Cardiology Groups Applaud FDA’s Draft Guidance Setting Voluntary Sodium Cuts for Processed Food Industry

The American Heart Association (AHA), the American College of Cardiology (ACC), and the director of the US Centers for Disease Control and Prevention (CDC) have come out in support of a draft guidance issued today by the Food and Drug Administration (FDA) that calls on the food industry to voluntarily reduce sodium in their products.

The 14-page document is now open to a formal, 90-day public comment period for four sections of the document and a full 150 days for an additional four sections. For those seeking specific numbers, the voluntary goals are elsewhere on the FDA website, with the proposed targets in a table accessed in an Appendix via a downloadable Excel spreadsheet. The spreadsheet sets out baseline sodium content (using 2010 data) for both packaged foods and restaurant dishes across a range of “major food categories” with separate columns for the proposed 2- and 10-year sodium targets.

So, for example, a “canned condensed soup” found in the Soups category currently contains a sales-weighted mean sodium content of 581 mg per 100 g. The FDA draft guidance proposes cutting this to 520 mg/100 g within 2 years and to 430 mg/100 g within 10 years. Likewise, tortillas and wraps, found in the Bakery Products category currently contain an estimated 750 mg of sodium per 100 g of product. The 2- and 10-year targets are 580 mg and 410 mg.

The draft guidance specifically targets “commercially processed, packaged, and prepared foods” defined as “processed, multiple-ingredient foods that have been packaged . . . for direct sale to consumers or for use in restaurants and similar retail food establishments.”

Also called out is salt added during processing, manufacturing, and preparing that is not required for “microbial safety, stability, and/or physical integrity.”

An FDA press statement announcing the document takes a strong stand. “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 US.”  The agency cites CDC studies suggesting that lowering US sodium intake by about 40 percent over the next decade could save 500,000 lives and nearly $100 billion in healthcare costs.

Currently, the FDA notes, average sodium intake by Americans, at approximately 3,400 mg/day, is 50% higher than recommended. The voluntary reductions urged by the agency are intended to help Americans to gradually reduce sodium consumption to 2,300 mg/day—as recommended in a 2013 Institute of Medicine (IoM) report.

Wide Support

The CDC, AHA, and ACC were swift to issue their support for the FDA document.

“Sodium reduction through voluntary reductions by industry and facilitated by FDA guidelines will put choice into the hands of consumers, will save lives and money, and is an achievable and effective public health strategy that should be implemented without delay,” CDC Director Thomas Frieden, MD, wrote in an editorial issued today in JAMA.

Likewise, ACC President Richard Chazal, MD, congratulated the FDA on today’s announcement, saying, “Salt reduction targets released by the FDA today are a positive step forward in raising awareness of excessive salt in the American diet and providing healthier food options.”

Finally AHA CEO Nancy Brown said, “The American Heart Association strongly supports the draft voluntary sodium targets released today by the FDA, and we call upon the agency to finalize them as soon as possible.” Her press statement went on to say that the “voluntary targets can have a significant impact on the nation’s health.”

In fact, the AHA has repeatedly called for much lower sodium consumption targets of no more than 1,500 mg per day and, in 2013, blasted the IoM for its target of 2,300 mg now adopted in the FDA draft document. Brown’s statement today characterizes the new targets as “an important step in the right direction.”

Browns statement goes on to applaud the voluntary sodium reduction steps already taken by some major food brands. As previously reported by TCTMD, the AHA has drawn fire in the past for publically applauding steps by a number of big food companies that also make major donations to the organization, relationship the association defends by underscoring the need to work with, not against industry, in order to make food healthier.

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