After decades of warnings about salt, the white, grainy mineral seems poised to become the grocery's next boogeyman. Health and consumer advocates who see a rising epidemic of high blood pressure and related disease are making the latest push, and that has foodmakers inching toward change.
The Centers for Disease Control and Prevention recently quantified the problem with a report saying most Americans consume more than double the daily recommended level of sodium, a major component of salt. An Institute of Medicine committee has begun exploring ways to control intake that could include new regulations, education and further efforts from the food industry.
Since sodium occurs naturally in a few foods and its use is ubiquitous, eliminating it from American diets would be impossible and not advised, because a small amount is needed for proper body function. But if reduction efforts are successful, proponents say there would be less hypertension, and less heart disease and fewer strokes, the No. 1 and No. 3 killers nationwide.
"There are a lot of dietary factors that affect blood pressure, but salt is front and center," said Lawrence J. Appel, a professor of medicine, epidemiology and international health at Johns Hopkins Medical Institutions and a salt panel member at the Institute of Medicine, a scientific advisory panel.
"Salt is why we have a blood pressure epidemic," he said. "No one knows how much salt he consumes or has easy control of it; it's why the solution is a public-health one."
Appel said putting down the shaker would be a good start. But most salt is added during processing or in restaurant preparation. That means retooling at the plants and commercial kitchens, and changing the way we think about food.
Take pizza, one of the saltiest and most popular foods. Makers would have to dump long-used recipes for crust and sauce, which would be hard to balance with the the potential for consumer backlash. They also would have to engineer new cheese, as salt is integral to its taste and preservation.
Appel said public tastes would acclimate to less salt quickly. If nothing is done, he said, the nation's blood pressure, which naturally climbs throughout people's lives, would continue to rise to unhealthy levels faster.
The CDC study released last month was the first to use national data to show that nearly 70 percent of adults should consume no more than 1,500 milligrams of sodium a day. They are people with high blood pressure, blacks and those older than 40. Other adults should consume less than 2,300 milligrams a day, or about a teaspoon.
The Center for Science in the Public Interest, a consumer group that sued in 2005 to get salt off the Food and Drug Administration's list of safe food ingredients, says restaurant and processed foods deliver more than three-fourths of the salt people consume.
Center Executive Director Michael F. Jacobson said regulation was necessary because, unlike fat, the public doesn't see an obvious result of overindulging and won't demand change.
Jacobson is further dismayed by recent consumer trends in "gourmet" salt and "natural" sea salt, which he says is still salt.
"Salt is the new bad guy and deserves to be," he said. "It's the single most harmful thing in the food supply."
Officials at the Grocery Manufacturers Association say they are taking action, although the problem can't be solved overnight, because Americans are used to the taste, and salt is used in production and preservation.
"Today there are more and more sodium- or salt-modified products available nationwide for consumers in the marketplace," Robert Brackett, chief science officer for the association, said in a statement.
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