Institute of Medicine Calls for Stricter Sodium Regulation

“If you live long enough in this country, you are almost guaranteed to get hypertension,” says Corinne Husten, MPH, MD, and member of the Institute of Medicine’s (IOM) Committee on Public Health Priorities to Reduce and Control Hypertension in the US population.

The IOM hopes to change that disturbing trend through important dietary recommendations released in a report on April 20, 2010. Commissioned by Congress in 2008, the completed report calls for stricter government regulations on the amount of sodium that can be added to food and beverages by restaurants and manufacturers. The American Heart Association (AHA) reports that processed foods account for 75% of dietary sodium; added table salt accounts for only 6%.

Manufacturers add salt to foods for a variety of reasons. Salt is often used as a preservative, but it also adds taste and texture that many individuals find extremely appealing. Low-sodium foods are often not well received by consumers, who find them to be bland.

“The goal is to slowly, over time, reduce the sodium content of the food supply in a way that goes unnoticed by most consumers, as individuals’ taste sensors adjust to the lower levels of sodium,” wrote the authors of the IOM report.

The AHA currently recommends a limit of 1500 mg of sodium per day, but the average American consumes twice that amount. Excess salt intake is linked to hypertension, coronary heart disease, and stroke.

A study published in the New England Journal of Medicine in February 2010 suggests that eliminating 3 g of dietary salt (1200 mg of sodium) per day could help prevent these conditions.

Researchers from the University of California-San Francisco used a computer model to analyze data from studies on US adults with heart disease aged 35 to 84. They estimated that a 3-g reduction would decrease the yearly number of new cases of stroke by 32,000 to 66,000; heart attacks by 54,000 to 99,000; and coronary heart disease by 60,000 to 120,000. The annual number of deaths by any cause would drop 44,000 to 92,000 cases.

At-risk populations for high blood pressure include individuals who are elderly, obese, sedentary, or eat an unhealthy diet. For an individual with high blood pressure, a 3-g reduction of salt—equivalent to one-half teaspoon—could lower systolic blood pressure by 3.6 to 5.6 mm Hg.

Until Congress acts on the IOM recommendations, pharmacists can counsel patients at risk for hypertension to reduce the amount of processed foods in their diet by choosing fresh or frozen foods or reduced sodium products whenever possible.