Without a pinch of salt: reducing sodium

14 November 2018

This year, with the advent of updated regulations to sodium content in foodstuff, manufacturers have been forced to cut salt levels in their products to follow regulations while maintaining consumer appeal. Here, Professor Witoon Prinyawatkul of the School of Nutrition and Food Sciences, Louisiana State University, elucidates on the initial and remaining challenges, and what companies are implementing to combat them.

Regulations governing salt and sodium content in food have come into force in some parts of the world this year. In fact, they have been updates to previous regulations. Despite the efforts manufacturers have made to cut the level of salt in their foods – some to great success – there remain challenges. Aside from the technical and scientific ones, the issue of public perception has been a big concern. Moves in the US to better label the alternatives used to avoid consumer confusion have been supported.

In the US, despite public health efforts to encourage consumers to cut back on sodium, they still consume about 3,400mg per day, nearly 50% more than the 2,300mg limit recommended by the US Food and Drug Administration (FDA)’s guidelines issued in June 2016. More than 40% sodium consumed originates from ten types of foods, of which the top six in the US diet are bread and rolls, cold cuts and cured meats, sandwiches, pizza, soup and processed poultry. Moreover, the American Heart Association states that 65% of sodium consumed comes from retailed foods, with around 25% coming from restaurant foods. Salt makes food taste pleasantly and serves multifunctional roles. So, reducing sodium is a great challenge faced by the food industry.

Potassium chloride has commonly been used as a replacement for salt. It has been affirmed as Generally Recognized As Safe (GRAS) by the US FDA as a multipurpose ingredient in foods with no limitation other than current good manufacturing practice (cGMP). Lowsodium products (<140mg per serving) containing potassium chloride are usually less acceptable due to bitterness. Many taste enhancement compounds, such as glycine and AMP, are applied to minimise undesirable off-flavours of the ingredient. The typical KCl-based salt substitute mixture consists of 40–50% NaCl, 30–45% KCl and 5–20% taste enhancement compounds.

Successes and challenges in sodium reduction

Setting sodium targets helps create a benchmark for the food industry to develop and launch food products with reduced sodium content, while making sure these products are safe for consumption and remain appealing to consumers. Supporting the sodium reduction initiatives has already begun by some companies including Walmart, Unilever, PespsiCo, General Mills, Mars and Nestlé. Another important task for the food industry is to develop effective salt substitutes for use in processed retailed and restaurant foods. Several potassium chloride-based salts have been commercialised with convincing claims, such as ‘reducing sodium by up to 50%, while improving the taste’.

According to Innova Market Insights, new meat, fish and egg product launches, formulated with the ingredient to reduce sodium, in the first three quarters of 2017 were ahead of those in 2016.

The World Health Organization (WHO) has recommended a global reduction in sodium intake to less than 2,000mg (5g of salt) daily. In the US, at least 25 major food companies, including restaurants, responded to the National Salt Reduction Initiative (NSRI by taking measures to decrease average sodium intake by 20% over a five-year period, between 2009–14), and continue committing to reduce the sodium content in some of their products.

Internationally, there are 75 countries committing to reduce sodium intake, of which more than 35 countries have developed initiatives, voluntary and mandatory efforts, to reduce sodium in one or more processed foods. Based on the initiatives developed by the UK’s Food Safety Authority, thousands of companies have voluntarily pledged to reduce salt in their foods, resulting in a decreased average sodium intake from 3,800 to 3,440mg per day, and decreased blood pressure between 2003–11. In 2012, Health Canada issued a voluntary guide, giving benchmark sodium reduction levels for processed foods. Overall, it is difficult to compare countries in terms of progress because foods typically consumed vary worldwide.

The reduction of sodium in processed foods often faces technical and practical challenges. Removing or reducing salt alters physicochemical properties, microbial safety and shelf life, and the sensory properties of finished products. Additionally, consumers likely equate low sodium with less flavour. Depending on the food matrices, different levels of potassium chloride have been applied to replace sodium without noticeably compromising sensory acceptance. Professor Witoon Prinyawatkul and his team at the Sensory Services Lab, Louisiana State University, demonstrated that low-sodium roasted peanuts containing 138.9mg of sodium per 50g of peanuts were acceptable to consumers. The health benefit statement regarding sodium reduction significantly improved liking and purchase intent.

