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Eating a diet high in sodium has negative consequences for heart health. However, less than 5% of the sodium in our diets comes from the salt shaker at the table. Reducing the amount of sodium in Americans’ diets therefore requires policies to reduce the amount of sodium that is added to our food through processing, packaging, and in restaurants, before it even gets to our tables.
The USDA’s 2010 Dietary Guidelines state that healthy adults can take in at most 2,300 mg of sodium per day without raising the risk of adverse health consequences. The Guidelines note, however, that about half of the American population (including the majority of adults), actually should consume no more than 1,500 mg per day. The Institute of Medicine (IOM) has found that the Adequate Intake level of sodium for the average adult is 1,500 mg per day. While we do need to eat some salt, the necessary amount is quite small (only 180 to 500 mg per day) compared to the amounts we regularly eat. According to CDC figures, the average American over the age of 2 years old regularly takes in about 3,436 mg of sodium per day.
This excessive sodium consumption has real consequences for our health. Eating too much sodium raises blood pressure. High blood pressure in turn is a major risk factor for heart disease and stroke, which are the nation's first and third leading causes of death, respectively. The good news is that blood pressure levels can also drop when sodium consumption is reduced and, research shows that preferences for salty taste also respond to reductions, so people’s preferences do adjust to sodium levels in their food. This means that sodium reductions can improve our health, and won’t taste bad to us, especially if they’re done gradually. But if most of the salt in our food gets there before we even touch it in the store or restaurant, what can we do about it?
The Food & Drug Administration (FDA) considers salt’s use as a “common food ingredient” to be “Generally Recognized as Safe” (GRAS) without any special conditions. Essentially, this means that there are no legal limits on how much salt manufacturers and processors can add to food, as long as they stay within what is called “good manufacturing practices”. In 2010, the IOM released Strategies to Reduce Sodium Intake in the United States (“IOM Report”) which documented a series of recommendations for reducing U.S. sodium intake. The IOM’s primary recommendation is that the sodium content of packaged and restaurant foods should be reduced by having the FDA change the GRAS status of salt and other sodium compounds so that the salt amounts that qualify as GRAS would decrease gradually, in a stepwise manner, over time. The Report suggests that labeling also could be used to encourage food companies to accelerate reduction efforts, and to promote consumer awareness.
Beyond trying to implement this IOM recommendation, there are several other ways that federal, state, and local governments are addressing concerns about overconsumption of salt, through both regulation and voluntary programs. Regulatory approaches include regulation of food nutritional labeling and front-of-pack claims such as “healthy” or “low sodium.” The FDA is also currently reconsidering sodium’s Daily Value in relation to nutrition labeling requirements – sodium’s Daily Value is currently 2,400 mg/day. The nutritional standards for the national school breakfast and lunch programs include stepwise sodium reductions, as do the proposed voluntary nutritional principles issued in April 2011 by the Interagency Working Group for Food Marketed to Children.
In addition, school districts, government agencies, businesses, and organizations of all kinds can participate in sodium reduction efforts by including sodium limits in their food procurement policies, including healthy vending contracts.
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On February 10, 2017, the Appellate Division of the New York Supreme Court upheld New York City’s sodium warnings rule. After thirty days passed and the National Restaurant Association did not appeal this decision, the legal battle over the New York City’s sodium warnings rule ended and the rule remained in effect. The Public Health Law Center filed two amicus briefs in support of the rule during the case.