by Marion Nestle

Currently browsing posts about: Salt

Apr 16 2024

What is the FDA’s food regulatory role anyway?

The keynote address at the Consumer Federation of America’s annual food policy conference was given by the FDA’s new Deputy Commissioner for Human Foods, James “Jim” Jones.

He talked about his priorities and what he’s hoping the FDA will do.  Fine.

But in the Q and A, he was pushed repeatedly by Mike Jacobson (former head of CSPI) to say what the FDA would be doing to pressure the food industry to reduce salt in the food supply, something the FDA has promised to do for years with little progress.

In response, Jones said: “…I wouldn’t say pressure.  Pressure is not our statutory authority…isn’t to pressure….it is to help manage the food supply in a way that makes it healthier for Americans.”

Oh dear.

Pressuring the food industry most certainly is in the FDA’s authority.  I can think of lots of things the FDA has done that directly oppose food industry interests despite plenty of industry pushback: food labels in general and trans fat and sugar labeling in particular, restrictions on health claims, food safety regulations, and anything else the agency has done to force food companies to behave in the interest of public health.

Food companies will act in the public interest, only when they have to.  Jones’ statement, if that’s what he meant, is an alarming indication of agency capture.

The FDA is a regulatory agency and part of the Public Health Service.  It’s not supposed to win popularity contests.  It’s not supposed to be an arm of the food industry.

It’s supposed to take whatever tough steps are needed to keep the food supply safe and healthy so as to improve the overall health of Americans.

Yes, the FDA should be pressuring food companies about salt (and sugar, for that matter), and as strongly as possible.

Maybe I am misunderstanding what he said.  I hope so.

Here’s the video of the session.  Jacobson’s questions begin at 19:30.  Watch and decide for yourself.

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Oct 5 2023

Annals of marketing: is “not healthy” the latest trend?

My distant but dearly loved cousin, Michael Kravit, has scored again: “Not Healthy.”

According to the company’s website, these things are “Tasty purffs.  Five flavors.  No health claims…So unhealthy, I bought 15 bags for my family and friends…If you are worried about FFUPs being healthy, you’re on the wrong website.  Go eat some carrots! [Not a bad idea, this last one].

I managed to find the Nutrition Facts for one of them.  They have a lot of salt—320 mg per ounce.  The ingredient list:

Besides salty, how do these things taste?  If you can find some, please let me know.

While we are at it, my daughter sent this photo from the new It’s Sugar store on Market Street in San Francisco.

OK.  Let’s give these companies high marks for truth in advertising.  But do these represent the latest trend?

Caveat emptor.

 

Jan 24 2022

Marketing to dietitians: the benefits of MSG

Members of the Academy of Nutrition and Dietetics get SmartBriefs sent to their email addresses.

The subject line of this one: “A Surprising Sodium Reduction Tool for Your Clients

 

It is an advertisement; it even says so.  But it does not say who paid for it.

To find that out, you have to click on the subscribe or resource links.

Bingo!  Ajnomoto, the maker of MSG.

All of this is to convince dietitians to push MSG as a salt substitute:

 Extensive research has affirmed not only the ingredient’s safety, but its benefits for sodium reduction. Even the National Academies of Sciences, Engineering and Medicine has recognized MSG as a tool to reduce sodium in the food supply.

Is this a good or bad idea?  MSG still has sodium and its health effects remain under debate.

This kind of sponsorship should be disclosed, front and center, in ads like this, especially because much of the research demonstrating benefits of MSG was funded by guess which company.

The Academy of Nutrition and Dietetics should not permit ads that lack full disclosure.

Members: Complain to the Academy that you want these ads to stop.

Thanks to Jackie Bertoldo for alerting me to this one.

Dec 9 2021

Some recent articles on food product reformulation

What with all the pressure to make foods healthier, food manufacturers have been tweaking their products to reduce less healthful ingredients, especially salt and sugar.

Reformulated ultra-processed foods are still ultra-processed.

They raise the question: is a slightly healthier ultra-processed food a good choice?

These articles come from FoodNavigator-Asia.com, which tracks the food industry in that part of the world.

Oct 19 2021

Big news: FDA finally issues guidance on sodium reduction

On October 13, the FDA finally got around to finalizing its guidance for the food industry for voluntary, short-term (2.5 year) sodium reduction targets for lots of processed, packaged and prepared foods.

