A consumer group has filed suit against the Food and Drug Administration (search) for failing to make good on a 20-year-old promise to consider regulating salt in the food supply.

Americans continue to consume dangerously high levels of salt despite repeated calls from health authorities and experts to reduce the amount of sodium in their diets.

According to the Center for Science in the Public Interest (search), the watchdog group behind the lawsuit, salt consumption (search) for adults in America has drifted upwards over the past three decades. The group estimates that the daily consumption of salt is near 4,000 mg per day — nearly twice the recommended amount.

In the U.S., poor diet is linked to many major chronic diseases including heart disease and high blood pressure. The 2005 dietary guidelines, to promote health and disease prevention, recommend the amount of salt be limited to about 1 teaspoon a day — 2,300 mg. However certain groups — those with high blood pressure, the elderly, and African-Americans — should limit their intake even more, to 1,500 mg a day.

The CSPI says that packaged food nutrition labels have failed to reduce Americans’ sodium intake to recommended levels, and that cutting the nation’s sodium intake could substantially reduce the incidence of health problems associated with high blood pressure.

“Those innocent-looking white crystals are causing tens of thousands of premature deaths every year,” Michael F. Jacobson, PhD, the group’s executive director, told reporters Thursday.

More than 65 million Americans have hypertension, a major cause of heart disease and stroke, according to federal health statistics. Another 45 million have prehypertension, a risk for heart disease. Excessive sodium intake has been identified as a contributor to high blood pressure, and several federal agencies, including the National Institutes of Health, have issued recommendations urging people to lower their sodium consumption.

A study released in the American Journal of Public Health in 2004 estimated that blood pressure reductions — attainable by halving individual sodium consumption — could prevent 150,000 deaths per year.

Jacobson contends that packaged food labeling required by law since 1994 has helped Americans moderate their sodium intake, but that food companies and restaurants continue to have high salt levels that make it difficult for most Americans to meet recommendations.

Restaurants: How Big a Contribution to Salty Diets?

According to the report, processed foods and restaurant foods contribute almost 80 percent of sodium to the diet. Thousands of processed foods, such as frozen dinners and soups, contain between 500 and 1,000 mg of sodium per serving.

“Considering the ubiquity of salt-laden foods, it’s virtually impossible to consume [the recommended amount in a] diet,” he says.

Many companies sell prepared food brands with lowered sodium levels, which are often more expensive than regular varieties.

The group issued a report highlighting dozens of foods it says are contributing to overconsumption of salt. For example, a single package of popular Maruchan Ramen Noodles contains 1,400 mg of sodium, more than half the recommended level for younger adults. The report also singles out restaurants, which it says rarely provide nutrition information on menus but use high levels of salt to flavor foods.

“Clearly most companies have not been making an effort, certainly restaurants have not been making an effort,” Jacobson says.

Robert Earl, senior director for nutrition policy at the Food Products Association, a lobbying group for the processed food industry, says in an interview that his industry has gradually cut sodium levels over time, even in traditionally high-salt foods such as pretzels and potato chips.

He also says that grocery store packages alert consumers to sodium content and that increasing consumption of fresh fruits and vegetables is a widely known method of cutting sodium consumption.

“The [U.S.] dietary guidelines recommend a food pattern that if Americans were motivated to follow it would reduce their sodium,” he says.

Case in Court

CSPI filed a lawsuit Wednesday in federal court, urging a judge to order the FDA to determine whether salt is a safe food additive. The group alleges that the FDA pledged in 1984 to issue conclusions on salt’s safety but never completed the review.

Jacobson said that “not a single” FDA scientist is dedicated to reviewing sodium levels in the U.S. food supply, despite the mineral’s probable contribution to heart disease and strokes.

“Without the court’s intervention, the FDA will almost certainly continue to delay. Because the millions of Americans at risk of hypertension and cardiovascular disease are paying for the FDA’s delay with their health, the court should compel FDA to take prompt action,” the complaint states.

The FDA “is currently evaluating CSPI's report on salt, including the recommendations,” says FDA spokeswoman Kathleen Quinn. She declined to comment on the lawsuit.

By Todd Zwillich, reviewed by Brunilda Nazario, MD

SOURCES: Michael F. Jacobson, executive director, Center for Science in the Public Interest. National Center for Health Statistics, Centers for Disease Control and Prevention.National Health and Nutrition Examination Survey, 1999-2000, CDC. Dietary Guidelines for Americans, 2005, U.S. Department of Agriculture. “Reducing the Public Health Burden from Elevated Blood Pressure Levels in the United States by Lowering Intake of Dietary Sodium,” American Journal of Public Health, January 2004; vol 94. Robert Earl, senior director, nutrition policy, Food Products Association. Petition for a Writ of Mandamus, filed by CSPI, U.S. Court of Appeals for the District of Columbia Circuit. Kathleen Quinn, FDA spokeswoman.