May 2017

The Center for Science in the Public Interest found widely varying amounts of sodium among brands of 100% whole wheat and white breads.  For instance, Whole Foods’ Organic 100% Whole Wheat Sandwich Bread has an astounding two-and-a-half times as much sodium per 100 grams as Target’s Simply Balanced 100% Organic Whole Wheat Bread.  In fact, when it comes to sodium, eating one slice of the Whole Foods’ bread is like eating 22 potato chips. 

Sodium levels also vary widely in white breads. Pepperidge Farm's Farmhouse Hearty White Bread has 70 percent more sodium per 100 grams than Whole Foods' 365 Everyday Value Classic White Bread. 

To view the full release, please click here.

2016

The Sodium Reduction in Communities Program (SRCP), administered by the Center for Disease Control’s Division for Heart Disease and Stroke Prevention (DHDSP), awards funding to communities across the country to implement strategies to reduce sodium intake. As the majority of sodium consumed is already present in foods before purchase or preparation, awardees work with entities that provide food service and collaborate with food industry partners to increase the availability of lower sodium foods. 

They have produced an infographic to highlight awardees’ work in their communities during the 2013–2016 award cycle. Examples include making recipe modifications and replacing products with lower sodium options in hospitals, schools, and other local organizations. To view this infographic, please click here.

August 2016

The National Salt Reduction Initiative (NSRI), coordinated by the New York City Health Department, found that sodium levels decreased in a sample of top selling packaged foods by about 7% between 2009 and 2015. The NSRI is a coordinated partnership of 100 city and state health authorities and national health organizations set voluntary targets on 62 categories of packaged foods and 25 categories of restaurant foods  and encouraged the food industry to adhere to these targets, with the aim of lowering sodium in packaged and restaurant foods by 25% over five years.
When the targets were set in 2009, no packaged food categories met them but by the end of 2014,  26% of the categories met the 2012 targets and 3% met the 2014 targets. However restaurants made only minor progress with sodium levels changing very little across top chain restaurant foods during the same period. For more information, please visit the American Journal of Public Health.

Almost 30 food companies committed to NSRI targets:

• Au Bon Pain
• Bertucci's Italian Restaurant
• Black Bear European Style Deli
• Boar's Head Provisions Co.
• Butterball
• Campbell Soup Company
• Delhaize America
• Dietz & Watson
• FreshDirect
• Furmano's
• Goya Foods
• Hain Celestial
• Heinz
• Hostess
• Ken's Foods
• Kraft Foods / Mondēlez International
• LiDestri Foods / Francesco Rinaldi
• Mars Food US
• McCain Foods
• Premio
• Red Gold, Inc.
• Snyder's-Lance, Inc.
• Starbucks Coffee Company
• Subway®
• Target Corporation
• Unilever
• Uno Chicago Grill
• White Rose

June 2016

The U.S. Food and Drug Administration issued draft guidance for public comment on voluntary sodium reduction targets for the food industry. The guidance to industry proposes levels of sodium in 150 categories of processed and restaurant foods, as well as sales weighted average for companies to meet. The FDA estimates that less than 10 percent of packaged foods account for more than 80 percent of sales. Furthermore the USDA’s Economic Research Service estimates that around 50% of every food dollar is spent on food outside of the home which is why the draft voluntary guidance also covers common foods served in restaurants and other food service establishments.

Once finalised, interim targets would be set to be met in two years and more ambitious targets set to be met in 10 years.  Average sodium intake in the U.S. is approximately 3,400 mg/day, almost 50 percent more sodium than what most experts recommend. One in three individuals has high blood pressure, which includes one in two African Americans and one in ten children aged 8-17 years. The draft short-term (two-year) and long-term (10-year) voluntary targets for industry are intended to help the American public gradually reduce sodium intake to 2,300 milligrams (mg) per day, a level recommended by leading experts and the overwhelming body of scientific evidence.

The draft guidance is currently open for comments. Click here for further details

September 2015

NYC is the first city in the nation to require chain restaurants to post warning labels next to menu items that contain high levels of sodium. The sodium warning rule requires chain restaurants with 15 or more locations nationwide to identify menu items that contain more sodium than recommended in an entire day to be identified with an icon and a warning statement.

For additional information, go to nyc.gov/health.

July 2015

A study from the University of Illinois examined the impact of fast food and restaurant food on the daily energy and nutrient intake of US adults. The study found that fast food consumption gave a net increase of 190.29 kcal in daily total energy, 10.1g in total fat, 3.49g in saturated fat and 297.47mg in sodium. Restaurant food was found to give a net increase of 186.74 kcal in daily total energy, 9.58g in total fat, 2.46g in saturated fat and 411.94mg in sodium. Click here to view the study.

