further progress on this significant public health issue.