Center for Communications, Health and the Environment
|Spring 2011||Vol. 6, Issue 1|
New U.S. Dietary Guidelines Target Consumption to Combat Obesity, Other Chronic Diseases
Written in conjunction with the staff of the Center for Science in the Public Interest
The 2010 Dietary Guidelines for Americans (DGA) task the population to lower its daily sodium intake, and to compare foods and choose those with lower sodium contents. And with good reason.
Eating less salt is one of the single best ways to prevent high blood pressure, heart attacks and strokes. Yet, despite decades of pressure by groups like Center for Science in the Public Interest (CSPI) and admonitions by prominent health experts, per capita sodium consumption has risen, and continues to increase.
Applying the adequate and tolerable intake levels developed by the Institute of Medicine (IOM), the current DGA recommend that individuals 14 years and older consume no more than 2,300 milligrams (mg) of sodium a day (about a teaspoon of salt), while people with hypertension, diabetes or chronic kidney disease, those who are 51 years and older, African Americans and children 9 to 14 consume no more than 1,500 mg of sodium daily. This 1,500 mg recommendation applies to about half of the U.S. population. Meanwhile, children ages 4 to 8 are advised to consume no more than 1,200 mg of sodium a day, and children ages 1 to 3 no more than 1,000 mg.
In fact, virtually all Americans consume more sodium than they need – about twice the recommended levels – and that’s the case for most people around the world. The National Cancer Institute’s 2005-2006 National Health and Nutrition Examination Survey (NHANES) found that average estimated daily sodium consumption was about 3,400 mg for adults, with children also grossly over-consuming the mineral (see chart). Actual daily intake, however, is probably even higher – closer to 4,000 mg/day for adults – since NHANES estimates omit salt added at the table or in cooking, and survey respondents often underestimate their actual consumption.
Contrary to popular belief, most of the sodium populations in industrialized countries consume is not from the salt shaker. Three-quarters of all sodium comes from processed and restaurant foods. Many restaurant meals, especially at table-service restaurants, provide huge amounts of sodium – mostly from salt – in a single meal. At Applebee’s, for example, a meal of Sizzling Shrimp Skillet Fajitas and accompanying sides contains 5,310 mg of sodium; and while their Weight Watchers® Chipotle Lime Chicken with sides may pack only 490 calories, it shocks the system with 4,990 mg of sodium. At Red Lobster restaurants, the Admiral’s Feast alone contains 4,300 mg of sodium. Add in a Caesar Salad, a Cheddar Bay Biscuit and a Light Lemonade, and dinner delivers 5,265 mg – more sodium than is safe for most people to consume in three days!
Even some foods purchased at the grocery store have unsafe levels of salt. A Swanson Hungry Man Roasted Carved Turkey frozen dinner contains 1,620 mg of sodium. And some foods intended for children, like an Oscar Mayer Lunchables with Lean Ham and Cheddar Cracker Stackers, has more than 1,000 mg of sodium – nearly an entire day’s worth for kids ages 4 to 8.
But everyday foods such as bread also add up to surprisingly large amounts of sodium – not because they are salt-laden, but because people consume such foods frequently. In fact, yeast breads, including white bread/rolls, mixed-grain bread, flavored bread, whole-wheat bread/rolls, bagels, flat breads, croissants and English muffins, contribute 7 percent of the sodium in the U.S. diet, based on data from the 2005–2006 NHANES. Meanwhile, chicken naturally contains little sodium, but the ways in which it is both packaged and prepared often add tons of salt to an otherwise low-sodium option.
According to the DGA, “...calorie intake is associated with sodium intake (i.e., the more foods and beverages people consume, the more sodium they tend to consume).” So limiting calorie consumption can help reduce sodium intake, although this is not a given, as in the case of Applebee’s Weight Watchers® Chipotle Lime Chicken dinner.
Lowering sodium consumption also would save tens of billions of dollars in annual healthcare costs. A 2009 RAND Corporation study estimates that reducing average sodium intake from 3,400 to 2,300 mg per day would reduce direct medical costs by $18 billion per year. And a further reduction to 1,500 mg per day could cut medical costs by $28 billion annually. Because hypertension is a major cause of disease and death in most countries around the world, similar benefits due to lowering sodium consumption would accrue to most nations.
That said, with many restaurants now making their nutritional information publicly available, sodium levels may finally be dipping. For example, Red Lobster’s above-mentioned Admiral’s Feast, Caesar Salad, Cheddar Bay Biscuit and Light Lemonade previously packed 6,555 mg of sodium, 1,290 mg more than it does today. Perhaps, the food industry is getting the message (or adjusting portion sizes to deliver the difference).
Meanwhile, America’s biggest hope for widespread sodium reduction rests on the National Salt Reduction Initiative (NSRI). Based upon the U.K.’s Salt Reduction Campaign, the NSRI is a coalition of 72 local and state health authorities and health organizations working to help food manufacturers and restaurants voluntarily reduce the amount of salt in their products. The goal of the NSRI is to reduce sodium intake by 20 percent over five years, by cutting the salt in packaged and restaurant foods by 25 percent during that time. Spearheaded by the New York City (NYC) Health Department, it is currently led by NYC health officials, who, after receiving input from industry, in April 2010, announced final targets for 62 categories of packaged food and 25 categories of restaurant food. To date, 28 food manufacturers and restaurant chains have committed to the NSRI sodium targets, including Campbell Soup Company, Kraft Foods, Au Bon Pain, Starbucks Coffee Company, Unilever and Target Corporation.
Other companies (including major ones such as ConAgra, Pepperidge Farms and Frito-Lay) have also committed to reducing sodium on their own accord by about 10 to 25 percent over the next several years.
To ensure that all food manufacturers and restaurant chains reduce sodium in their foods, the FDA needs to take action and set mandatory limits on salt, which could be phased in gradually over time. This is exactly what a landmark IOM report on strategies to reduce sodium called for in April 2010. Mandatory measures are also likely to be necessary in other countries that are experiencing unnecessarily high rates of cardiovascular disease due to excess dietary salt.
Sodium reduction should be a top health priority for governments around the world. The new dietary guidelines have upped the ante in America, and CSPI will continue to urge the U.S. government and the food industry to cut sodium; but health advocates will be the key to measures that are truly “worth their salt” at reducing sodium levels both in the United States and around the world.
|Copyright © 2011 Center for Communications, Health and the Environment (CECHE)
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