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Strategies to Reduce Sodium Intake in the United States
food supply. In short, the primary strategies are linked to the following conclusions:
Excess salt intake is a major public health problem.
More than 40 years of voluntary initiatives have failed to reduce salt intake.
Most salt consumed is in foods sold to consumers.
Standards for the addition of salt to processed and restaurant/food-service foods are the best strategy to protect the public health.
The goal is clearly not to ban salt use or to make foods unpleasant for consumers, but to begin the process of reducing the excessive addition of salt to processed foods and restaurant/foodservice menu items. If used judiciously and with careful preliminary analysis, setting standards for the levels of salt in food should reduce sodium intake. If the process of implementing such regulatory provisions is carried out over time in a stepwise manner, negative impacts on the consumer’s enjoyment of food and response to food flavors should be minimized.
The starting point for use of the available regulatory tools is the conclusion first voiced in 1979 that salt—given the levels at which it is currently added to the food supply—is no longer a substance for which there is a reasonable certainty of no harm. However, rather than revoke the status of salt as a GRAS food substance, the committee recommends activities to modify the conditions under which salt added to foods can remain GRAS and by which total levels of sodium in the food supply can be reduced. That is, taking into account current dietary recommendations for its consumption, salt is a substance for which a safe use level in foods could be established. This approach is preferable to revoking the GRAS status of all uses of salt. First, salt is GRAS at some levels of consumption. Second, revoking GRAS status would cause disturbances in the food supply that could undermine consumers’ support for regulatory actions to protect their health while increasing the regulatory burden on both FDA and the food industry to likely unacceptable levels. Further, revoking GRAS status is not consistent with the fact that sodium is an essential nutrient.
The committee regards modification of the GRAS status of salt as underpinning a new set of strategies that could effectively reduce sodium intake. It would address the concern that much of the sodium in the diet comes from sources largely outside consumers’ direct control. There is evidence that “passive” changes in the environment can impact consumers’ health and well-being more effectively than placing the entire burden on consumers to act to modify their environment and behavior in the face of many competing priorities and challenges.
Given the ability of the existing regulatory provisions to set standards