Industry Perspectives on Regulation and Labeling of Salt and Sodium Robert Earl, MPH, RD Grocery Manufacturers Association...
The Grocery Manufacturers Association (GMA) represents the world’s leading food, beverage and consumer products companies....
General Principles <ul><li>Policies should serve the best interest of the public  </li></ul><ul><li>Policies should be com...
General Principles <ul><li>Functionality and safety are critical </li></ul><ul><li>Small steps in reducing sodium intake a...
General Principles <ul><li>One-size-fits-all regulatory approach will not work </li></ul><ul><li>Consider all factors rela...
Regulation of Salt <ul><li>FDA should support its 1982 assessment of salt </li></ul><ul><li>GRAS process has worked for ov...
Safety Principles for Essential Nutrients <ul><li>Nutrients, even essential nutrients, can have adverse effects at high le...
FDA Salt/Sodium Policy <ul><li>Further work will be extremely cumbersome </li></ul><ul><li>GRAS is not determined by dieta...
FDA Salt/Sodium Policy <ul><li>All risk factors and research must factor into any FDA policy </li></ul><ul><ul><li>Diet, p...
FDA Salt/Sodium Policy <ul><li>Policies should not rely on assumptions </li></ul><ul><li>“Progress” in hypertension risk r...
Functionality and Safety <ul><li>Critical considerations— </li></ul><ul><ul><li>Chemically leavened products : sodium ingr...
Collaboration and Partnership <ul><li>Government focus should be on improvement of overall food choices and dietary patter...
Collaboration and Partnership <ul><li>“One-size-fits-all” approach should not be adopted </li></ul><ul><li>Food industry s...
Labeling and Consumer Information <ul><li>All packaged food products disclose amount of sodium and percent Daily Value </l...
Labeling and Consumer Information <ul><li>“Healthy” labeled products are growing in number </li></ul><ul><li>FDA expected ...
Labeling and Consumer Information <ul><li>Warning messages on salt containers may be counter productive </li></ul><ul><li>...
Labeling and Consumer Information <ul><li>More consumer research is required </li></ul><ul><ul><li>Label claims evaluation...
Sources of Sodium, c. 2003-2004 Source: NHANES 2003-2004; Courtesy of General Mills Bell Institute Soup 3%
Top 20 Individual Food Sources of Sodium  in the American Diet Based on the Combination of Frequency of Consumption and So...
Sources of Sodium <ul><li>Over half have sodium levels below FDA “healthy” level of 480 mg (per portion) </li></ul><ul><li...
Sodium Reduction Over Time - 29 % 180 258 254 1 slice Bread, white, enriched - 35 % 649 1,124 1,000 1 c Chicken noodle sou...
Dietary Guidelines & MyPyramid <ul><li>≤ 2,300 mg/d recommendation </li></ul><ul><li>Food patterns for adults range from 1...
MyPyramid <ul><li>Sample menus for consumers average about 2,900 mg sodium per day </li></ul><ul><li>Lowest is about 1,600...
Questions <ul><li>When will fruits, vegetables, and whole grains be “Top 10” consumed foods? </li></ul><ul><li>What to do ...
Take A  Peak  MyPyramid Promotion <ul><li>Assess effect of incremental changes  </li></ul><ul><li>Menu modeling overview <...
Take A  Peak  MyPyramid Promotion <ul><li>HEI score increased over 3 weeks from base from 41 to 93.5 </li></ul><ul><li>Met...
Take A  Peak  MyPyramid Promotion <ul><li>Demonstrates that small, incremental changes to food choices over time can meet ...
Additional Research Needs <ul><li>FDA and government support and advocate for— </li></ul><ul><ul><li>CVD outcomes trial </...
Conclusion <ul><li>Food industry takes seriously product development issues addressing nutrition & health—including sodium...
www.gmaonline.org
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Industry Perspectives on Regulation and Labeling of Salt and Sodium