In a statement, the FDA says its new guidance

provides voluntary, short-term sodium reduction targets for food manufacturers, restaurants, and food service operators for approximately 160 categories of processed, packaged and prepared foods. The targets seek to decrease average sodium intake from approximately 3,400 milligrams (mg) to 3,000 mg per day—about a 12% reduction—over the next 2.5 years.

Reducing sodium has been on the FDA agenda for years.  It issued draft guidance in 2016.  On this, it received about 200 comments.  

The FDA’s idea for this first target is to reduce average daily sodium intake by about 12%—from approximately 3,400 milligrams (mg) to 3,000 mg per day—in 2.5 years.

This is still higher than the recommended 2300 mg.  Why so limited?

Politics, of course.

The FDA believes

  • These targets are feasible.
  • Gradual reduction will accustom people to lower sodium intake.
  • Food companies might be willing to do this.

A quick review of the basics:

  • Salt is 40% sodium (2300 mg sodium means about 6 grams of salt or 1.5 teaspoons).
  • High salt diets are strongly associated with high blood pressure and stroke.
  • We require less than 500 mg sodium a day; average diets are greatly in excess.
  • Most salt in the diet comes from pre-prepared foods (70%); 20% is added at the table; 10% is innate in foods.
  • The taste for high-salt is acquired; the more salt you eat, the more salt it takes to make foods taste right.
  • For people used to high-salt diets, low-salt makes food taste bland.  It takes about three weeks to get used to low-salt.
  • Once accustomed to low-salt, typical levels of salt make food taste too salty.

Thus, the FDA’s strategy is to gradually accustom people to lower salt intake.

The guidance is voluntary: “This voluntary, iterative approach is similar to approaches successfully implemented in other countries.”

By other countries, the FDA must mean Great Britain.  The UK did a big voluntary salt reduction campaign some years ago and got enough buy in from food companies to see a real difference in salt intake and blood pressure.

When the government changed and laid off the pressure, companies put back most of the salt (not all though). That history is here.

So this could work if food companies cooperate.  Presumably, the FDA will assess the results of this voluntary effort in 2.5 years.

The stick?  The implied threat of mandatory reductions if the voluntary ones don’t work.

2.5 years is a long time to wait for voluntary compliance.

My view

  • These should have been mandatory to begin with.
  • The target levels should be lower.
  • The time scale should be faster.

Other than that, the FDA’s plan could be a useful first step.  We shall see.

Statements

Documents

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Jun 24 2021

Do product reformulation strategies make any nutritional difference?

That’s my question when I see what food companies are trying to do to reduce the content of sugar and salt in their ultra-processed junk food products.

To put it another way, does making an ultra-processed food or beverage slightly better for you convert it to a good choice?

We can argue about this, but companies really are trying hard, as this collection of articles from FoodNavigator.com indicates.

Special Edition: Nutrition and reformulation strategies

Most shoppers say they want to reduce consumption of products that are high in fat, salt and sugar. But many struggle to cut HFSS foods and beverages from their diets and reformulation efforts often face the headwind of perceived quality issues. Meanwhile, the fortified food market in Europe is expected to see a CAGR of 5.2% through to 2025. While reformulation efforts take out the ‘baddies’ is there also an opportunity to add positive nutrients through fortification?

Mar 10 2021

New York City’s terrific food initiatives

New York City is taking big steps to improve its food system.   Two reports are worth noting, one from the Mayor’s office and one from the Health Department.

I.  Mayor Bill de Blasio and Kate MacKenzie, Director of the Mayor’s Office of Food Policy (MOFP) have released Food Forward NYC: A 10-Year Food Policy Plan.

Here’s how they introduce this impressive report:

Food Forward NYC is the City’s first ever 10-year food policy plan, laying out an comprehensive policy framework to reach a more equitable, sustainable, and healthy food system by 2031.

Food Forward NYC emphasizes the importance of equity and choice – enabling a food system where everyone should be able to access the food they want wherever they may want it. To enable this choice, we need to support both our food workers and our food businesses. To strengthen the sustainability and resiliency of our food system, we need to rethink our food infrastructure and deepen our connections with the region.