December 2014

The Centre for Science in the Public Interest (CSPI) released the following press release:

Top 25 Restaurant Chains Make No Progress Reducing Salt FDA Lags Behind Other Countries, Says CSPI

The nation’s top 25 restaurant chains failed to reduce sodium levels in almost 3,000 menu items between 2012 and 2014, according to a report released today by the Center for Science in the Public Interest. The nonprofit nutrition and food safety watchdog group analyzed restaurant sodium data from MenuStat.org, the New York City Department of Health and Mental Hygiene’s online nutrient database.

Excess sodium in the diet is a leading contributor to hypertension, stroke, heart disease, and other major health problems—and 80 percent of the sodium Americans eat comes from processed and restaurant foods. Between 2012 and 2014, the decline in sodium across 2,925 appetizers and sides, burgers, entrees, fried potatoes, pizza, sandwiches, and soups was less than one percent, from an average of 1,267 to 1,256 milligrams. An analysis of the 1,874 items that were on those restaurants’ menus in both 2012 and 2014 showed no decline, with an average of 1,201 mg in both years.

“As a whole, the nation’s leading restaurants are failing miserably when it comes to their patrons’ heart health,” said Michael F. Jacobson, CSPI executive director. “And, unfortunately, the U.S. Food and Drug Administration has failed for decades to tell the food industry to lower sodium and by how much.”

The data reveal some alarming increases in sodium. Chili’s increased sodium in its Loaded Baked Potato Soup by 57 percent, IHOP increased sodium in its Simple & Fit Simply Chicken Sandwich with Fresh Fruit by 80 percent, and Taco Bell increased sodium in its Cheesy Nachos by 48 percent. In contrast, Olive Garden cut the sodium in its Caprese Flatbread by 63 percent, and Red Lobster cut the sodium in its French fries by 57 percent.

Outback Steakhouse showed the biggest overall decrease, a nine percent average decline across 80 items. IHOP showed the biggest increase, with a nine percent average increase across 129 items. At table-service operations such as Applebee’s, Chili’s, IHOP, and Olive Garden, the
average sodium level per menu item was equal to or exceeded 1,500 mg, the daily recommended limit for the majority of Americans.

In 2010, the Institute of Medicine called on the FDA to mandate limits for sodium in restaurant and processed foods, gradually reducing sodium in the food supply over time. It is estimated that reducing sodium consumption by half would prevent about 100,000 deaths from heart attacks and strokes in the United States each year.

While the FDA has not acted on the IOM recommendations, in recent years many other nations have launched sodium reduction initiatives in their countries. The United Kingdom has probably had the most aggressive program, leading to a 15 percent reduction per capita in sodium consumption between 2001 and 2011. Argentina, Australia, Belgium, and South Africa also waged effective sodium reduction campaigns.

A critical public health concern is children’s sodium consumption. The Centers for Disease Control and Prevention released data in September 2014 showing that children ages 6 to 18 consume on average 3,300 mg a day, well above recommended levels.

CSPI’s analysis of sodium in kids-menu items found a decrease of eight percent between 2012 (163 items) and 2014 (222 items). However, when the analysis was restricted to those items that were on menus in both years (116 items), average sodium actually increased two percent. That indicates that any progress is due to the addition of lower-sodium items, such as apple slices, not to the reformulation of existing menu items.

The Center for Science in the Public Interest (CSPI) is a nonprofit health-advocacy group based in Washington, D.C., that focuses on nutrition and food safety. CSPI is supported largely by the 900,000 U.S. and Canadian subscribers to its Nutrition Action Healthletter and by foundation grants.

June 2014

The New York City Department of Health co-released a Consensus Statement on Sodium, bringing together 34 of the world’s leading scientists to reaffirm the benefits of reducing population sodium intake to heart disease.
Our chairman Professor Graham MacGregor, along with expert members of WASH, is a signatory on this statement. This is a great resource to cite in sodium efforts in NYC, showing that there is a large group of distinguished scientists who affirm that the weight of the scientific evidence supports population-wide sodium reduction.

Consensus Statement on Sodium

Cardiovascular diseases, including heart disease and stroke, are leading causes of death in the United States. Influencing the major risk factors for cardiovascular disease provides an opportunity to improve Americans’ health, which in turn can prevent illness and disability, reduce health disparities, save lives and reduce healthcare costs. Considering the full scope of research, the undersigned affirm the scientific basis for lowering current sodium consumption levels in the U.S. population.

