25 April 2012 --- Two years ago the Institute of Medicine concluded that the food industry had not heeded calls over the preceding 40 years to voluntarily reduce sodium levels in its products and therefore called for mandatory limits. But even as diets too high in sodium contribute to tens of thousands of premature deaths each year and billions in medical costs, the Food and Drug Administration has not taken any action to curb the salt in packaged or restaurant foods.

In a letter today, Center for Science in the Public Interest executive director Michael F. Jacobson told FDA Commissioner Margaret Hamburg that upwards of 100,000 lives could be saved annually if sodium levels in packaged and restaurant foods were halved. High levels of sodium consumption promote costly health problems, such as high-blood pressure, heart disease, stroke, and kidney disease. According to CSPI, direct medical costs would be cut by about $18 billion per year if sodium consumption were reduced from 3,400 milligrams per day to 2,300 mg per day; $28 billion could be saved if consumption were further reduced to 1,500 mg per day.

"There is virtually nothing else the FDA could do to improve America’s food supply that would provide a greater benefit to public health than to reduce sodium levels," Jacobson wrote. "We urge the FDA to issue strong rules that will protect Americans’ health."

In April 2010, the IOM recommended setting gradually decreasing limits on sodium in the coming years, giving American palates time to adjust to safer levels. Companies could lower sodium in a variety of ways depending on the food, according to CSPI. Besides simply using less salt, companies could replace some of the sodium chloride with potassium chloride, use salt crystals of different sizes and shapes, add herbs and spices, or salting just the outside or one surface of foods.

A study published earlier this month in the Canadian Medical Association Journal shows that American fast-food companies have plenty of room to bring sodium levels down at least to the levels seen in other countries. In the United Kingdom, where food regulators had made salt reduction a priority, several categories of fast food had about 15 percent less sodium than in the United States.

"Every year of delay on the part of the Food and Drug Administration means hundreds of thousands of additional strokes, heart attacks, and deaths that could have been prevented," said Stephen Havas, M.D., adjunct professor of preventive medicine at Northwestern University Feinberg School of Medicine. "I't's really astonishing that the agency has not seized the opportunity presented by the Institute of Medicine's landmark report and begun to use its regulatory authority to fix this huge problem with our food supply. How many more deaths will it take before they act?"