Food Forward NYC is organized around five overarching goals:

  1. All New Yorkers have multiple ways to access healthy, affordable, and culturally appropriate food.
  2. New York City’s food economy drives economic opportunity and provides good jobs.
  3. The supply chains that feed New York City are modern, efficient, and resilient.
  4. New York City’s food is produced, distributed, and disposed of sustainably.
  5. Support the systems and knowledge to implement the 10-year food policy plan.

The full report is here.  It was prepared in response to Local Law 40 of 2020 and recommendations from the New York City Council’s 2019 report, Growing Food Equity in New York City.  

New York City is a complicated place and it’s wonderful to have all this information put together in such a coherent way.  Let’s hope everyone gets behind this and puts the recommendations into action.

II.  The Bureau of Chronic Disease Prevention at the NYC Health Department has an update on its  National Salt and Sugar Reduction Initiative (NSSRI).

In October 2018, the Bureau announced draft sugar reduction targets.  Now they have updated them and added targets for salt reduction, as well.  As I was informed in an e-mail,

The NSSRI is a partnership of over 100 local city and state health departments, associations, and health organizations, convened by the NYC Department of Health. We have set voluntary sugar reduction targets for 15 categories of food and beverages. The targets represent a 10% reduction in sugar content of products by 2023, and a 20% reduction by 2026 for food with a 40% reduction for beverages.

The current public health landscape demonstrates that diet remains critical, even during a public health emergency like COVID-19. Diet-related health conditions such as diabetes and heart disease, which can increase the risk of severe illness from COVID-19, are important to address right now.

Here’s what one of the sugar reduction targets looks like:

The objective of NSSRI is this:

To promote gradual, achievable and meaningful reductions in sugar content in packaged foods and beverages. This is because intake of added sugars is associated with increased risk of excess weight, type 2 diabetes, hypertension, stroke, heart disease and cavities.

The targets are indeed gradual; the hope it that they will be met by 2026.

The targets are, of course, voluntary.  The best NSSRI can do is to encourage companies to comply and hold them accountable.

It’s a start.

Oct 23 2020

Weekend Reading: Salt Wars!

Michael F.  Jacobson.  Salt Wars: The Battle Over the Biggest Killer in the American Diet.  MIT Press, 2020.

Salt Wars: The Battle Over the Biggest Killer in the American Diet - Kindle edition by Jacobson, Michael F., Frieden, Tom. Professional & Technical Kindle eBooks @ Amazon.com.

Michael Jacobson was one of the founders of the Center for Science in the Public Interest, which he directed for more than 40 years.

His book comes with an introduction by Tom Frieden, former head of New York City’s Health Department and Director of the CDC.

I wrote a blurb for it:

Public health authorities advise eating less salt as a way to prevent high blood pressure, but a few scientists disagree. For anyone confused by these arguments, Salt Wars is a must read.  Michael Jacobson has been fighting these wars for decades, and his assessment of the research on both sides—and the policy implications–is exceptionally fair, balanced, and fascinating.

Here are a few excerpts:

  • One reason that the debate has been so vigorous is that most journalists treat new reports supporting the conventional view on salt with a yawn.  Dog bites man?  Big deal.  What does capture the attention of journalists and headline writers are the man-bites-dog reports—those suggesting that eating less salt would be harmful—especially when they are conducted by credentialed researchers at prominent universities and published in respected journals…The poor consumer, lacking an advanced degree in epidemiology or nutrition, can get dizzy trying to follow the arcane biomedical and statistical jousting (p. xvi).
  • I was sorely disappointed that the FDA was not setting mandatory maximum sodium levels.  Such limits for all foods in a category…have at least three advantages over a voluntary approach.  First, they would have teeth and ensure that all companies actually trimmed sodium in their saltiest products.  Second, the FDA could easily enforce them.  And third, they would provide a level playing field…I have since been persuaded that the voluntary approach was inevitable (p. 139).
  • The process to propose sodium reductions was frustratingly slow, but there was no villain or cabal that sought to undermine the FDA’s effort to lower sodium consumption.  Rather, it was a case of how the Washington policy-making apparatus works when it comes to anything that is complicated, controversial, and consequential…It took the administration so long to propose the guidelines that there was no time to finalize them and the matter has languished for four years  (p. 143).
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