The American Medical Association said in June that salt should not be "generally recognized as safe" and has urged the Food and Drug Administration to revoke its GRAS status and to develop safe upper limits for sodium in processed and restaurant foods.
"Cardiovascular disease remains the No. 1 killer of Americans," said Dr. J. James Rohack, a cardiologist and AMA board member. CVD accounts for about 40 percent of all U.S. deaths. "There is overwhelming evidence that excessive sodium intake is a risk factor for the development or worsening of hypertension and may be an independent risk factor for other CVDs," such as aortic stiffness, according to a report by the AMA. In 2006, CVD costs are expected to reach a heart-stopping $400 billion in the United States.
The AMA issued new guidelines at its annual meeting, calling for a 50 percent reduction over the next 10 years in the amount of sodium in processed foods, fast foods and restaurant meals.
"Despite the recommendations of leading scientific authorities and government agencies … manufacturers can add substantial amounts of sodium to processed foods," the report said. "Revoking the GRAS status would not ban salt, but require [the] industry to petition the FDA to approve the use of salt as a food additive at specified levels in various types of food, and would establish a process and procedures for establishing and regulating these amounts."
The medical group also called for improved labeling to highlight the amount of sodium in processed foods. At least one major natural foods company has already begun offering low-salt soups, beans, chilis and frozen entrees. Amy's Kitchen, based in Santa Rosa, Calif., introduced its Light in Sodium line last year. But it had nothing to do with any anticipated medical or government recommendations. "Our reasons for introducing these products have to do with what consumers tell us," said Steve Warnert, director of sales and marketing at Amy's. "Rachel [Berliner]—the owner—reads every consumer e-mail that comes through."
According to the AMA, Americans consume an average 4,000 mg of sodium daily, and about 75 percent of that comes from processed foods and foods eaten away from home. Numerous governments and scientific groups recommend limiting salt intake to 2,300 mg. More than 95 percent of American men and 75 percent of American women regularly consume more than that, the group said.
"Any meaningful strategy to reduce population salt intake must rely on food manufacturers and preparers to reduce the amount added during preparation," according to the AMA report. "In addition to sodium limits, changes in labeling directives could require companies to put recognizable symbols on the labels of products that are high in sodium."
While AMA's guidelines have no legal standing, the group's 250,000 members have considerable clout in Washington, D.C., and could force the FDA to reconsider its stance on the seasoning.
"It sounds like a good idea to me. It's part of a heating up of approaches to try to do something about health," said Marion Nestle, professor and former chair of the department of Nutrition, Food Studies and Public Health at New York University.
Manufacturers could begin to explore using salt substitutes. A common salt substitute is potassium chloride, but that's no panacea, since excess potassium levels could endanger people with kidney and heart problems. Most people will be fine with more potassium however, said Nestle. "The [Institute of Medicine] says most people don't get enough," she said.
Warnert said Amy's has removed the sea salt without adding any new flavorings. "It has to start with great ingredients and great flavor to begin with," he said.
The products have been a hit, Warnert said. "The items we have introduced—the sales success of those items has been largely incremental. It's a consumer that's been discriminating at the shelf, and looking and waiting for items to come along that meet their needs. The success has not come at the expense of the parent product."
Natural Foods Merchandiser volume XXVII/number 8/p. 11, 14