by Marion Nestle
Jan 11 2010

New York City’s new health initiative: Salt!

The New York City Health Department is at it again.  First trans-fat, then calories, then sodas.  Now, it’s going after salt in packaged foods and restaurant meals.   It is asking for a 25% reduction in the next five years.   How come? Because nearly 80% of salt in American diets is already in packaged and restaurant foods and if you eat them at all you have no choice about the amount of salt you are getting (see previous posts).

The Health Department is sending a clear message: reducing the salt content of packaged and restaurant foods will help New Yorkers stay healthy.

The initiative is voluntary.  But if everyone complied, we would all get used to a less salty taste and the current high salt levels will taste too salty.

This is actually a modest proposal.  We still have a long way to go.  The proposed standard for marketing foods to children, for example,  is 480 mg sodium (more than a gram of salt) per serving.  A mere half-cup of Campbell’s low sodium soups contains that much.  Campbell says it’s up to you to get the company to do better.

According to today’s Wall Street Journal, companies are already cutting the salt, albeit surreptitiously.   And according to the account in the New York Times, a Campbell official said: “We will continue to reduce sodium as long as there’s consumer acceptance in the marketplace.

So they think it’s up to you.   Fine.  Give companies plenty of reason to cut the salt.  Tell companies you want real consumer choice.   You want to decide how much salt to eat.  In the meantime, FDA: get busy on this one.

Correction, January 22:  Juli Mandel Sloves of Campbell Soup correctly points out that I am in error.  A serving of soup is 8 ounces, not 4, even though the label says that a serving is half a cup.  How come?  Because the can is to be diluted with another can of water, making it 21 ounces divided by 2.5 servings per can, or about 8 ounces.    Complicated, no?  But this means the sodium content is 480 mg per cup, not half cup, despite what the label says.   I apologize for the error.  But isn’t this a good reason to redesign the Nutrition Facts label?

Comments

  • Anthro
  • January 11, 2010
  • 11:33 am

The NYTimes article has generated more comments than health care reform! Many of them are the angry “get the govt out of my life” sort complaining that they don’t want to be “forced” to eat bland food! One wonders if they even read the article. Not only is it voluntary, but the target is only 25% over FIVE years and only aimed at best-selling foods! Many niche products will no doubt be excepted.

The responses from the industry were mostly cold and downright snotty (can’t think of a better word, sorry).

The anger of these people, I think, would be better aimed at the food industry itself. Go figure.

I just read this article, and while I love the idea of the initiative, do I actually think it will work? No. It took a law to get most companies to cut trans fat. Why would they want to cut salt? Salt is one of the addictive ingredients that makes consumers come back for more and more. I have hopes that companies will progress towards looking out for customers’ health instead of just their money, but I’m not sure we’re quite to this point yet.

[...] is asking for a voluntary 25% reduction in salt in packaged food and restaurant meals, with commentary from my favorite nutrition expert, Marion [...]

  • Daniel
  • January 12, 2010
  • 12:34 am

FoodFitnessFreshair: I question your notion that salt is “one of the addictive ingredients.” While high sodium content is associated with increased palatability, there is very little, if any, research demonstrating salt addiction.

I’m curious to see the 2010 guidelines. In early committee talks there was discussion of reducing the sodium value to 1600mg. While on paper this might sound socially responsible, with average consumption over twice this, I would hope that the committee is more aligned with current consumption behavior in making their recommendations. Unfortunately, dramatically reducing recommendations isn’t a salient trigger for behavioral change.

[...] be present in meat, but many poultry producers inject their chicken with it, as well). Nutritionist Marion Nestle frequently writes about the high levels of sodium in the foods we eat arguing that most of the [...]

  • Emily
  • January 12, 2010
  • 10:43 am

It will be interesting to see if these NYC interventions have a long-term effect on people’s health. I’m not convinced they will, since highly processed foods will continue to be more available than whole ones, but I certainly hope I’m wrong!

