The FDA’s sodium problem

The government says excess sodium is killing us – but are we making any progress? And a new publication pairs wine and climate change.

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Today, in Food Fix: 

– The government says excess sodium is killing us – but are we making any progress?

– A new publication pairs wine and climate change


FDA’s sodium problem

It’s been almost two years since the Biden administration finalized short-term sodium reduction targets – a long-delayed policy aimed at nudging food makers to slowly cut salt out of the American diet.

The backstory: After traversing a very, very long road, it was a big deal that FDA finally got this out. If you want the full history, read Chapter 4 – otherwise, here’s a quick refresher: 

Back in 2010 (so, 13 years ago), the Institute of Medicine urged FDA to set mandatory sodium limits for foods, at the time estimating that reducing sodium intake nationwide could prevent more than 100,000 deaths and save billions in annual health care costs. The Obama administration wanted to move on sodium reduction, but the work was repeatedly delayed thanks to a combination of bureaucracy, politics and industry pushback.

In 2016, FDA finally issued draft voluntary sodium reduction goals across more than 150 categories of food, from pickles to pizza. Yet it wasn’t until October 2021 that FDA finalized some of the voluntary targets – only the short term ones, not the harder-to-meet longer-term targets. 

While I’ve just summarized more than a decade of history, this saga goes back much further for Michael Jacobson. The Center for Science in the Public Interest (CSPI), a leading health advocacy group that Jacbson co-founded and led until retiring in 2017, first petitioned the FDA to crack down on sodium in 1978.

Even in his retirement, Jacobson seems haunted by the government’s unfinished work on sodium. Public health agencies have repeatedly confirmed that excess sodium consumption is a major cause of premature death and cardiovascular events. Even in the Trump administration, then FDA Commissioner Scott Gottlieb publicly backed the need to cut back, saying in a 2018 speech: “There remains no single more effective public health action related to nutrition than the reduction of sodium in the diet.”

Despite all this, there has been no concrete progress. No one knows if this voluntary reduction strategy is working. The short-term targets FDA finalized in 2021 span two and a half years, so the deadline doesn’t hit until spring 2024. The FDA has not said when or how it intends to measure the industry’s progress, or lack thereof – a frustration to health and industry groups alike.

Show me the documents: About a year ago, Jacobson filed a Freedom of Information Act (FOIA) request seeking any and all documents that would show FDA’s efforts to “encourage the packaged food and restaurant industries to lower sodium levels and meet the targets, as well as efforts to encourage consumers to lower their sodium intake.” He got more than 800 pages back from the agency – a trove that he shared with me – but there just wasn’t much there. It was mostly perfunctory emails either between agencies or between FDA and industry groups sharing things like online resources or a PowerPoint presentation about FDA’s sodium reduction work. (The PowerPoint file is repeatedly included in the FOIA, which may explain the large page count.)

The most interesting part of the FOIA response was a list of meetings FDA held with outside groups about sodium reduction. The list also included press calls, social media and web postings about sodium. But Jacobson didn’t want to see routine meetings and PowerPoint presentations – he wanted to see real pressure, intense and direct industry engagement, and, better yet, public pressure on companies that might result in real cuts to sodium in the foods sold to millions of consumers. 

“There’s no sense of urgency, no sense of understanding the death toll that comes from excessive sodium,” Jacobson told me in an interview. “Their plans [for engagement] are pathetic, just a webinar here or there.” In his view, FDA should look to the playbook from the UK, where government officials held public events and engaged in a high-profile media campaign to pressure food makers to cut back on salt (and they did). “The FDA hasn’t done any of that,” he noted. 

FDA is working on it. In fairness to the FDA, none of this is easy. Moving forward on sodium reduction has been an uphill battle. At multiple points, Congress has intervened or even directly slowed things down at the behest of the food industry. Despite these hurdles, the agency says it’s committed to this work and contends it is engaging directly with the food industry.

“The FDA is committed to monitoring the sodium content of the food supply and evaluating progress towards achieving the short-term targets announced in the agency’s October 2021 final guidance,” an agency spokesperson said in a statement to Food Fix. “During the past 2.5 years, the FDA continued its industry engagement on this issue, which began when the draft guidance was issued in 2016 and continues today through various industry-focused webinars and individual meetings.”

The FDA has also approved the use of potassium chloride (an ingredient that can be used to replace sodium in foods) labeled as “potassium salt” to make it more palatable to consumers, and the agency is pursuing more regulatory flexibility for salt substitutes. (P.S. If you’ve experimented with potassium salt, get in touch! I’m curious.)

Public health groups urge more action. I asked Peter Lurie, CSPI’s current president and executive director, whether he’s also frustrated by the long timeline on sodium – and the lack of clarity on when we’ll know if any of this has worked. Lurie first acknowledged it’s quite possible the FOIA doesn’t capture the full extent of FDA’s engagement with industry, but he agrees pressure is needed because the reduction targets are not mandatory. “It’s clear that for a voluntary process to succeed, there’s going to have to be some goading from the agency,” he said. 

CSPI has called on FDA to also set interim reduction targets – between the two and a half year and ten year goals – to urge more cuts from food makers in the near term. The group has also called for monitoring and regular updates from FDA so we know whether real progress is being made. “We have no idea what it is that FDA plans in that regard, there’s been no specifics about how they would go about doing it,” Lurie noted.