Public health recommendations are made after weighing all of the evidence, including studies of greater and lesser strength of design and some with conflicting results.  A vast body of research, including observational studies, feeding studies, and randomized controlled trials, indicates that lowering sodium intake lowers blood pressure, a major risk factor for cardiovascular disease.  After reviewing evidence on sodium intake and cardiovascular disease outcomes, the Institute of Medicine recently concluded that reducing population sodium intake would have a positive effect on public health.  This is consistent with the compelling body of evidence from laboratory, clinical, and population research that together establishes that high sodium intake causes increases in blood pressure.

We conclude that the evidence is clear.  Population-wide reduction of sodium intake is an integral approach to reducing cardiovascular disease events and mortality in the United States.

For more information, visit the NYC Health website.  

 

February 2014

The Sodium Reduction in Communities Program (SRCP), administered by the Center for Disease Control’s Division for Heart Disease and Stroke Prevention (DHDSP), published an article in the Journal of Public Health Management & Practice presenting insights, lessons learned and progress updates from strategies implemented by SRCP communities in the first 2 years of their projects. Click here for more information. 

2012

The American Heart Association is taking an aggressive stance on salt reduction.  For the past year, the association has been engaging public health organizations, including the New York City Department of Health and Mental Hygiene, as well as other key members of the scientific community to support implementation of the Institute of Medicine’s sodium reduction recommendations made in the report, Strategies to Reduce Sodium Intake in the United States. A focus has been placed on the primary recommendation of the Food and Drug Administration setting mandatory national standards for the sodium content of foods.  

March 2012

Assessing Levels of Sodium in Food:  

Researchers with the United States Department of Agriculture (USDA) and Health and Human Services (HHS) are working to assess the sodium content of the food supply to assist in monitoring changes in sodium content of foods and changes in population sodium intake over time.
A Nutrient Data Laboratory study found that sodium in pizza has increased over the past 10 years, but sodium in pasta sauce and tomato soup decreased. The Nutrient Data Laboratory also studied salt in baked products over a decade, including a variety of snack foods such as potato, tortilla, and corn chips; pretzels; and cheese puffs, and found a reduction in sodium across all categories. The largest decline—40 percent—was found in canned, stacked potato chips.

The new data have been included in the most recent release of the USDA-ARS National Nutrient Database for Standard Reference.

For more information please click here

January 2012

'Cut the Salt and Help Your Health'

The American Heart Association is taking an aggressive stance on salt reduction, calling for all Americans to consume no more than 1500 mg of sodium per day by 2020.
Focus on school food:

On January 13, 2011, the U.S. Department of Agriculture (USDA) published in the Federal Register (76 FR 2494) a proposed rule to improve nutrition standards for meals served through the National School Lunch (NSLP) and National School Breakfast (NSBP) programs. The final rule, “Nutrition Standards in the National School Lunch and School Breakfast Programs”, was published in the Federal Register. According to the final rule, sodium content of meals will be reduced gradually over a 10 year period through two intermediate sodium targets at two and four years post implementation. Schools will be required to meet the first intermediate sodium target in the NSLP and NSBP no later than July 1, 2014, two years after the final rule has been implemented.

• The final sodium targets for the NSBP are < 430 mg, < 470 mg, and < 500 mg for grades K-5, 6-8, and 9-12, respectively.
• The final sodium targets for the NSLP are < 640 mg, < 710 mg, and < 740 mg for grades  K-5, 6-8, and 9-12, respectively. Other changes include ensuring students are offered both fruits and vegetables every day of the week, increasing offerings of whole grain-rich foods, and offering only fat-free or low-fat milk.

For more information on 'The final rule' please click here  

January 2010

New York City’s coordinates National Salt Reduction Initiative (NSRI):

The National Salt Reduction Initiative is a coalition of 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 is to reduce Americans' salt intake by 20% over five years. This will save tens of thousands of lives each year and billions of dollars in health care costs.

To keep up-to-date with the activities taking place in New York please click here

March 2009  

The Institute of Medicine has formed a committee, which is undertaking a project to review and make recommendations that could be employed to reduce dietary sodium intake to levels recommended by the Dietary Guidelines for Americans.  The group will look at actions by food manufacturers, at a governmental level and by public health professionals.  The report is expected to be published in early 2010.

New data published by CSPI has shown that the average sodium content of 528 packaged and restaurant foods has essentially remained the same between 2005 and 2008, even though food industry has acknowledged that sodium levels are too high.  WASH members signed a petition to the Food and Drug Administration to reduce the status of salt from ‘Generally Recognised as Safe’ to an additive.  The Centre for Science in the Public Interest (CSPI) issued a statement stating that nothing has been done since the hearing.  However in the absence of a national initiative, New York City is preparing to add permissible sodium levels to menus.   