If you read David Kessler’s book, The End of Overeating, you’ll understand how our processed food is a very complex “sandwich” of salt+fat+sugar many times over.
The salt does not stand alone. I am totally in favor of the measures Bloomberg is taking. I just wish it was faster and stronger.
We have Bloomberg to thank for the many world-wide city restaurants now smoke-free.
I rarely salt my food and I find most restaurant/processed food over-salted, so I’m biased. I also have low blood pressure :)

Mark Kurlansky, the author of “Salt: A World History,” was on WNYC yesterday discussing the proposal, and he argued that studies have been inconclusive about whether or not salt is actually detrimental to health, or if it even causes high blood pressure – a huge surprise to me, I must say. He mentioned that reducing salt intake has been shown to REDUCE high blood pressure, but that high levels of salt intake still haven’t been definitively proven to CAUSE blood pressure to rise. Not sure I buy it…but interesting.

But either way, I think the important issue at hand here really is consumer choice – giving us the option to moderate our own sodium intake would be a massive and empowering shift! I’m personally keeping a low-salt diet for the month of January as part of a winter detox effort, I can attest that the palate definitely adjusts to need less salt, and very quickly. (I’m also cooking all of my own food, knowing that it’s extremely difficult to eat in a restaurant with salt restrictions without irritating the heck out of the chef). Salt may be addictive (making us use more and more to get a “fix”), but it’s a pretty easy addiction to break. This initiative could give us a chance to do just that.

  • Cathy Richards
  • January 12, 2010
  • 3:11 pm

Here’s a 2008 presentation by Rosemary Hignett of the UK on their national sodium reducing success (you’ll have to copy and paste).
http://www.cspinet.org/canada/2008conference/presentation/Hignett1_ReformulatingFoodPanel.pdf

And if you want an American perspective:
http://www.cspinet.org/canada/2008conference/presentation/Appel.pdf — Johns Hopkins guy. His catch phrase was along the lines of “extending consumers’ shelf-life instead of product shelf-life”.

The root site for the 2008 conference on food policy has many more presentations. But these were the best 2 on sodim.

  • Daniel
  • January 12, 2010
  • 5:19 pm

Chelsea: An alternate explanation for the association between reducing dietary sodium intake and lower incidence of hypertension is that when sodium is reduced, palatability food is blander, palatability decreases and consumption decreases. The reduction of blood pressure is not a direct result of lower sodium intake, but a result of weight loss associated with a lower calorie diet. While sodium has not been directly correlated to hypertensive symptoms, body weight has.

  • Anthro
  • January 12, 2010
  • 6:04 pm

@Daniel

Are you a physician? A researcher? My understanding is that about 1/3 of the population is salt-sensitive in terms of high BP resulting from too much salt. The other 2/3′s aren’t as conclusively correlated
to salt sensitivity, but because doctors cannot easily determine who is who, they recommend lower salt intake for everyone. This is from my cardiologist. The issue of the salt/BP relationship is separate from the weight/BP issue as it has been explained to me. Do you have any sources or were you just musing in response to Chelsea’s post?

  • Cathy Richards
  • January 13, 2010
  • 2:10 pm

Daniel, there have been very well designed studies to show that sodium is a direct cause of hypertension in many people. Controlling for calories, carbs/fats/protein, vegetarian vs omnivore, income, education, activity, etc etc. While sensitivity to salt is inconsistent between individuals, it is not inconsistent amongst populations (eg. Canada vs. US vs. Japan). Population wise, excess sodium perpetuates a tremendous human and dollar cost to our families, businesses, and health care.

The taste changes you refer to are generally temporary. Then you start to taste the real food. Which is quite flavourful — not bland! It only seems bland in the transition period while your taste buds and physiology adjusts. Small amounts of salt can be used by most people to enhance the flavour of cooked-from-scratch foods, either while cooking or at the table for individual tastes. It’s the mountains of salt in processed food and condiments that are creating the severe health impacts.

