Omaha-based ConAgra Foods will continue its effort to scale back the sodium in its products despite recent studies that challenge current government guidelines for a low-sodium diet.
The company is halfway to achieving its stated goal of cutting sodium in many of its consumer products by 20 percent before 2015 and is on track to meet the goal, said Mark Andon, vice president of nutrition.
“We're sticking with the pledge and we plan to execute against it,” he said.
That's despite Andon's changing belief about whether the initiative is necessary. Before, “I was an advocate for, 'It would be good if we could reduce sodium,' and now I'm not, or it is a big question,” Andon said.
The company's top nutritionist said his thinking has evolved in light of several studies, including an Institute of Medicine report published Tuesday.
That report concluded that people who are 51 and older, African-American or who have hypertension, diabetes or kidney disease — more than half of Americans — no longer need to try to adhere to the institute's previous low recommendation of 1,500 milligrams per day of sodium. They can strive for 2,300 milligrams per day like everyone else.
That level is still less than the average American consumption of more than 3,400 milligrams per day. And the institute continues to warn against too much sodium, saying it may lead to high blood pressure and heart disease.
But the group said it isn't clear what that limit should be. More research is needed to recommend a range for sodium intake, said Dr. Brian Strom, institute committee chairman.
American Heart Association Chief Executive Officer Nancy Brown said the institute's report “is missing a critical component — a comprehensive review of well-established evidence that links too much sodium to high blood pressure and heart disease.” The association's recommendation remains at 1,500 milligrams per day for everyone.
But Dr. Robert Heaney, a Creighton University scientist who maintains that people may consume from 3,000 to 6,000 milligrams, on Tuesday called the institute's revision a “major, major change,” and a good step toward loosening sodium restrictions.
Dr. Troy Plumb, a University of Nebraska Medical Center kidney specialist, said he doubted the new report would change how he deals with patients. He already encourages patients not to add salt, to read labels on packaging and to aim for 2,000 to 3,000 milligrams a day. Plumb said high amounts of sodium contribute to high blood pressure and water retention.
“We know that lowering sodium in the diet can be one of the things that we do to lower blood pressure, specifically in people with kidney disease,” Plumb said.
Evolving research can be confusing for consumers, but sodium will likely continue to be a concern, said Harry Balzer, chief food industry analyst and vice president of the NPD Group.
“I don't think all of a sudden we'll see a run on salt,” Balzer said.
Along with calories and fat, sodium is one of the top three reasons why consumers look at food nutrition labels. But today's consumers are focused less on what to cut from their diets as on what healthful options to add in, he said, and cutting salt is just “one of many ways of addressing your health.”
ConAgra announced its sodium-lowering initiative in 2009, one of the first of several major food makers and restaurants to announce plans to cut sodium in response to government warnings and consumer concern.
In 2010, Kraft said it would cut sodium by 10 percent from its food products, and Campbell Soup said it would reformulate soups to cut sodium. Companies including Subway, Heinz and Butterball joined the National Salt Reduction Initiative, a project led by the New York City Health Department.
The Institute of Medicine has said that restaurants and food manufacturers need to gradually wean Americans off high-sodium diets. The institute said in 2010 that the “preference for salty taste can be changed” through a coordinated effort by the food industry.
Not only was it public health policy to reduce sodium, there was also a business case for the decision: ConAgra cited a HealthFocus consumer study showing an increase in grocery shoppers' interest in, and purchase of, lower-salt foods. In 2008, 41 percent of consumers were using low-sodium products weekly, compared with 19 percent four years earlier. (The number has declined since then; in 2012, 33 percent said they used low-sodium products once a week or more.)
“Americans need less salt in their diets, and they want less salt in their diets,” Chief Executive Officer Gary Rodkin said in announcing the initiative.
ConAgra did not arrive at its decision lightly.
Working with its own scientific advisory board, the company took about 18 months to review the existing research, look at how earlier manufacturers' pledges were structured and ask if it was time to “get ahead of the curve,” Andon said.
Even then, there was dissent among the company's advisory board members. Andon said that while there are data linking a reduced-sodium diet to slightly lower blood pressure and linking high sodium consumption to stroke and heart attack, evidence did not show that lowering sodium intake to the 1,500-milligram level necessarily lowered the risk of cardiovascular disease.
The new Institute of Medicine report, in fact, suggests that in some cases a very low sodium diet can be harmful.
Andon said that when sodium levels fall, blood pressure falls because blood volume drops. He said the body responds by restricting blood vessels. “Your vascular system is not like a rigid PVC pipe. It's a living system with lots of feedback.”
He said better ways to lower blood pressure in the long run are exercise and quitting smoking.
“What these new data are showing is, the mechanism counts.”
The company also studied the issue carefully because cutting sodium out of food products isn't as simple as putting less salt in a recipe. Consumers of packaged foods come to expect a certain taste and may not buy a product again if it tastes different, Andon said. Sodium is also a preservative in some foods and is essential to the familiar look and texture of bread and cheeses.
Depending on the product, ConAgra has used different techniques to cut salt. Hunt's tomato sauce and diced tomatoes are some of the easier products to remove salt from, because they're commonly used as ingredients in a recipe, not a stand-alone dish. A frozen dinner might contain a new blend of spices, or lower sodium sea salt, to add flavor while removing sodium.
Microwave popcorn can take advantage of “micron salt,” or salt with smaller granules that dissolve faster on the tongue and give a saltier taste.
Still, food makers as a whole have not come as far in cutting salt as some health advocates would like.
A report published Monday, led by Michael Jacobson from the Center for Science in the Public Interest, said that restaurants and food manufacturers have made little progress in trimming salt, the Los Angeles Times reported. Between 2005 and 2011, sodium in 402 processed foods fell 3.5 percent. Restaurant items examined actually added 2.4 percent more salt in the same period.
The authors concluded that voluntary action has failed to reduce sodium levels and that regulatory action is necessary.
In response, the Grocery Manufacturers Association industry group said the center's study has a narrow sample size and does not accurately depict the “substantial strides” food manufacturers have made in lowering sodium content.
“Our industry has developed thousands of products with reduced, low or no sodium and has also silently and incrementally reformulated many products to reduce the amount of sodium within consumer taste preferences,” the association said in a statement. “Reducing sodium in products without negatively affecting consumer acceptance must be taken into consideration, because a 'healthy food' will not promote health if it is not purchased or eaten.”
Hy-Vee nutritionist Elisa Sloss said she will not immediately change the advice she gives customers at her 5150 Center St. store: to strive for no more than 1,500 milligrams of sodium per day.
Sloss steers customers to the produce aisle, teaches them to read labels and shares tricks such as rinsing canned beans before eating them. “Even in bread there is sodium. You have to really watch what you eat.”
For its part, ConAgra plans to continue along its path to reducing sodium 20 percent, considering that official public health policy hasn't changed and that the Institute of Medicine still recommends limiting consumption.
“We and the other companies that make food, we're following the public health policy,” Andon said. “We want people to eat less sodium.”
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