CDC report on usual sodium intake compared with dietary recommendations

American Heart Association comment:
CDC report on usual sodium intake compared with dietary recommendations

Americans are eating too much sodium, and the American Heart Association believes that we need to increase our public health efforts to encourage the public and private sectors of the food industry to reduce sodium in the food supply, a point emphasized in a report issued today from the US Centers of Disease Control and Prevention (CDC).

Currently, more than 75 percent of the sodium we consume comes from packaged or prepared foods, and sodium levels are high in many restaurant foods. Statistics presented in the CDC report underscore the urgency of reducing sodium in the U.S. food supply. Experts agree that people in certain population groups, such as those who either have high blood pressure or who are at high risk of developing it, should aim for a sodium target of less than 1500 mg a day. Ninety-eight percent of the people in the highest risk groups, which include African-Americans, older adults (51+) and persons with hypertension, diabetes, or chronic disease, are not achieving that goal.

“However, we believe this CDC report is too conservative in its suggestion that only 47.6 percent of American adults fit into the population group that should be consuming no more than 1500 mg a day of sodium,” says Gordon Tomaselli, M.D., president of the American Heart Association, and the Michel Mirowski, M.D., professor of cardiology at Johns Hopkins University School of Medicine in Baltimore, Maryland. “With the direct and indirect costs of cardiovascular disease already at $444 billion a year and rising, and with high blood pressure the single largest driver of those costs, this suggestion doesn’t go far enough to address either the human or economic burden that our excessive intake of salt costs. Other countries have realized this and are addressing it aggressively.”

The American Heart Association believes that many more Americans should heed a target sodium intake of 1500 mg a day or less. “Given that most of us – as many as 90% - will develop high blood pressure with age, we all should be consuming less than 1500 mg a day of sodium, unless your healthcare provider has told you that this doesn’t apply to you,” says Clyde Yancy, M.D., former American Heart Association president and the Magerstadt professor of medicine and chief of the division of cardiology; Northwestern University, Feinberg School of Medicine; Chicago, Illinois.

Yancy points out that a prior 2009 report from the CDC on this same topic suggested that approximately 70 percent of American adults should be included in the 1500 mg/day of sodium restriction. In the absence of new science, this target certainly shouldn’t be reduced. Yancy says, “The data which drove us to this new target of 1500 mg of sodium per day cannot be minimized and conversely the benefits of significant sodium reduction globally and especially in those at risk cannot be overstated.”

Given that an estimated 90 percent of adults will develop high blood pressure in their lifetime, this is not the time to be moderate in this recommendation. People who don’t currently have high blood pressure may be able to prevent it or blunt the rise in blood pressure that accompanies aging by lowering their sodium intake and achieving that limit.

As a science-based organization focusing on the strong evidence linking sodium intake with blood pressure -- and on the major adverse outcomes of heart disease, stroke and kidney disease – the American Heart Association will continue to advocate specifically that the daily intake of sodium for all American adults should be limited to 1500 mg.

Public policy efforts to reduce sodium consumption, much like the early work in reducing tobacco consumption, will not be easy. Collaborations with government agencies, other health organizations and the restaurant and food industry, including those areas influencing prepared and packaged foods, will be necessary. However, if the majority of Americans achieved a daily sodium intake of 1500 mg/day or less, we might save an estimated $24 billion in healthcare costs per year. Americans deserve the freedom to choose how much sodium they eat—and with the levels of sodium currently so high in the food supply, that choice has been taken away.

The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.

President’s advisory on sodium link: http://my.americanheart.org/professional/General/Cutting-Sodium-to-Prevent-CVD-and-Stroke_UCM_424966_Article.jsp