The AAFP doesn't normally condone salty language, but in the case of the FDA's draft guidance on voluntary sodium reduction goals for commercial food producers,(www.fda.gov) the Academy fully backs the effort.
This guidance, which was published in the June 2 Federal Register(www.federalregister.gov) with a request for public comment, describes voluntary short- and long-term goals for sodium reduction in a variety of foods that are commercially processed, packaged or prepared.
AAFP Board Chair Wanda Filer, M.D., M.P.H., of York, Pa., responded to that comment request in an Oct. 26 letter(2 page PDF) to Leslie Kux, the FDA's associate commissioner for policy.
"The AAFP applauds the FDA for releasing this guidance," Filer said in the letter. "We agree with the FDA and expert advisory panels that scientific evidence supports the value of reducing sodium intake in the general population. Furthermore, we concur that the current U.S. intake of sodium is excessive, that it should be reduced and that reduction in sodium intake is expected to result in a significant public health benefit."
Evidence of Sodium Intake Reduction Benefit
As background, the FDA's draft guidance referenced the 2013 Institute of Medicine (IOM) report Sodium Intake in Populations: Assessment of Evidence,(www.nap.edu) which confirmed a positive relationship between higher levels of sodium intake and the risk of heart disease.
- The Academy recently sent a letter to the FDA supporting the agency's draft guidance on voluntary sodium reduction goals for commercial food producers.
- The FDA's draft guidance referenced the 2013 Institute of Medicine report Sodium Intake in Populations: Assessment of Evidence, which confirmed a positive relationship between higher sodium intake levels and heart disease risk.
- The agency estimated that reducing mean population intake to about 2,300 mg per day (from the current level of about 3,400 mg per day) could be attainable if the food industry met its sodium reduction goals.
Additionally, the report found that reducing sodium intake to 2,300 mg per day led to substantial population benefit with no evidence of negative health effects. IOM researchers also said different investigative teams had used other methods and data to come to the same conclusion -- namely, that the U.S. population ingests too much sodium and reducing intake would significantly benefit public health.
The letter explained this reduction is important because previous research has shown(hyper.ahajournals.org) that lowering sodium intake to a similar level of 2,200 mg per day would avoid between 280,000 and 500,000 premature deaths during the course of 10 years, and further sustained sodium reductions would prevent additional premature deaths.
Furthermore, the Scientific Report of the 2015 Dietary Guidelines Advisory Committee(health.gov) confirmed high sodium intake was associated with increased blood pressure and risk of cardiovascular disease.
Voluntary Sodium Reduction Goals Explained
In its draft voluntary sodium reduction goals, the FDA set baseline sodium concentrations(www.fda.gov) for each food category using concentrations from 2010 label data for packaged foods sold directly to consumers and menu nutrition data for foods sold in large restaurant chains. Voluntary target mean and upper bound sodium concentrations also are offered for each category. The packaged food items were selected based on placing in the top 80 percent of sales by volume in each category.
Based on a model of sodium intake in these food categories and current What We Eat in America survey consumption data,(www.ars.usda.gov) the FDA estimated a reduction in mean population intake to about 2,300 mg per day (from the current level of about 3,400 mg per day) could be attainable if the food industry met its sodium concentration goals.
Food categories for which sodium reduction goals have been identified are
- fats, oils and dressings;
- fruits, vegetables and legumes;
- nuts and seeds;
- sauces, gravies, dips, condiments and seasonings;
- bakery products;
- meat and poultry;
- fish and other seafood;
- mixed ingredient dishes;
- other combination foods; and
- infant/toddler foods.
Although the FDA is not conducting rulemaking on this sodium guidance and these goals are voluntary, the Academy "acknowledges the potential and significant benefits to public health in sodium reduction" and supports the FDA's role in "exploring effective and efficient strategies to promote sodium reduction in the food supply," said Filer in the letter.
"The AAFP shares the FDA's hope that voluntary goals can be an effective means to achieving significant benefits to public health through sodium reduction in commercially processed, packaged and prepared foods, since most people in the United States get more sodium in their diets than they need."
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