AMA: Americans Need to Shake the Salt Habit

CHICAGO, June 15 ? The American Medical Association has added its weight to the many health groups in the country that have long advocated a reduction in salt consumption to help reduce the burden of cardiovascular disease.

The AMA would have consumers cut their salt consumption by 50% over the next decade by starting with the simple expedient of removing salt shakers from the dinner table. The doctors' groups would also have the food industry remove most of the sodium from processed foods and restaurant meals.

As part of that plan, which was approved by the AMA's policy-making House of Delegates, the organization will ask the FDA to take salt off the "generally regarded as safe" or GRAS list.

That step would allow the FDA to regulate sodium content in foods, said Melvyn Sterling, M.D., an Orange, Calif., internist and member of the AMA's Council on Science and Public Health, which drew up the AMA's new anti-salt policy.

Dr. Sterling said that if salt were removed from the GRAS list food processors would be required to petition the FDA to approve the use of salt as an additive at specified levels in various foods.

The Council on Science and Public Health's salt report recommends a stepwise national plan to achieve a minimum 50% reduction in sodium in processed foods, fast foods and restaurant meals over the next decade.

In addition, the council wants the AMA to help the nation achieve the public health goal of having 65% of the population consuming recommended levels of salt by 2010. Currently only 21% of Americans are consuming recommended levels of sodium, according to the council.

Salt, noted J. James Rohack, M.D., a cardiologist from Temple, Tex., an AMA trustee, is a major driver of hypertension. "And hypertension is a major risk factor for heart failure, which is the number one discharge diagnosis of elderly Americans."

He said that "hidden salt" is a particular problem for patients battling hypertension. He said he warns his patients, for instance, to avoid the heavy salt loads in Texas barbecues.

Dr. Rohack said the AMA will also ask the FDA to simplify food labeling so that it is easier for patients to understand the true sodium content of foods.

In other public health actions, the AMA policy-makers defeated by two votes out of 486 a proposal to support a tax on sugared beverages.

Ronald Davis, M.D., a preventive medicine specialist from East Lansing, Mich., who was elected AMA president-elect on Saturday, tried to rally the delegates to support the measure by citing data that suggest that sodas and soft drinks are the number one source of added sweeteners in the American diet and the leading source of calories for some adolescents.

But despite strong support from the AMA Board of Trustees as well as the American Academy of Pediatrics and the American Academy of Family Physicians, the House of Delegates merely asked the AMA board to review the issue again in six months.