I’m not the only one that expresses strong viewpoints (which I admit can be annoying, especially for my family). This week’s JAMA published a very opinionated article in its viewpoint section with accompanying statistics that are so significant that I feel compelled pass on…
The article, written by the director of the CDC, expresses outrage over the amount of dietary sodium in our US food supply. According to Dr. Thomas R. Frieden,”9 out of 10 US adults and children consume too much sodium with an average sodium intake of 3400 mg a day which is well in excess of the 2300 mg recommended by the new dietary guidelines for Americans.”
What are the salty issues? Well here are the stats he quotes: “High blood pressure is the leading cause of death from heart disease and stroke in the United States, contributing to more than 1000 deaths per day. One in three US adults -more than 70 million people – have hypertension and only half have it controlled. Another one in three adults have pre-hypertension. Each 20 point increase in systolic blood pressure above 115 mmHg doubles the risk of death from heart disease and stroke.” He then states that there is strong evidence in more than 100 randomized clinical trials that sodium reduction reduces blood pressure in adults. It is now estimated that a decrease in sodium intake by as little as 400 mg a day could prevent 32,000 myocardial infarctions and 20,000 strokes every year. And if we were to reduce it even more, so that intake was 1200 mg a day, the number of people with hypertension would be reduced by nearly 11,000,000. This could prevent up to 500,000 deaths.
In the article he takes into account the fact that athletes are supposed to consume more salt. (After all we now have the Olympic Games to divert our attention from our less athletic political circus.) But apparently the estimated average requirement to 1500 mg of sodium a day will accommodate athletes even if they have extreme physiologic sodium excretion. (i.e.they sweat it out.)
The real issue is that currently, consumers often cannot choose how much sodium they ingest. More than 70% is in food before it reaches the table. Half of all adults report attempting to reduce their sodium intake but 90% of them continue to consume excess sodium. So there will have to be changes in the food supply that will help put choice back into consumers hands. We also should remember that fruit, vegetables and food that we prepare will have less and controllable amounts of sodium. And because salt makes things tasty, our culinary habits, our use of processed foods and our enjoyment of restaurant meals (not just fast food but the more costly ones) all regrettably increase our sodium load.
Thirty-nine countries have established sodium targets for food and meals. Support for this has already begun by companies such as Walmart, Darden, Unilever, Pepsi Co., General Mills, Mars, Nestlé and others. The United Kingdom is already setting sodium reduction targets. They started in 2003 and found that from 2003 to 2011 sodium intake decreased 15%. During the same period average blood pressure decreased and deaths from ischemic heart disease and stroke decreased by approximately 40%!
Yes we need industry to voluntarily reduce the sodium in foods, as do restaurants and yes chefs. After reading this I probably will never eat soup again. Obviously potato chips, pretzels and a lot of breads are out… But eggs without salt? I’ll have to figure out how to do that.