POLL: Should the Government Regulate Salt Consumption?

by Melinda Carstensen

Salt is killing Americans, and few understand how much salt they really consume.

That was the argument put forth in a recent New York Times opinion piece by Thomas A. Farley, a physician and fellow in public policy at Hunter College and a former commissioner of health for New York City.

Processed food in America is packed with salt, Farley wrote, which has in turn led has led to an epidemic of hypertension. Nearly 67 million Americans, including two-thirds of people over the age of 60, have been diagnosed with high blood pressure, according to the Centers for Disease Control and Prevention.

That hypertension epidemic has led to an increase in strokes and heart attacks, which account for between 40,000 and 90,000 deaths a year and, Farley estimates, $20 billion per year in costs to healthcare industry — an expense that even the most health-conscious consumers end up paying for. Worse, Farley argues, it’s nearly impossible to cut back on salt because it has been added to so many foods.

"Doctors warn people with high blood pressure to go on a low-salt diet,” he wrote. "But that’s virtually impossible in today’s world, because nearly 80 percent of the sodium that Americans eat comes in packaged and restaurant food (whether it’s a bagel, a sandwich or a steak dinner). You can’t take it out.”

A new study published in the BMJ (previously the British Medical Journal) shows there is a possible solution: government intervention.

After Britain’s Food Standards Agency set distinct salt reduction goals for processed foods in that country, sodium consumption fell by nearly 15 percent, from 2001 to 2011.

As a result, the population’s average blood pressure has dropped, while heart attack rates have declined by 40 percent and deaths from stroke have been reduced by 42 percent. And that has meant big savings in healthcare costs.

Here in the U.S., the Institute of Medicine, the health arm of the National Academy of Sciences, urged the FDA in 2010 to set national standards for added salt to packaged foods in grocery stores and restaurant meals.

Although the administration began working on the voluntary, coordinated plan, it since has been halted due to opposition from the food industry.

The Center for Science in Public Interest, which has a live counter that tracks “salt’s deadly toll” on its website, has petitioned the FDA to limit sodium levels and reduce the daily value for sodium on labels from 2,300 milligrams.

The center estimated that if Americans cut their sodium intake by half, 150,000 lives would be saved.

"The FDA would probably act in a heartbeat if experts found that an unsafe drug or medical device was responsible for 100,000 deaths a year,” Jim O’Hara, the center’s health promotion policy director, told the Oregonian. “But it is tolerating a deadly level of sodium in our food supply. While this administration talks about the need for healthy eating, it is failing to pursue a policy that would create a food environment in which Americans could routinely make healthier choices.”

What’s left is an initiative by the health department in New York City, which has historically pioneered these types of laws (see the “Big Gulp” soda cup fiasco, its cigarette tax, which is the highest in the country, and, most recently, a new e-cigarette ban). 

The salt initiative works with organizations like the American Heart Association and the American Medical Association to encourage companies to voluntarily reduce sodium in their products, using Britain’s success story as inspiration. Among those companies that have joined are Mars, Subway and Kraft. But of 62 proposed categories, 18 got no commitments, the Times article noted.

How would you feel if the federal government followed Britain’s lead, or if your local government developed an initiative like New York City’s, and restricted the salt content of processed foods? Who’s responsible for the increase in health costs due to salt: consumers or food manufacturers? And how do you feel about paying for other people’s medical expenses when they lead unhealthy lifestyles?

Discuss the issue in the comments below with fellow Patchers from around the country, and let us know if you think government has a role to play in the great salt debate.