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  • The meeting in Chicago did not provide time enough to discuss the ongoing controversy among medical experts over the scientific questions. The science was reviewed by Dr. Larry Appel, a member of the anti-salt activist group WASH #273 at http://www.worldactiononsalt.com/home/docs/wash_members.xls



    For balance, I've downloaded a recent PPT by Dr. Hillel Cohen, author of several health outcomes studies of the NHANES database. You can find it at



    http://www.slideshare.net/rhanneman/salt-and-cardiovascular-mortality







    Dick Hanneman, Salt Institute
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  • The “General Principles” are well worth repeating, with one exception. We would improve our success on all our issues surrounding dietary policy if we:

    1. Recognize that functionality and safety are critical

    2. Focus on overall dietary patterns

    3. Design an intervention that recognizes that one size does not fit all

    4. Consider all factors involved in producing the health outcome desired

    5. Generate additional research on health outcomes of dietary salt (as GMA and the Salt Institute have testified to FDA)

    The one point requiring some further comment is the recommendation that “small steps in reducing sodium intake are successful….” No research in your presentation or by anyone else at the meeting documented that point: that choosing food items lower in sodium actually produces the hypothesized end result of reducing total dietary sodium. Please add that to your research agenda.

    We likewise commend GMA for its advocacy to FDA that

    1. “Policies should not rely on assumptions”

    2. A focus on “overall dietary patterns” is required, including “adequate intakes of foods and nutrients” (emphasize the positive)

    3. “Avoid unintended consequences of single nutrient focus” – as the GMA/CSPI conference concluded last Fall.



    Dick Hanneman

    Salt Instiute
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Industry Perspectives on Regulation and Labeling of Salt and Sodium

