In the wake of its city-wide diabetes reduction and restaurant nutrition labeling initiatives, the New York City Department of Health is leading yet another dietary health campaign, this time one that involves a national coalition of cities, states, and medical organizations. My hat’s off to them, even though I think the demands they intend to make of the food industry are much too light and much too toothless.
The National Salt Reduction Initiative, announced on Monday, will encourage “voluntary compliance” from the processed food and restaurant industries to lower their sodium content by about 20% over the next 5 years. That’s pretty modest considering that both industries have doubled the standard sodium content of many common foods in the past 20-30 years, and that the national obesity epidemic seems to have coincided pretty nearly with that trend.
The UK’s national salt reduction campaign, which started in 2003 and serves as a model for NSRI, has government backing and its goal is 40% reduction of sodium in processed foods within 5 years, not 20%. They seem to be getting there, too.
NSRI’s coalition includes the Los Angeles Department of Health and a variety of medical organizations like the American Heart Association and the American College of Cardiology. What it doesn’t include this year, to my surprise–and, frankly, dismay–is involvement, funding or guidance from the National Heart, Lung and Blood Institute at NIH.
Ten years ago the NHLBI would have participated one way or another in encouraging this sort of initiative, but that was before the Bush years. NHLBI has been reorganized several times in the last decade. Two of its key diet-related outreach and education programs–the National Cholesterol Education Program and the National High Blood Pressure Education Program, which would have been the leading outreach proponent for NSRI–have receded from view, with perfunctory descriptions on the agency web site, no functioning links to current activities if there are any or to updated program pages, and no clear leadership or place in the agency’s organizational chart. But the need for them certainly hasn’t ended.
Voluntary compliance programs don’t have a great track record in the processed food industry. Look at the recent Smart Choices nutrition labeling program fiasco (see under, Froot Loops) from October.
Starting a national program like this with voluntary compliance as a key component means the designers don’t think there’s much way to enforce the changes other than persuasion. It also means the government doesn’t have the tools, the money, or–and here is the crux of it–the will to enforce even modest limits on sodium content. Both the AHA and the AMA have been working on the FDA for years to get salt off the “generally harmless ingredient” list and start regulating it responsibly, but to no discernible avail. The Center for Science in the Public Interest (of fettuccine alfredo as “heart attack on a plate” fame) actually sued the FDA in the early 2000s for the same purpose.
So I’m not all that sanguine about the great benefit to public health that such a modest sodium reduction over such a long lead time will produce, and I’m not looking forward to all the salt proponents being able to point a finger at the lackluster results and say, “See? Cutting salt makes no difference!” when the truth is that no one even tried very hard from the beginning.
I think we’re aiming too low in the U.S., without a good reason other than the usual “people will scream”–by which the processed food industry means “You’re asking us to DO something?!” The NSRI organizers seem to have accepted the standard food industry line about potential damage to business from consumer rejection of “less tasty” reduced-sodium foods without even a little skepticism.
But if you look at the public reaction, “the people” aren’t buying that as easily. New York’s previous big health initiative to get nutrition labeling on restaurant food seems to be making a difference after 2 or 3 years –restaurants have cut the salt, fat and calories back on some of their worse offenders. And back in April this year, when NSRI was still in the proposal phase, commenters seemed not to buy John Tierney’s sloppily alarmist NY Times article on the “dangers” of cutting salt back to something semi-sane. After all, we managed on half the salt 30 years ago.
However, there’s one immediate benefit to NSRI’s launch. If there’s a lesson that can be dredged out of NSRI’s fact sheets and proposed sodium reductions (available from the NYC Department of Health’s NSRI page), it’s that the restaurant food most worth skipping is…biscuits. In any form, they currently run about 980 mg sodium, more than 2 grams of salt, per 100 g or 3.5 oz of biscuit. That makes them very nearly the saltiest item (other than pickles) on any common menu. And since the restaurants that tend to offer them at all seem to offer them at all times of day, they can be skipped at a number of meals, from breakfast to dessert.
Filed under: DASH Diet, Eating out, Food Politics, nutrition | Tagged: fast food, Food Politics, heart disease, high blood pressure, hypertension, John Tierney, low sodium, low-salt, National Salt Reduction Initiative, NHLBI, NIH, NSRI, nutrition labeling, NYC Department of Health, processed food, public health, restaurants, UK salt reduction |