The Food and Drug Administration (FDA) has issued draft guidance for the food industry designed to encourage a voluntary gradual reduction in sodium levels of processed and prepared foods in the U.S.

Currently, the average sodium intake for U.S. adults and children is ≈3400mg per day. The Departments of Health and Human Services (DHHS) and Agriculture (USDA) recommended a limit of 2300mg/d in their 20152020 Dietary Guidelines for Americans.

If the food industry adjusts its sodium level targets to comply with the FDA’s guidance, the FDA estimated (using National Health and Nutrition Examination Survey data), that in 2 years sodium intake should be reduced to about 3,000mg/d, and in 10 years to the recommended intake limit of 2,300mg/d. The gradual reduction approach is aimed to give food manufacturers, food service operators, and restaurants time to adjust. 

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In a JAMA viewpoint, Thomas R. Frieden MD, MPH, writes that there is, “incontrovertible evidence of direct, dose-response relationship between sodium and blood pressure.” One in 3 adults in the U.S. has hypertension and only half of them have it controlled. It is estimated that reducing sodium intake by 400mg/d could prevent 32,000 myocardial infarctions and 20,000 strokes each year. In addition, cases of hypertension could be reduced by 11 million if sodium intake is reduced by 1,200mg/d.

The new guidance cites the difficulty for Americans to limit their sodium intake due to many processed and prepared foods already containing high sodium levels by the time it reaches the consumer. The results of a similar voluntary sodium reduction guideline in the United Kingdom proved very positive. The U.K. sodium reduction goals were introduced in 2003, and from 2003 to 2011, the sodium intake dropped by 15%. This correlated with a decrease in deaths from ischemic heart disease and stroke by approximately 40%.

The American Heart Association (AHA) has expressed support of the draft targets. A statement by CEO Nancy Brown issued, “These new targets will spark a vital, healthy change in our food supply, a change consumers say they want.” The statement also urged food companies to “follow the lead” of Mars, Nestle, PepsiCo and Unilever who have all supported sodium reduction targets. Prior to the FDA announcement, the National Salt Reduction Initiative reported securing sodium reduction commitments from close to 30 other companies. 

The FDA will open the draft guidance for comments on June 2, providing 90 days for comment on the short-term (2-year) targets and 150 days on the long-term (10-year) targets.

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