April 23, 2009

NYC Seeks To Intervene In Salt Consumption

New York City health department officials have again expanded their campaign against culinary criminals.  First came the ban on trans-fats.  Then the ordinance that calorie content had to be listed in menus.  Now they are tackling the high salt content of common staples like soup, pasta sauce and salad dressings.

According to national health studies, roughly 75 percent of the average American's salt intake comes from already prepared and processed foods, rather than their own salt shakers.  New York health officials say the food industry needs to help out citizens by reducing the amount of sodium they add to their products.

"It's very hard for an individual to do this on their own," said assistant commissioner to the NYC health department Dr. Lynn Silver.

In recent years, the health department has flexed its muscles and forced fast food chains to modify their menus at the national level as numerous smaller municipalities followed New York's lead.

Many food manufacturers explained that as hard as it was to eliminate trans fats from their cuisine, reducing salt will likely prove an even greater challenge.

Unlike the various artificial sweeteners that can be used in place of sugar, there's no real substitute for salt.  Creamy soups such as those found frequently in traditional casserole dishes represent the biggest challenge to industry, explains George Dowdie, leader of the research and development arm of Campbell Soup Co. 

Campbell Soup is one of several companies that has already entered into talks with New York health officials.

The iconic soup maker has for years offered reduced sodium versions of its most popular products.  By fall 2009, Campbell says they will have almost 100 low-sodium soups in their repertoire, including their very first product, tomato soup, available in a 30 percent reduced salt version.

Industry leaders hope that reducing salt content will remain voluntary.

Robert Earl, vice president of science, nutrition and health for the Grocery Manufacturers Association, explained: "Literally freight cars full of salt have been removed from these products gradually over time.  It has been done carefully, gradually and incrementally over time."

Health experts have suspected for years that a diet full of salt is one of the most common causes of high blood pressure "“ a condition that in turn increases the risk of various forms of heart disease.  Some studies have suggested that even small decreases in the amount of salt contained in manufactured products can reduce the incidence of heart disease by several hundred thousand cases per year.

"Very, very small changes in diet could have dramatic effects," said Dr. Kirsten Bibbins-Domingo of the University of California in San Francisco.

The New York crusade against sodium stated as its goal the reduction of salt intake by at least 20 percent within five years.  Modeling their program after a similar program carried out in England, New York officials have recruited medical groups and public health agencies around the country to help set voluntary salt reduction targets for 85 different categories of food.

According to Corinne Vaughan of Britain's Food Standards Agency, companies that participated demonstrated surprising ingenuity in their approaches to the problem and have been extremely effective in making "quite huge reductions in salt levels."

Some types of foods proved easier than others to adapt to the new standards, Vaughan admitted.  Pasta sauces and soups easily reduced their salt content by as much 30 percent, while other products like cheeses and breads have proven trickier due to complications in processing procedures.

A number of British companies have begun using a "traffic light" system on packaging labels to give customers an easy visual cue for gauging salt content of a product before they purchase it.  A green light indicates low salt content, while a red light warns of higher levels.

Sodium chloride "“ commonly known as table salt "“ is a necessary component of everyone's diet.  Problems arise however when people begin to exceed the daily recommended value 2,300 milligrams, or about one teaspoon.  Many Americans consume more than double the recommended of salt; a task that is not difficult when one considers that there are more than 1,000 milligrams of sodium in a single Big Mac.

Recent government statistics show that people already at an increased risk of high-blood pressure "“ including everyone over 40 and African-Americans "“ should be eating even less than the recommended amount of salt; about 1,500 milligrams instead of 2,300.

Despite the potential health risks of a high sodium diet, many people are concerned about the government's increasingly pro-active role in regulating what people eat.  A number of critics noted the fact that not all people have the same sensitivity to salt.  Others have observed that there is not enough scientific evidence to prove that a reduction in salt intake necessarily leads to a decreased risk of heart disease.

Nevertheless, there is tremendous support in the medical field for increased governmental intervention in the field of dietary health.

"When you've got groups...all saying we need to reduce salt, the evidence is exceedingly strong; you don't want to do more trials," explained Dr. Stephen Havas of Northwestern University's medical school and former vice president of the American Medical Association.

The U.S. Food and Drug Administration says it will wait for the a committee report on the matter from the Institute of Medicine before issuing any new regulations.

Meanwhile, researchers like Bibbins-Domingo say that she and her colleagues support efforts to lower salt levels, either by voluntary efforts or by regulatory force.

She explained that many of her patients with high blood pressure have an extremely hard time cutting down their salt intake.  They may give up French fries and salty nuts, but they often end up replacing them with pasta sauces, soups and dressings that have contain almost as much sodium.

"I realized how hard it is for patients who want to make those changes" to succeed she explained.  Whether government regulation is the best means to address the problem remains dubious at best.


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