  1. 1. Industry Perspectives on Regulation and Labeling of Salt and Sodium Robert Earl, MPH, RD Grocery Manufacturers Association July 9, 2008 Nutrient Essentials National Restaurant Association Chicago, Illinois
  2. 2. The Grocery Manufacturers Association (GMA) represents the world’s leading food, beverage and consumer products companies. The Association promotes sound public policy, champions initiatives that increase productivity and growth and helps to protect the safety and security of the food supply through scientific excellence. The GMA board of directors is comprised of chief executive officers from the Association’s member companies. The $2.1 trillion food, beverage and consumer packaged goods industry employs 14 million workers, and contributes over $1 trillion in added value to the nation’s economy. For more information, visit the GMA Web site at www.gmaonline.org.
  3. 3. General Principles <ul><li>Policies should serve the best interest of the public </li></ul><ul><li>Policies should be compatible with and support the Dietary Guidelines </li></ul><ul><li>FDA should support its 1982 assessment of salt </li></ul>
  4. 4. General Principles <ul><li>Functionality and safety are critical </li></ul><ul><li>Small steps in reducing sodium intake are successful in meeting or moving toward recommendations </li></ul><ul><li>Efforts should focus on overall dietary patterns and food choices </li></ul><ul><li>Incremental reductions help consumers reduce sodium </li></ul>
  5. 5. General Principles <ul><li>One-size-fits-all regulatory approach will not work </li></ul><ul><li>Consider all factors related to hypertension and heart disease </li></ul><ul><li>Additional research is required relating to health outcomes, taste, salt alternatives, and consumer understanding and behavior </li></ul>
  6. 6. Regulation of Salt <ul><li>FDA should support its 1982 assessment of salt </li></ul><ul><li>GRAS process has worked for over 50 years to evaluate common food ingredients </li></ul><ul><li>Salt, used since antiquity, clearly meets GRAS definition </li></ul>
  7. 7. Safety Principles for Essential Nutrients <ul><li>Nutrients, even essential nutrients, can have adverse effects at high levels of intake—not unique to salt </li></ul><ul><li>All nutrients can be present in the diet at levels that cause deficiencies, optimal or excessive nutrition </li></ul><ul><li>Sodium, at normal dietary levels, is safe from a toxicological point of view </li></ul>
  8. 8. FDA Salt/Sodium Policy <ul><li>Further work will be extremely cumbersome </li></ul><ul><li>GRAS is not determined by dietary modeling, but by toxicology </li></ul>
  9. 9. FDA Salt/Sodium Policy <ul><li>All risk factors and research must factor into any FDA policy </li></ul><ul><ul><li>Diet, physical activity, weight, smoking, alcohol consumption, genetics, etc. </li></ul></ul><ul><ul><li>MyPyramid and DASH dietary patterns can successfully reduce sodium and improve blood pressure </li></ul></ul>
  10. 10. FDA Salt/Sodium Policy <ul><li>Policies should not rely on assumptions </li></ul><ul><li>“Progress” in hypertension risk reduction is a better strategy </li></ul><ul><ul><li>Adoption of overall dietary patterns </li></ul></ul><ul><ul><li>Adequate intakes of foods and nutrients </li></ul></ul><ul><ul><li>Avoid unintended consequences of single-nutrient focus </li></ul></ul>
  11. 11. Functionality and Safety <ul><li>Critical considerations— </li></ul><ul><ul><li>Chemically leavened products : sodium ingredients required for functionality </li></ul></ul><ul><ul><li>Cheese : sodium content of milk is fixed and salt required for cheese manufacture </li></ul></ul><ul><ul><li>Smoked fish : salt required for C. bot prevention </li></ul></ul><ul><ul><li>Cured and fermented meats : sodium compounds required for microbial control </li></ul></ul>
  12. 12. Collaboration and Partnership <ul><li>Government focus should be on improvement of overall food choices and dietary patterns </li></ul><ul><li>Food and dietary pattern changes overall will benefit health generally, improve sodium intake levels </li></ul>
  13. 13. Collaboration and Partnership <ul><li>“One-size-fits-all” approach should not be adopted </li></ul><ul><li>Food industry supports collaboration with FDA and other government agencies </li></ul>
  14. 14. Labeling and Consumer Information <ul><li>All packaged food products disclose amount of sodium and percent Daily Value </li></ul><ul><li>Sodium claims in labeling provide expanded product options for consumers </li></ul><ul><li>Products with claims offer positive choices </li></ul>
