The Food and Drug Administration on Tuesday announced a gradual but potentially far-reaching effort to reduce the amount of salt Americans consume in a bid to combat high blood pressure, heart disease, strokes and other health problems that have soared to near-epidemic proportions.
The FDA's efforts will begin by seeking voluntary cutbacks by the food industry. But ultimately, the agency may resort to regulating acceptable levels of sodium in food and beverages.
"Nothing is off the table," said FDA spokeswoman Meghan Scott. "Everyone's in agreement that something needs to be done….We just don't know what it's going to look like."
The FDA's decision was applauded by public health advocacy groups and scientists, who have long pointed up the link between high salt intake and a host of serious – and costly – medical problems.
But it was also criticized by some industry groups, and some conservative political leaders denounced it as another government assault on personal freedom.
The deliberate pace sketched by the FDA, and the absence of any immediate plans to issue regulations, were in contrast to a strongly worded report concurrently released Tuesday by the Institute of Medicine, the health arm of the National Academy of Sciences.
The institute declared that expeditious "regulatory action is necessary" because efforts to educate the public about the perils of excessive dietary salt and voluntary sodium-cutting efforts by industry have failed, although the institute called for such regulations to take effect gradually.
On a daily basis, Americans consume almost 50% more than the roughly one teaspoon of salt recommended as a maximum by the federal government's 2005 Dietary Guidelines for Americans, according to the institute's report.
Sodium intake is "simply too high to be safe," said Dr. Jane E. Henney, former commissioner of the Food and Drug Administration and chairwoman of the institute committee that produced the report. "Clearly, salt is essential.… We need it. But the level we're taking in right now is far beyond the maximal levels we need."
The 14-member panel's findings, more than a year in the making, come on the heels of a welter of studies tallying the health and economic costs of excessive salt intake.
Researchers from the Harvard School of Public Health predicted that, if dietary sodium consumption declined to the levels recommended in the 2005 federal guidelines, some 90,000 deaths could be averted yearly.
A Rand Corp. study published in September estimated that reducing American sodium intake to recommended levels could save $18 billion yearly in treatment for hypertension, stroke, renal disease and heart failure associated with excessive salt consumption.
"There is now overwhelming evidence that we must treat sodium reduction as a critical public health priority," said Dr. Walter Willett, chairman of the Harvard School of Public Health's department of nutrition.
Willett, who was a key figure in the recent federal initiative to drive trans fats from the U.S. food supply, noted how quickly the U.S. food industry adapted to those new rules, and called for that industry's "best creative minds to bring similar leadership" to the bid to reduce sodium.
But the head of the salt lobby blasted efforts to curb salt consumption as unwarranted and overly broad.
"It's not scientifically sound," said Lori Roman, president of the Salt Institute. "They're talking about some very drastic reductions. They could be harming people."
Another key industry trade association, the Grocery Manufacturers Assn., took a more measured approach.
It said in a statement that food makers already offer low- or no-sodium versions of many items. "We look forward to working with the U.S. Food and Drug Administration to develop a national sodium reduction strategy that will help the consumer," the group said.
The FDA's decision to press food makers to reduce salt caps a 30-year campaign by the Center for Science in the Public Interest. The center sued the FDA in 2005 to try to force the agency to reclassify salt as a food additive subject to regulation.
Salt currently is categorized as a substance "generally recognized as safe," hence not regulated in food products.
Center director Michael Jacobson urged the FDA to adopt mandatory limits on salt swiftly, and then phase them in slowly. A gradual phase-in is considered crucial so that consumers do not notice a taste difference in foods with diminished amounts of salt.
While public health advocates like Jacobson hailed the clampdown, libertarian skeptics of government viewed it as another sign of a nanny state run amok.
"It's another encroachment on people's personal freedom," said Gary Howard, spokesman for Campaign for Liberty, a libertarian advocacy group formed in the wake of Texas Rep. Ron Paul's 2008 presidential campaign.
"They've already gotten into people's medical care," Howard said. "Where will they go next? Will they mandate exercise?"