However, an important unwanted health issue related to high potassium intake, so-called ‘hyperkalemia’, cannot be disregarded.

Salt is one of the least expensive ingredients in any food formulations, so there will likely be an increased cost when using salt substitutes. Commercial salt substitutes may cost up to 12 times higher than the price of regular salt. In addition, when salt is reduced, at least one taste enhancement ingredient is often needed.

To one’s heart contents

Over the years, many regulatory actions have been taken to lower the sodium intake of Americans. In 2016, FDA developed draft guidance with sodium reduction targets to encourage industry to gradually reduce sodium in a wide range of foods for voluntary shortterm (two years) and long-term (ten years) targets. According to WHO, adults should consume less than 2,000mg of sodium and at least 3,510mg of potassium per day. Recent studies estimated the potassium intake in the US, Mexico, France and UK at 80, 95, 77 and 95%, respectively. All of which fall below the WHO guideline. The acceptable daily intake (ADI) for chloride salts is not limited, indicating its very low toxicity. The safety of oral consumption of potassium chloride is supported by its long history of use in foods, and its regulatory acceptance for food use in the US, the EU, and by many international scientific bodies and regulatory authorities. While there is currently no established upper limit for potassium intakes, based on current estimated intakes, the European Food Safety Authority (EFSA) stated that the adverse effects from potassium intake from food sources at 5,000–6,000mg per day post a low risk for the generally healthy population.

The UK Government previously advised against potassium chloride as a salt replacer. This was decided due to the risk to people with chronic kidney disease (CKD). However, the Scientific Advisory Committee on Nutrition (SACN) and Committee on Toxicology (COT) in the UK published a report concluding that, at a population level, “the potential benefits of using potassium-based sodium replacers to help reduce sodium in foods outweigh the potential risks”. Current EU labelling requirements for potassium are voluntary, and it may be labelled on packaged food nutrition facts panel if it is present in ‘significant amounts’, with the reference value at 2,000mg. The US FDA will require potassium to be listed on the Nutrition Facts panel by January 2020, with an updated Daily Value (DV) of 4,700mg.

Consumers should definitely check labels when available. However, not all foods are labelled, such as deli meats in grocery stores or foods served at restaurants. In 2015, New York City became the first city in the US, followed by Philadelphia in June 2018, to pass a mandate for sodium warning labels for restaurants. Health conscious consumers are looking for clean or clear labels and might be confused or misled by the chemical-sounding potassium chloride, and likely associate it with chlorine.

NuTek Food Science filed a petition with the US FDA in June 2016 to allow ‘potassium salt’ as an alternate name for KCl on food labels. Walmart, Nestlé USA, Unilever, Campbell Soup Company, H.E.B. and 7-Eleven, among others, have supported this petition. Labelling KCl as ‘potassium salt’ on food labels would improve consumer understanding and acceptance, thus helping the food industry achieve the dual goals of lowering sodium and increasing potassium intakes. Interestingly, the 2016 UK petition for mandatory label of potassium content on packaged and processed food was to avoid health risk for people with CKD.

The future of salt replacement

Potassium chloride, as a salt replacer, has gradually gained regulatory acceptance for use in foods in the US, the EU and worldwide. The question remains as to when the public will see the positive outcomes materialised. In the US, FDA is encouraging companies to meet shortterm targets in two years. If the food industry broadly reaches the initial targets it will expectedly reduce average sodium intake to about 3,000mg per day. It can further be expected that the long-term targets would achieve an average sodium intake of about 2,300mg per day. What does this mean? Let’s consider, just in the US alone, more than 800,000 people die annually from heart and other vascular diseases, costing about $273 billion in healthcare expenses. Lowering sodium intake by 40% over the next decade will likely save 500,000 lives and cut down nearly $100 billion in healthcare costs.

Yes, salt makes food taste good, but excessive sodium intake is a major cause of premature death. Awareness of potential adverse effects of high sodium consumption is critical. Hence, sodium reduction initiatives are an urgent public health priority, and will only be materialised via the coordinated effort from government authorities, food manufacturers, educational entities and consumers. So, will you cut down salt in your diet?

The use of potassium chloride is beneficial in combating the severe health risks of sodium.
Major corporations, such as Walmart, Unilever, PepsiCo and Nestlé have shown continued support for sodium reduction. Specialists are now focusing on retailed and restaurant foods.

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