FDA’s 4-Year Delay in Finalizing Sodium Reduction Targets May Cause 265,000 Deaths Over 14 Years, Study Says

February 21, 2022 (NEW YORK, NY)—Last October, the U.S. Food and Drug Administration (FDA) finalized a set of short-term, voluntary goals for lowering sodium levels in foods—five years after they were proposed in 2016. A new study shows this delay cost thousands of lives, as many as 265,000. Lowering sodium in packaged and prepared foods in the American diet has been proven to protect against high blood pressure, a major cause of strokes, heart attacks, and kidney disease and save billions of dollars.

The study in Hypertension—a journal published by the American Heart Association—concluded that if the food and restaurant industries would have adopted the lower sodium levels presented in FDA’s proposed two-year and 10-year targets on schedule, nearly 265,000 lives could have been saved between 2017 and 2031.

Experts have estimated that high sodium intake causes as many as 100,000 deaths from heart disease and stroke each year in the United States. Reducing the current average intake of 3,400 mg of sodium a day to 2,300 mg has been estimated to save $18 billion in health care costs and reduce the number of high blood pressure cases by 11 million annually.

“Reducing sodium in the food supply can help reduce the rates of hypertension and cardiovascular disease—particularly among those who are disproportionately burdened by these conditions,” said Dr. Tom Frieden, President and CEO of Resolve to Save Lives. “These modest changes will save hundreds of thousands of lives and billions in annual health care costs. The FDA must fully commit to fast-tracked implementation of the new targets and track industry progress.”

While FDA’s delay caused many deaths, the Hypertension study estimates that gradually reducing sodium intake to the recommended levels will save about 446,000 lives between 2021 and 2031, notwithstanding the delay in setting targets.

“The FDA now needs to ensure that sodium consumption actually declines,” said Michael F. Jacobson, co-founder of the Center for Science in the Public Interest. “For starters, the FDA needs to mount a full-scale campaign to motivate consumers to switch to lower-sodium foods. It also should finalize its proposed 10-year targets and set earlier targets to shorten the 7.5-year gap between its two current sets of targets. Importantly, the FDA needs to develop contingency plans in case industry falls short of the voluntary goals. For instance, FDA could set mandatory limits on sodium and require warning notices on foods that exceed certain voluntary targets. That work should begin immediately because adopting new regulations takes years.”

FDA’s sodium goals aim to lower average daily sodium intake by about one-third, from the current 3,400 mg to 2,300 mg. About three-fourths of that sodium comes from packaged and prepared foods. Another 13 percent is naturally present, with the rest coming from salt added in cooking, at the table, and through water and dietary supplements.

Many national governments, including those in Turkey, South Africa and Brazil, have set legal limits on sodium in key foods. Other countries, including Chile, Mexico and Israel, require disclosures on the front labels of foods high in sodium (as well as calories, saturated fat and refined sugars). In May 2021, the World Health Organization set new sodium benchmarks for more than 64 categories of foods and beverages to guide health authorities in its 194 member states to reduce global sodium consumption.

“This study shows how vital it is for governments to take strong measures to lower sodium as soon as possible,” said Graham A. MacGregor, Professor of Cardiovascular Medicine, Chairman of World Action on Salt, Sugar and Health (WASSH), a leading advocate for lowering sodium intake globally. “The months and years most governments have taken to lower sodium is causing many thousands of unnecessary and premature deaths every year.”

This study discusses how industry has numerous strategies for lowering sodium levels without impairing taste or safety. It can simply use less salt, replace sodium salt (sodium chloride) with potassium salt (potassium chloride) and add more flavorful ingredients. The goal is not to eliminate all salt and sodium, but to reduce the current levels by one-third.

The study was conducted by Jing Song, Feng J. He, Graham A. MacGregor, and Mhairi K. Brown from the Wolfson Institute of Population Health at Queen Mary University of London; Laura Cobb and Nicole Ide from Resolve to Save Lives, an initiative of Vital Strategies, in New York City; and Michael F. Jacobson, the co-founder of the Center for Science in the Public Interest in Washington, DC and author of Salt Wars: The Battle Over the Biggest Killer in the American Diet.

While FDA has made progress with its two-year targets, the agency must act now to finalize its longer-term 10-year targets before 2024. Simple, targeted sodium reduction goals can prevent thousands of heart-related deaths and reduce the burden on health care systems that continue to be overwhelmed by COVID-19. Further delays to these targets could result in lost American lives.


Media Contacts:

Steven Chlapecka, Resolve to Save Lives: [email protected],+1.917.623.0246

Christina Honeysett, Vital Strategies: [email protected]; +1.914.424.3356

David Clarke, World Action on Salt, Sugar and Health (WASSH): [email protected], +44 7773225516

About Resolve to Save Lives

Resolve to Save Lives is an initiative of the global health organization Vital Strategies, focused on preventing 100 million deaths from heart disease and making the world safer from epidemics. It is led by Dr. Tom Frieden, former director of the U.S. Centers for Disease Control and Prevention. To find out more visit: https://www.resolvetosavelives.org or Twitter @ResolveTSL.

About Vital Strategies

Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. We work with governments and civil society in 73 countries to design and implement evidence-based strategies that tackle their most pressing public health problems. Our goal is to see governments adopt promising interventions at scale as rapidly as possible. To find out more, please visit www.vitalstrategies.org or Twitter @VitalStrat.

About World Action on Salt, Sugar and Health (WASSH)

World Action on Salt, Sugar and Health (WASSH) is a global group with the mission to improve the health of populations throughout the world by achieving a gradual reduction in salt, sugar and excess calorie intake. Based at Queen Mary University of London, WASSH were established in 2005 to translate the success of the UK’s salt reduction programme worldwide, providing resources and expert advice to enable the development and implementation of salt reduction programmes in high-, middle- and low-income countries. WASSH have a network of more than 600 members in 100 countries, all of whom are working towards reducing population salt, sugar and calorie intake.

Media Contact

[email protected]

About Resolve to Save Lives

Resolve to Save Lives is a not-for-profit organization partnering with countries, communities and organizations to prevent 100 million deaths from cardiovascular disease and make the world safer from epidemics. To find out more, visit: resolvetosavelives.org or Twitter @ResolveTSL.