Following New IOM Report, CSPI Urges Consumers, Industry, and Government to Reduce Sodium

Statement of CSPI Nutrition Director Bonnie Liebman

May 14, 2013

The new sodium report from the Institute of Medicine should not keep the government, food industry, health professionals, and consumers from acting on a public health problem of critical importance. As the IOM itself stated in 2010, urgent government action, including mandatory limits on salt in packaged foods, is required to help Americans bring their sodium consumption down to safe levels.

The committee found too little evidence to say whether the safest intake—the green zone—is below 2,300 milligrams a day or below 1,500 milligrams a day. What the committee failed to emphasize is that most Americans are deep in the red zone, consuming 3,500 to 4,000 milligrams of sodium a day. It's clear that those excessive levels increase the risk of high blood pressure, heart attacks, and strokes. Whether we aim for 2,300 or 1,500 milligrams a day is irrelevant until we move down out of the red zone.

At restaurants, you can get roughly 2,000 milligrams of sodium from just one burrito, a single-serve pizza, or an order of kung pao chicken, and at least 1,000 milligrams from a typical sandwich or burger. As the IOM concluded in 2010—and as our new study published yesterday in JAMA Internal Medicine confirms—getting down to 2,300 will be nearly impossible until the government phases in reasonable limits on the sodium content of foods.

The committee was boxed in by a narrow charge to examine only studies that looked at hard endpoints like heart attacks and strokes. Because of flaws in those studies, the committee did not conclude that low sodium intakes are harmful.

No large scale studies have tested whether sodium intakes below 1,500 milligrams a day reduce the risk of heart attacks and strokes. Instead, health authorities have rightly relied on a mountain of evidence that higher sodium intakes raise blood pressure, and that high blood pressure raises the risk of cardiovascular disease.


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