U.S. Food Industry Progress Towards Salt Reduction Slowed Without Sodium Targets

Abstract

Abstract Objectives The National Salt Reduction Initiative (NSRI) achieved a 7% reduction in sodium in packaged foods between 2009 and 2014 through industry engagement, target setting, and food supply monitoring. The initiative was created as a model for federal action, but FDA has not yet finalized proposed sodium reduction targets, leaving a gap in U.S. sodium policy since 2014. This study assesses the extent to which reductions in sodium occurring during the NSRI continued after 2014. Methods We used data from the NSRI Packaged Food Database, a novel nutrition database linking national sales of top-selling products to nutrition information in 2009, 2012, 2014, and 2018. Generalized linear regressions estimated sales-weighted mean sodium density and the % of products meeting NSRI targets set for 2012 and 2014 at each time point. Generalized estimating equations accounted for products appearing in multiple years. Results Between 2009 and 2018, sales-weighted mean sodium density of U.S. packaged foods decreased 8.4%, with most of the decline (5.1%) occurring before 2012 (mean difference = −30mg/100g, P < 0.001). The rate of change slowed from 2012–2014 (−10mg/100g, P = 0.037) and from 2014–2018 (−10mg/100g, P = 0.002). The proportion of U.S. packaged foods meeting the 2012 and 2014 targets increased from 27.7% to 40.9% and 13.6% to 19.7%, respectively, from 2009–2018; all changes occurred from 2009–2012. Among products in the top 80% of sales in all years, sodium declined 5.5% from 2009–2012 (−32 mg/100g, P < 0.001) and 1.5% from 2012–2014 (−15 mg/100g, P = 0.029) due to reformulation, with no further changes after 2014. Products new to the marketplace after 2009 showed no decline in sodium density after 2012. Conclusions The rate of sodium reduction in the packaged food supply was not sustained following the end of the NSRI. Final FDA industry guidance can help turn attention back to prioritizing reducing sodium in the food supply. Funding Sources The NSRI Packaged Food Database was funded, in part, through a cooperative agreement with the Centers for Disease Control and Prevention. This research was supported by the New York City Department of Health and Mental Hygiene.