NYC Takes a Bite Out of Salt Consumption

(Jan. 11) – A New York Reuben may soon taste a little different.

The New York Health Department today announced a new scheme aimed at an old seasoning: salt. The program, called the National Salt Reduction Initiative, aspires to reduce the amount of salt in foods by 25 percent over the next five years in an effort to lower the country's blood pressure and combat cardiovascular disease.

The city says the initiative puts the salt shaker back in the hands of the people. Currently 80 percent of the salt Americans eat is already in the food they buy. Under this plan, the Health Department says, if you decide you want more salt on your deli meats, you can add it yourself.

"Right now people don't have a choice about the amount of salt they're getting," said Dr. Sonia Angell, director of the Cardiovascular Disease Prevention and Control Program at the New York City Department of Health and Mental Hygiene.

Many in the medical community agree that salt consumption in the United States is a major problem, contributing to heart attacks and strokes. Cardiovascular disease is the leading cause of preventable death in the United States, with 800,000 deaths nationwide each year, according to the NYC Health Department.

The federal government's recommended daily intake of sodium is 1,500 to 2,300 milligrams a day. But many Americans are eating four to five times that, according to Dr. Clyde Yancy, president of the American Heart Association and supporter of the National Salt Reduction Initiative.

"This is a disclosure of food content," Yancy said. "This is not a circumstance where ignorance is bliss."

But not everyone agrees.

"This is pie-in-the-sky dreaming based on pseudoscience or junk science," said Richard Hanneman, president of the Salt Institute, an advocacy group for the salt industry. Reducing the amount of salt in food will likely lead to people eating more of the less salty food, he said.

"People's bodies determine how much salt they consume," he said. "When you reduce salt in your diet, there are unintended consequences."

And as for the American Medical Association's warning that we're ingesting far too much salt?

"They're wrong," he said.

(For scientific evidence, Angell points to a 2004 Institute of Medicine review of literature on the subject, which concluded that most people eat too much salt.)

But Hanneman isn't alone. Dr. Michael Alderman, a professor at the Albert Einstein College of Medicine, wrote in a New York Times op-ed last year that reducing salt in your diet could cause "greater resistance to insulin, increased sympathetic nerve activity and activation of the kidney-based renin-angiotensin system. All three of these effects increase the risk of heart attack and stroke."

The program will set target sodium levels and asks companies to commit to reducing the salt in their products to those numbers. The levels will be tracked by a database in New York City, but because the program is voluntary, companies will not be legally required to uphold their end of the bargain.

Supermarket giant A&P is already on board, as is Subway, reports the New York Times. Because the companies involved would likely be national brands with widespread products, the salt reduction, if it is successful, will be a national phenomenon.

"I think this will almost certainly have some benefit for the health of the population in New York City," said Dr. Walter Willett, chairman of the Department of Nutrition at the Harvard School of Public Health. "And if it's like the trans fats ban, it will have benefits across the rest of the country."

The "trans fats ban" in question is a restriction on cooking with trans fat oils, put in place by New York Mayor Michael Bloomberg in 2006. Since then, "estimated restaurant use of artificial trans fat for frying, baking, or cooking or in spreads had decreased from 50% to less than 2%," Angell and others wrote in a 2009 article in the Annals of Internal Medicine.

Bloomberg has been on other health crusades as well. In 2003, the city banned smoking in bars and restaurants, and in 2006 it voted to require chain restaurants to list the calories in each of the items on their menus.

Whether or not they are related to these initiatives, New York City has seen some changes since then. Between 2002 and 2008, the number of smokers declined by nearly 6 percent, according to the Health Department's Community Health Survey. A Stanford University study of Starbucks receipts released this month found that after calories were listed on menus, the "average calories per transaction falls by 6%." Since the New York City trans fats ban, several other areas, including Philadelphia and California, have followed suit.