FDA Issues Guidelines to Reduce Salt in Foods

The Food and Drug Administration, citing an epidemic of diet-related illnesses, released new guidelines Wednesday aimed at reducing the amount of salt that Americans consume at restaurants, school cafeterias and food trucks, or when they are eating packaged and prepared foods at home.

The recommendations, issued after years of delay, seek to reduce the average daily sodium intake by 12% over the next 2 1/2 years by encouraging food manufacturers, restaurants and food service companies to scale back their use of salt.

That goal translates into 3,000 milligrams of salt — slightly more than 1 teaspoon — compared to the 3,400 milligrams that Americans typically consume in a day. Health experts offered modest praise for the new guidance, saying it would help draw attention to the problem of excess sodium, but many expressed concern that voluntary measures might not be enough to compel change in an industry that often bridles at regulatory oversight.

America’s love affair with salty foods has been linked to alarmingly high rates of high blood pressure, a leading risk factor for heart attacks, strokes and kidney failure. More than 4 in 10 American adults have high blood pressure; among Black adults, that number is 6 in 10, the FDA said.

Much of the excess sodium that Americans consume, about 70%, comes from processed and packaged food and meals served at restaurants, according to researchers.

In a news conference announcing the recommendations, Dr. Janet Woodcock, the acting FDA commissioner, said they were the first step in a multiyear campaign to gradually lower the nation’s sodium intake so it more closely aligns with the current Dietary Guidelines for Americans, which suggest a healthy diet should contain no more than 2,300 milligrams of sodium a day.

Lowering sodium intake by about 40% over a decade, the FDA said, could save 500,000 lives. Woodcock declined to say whether the agency would consider imposing mandatory limits on food producers should the industry fall short of the goals. Instead she emphasized the benefits of a cooperative and incremental effort, which she said would give consumers and manufacturers time to adapt.

“We recognize this isn’t a change that will happen overnight. It requires an iterative approach that supports gradual reductions in sodium levels broadly across the food supply over time,” she said. “This approach will also allow consumers’ tastes to adjust and result in better health outcomes.”

The guidance will apply to 163 categories of processed and packaged food and provide different targets for, say, rye bread, salad dressing and baby food. The recommendations also include scores of the most common dishes served by large restaurant chains, like cheesy pasta, french fries and tacos.

Nutritionists and public health experts commended the FDA for taking on the problem of excess sodium, saying the effort would help sharpen the public’s focus on the dangers of overindulgence and create pressure on food companies to reduce their reliance on salt as a cheap flavor booster. But many said that voluntary measures were unlikely to move the needle very much. Some experts have suggested mandatory reductions, though they acknowledge that the food industry’s formidable lobbying power makes such measures unlikely at the federal level.

“This is a good start because there hasn’t been much guidance on sodium reduction from the FDA in many years, but I would have preferred stronger guidance that is closer to mandatory,” said Dr. Larry Appel, director of the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research. “Voluntary measures just kick the can down the road.”

The food industry’s reaction to the new recommendations was somewhat muted. The National Restaurant Association and the Consumer Brands Association, which represents packaged food companies, declined to comment on the new guidelines; multinational food companies like PepsiCo, Nestlé and McDonald’s declined to comment or did not immediately respond to emailed requests for comment.

The Sustainable Food Policy Alliance, a lobbying group created by the U.S. divisions of Nestlé, Danone, Mars and Unilever, applauded the new guidelines. “These targets present another opportunity for the food industry to support healthy eating by continuing to improve the nutrition profile of products,” it said in a statement.

The perils of excess sodium consumption are well documented, and public health experts have long urged federal regulators to take a more aggressive approach to reduce sodium levels in processed and prepared foods. The call to action first gained prominence at a 1968 White House conference on nutrition, followed a year later by an FDA advisory committee report, which warned that salt was unhealthy at the levels then being consumed by most Americans.

In the decades since, salt consumption has remained well above recommended levels, and the results have been catastrophic for public health, even more so for communities of color. On Wednesday, Xavier Becerra, the health and human services secretary and the first Latino to head the agency, sought to frame the new guidance as a way to tackle the health disparities that have become even more apparent during the coronavirus pandemic and its disproportionate toll on Black and Hispanic people.

Referring to an aunt and an uncle whose premature deaths, he said, were linked to high blood pressure, he pointed out that low-income Americans whose diets are heavy in sodium-laden processed food are especially vulnerable.

“The human and economic costs of diet-related diseases are staggering, and hundreds of thousands of Americans are learning that the hard way as they contract these chronic diseases and face the consequences of poor nutrition,” he said. Health officials also expressed alarm about elevated sodium levels among the young and the consequences that can have later in life. Susan Mayne, director of the FDA’s Center for Food Safety and Applied Nutrition, said more than 95% of children 2 to 13 consume more sodium than is recommended. Eating habits, she noted, are set early in life and often persist into adulthood. “This can have profound impacts on later health outcomes,” she said.

Michael Jacobson, a longtime advocate for healthier diets and author of the book “Salt Wars: The Battle Over the Biggest Killer in the American Diet,” said he was pleased the FDA had finally acted — five years after the agency issued its draft guidance. But he lamented that four decades had passed since an FDA advisory committee first warned about the dangers of excess salt consumption. During that same time, he said, millions of Americans have perished from chronic illnesses that are often preventable through dietary changes.

“It’s just been very sad to see the government be so lackadaisical about such a serious health problem,” he said.