Approaches to Reducing Sodium Consumption

Transcription

1 Approaches to Reducing Sodium Consumption Kasey Heintz, M.S. Office of Food Additive Safety Center for Food Safety and Applied Nutrition U.S. Food and Drug Agency September 23,

2 Objectives Importance of reducing sodium Consensus on sodium reduction Sodium sources and role in food Successful salt reduction FDAs commitment to sodium reduction 2

3 Why Reduce Sodium Intake? 1 in 3 adults have high blood pressure (HBP) HBP is a major cause of heart disease and stroke Sodium intake exceeds recommendations Reducing average US population sodium intake to under 2,300 mg/day could prevent numerous deaths and save billions of dollars 3

4 Poll: How Much Sodium Do American s Eat? a) 3,800 mg/d b) 3,400 mg/d c) 2,400 mg/d d) 2,300 mg/d Population average 4

5 Answer: How Much Sodium Do American s Eat? a) 3,800 mg/d b) 3,400 mg/d c) 2,400 mg/d d) 2,300 mg/d Population average 5

6 Poll: How Much Sodium Should We Eat? B C D A 1/2 1 tsp 1 tbsp 1/4 Based on US Guidance 6

7 Answer: How Much Sodium Should We Eat? A 600 mg/d B 1,200 mg/d 1/4 1/2 C 2,400 mg/d 7,200 mg/d 1 tsp 1 tbsp D Based on US Guidance 7

8 Recommendations and Guidelines Reduction in Intake 2010 US Dietary Guidelines Lower sodium intake to less than 2,300 mg/day for the general population, and further reductions to 1,500 mg/day for those at high risk Healthy People 2020 (2010) Reduce mean U.S. population sodium intake to 2,300 mg/day by 2020 American Heart Association 2013 Aim to eat no more than 2,400 milligrams of sodium per day. Reducing daily intake to 1,500 mg is desirable because it can lower blood pressure even further IOM Report Reaffirmed importance of population-based efforts to lower excessive dietary sodium 8

9 Sodium from Food Most from Processed and Restaurant Foods Mattes,1991 9

10 Two Diets 10

11 High Sodium FOOD Sodium kcal FOOD Sodium kcal Croissant, Egg, Cheese, Bacon (1) Coffee, black (1 c) 889mg 5mg Bran Flakes (1 1/2 srv) Low-fat milk (1/2 c) Apple (1 med) 310mg 54mg 2mg Coffee, black (1 cup) 5mg 5 Pepperoni Pizza (2 sl) Cookies, Choc-chip (2) Iced tea (12 fl oz) 1651mg 116mg 15mg Turkey Sandwich on 2 slices Whole grain with Mustard Tomato soup (1c) Diet iced tea (12 fl oz) 1046mg 960mg 20mg Chips, plain, salted (1 small bag) 180mg 150 Pretzels (2 srv) Light Yogurt (1 c) 600mg 118mg Fried Chicken (1 breast with skin) Mac n Cheese (1 c) Corn on cob w/salt (1) 1184mg 720mg 151mg Grilled chicken (1 fillet) Seasoned mixed veggies (1/2 c) Whole-grain Couscous (1/3 c) Side salad Lite Italian dressing (1 tbsp) 413mg 247mg 510mg 58mg 161mg Banana (1 med) 1mg 53 4,906mg Sodium; 2,447 Calories 4,505mg Sodium; 1,597Calories 12

12 Sodium Role in Food In most foods Inexpensive Does not contribute calories Adds flavor Food safety/preservation Various technical effects Top 10 Food Sources 1) Breads and rolls 2) Cold cuts and cured meats 3) Pizza 4) Poultry 5) Soups 6) Sandwiches 7) Cheese 8) Pasta dishes* 9) Meat dishes 10) Snacks 13 CDC, Vital Signs, Feb

13 Recommendations and Guidelines Reduction in Food American Medical Association 2006 Stepwise, reduction in sodium of at least 50% in processed foods, fast-food products, and restaurant meals over the next decade 2010 US Dietary Guidelines Deliberate reduction in the sodium content of foods in the marketplace is necessary to allow consumers to reduce sodium intake to less than 2,300 mg or 1,500 mg/day Institute of Medicine 2010 Reduce the salt content of the U.S. food supply in a stepwise manner reduce sodium in processed foods and menu items 14

14 2010 IOM Recommendations Forty years of education and outreach have not worked Strategies Primary: FDA to set mandatory national standards for sodium content of foods Interim: Voluntary actions by food industry to reduce sodium Supporting: Nutrition labeling, education, monitoring 15

15 Taste Preference Can Change Elmer, 1988 (IOM reference) 16

16 International Efforts Over 35 countries working on reducing sodium 17 WASH 16

17 Poll: Which Initiative Recently Published Data Linking Salt Reduction to Health Outcomes? a) Spain b) England c) Canada d) Argentina 18

18 Answer: Which Initiative Recently Published Data Linking Salt Reduction to Health Outcomes? a) Spain b) England c) Canada d) Argentina 19

19 Impact in England/UK Falls in BP between 2003 and 2011 are largely attributable to the reduction in salt intake BP reduction predicted to reduce stroke by 11% and ischaemic heart diseases by 6% 20

20 Progress in England/UK GOAL: 6 g/d or 2,400 mg/d by salt 9.5 g/d 8.6 g/d 8.1 g/d sodium 3,800 mg/d 3,440 mg/d 3,240 mg/d Retailers met all/majority of 2010 targets; some of 2012 Still working toward goal of 6g/d (2,400 mg/d) Revised targets in 2013 to encourage reformulation New max targets for catering/take-away sector Company promotion/education More company commitments 21

21 Company Progress Reduced sodium in other countries in similar products At least 80 major packaged and restaurant companies have made public announcements in the media or on their websites Some of these also committed to the NYC National Salt Reduction Initiative (62 packaged; 25 restaurant) Other commitments (e.g. Partnership for Healthier America) Testing of sodium alternatives 22

22 FDA s Commitment to Sodium Reduction 23

23 FDA Food and Veterinary Medicine Program 24

24 FDA Sodium Reduction Efforts Education Outreach campaigns (Spot the Block) Nutrition Facts label materials Million Hearts campaign Labeling Proposed Rule for Menu labeling in chain restaurants (written materials for chain restaurants) Updating the Nutrition Facts Panel Front-of-Package labeling 25

25 FDA Sodium Reduction Efforts (Cont.) Technical Review Food technology/industry practices research Food surveillance (sodium content of food) Consumer behavior research Soliciting Input Docket on Sodium Reduction with USDA (Sept. 2011) Public meeting with CDC & USDA (Nov. 2011)

26 Where are We Headed? FDA considering various regulatory options, but at this time, we are working toward the development of voluntary sodium reduction targets. Committed to a sodium reduction effort that is Gradual, achievable and sustainable Accounts for consumer acceptance, food safety and technical role of sodium in food Ensures consistent application over the entire food supply Incorporates monitoring of food levels and intake And is supported by continued commitment to consumer education 27

27 Stakeholder Participation Federal partners External partners USDA/ARS NIH/HHS FDA USDA/FSIS CDC USDA/CNPP Retailers & Wholesale Restaurant & Food Service Food Manufacturers Public Health Organizations All parties must work together to see success 28

28 Conclusion Continued interest in public health benefits from reduced sodium intake Committed to basing actions on best available current scientific data Win-Win-Win Consumers Industry Public health agencies 29

29 Thank you! FDA ents/ucm htm CDC USDA