Salty Success

Originally Published NO March 2010

Heart disease is the leading cause of death in the United States. With that said, the next great cure could come from food producers around the country.

At least experts at the New York City Health Department think so. That's why the agency has introduced the National Salt Reduction Initiative (NSRI), a nationwide effort to reduce the population's sodium intake by 20% over the next five years. With the backing of more than 40 cities, states, and national health organizations, NSRI is encouraging food manufacturers and restaurants to voluntarily reduce the sodium content of their products by 20%.

"We know that by making that level of reduction nationally, we'll save tens of thousands of lives each year," says Christine Johnson, nutrition policy coordinator for the Bureau of Chronic Disease Prevention and Control at the New York City Health Department. "Salt reductions will result in fewer strokes and heart attacks, and save billions of dollars of healthcare costs," she adds.

A study published online at the New England Journal of Medicine in January drives this theory home. Using the Coronary Heart Disease Policy Model, a computer simulation of heart disease incidents in the United States, researchers determined that reducing overall salt intake in the population by three grams (1200 mg per day) could result in 60,000 fewer cases of chronic heart disease, 32,000 fewer stroke incidents, and 54,000 fewer heart attacks, annually-not to mention $10 billion to $24 billion saved each year in healthcare costs.

How can food manufacturers help? The brains behind NSRI have compiled a database using national sales data and nutrition data for every major food category, which establishes food-specific target commitments for lowering salt. Sign on to meet your targets, and the NSRI will work with your company to help you achieve your unique goals. Major companies have already committed to the initiative, including Subway, which will commit to meeting some sandwich targets.

"These targets are for 2012 and 2014, so it levels the playing field," says Johnson. "It allows companies to plan their reformulation cycles, plan new product launches, and know what the targets are."

And this commitment doesn't necessarily require taking those salty breadwinners off the market. Johnson notes that only a sales-weighted average of your products must meet the overall reduction; for instance, you can still sell a very salty cracker, but all of your crackers overall should meet a reduced level.

NSRI is actually based on a successful ongoing program first implemented in the United Kingdom in 2003. Major food associations and food manufacturers?(including Heinz and Nestlé) have been working to reach their own targets in various food categories, and the results have shown. Using urine analyses, the average sodium intake of the UK population has actually decreased by 9% from 2001 to 2008.

Joseph Harrington, assistant commissioner for the Chicago Department of Public Health, says one reason his agency is backing the initiative is the consistent relationship between salt intake in the American diet and bad health outcomes. But Nutritional Outlook asked, "What incentives are available for food manufacturers for committing to targets, beyond keeping consumers healthy?"

"The main incentive for manufacturers to commit to these healthier, lower-salt targets is that their products will be more in line with what their customers, current and potential, want from food," says Harrington. "Chances are, they would promote their healthier products-both on their packaging and in their advertising-just as they did to promote their products when public sentiment turned against trans-fats. And that has a snowball effect that can increase people's awareness of healthier food."

NSRI will be announcing final sodium targets for companies this spring. Making a 20% salt reduction may seem like a big step to companies, which probably have concerns ranging from how to deal with technology changes and even microbial activity during the shift.

Companies can learn more about how to address these concerns, and what targets apply to them, by visiting NSRI's website at www.nyc.gov/health/salt.