September 2008

WASH members have submitted comments in response to the Food and Drink Association hearing regarding salt's classification as 'Generally Recognised as Safe' (GRAS).  WASH has further detailed the success of the UK salt reduction initiatives for the consideration of the FDA.  For the full submission please click here

July 2008   

The U.S. Food and Drug Administration, at the urging of the Center for Science in the Public Interest, late last year convened a public hearing to help determine whether the use of sodium should be regulated in food preparation. The agency continues to collect comments on the issue. The Washington, D.C.-based CSPI favors reducing by half the use of salt in restaurant and prepared foods.

October 2007

The US FDA considers revising its regulations on salt

The Food and Drug Administration launched a petition to revise the regulatory status of salt (currently ‘Generally Recognised as Safe’) and establish food labelling requirements.  WASH members were urged to comment resulting in fantastic support for the petition across the world.
The US Food and Drug Administration has set a date for a public hearing (29th Nov 2007) to consider revising its regulations on salt, as a result of the petitioning from the consumer group Center for Science in the Public Interest.

For the article please click here
For press release please click here

September 2007

Commentary – The Urgent Need to Reduce Sodium Consumption (JAMA)

Stephen Havas, MD, MPH, MS; Barry D. Dickinson, PhD; Modena Wilson, MD, MPH

The USA has called for action to reduce sodium consumption, with a focus on reducing salt in processed and restaurant foods.  The article states that in the absence of substantial voluntary reductions in sodium, a regulatory approach is necessary. For substantiation, the commentary reviews the policy recommendations and actions currently in place around the world.  

For the full article please click here

July 2007

Report 10 of the Council on Science and Public Health (AMA)

The AMA published a report on reducing the population burden of cardiovascular diseases by reducing sodium intake.  The document highlights how salt intake is related to the level of blood pressure, the incremental rise in blood pressure with age, and the prevalence of hypertension across populations.  The results from the Dietary Approaches to Stop Hypertension (DASH)-Sodium Trial showed that the most substantial benefit in reducing systolic blood pressure was gained from reducing sodium intake from 2.3 g to 1.5 g per day.  Attaining this lower level of intake on a population basis would require that sodium in processed and restaurant foods be lowered an average of ~80%.

The Annual Meeting called for the following actions:
1. The AMA calls for a stepwise, minimum 50% reduction in sodium in processed foods, fast food products, and restaurant meals to be achieved over the next decade.  Gradual but steady reductions over several years may be the most effective way to minimize sodium levels.  
2. The AMA urges the Food and Drug Administration (FDA) to revoke the “generally recognized as safe” (GRAS) status of salt, and to develop regulatory measures to limit sodium in processed and restaurant foods.  
3. To assist in achieving the Healthy People 2010 goal for sodium consumption, the AMA will work with the FDA, the National Heart Lung Blood Institute, the Centers for Disease Control and Prevention, the American Heart Association, and other interested partners to educate consumers about the benefits of long-term, moderate reductions in sodium intake.
4. The AMA will discuss with the FDA ways to improve labelling to assist consumers in understanding the amount of sodium contained in processed food products, and to develop label markings and warnings for foods high in sodium.
5. The  AMA recommends that the FDA consider all options to promote reductions in the sodium content of processed foods.

For the full report please click here

June 2006

In June 2006, The American Medical Association (AMA) (a national group of doctors representing more than 250,000 doctors) unanimously passed a resolution calling on all of the food industry adding salt to food to cut it by 50% during the next ten years.  Importantly, the AMA also asked the FDA to cease the rule that allows salt and its component sodium to be treated as "generally recognized as safe", as this makes it very difficult to take any action about the huge amounts of salt added to foods in the USA.  The AMA have a very strong lobby presence in Washington and it is likely that there will be a lot more publicity about the dangers of eating too much salt coming from the USA, and at long last hopefully some action.

January 2000

In spite of consistent advice to reduce salt intake to 5 to 6 grams/day since the 1980s, very little has happened in the USA.  In January 2000 a meeting was organised by the National Heart, Lung and Blood Institute in Washington where all of the evidence was reconsidered. The conclusion of this meeting, unsurprisingly, was that "Americans consume more sodium than they need and a population wide strategy of reducing salt in the food supply is an important public health strategy that can lower blood pressure among populations". However, little action has occurred - presumably due to the power of the food industry. The Center for Science in the Public Interest (CSPI) last year decided to take action and published a report on salt and took legal action against the Food and Drug Administration (FDA) as they felt the FDA should have taken more responsibility for doing something about salt and had not, and that many thousands of Americans had thereby died unnecessarily.