I also checked in with the American Heart Association (AHA), a major backer of cutting down on salt, about the status of FDA’s work. 

“Lowering the daily sodium intake for adults to 2,300mg could prevent an estimated 450,000 cases of cardiovascular disease and save approximately $41 billion in health care costs over the next two decades,” said Eduardo Sanchez, chief medical officer for prevention at AHA. “We want to know how much headway has been made over the past two years and encourage FDA to share its timeline and plan to measure the success of the targets soon.”


A new publication pairs wine and climate change

Hot tip for all you food nerds: Chase Purdy, a dear friend and my former colleague at Politico, has just launched Grape Rush, a new online publication/newsletter focused on the intersection of wine, climate and generational change in the winemaking world.

I don’t know much about the wine industry, but after reading Chase’s recent coverage on how the sector is grappling with climate change – including potentially needing to transition to different kinds of grapes! – I’m officially hooked.

I caught up with Chase this week about his new project. Here’s a snippet of our conversation: 

Helena: I just read your new story about a Southern California winemaker who says we need to diversify the types of grapes we’re using for wine. They called vitis vinifera, the most commonly used species of grape, “a drag on our resources, our creativity, and our joy, and it’s time to explode the narrow box — the coffin — that we’ve put wine in for far too long.” I had no idea this topic was so emotional. How did you get into this story?

Chase: After I wrote Billion Dollar Burger, which came out during the thick of the pandemic, I found myself burned out from writing – I had written the book while working full time at Quartz. When the pandemic hit, it slowed a lot of things down. Life got small – and I had a group of friends who were suddenly buying a ton of wine. I remember coming across a study that basically said that in the early months of the pandemic, sales for spirits, beer and wine went up like double digits – I thought yeah, this makes sense. I was drinking a lot more wine and I just got more and more interested in it. 

I started wondering about wine production and climate change and I ended up coming face to face with a really entrenched culture around this food product, this beverage. It turns out the wine industry is facing multiple existential questions right now, including one of climate change. The other is that no one under the age of 60 wants to drink wine anymore. In the midst of it, there are a lot of really cool next-generation winemakers doing extremely neat things, in terms of growing wine grapes and making wine in more sustainable ways. One of the ways that’s caught my interest particularly is the use of hybrid grapes. There are other examples, too. It’s just a wild and wooly world. 

Helena: Are the people pushing hybrid grapes as part of the solution seen as renegades? Are there parallels to how some of the alternative protein folks started out? 

There is a similar upstart feeling. They are upstarts in the same way that cell-cultivated meat has upstarts who are challenging a bigger system. There’s a whole sort of industrial complex around wine that can be seen as snooty and hoity-toity, so more than anything the people who are making wine from grapes that are more sustainable are up against this very ingrained stigma. It’s even taught in wine school. 

So, if readers are interested in wine and also concerned about climate change, what should they do next (after signing up for your newsletter, of course)? Do you recommend trying hybrid grape wines? What’s the starter pack here?

Go to a wine shop, and ask the person behind the counter if they have any hybrid wines. Just watch their expression change from either confusion about what a hybrid grape wine even is, why you’re even asking about a hybrid grape wine, and then watch them go into their system to see if they have anything. Some will have one!

I’m totally going to ask at Scheider’s on Capitol Hill. I’ll report back!

Sign up for Chase’s brand new newsletter here – the first edition drops next week.


What I’m reading

Big Food runs greenwash risks over regenerative farming push (Bloomberg). “The food industry’s efforts to shift farming away from environmentally damaging practices are being hobbled by the absence of established targets,” report Agnieszka de Sousa and Dasha Afanasieva. “Many of the world’s biggest food suppliers — from Nestle and Unilever to Walmart Inc. and PepsiCo Inc. — are pursuing “regenerative” agriculture that seeks to reduce the environmental and social impact of conventional farming approaches. But that revolution, embracing everything from crop rotation and carbon capture to improving water quality and preserving biodiversity, lacks clear goals and a single definition, according to FAIRR, a network supported by investors with total assets exceeding $70 trillion.”

Many of today’s unhealthy foods were brought to you by Big Tobacco (Washington Post). “In the 1980s, tobacco giants Philip Morris and R.J. Reynolds acquired the major food companies Kraft, General Foods and Nabisco, allowing tobacco firms to dominate America’s food supply and reap billions in sales from popular brands such as Oreo cookies, Kraft Macaroni & Cheese and Lunchables. By the 2000s, the tobacco giants spun off their food companies and largely exited the food industry — but not before leaving a lasting legacy on the foods that we eat,” writes Anahad O’Connor. “New research, published in the journal Addiction, focuses on the rise of ‘hyper-palatable’ foods, which contain potent combinations of fat, sodium, sugar and other additives that can drive people to crave and overeat them. The Addiction study found that in the decades when the tobacco giants owned the world’s leading food companies, the foods that they sold were far more likely to be hyper-palatable than similar foods not owned by tobacco companies.”

FDA continues work on a plan to reduce infant illnesses from Cronobacter in formulas (Food Safety News). “The Food and Drug Administration has released an update on its work to develop a strategy to help prevent Cronobacter sakazakii illnesses related to powdered infant formula,” reports Coral Beach. “The agency is working on the strategy as part of its response to an outbreak of illnesses and the subsequent temporary closure of the Abbott Nutrition production plant in Sturgis, MI. The closure led to a nationwide shortage of infant formula that lasted for months.”


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