I was hoping for a brief word about iodine. I grew up thinking that I had to eat salt or I’d get a goiter. Now I eat seaweed, but recently I read on Wikipedia that, “Worldwide, iodine deficiency affects about two billion people and is the leading preventable cause of mental retardation.” Just wondering how/if the salt industry is using this argument…

  • John
  • January 14, 2010
  • 7:21 am

Cathy, I think you’ve misrepresented the state of the science. The link between sodium intake and hypertension is very far from conclusive. See, for instance, here: http://www.thirdage.com/hypertension/shaking-up-conventional-thinking-about-sodium-and-hypertension

Also see here, where a clearly-understood biochemical mechanism is seen to implicate fructose consumption as the principal culprit: http://www.youtube.com/watch?v=dBnniua6-oM

Please give us a cite or two if you’d like to rebut.

  • Cathy Richards
  • January 14, 2010
  • 12:37 pm

John, see my earlier post, 2nd link re: role of sodium in POPULATION health, which is what I was discussing and which relates to Marion’s discussion about changing the food supply. I could find many more but don’t feel the need to further defend the work of medical and public health experts.

The RD article you attached addesses INDIVIDUAL health and relates to people changing their personal food choices. Certainly the DASH type diet she recommends is important, but can’t be legislated. Sodium reduction in the food supply can be legislated.

I’m not going to address the fructose issue. That’s pretty much a red herring.

  • John
  • January 14, 2010
  • 2:25 pm

Cathy, your Hopkins source hedges his conclusions six ways from Sunday. That’s not research, it’s speculation. What do you say to this from Gary Taubes, from an interview he gave last month:

“For fifty years, researchers have been trying to causally link salt consumption to hypertension and the data has continued to be, at best, ambiguous. It’s a nice hypothesis, but it just hasn’t panned out in human trials or even, really, in the observational studies. On the other hand, it’s been known since the 1870s that carbohydrates cause water retention and the more water you retain, simplistically speaking, the higher your blood pressure will be. It’s been known since the 1950s that when people go on carbohydrate-restricted diets their blood pressure drops dramatically because of that water loss, and it’s been known since the 1980s that one of the many things insulin does is regulate blood pressure. Moreover, hypertension is associated with obesity and diabetes so, in one sense, whatever causes obesity and diabetes also causes hypertension, and obesity and diabetes, as I explain in GCBC, are almost assuredly caused by the quality and quantity of carbohydrates in our diet.”

Full interview is here: http://www.thedailybell.com/604/Gary-Taubes-Good-Calories-Bad-Calories.html

If salt doesn’t cause hypertension in individuals, and if the mechanism of hypertension is known and unrelated to salt, then where is your public health case? To be clear I’m not saying there isn’t one, but I am saying that this isn’t it.

  • Cathy Richards
  • January 14, 2010
  • 3:33 pm

John,
Gary Taubes vs. the National Academy of Science, DRIs, Public Health Agencies, CDC, etc? My money’s not on Gary. One of my favourite lines I heard a long time ago is “keep an open mind, but don’t let your brains fall out”. Multifactorial causes of problems doesn’t not mean that one of those factors is not a factor.

My final word on this — please read my comments carefully as I usually endeavour to be precise with my choice of words — I said the effect of sodium on hypertension in individuals is INCONSISTENT, not non-existent.

very interesting article. salt intake has to be taken care as discussed to stay healty

[...] as you noted last week on your website, “nearly 80% of salt in American diets is already in packaged and restaurant foods and if you [...]

I wanted to take a moment to respond to this posting as a representative of Campbell Soup Company. Campbell has been gradually and silently reducing the sodium in our products since the 80s. In fact, since 2005 we’ve increased our reduced sodium options from 25 to over 110 products, and expanded beyond soup. These efforts include reducing the sodium content of our Campbell’s condensed kids soups not just once, but twice in the past few years by up to 45 percent.

I’d like to clarify that our kids soups contain 480 mg of sodium per one-cup serving (half cup of condensed soup reconstituted with the same amount of water). All 12 of our kids soups meet FDA/USDA criteria for healthy foods and also are low in fat, saturated fat, no trans fat.

As our quote in the New York Times states, we will continue to reduce sodium in our products. It’s our number one strategic priority. By “consumer acceptance,” we mean we’ll not just lower sodium, but make sure we offer the great-taste people expect from us. That’s one of the biggest challenges in sodium reduction – but we work every day to meet that challenge head-on.

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