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success for the industry as a whole. During the committee’s public workshop held in open session, industry panel members described their efforts and reported varying levels of success, and identified the need for a level playing field within the industry. The panel highlighted the difficulty in marketing lower-salt foods when competitors’ products that are not lower in salt are preferred by consumers. This situation is mirrored by available data indicating that relatively few foods bear sodium-related label claims and, over time, fewer newly introduced products bear sodium-related claims, compared to fat and calorie claims. Anecdotal reports suggest that to some consumers, such sodium claims signal that the food will not have a pleasing taste, and therefore they do not buy the product. Further, salt substitutes have limited applications.

Restaurant/foodservice operations—which contribute a significant amount of sodium to the American diet—have undertaken few organized efforts to reduce the sodium content of menu items. The reasons are believed to include the diverse nature of the operations coupled with little motivation to modify menu items to retain their appeal while reducing the salt content.

RECOMMENDATIONS

The committee organized strategies for reducing sodium intake by first identifying broad recommendations. The recommendations resulted in one set of primary strategies and several sets of interim or supporting strategies. These are listed in Box S-1.

Primary Strategies

Recommendation 1 encompasses the primary strategies and is linked to the fact that salt, as a substance added to foods marketed by the food industry, is regulated by FDA. Under the Federal Food, Drug, and Cosmetic Act, substances added to foods by manufacturers are subject to FDA pre-market approval unless they are generally recognized as safe (GRAS). The conditions under which a substance is GRAS can be specified by FDA to ensure safe use. Currently, the manufacturers’ addition of salt to foods is considered a GRAS use, but no standards have been set concerning the levels that would constitute a “safe use” of salt.

The committee concluded that the ability to adjust the GRAS status of salt by setting standards for its addition to foods is a potentially powerful yet relatively adaptable regulatory tool. The potential of GRAS modification seemed particularly promising given the failure of the non-regulatory options to accomplish meaningful reductions in the sodium content of the



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