It’s not often that consumer advocacy groups and the food industry align in pressuring the FDA to take action. Still, it’s happening now over a food labeling issue with important implications for improving health. Most people consume far more sodium than is necessary or healthy, and excess salt intake is the leading cause of high blood pressure, which in turn is the leading cause of death in this country and globally.
People want healthier food, and the industry wants to be able to provide it. However, the federal government has created a barrier to progress — a barrier that can be overcome easily.
There is a scientific consensus that reducing dietary sodium intake lowers blood pressure, prevents the onset of hypertension, and reduces the risk of stroke and kidney disease. Cutting sodium consumption by about a third could prevent nearly 100,000 deaths and save up to $24 billion in health-care costs in the U.S. annually.
Leading science and health organizations have long supported this reduction, prompting the U.S. Food and Drug Administration to issue targets to reduce the sodium content in food. Voluntary action by the food industry has had some impact— about a 7 percent reduction over the past decade — but this far less than needed. As a result, there are thousands of preventable deaths and billions of dollars in avoidable health spending every year.
Not only do we consume far too much sodium — but we also consume too little potassium. Potassium reduces blood pressure, the opposite effect of sodium. The strongest predictor of hypertension isn’t sodium alone, and it’s the ratio of sodium to potassium.
One effective strategy is replacing standard sodium salt with salt that has some potassium. Potassium can replace up to a quarter or more of the sodium in standard salt, thereby reducing the risk of hypertension.
Except for people who have kidney disease or are on certain medications for high blood pressure, the potassium salt is safe; the amount of potassium consumed daily from low-sodium, potassium-containing salt would rarely be more than what’s in 1-2 bananas.
By both reducing sodium and increasing potassium in our diets, we get a double cardiovascular health benefit.
The sticking point is how potassium salt should be listed as an ingredient in food content labels. The FDA wants to require companies to register potassium salt as “potassium chloride salt.” This is problematic because the term “potassium chloride” on an ingredient list could discourage consumers from purchasing these products.
Some consumers mistakenly believe that “potassium chloride” is an undesirable chemical substance that should be avoided, rather than an essential component of our diet. The sodium salt, of course, is sodium chloride. Labeling is a powerful motivator for manufacturers to maintain the current (and unhealthy) use of sodium chloride and avoid potassium salt substitution. There’s an easy fix.
It isn’t often that food industry lobbyists (including Nestle, Kraft Heinz, Unilever, the snack food association, the turkey and meat institutes, and others), consumer advocates (including the Center for Science in the Public Interest and others), and public health experts (including Harvard professors, public health departments, and non-governmental organizations) agree.
In this case, they concur on the use of “potassium salt” on food labels, and have asked the FDA to allow the industry to use this phrase on ingredient lists. The comment period for this petition has officially passed (although comments can still be submitted here); the FDA will announce its decision in the coming months.
Reducing salt consumption will improve health. Scientists and public health experts agree: pass less salt — but when you do pass it, pass the potassium salt.
Dr. Thomas R. Frieden, former Director of the Centers for Disease Control and Prevention, is currently President and CEO of Resolve to Save Lives (RTSL), an initiative of Vital Strategies. RTSL is a global initiative to prevent cardiovascular disease, including reducing sodium consumption.