  15. 15. Labeling and Consumer Information <ul><li>“Healthy” labeled products are growing in number </li></ul><ul><li>FDA expected and encouraged this in 2005 final rule for “Healthy” nutrient content claim </li></ul>
  16. 16. Labeling and Consumer Information <ul><li>Warning messages on salt containers may be counter productive </li></ul><ul><li>Undermine positive message about iodized salt </li></ul><ul><li>Unclear if required statement would lead to unintended consequences </li></ul>
  17. 17. Labeling and Consumer Information <ul><li>More consumer research is required </li></ul><ul><ul><li>Label claims evaluation </li></ul></ul><ul><ul><li>Consumer acceptance </li></ul></ul>
  18. 18. Sources of Sodium, c. 2003-2004 Source: NHANES 2003-2004; Courtesy of General Mills Bell Institute Soup 3%
  19. 19. Top 20 Individual Food Sources of Sodium in the American Diet Based on the Combination of Frequency of Consumption and Sodium Content <ul><li>Meat pizza </li></ul><ul><li>White bread </li></ul><ul><li>Processed cheese </li></ul><ul><li>Hot dogs </li></ul><ul><li>Spaghetti w/sauce </li></ul><ul><li>Ham </li></ul><ul><li>Catsup </li></ul><ul><li>Cooked rice </li></ul><ul><li>White roll </li></ul><ul><li>Wheat tortilla </li></ul><ul><li>Salty snacks/corn chips </li></ul><ul><li>Whole milk </li></ul><ul><li>Cheese pizza </li></ul><ul><li>Noodle soups </li></ul><ul><li>Eggs (whole/fried/scrambled) </li></ul><ul><li>Macaroni w/cheese </li></ul><ul><li>Milk, 2% </li></ul><ul><li>French fries </li></ul><ul><li>Creamy salad dressings </li></ul><ul><li>Potato chips </li></ul>Source: NHANES 2003-2004; Courtesy of General Mills Bell Institute
  20. 20. Sources of Sodium <ul><li>Over half have sodium levels below FDA “healthy” level of 480 mg (per portion) </li></ul><ul><li>3 are at FDA “low” of 140 mg or less </li></ul><ul><li>Vegetables, fruits, and whole grains largely absent </li></ul>
  21. 21. Sodium Reduction Over Time - 29 % 180 258 254 1 slice Bread, white, enriched - 35 % 649 1,124 1,000 1 c Chicken noodle soup, canned, condensed, prepared - 50 % 218 196 490 55 g Tuna, canned, oil - 81 % 95 N/A 497 ½ c Peas, frozen Change mg Na mg Na mg Na Serving Food USDA NDB, SR 20, 2007 USDA HG Bull 72, 1981 USDA Hdbk 8, 1963
  22. 22. Dietary Guidelines & MyPyramid <ul><li>≤ 2,300 mg/d recommendation </li></ul><ul><li>Food patterns for adults range from 1,800 – 2,700 mg/d </li></ul><ul><li>Focus on foods that must be prepared at home </li></ul>
  23. 23. MyPyramid <ul><li>Sample menus for consumers average about 2,900 mg sodium per day </li></ul><ul><li>Lowest is about 1,600 mg/d </li></ul><ul><li>4 of 7 are over 3,000 mg/d </li></ul>
  24. 24. Questions <ul><li>When will fruits, vegetables, and whole grains be “Top 10” consumed foods? </li></ul><ul><li>What to do about potassium intake? </li></ul><ul><li>How to encourage changes to food group consumption as well as to sodium levels over time? </li></ul><ul><li>What are incentives for industry? </li></ul><ul><li>Where do we meet the consumer? </li></ul>
  25. 25. Take A Peak MyPyramid Promotion <ul><li>Assess effect of incremental changes </li></ul><ul><li>Menu modeling overview </li></ul><ul><ul><li>Target menus developed for adult female </li></ul></ul><ul><ul><li>7 days of menus </li></ul></ul><ul><ul><li>Incremental changes over 3 weeks </li></ul></ul><ul><ul><li>Evaluated against MyPyramid, Dietary Guidelines, and Healthy Eating Index (HEI) </li></ul></ul>
  26. 26. Take A Peak MyPyramid Promotion <ul><li>HEI score increased over 3 weeks from base from 41 to 93.5 </li></ul><ul><li>Met MyPyramid food group recommendations </li></ul><ul><li>Met DG shortfall nutrients </li></ul><ul><ul><li>Calcium, fiber, magnesium, potassium, vt. A, vt. C </li></ul></ul><ul><li>Met DG targets for macronutrients </li></ul><ul><ul><li>Sodium reduced by 32% </li></ul></ul>
  27. 27. Take A Peak MyPyramid Promotion <ul><li>Demonstrates that small, incremental changes to food choices over time can meet dietary, food, and nutrient recommendations </li></ul>
  28. 28. Additional Research Needs <ul><li>FDA and government support and advocate for— </li></ul><ul><ul><li>CVD outcomes trial </li></ul></ul><ul><ul><li>Dietary Guidelines food & activity study </li></ul></ul><ul><ul><li>Dietary Guidelines barriers study </li></ul></ul><ul><ul><li>Salt taste mechanism and salt alternatives </li></ul></ul>
  29. 29. Conclusion <ul><li>Food industry takes seriously product development issues addressing nutrition & health—including sodium content </li></ul><ul><li>Alternatives and additional research will be better priorities for government and public </li></ul>
  30. 30. www.gmaonline.org

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