Despite research suggesting that sodium reduction would do little to improve public health, scientists writing in the Annals of Internal Medicine say  that a voluntary effort by the U.S. food service industry to reduce salt in processed foods could have far-reaching implications for the health of the U.S. population, preventing strokes and heart attacks in nearly a million Americans and saving $32.1 billion in medical costs.

The team developed a computerized model that simulates the effects of reduced sodium intake on a large population of people between the ages of 40 and 85. Based on a similar, salt-reduction campaign in the United Kingdom, the researchers estimated that a collaborative industry effort could lead to a 9.5 percent decline in Americans' salt intake.

This reduction would extend the lives of Americans by a collective 1.3 million years over the lifetime of the group studied, the researchers estimate. It would also save $32.1 billion, including $14 billion in hospitalizations for stroke and heart attack. Though no consideration was apparently given to the fact that people who live longer require more medical care, which also raises costs significantly.

The researchers estimated that the sodium tax would have less impact, leading to a 6 percent decrease in salt intake and a 0.93 mmHg reduction in blood pressure. That would result in 327,892 fewer strokes and 306,173 fewer heart attacks, they calculated. But the feasibility of this option seems less realistic because consumers don't appreciate busy bodies imposing taxes on their food.

But a voluntary reduction effort could spare some 513,885 Americans potentially fatal strokes in their lifetimes, and another 480,358 would not suffer heart attacks as a result of the reduced salt campaign.

The study comes at a time when there is much controversy surrounding the proposal to regulate salt content in foods as a way to lower blood pressure and thereby improve health outcomes. High blood pressure remains an enormous public health problem in the United States, with some 73 million Americans — or one in three adults — believed to suffer from the condition, which accounted for $73.4 billion in health-care costs in 2009, according to a recent report from the Institute of Medicine. Some public health advocates see sodium reduction as one way to curtail this serious health problem.

The United Kingdom began working with manufacturers in 2003 to decrease salt content in foods, resulting in a 20 to 30 percent decline in salt found in processed foods sold in stores. Japan, Finland, Ireland, Australia and Canada have recently launched similar initiatives.

In January, New York City introduced a wide-ranging health initiative to encourage food manufacturers and restaurant chains to curtail their salt use by 25 percent over the next five years. The Institute of Medicine also has called on the U.S. Centers for Disease Control and Prevention, as well as state and local governments, to develop new strategies for reducing dietary sodium.




Citation: Smith-Spangler et al., 'Population Strategies to Decrease Sodium Intake and the Burden of Cardiovascular Disease: A Cost-Effectiveness Analysis', Annals of Internal Medicine, March 2010, 152(10)