The federal Food and Drug Administration is considering limits on the amount of salt allowed in commercially prepared foods.

At a hearing Nov. 29, the American Medical Association and the Center for Science in the Public Interest urged the FDA to regulate sodium, arguing that America’s addiction to salt causes hypertension, leading to heart disease, kidney failure, and stroke.

The FDA currently recommends eating no more than 2,400 milligrams of sodium per day, which is about one teaspoon. The average American now consumes about 4,000 milligrams a day, which is about 20 times more than they need in order to survive.

"To properly function, our bodies only need about 200 milligrams a day, and you can get that from naturally occurring sources," said Debbie Wilburn, a consumer science agent with Hall County Extension Service.

How did our salt consumption get so out of control?

"Traditionally, salt was used more as a preservative rather than a flavoring agent," Wilburn said. "Now, I think manufacturers put so much in just because that’s the way it’s always been done, and because consumers’ taste buds have been trained that way."

Debbie Walls, a dietitian who works with Northeast Georgia Medical Center’s cardiac rehabilitation and
congestive heart failure programs, said nutritionists have noticed a disturbing trend.

"The sodium content of most foods has been steadily increasing over the past 20 years, and there’s no reason for it other than taste," she said.

But the manufacturers have created a vicious circle, because the more salt people consume, the more they want.

"I think you build up a tolerance to the taste," said Bobby Peck, manager of the Longstreet Cafe in Gainesville.

Food companies are reluctant to rein in sodium, because they want to satisfy their customers. But with almost 40 percent of American adults now believed to have hypertension or high blood pressure, some advocates say the industry is endangering public health.

"Some people don’t want government interference. But this is just common sense," Wilburn said. "Salt causes your body to hold on to excess fluid, and your heart has to work harder to pump it out. Now we’re seeing more hypertension in children. If we don’t do something, we’re going to pay for it down the road."

Wilburn thinks the industry could actually benefit from regulation. "If all the manufacturers cut salt at the same time, then they wouldn’t have to worry about losing sales to their competitors," she said.

Packaged-food manufacturers and fast-food restaurants have already worked diligently over the past couple of years to eliminate trans fats, a type of fat that’s now believed to cause cardiovascular disease. To do so, they had to get rid of partially hydrogenated oils and find a substitute that could give foods the same taste and texture.

By comparison, reducing sodium seems almost effortless: Just add less salt.

But this time, it’s not about the cost and effort of altering recipes. It’s about meeting the public’s expectations.

"Restaurants are a customer-driven business," Peck said. "If you start cutting back on things, you might have a backlash. People get irate if we make the slightest little change."

Juan Luna, owner of Luna’s restaurant in Gainesville, praises the value of salt but thinks many of the fast-food chains are using massive amounts of sodium to disguise bad cooking.

"Salt is a great ingredient. It brings out the flavor in food, so it’s hard to cook without it," he said. "But you don’t have to overpower the food."

Luna said he prefers to add as little salt as possible and let customers sprinkle it on at the table, if they choose.

"In really fine restaurants, there is no salt on the table. It’s considered an insult to the chef (for the customer) to add salt," he said. "You can make food taste delicious without much salt. We believe in using herbs."

At Longstreet Cafe, Peck said the cooks don’t add much salt to food during preparation, so the customer has more control over their own sodium intake.

"Most of what we do is made fresh, from scratch," he said. "We use very few processed ingredients."

It’s estimated that about 75 percent of the salt in the American diet comes from processed foods. The increase in sodium consumption is likely tied to consumers’ search for ever greater convenience.

Wilburn said there’s no way to reduce sodium intake on a diet of largely processed foods.

"When you’re cooking at home, you can use less salt. But when sodium is already in a purchased food, there’s no way the consumer can take it out," she said. "Some frozen meals and canned soups have as much as 1,800 milligrams in one serving, and that leaves you with very little sodium left for the rest of the day (from your recommended maximum)."

Fast-food restaurant fare can be even worse. A Burger King Double Croissan’wich with ham, egg, and cheese contains 2,210 milligrams of sodium, for example. And sodium lurks in items where customers wouldn’t expect it. A medium Oreo Sundae Chocolate Shake from Burger King has 720 milligrams.

"You cannot go by the taste to know how much sodium is in something," Walls said.

At least fast-food chains do publish nutrition information, even if they don’t sell many low-sodium items.

"When I tell patients to limit their sodium, they can’t even guess how much they’re getting when they eat out, except for fast food," Walls said.

Eating at home is a problem, too, for people who must severely limit their intake due to heart or kidney disease.

"Some medical professionals have suggested a limit of 1,500 milligrams a day for heart patients," Walls said. "But at that level, it is very hard to write menus that contain any processed foods. You’ve basically got to make everything from scratch."

She teaches patients to become avid readers of product nutrition labels.

"The problem is, you can read labels all you want, but there aren’t enough choices," she said. "In a typical grocery store, you might find one brand of low-sodium bread. Products that say ‘heart healthy’ tend to be low in fat but not in sodium. And even fresh meats, such as boneless, skinless chicken breasts, now already have sodium added. That didn’t use to be the case."

Walls hopes the proposal to regulate salt will spur manufacturers to voluntarily start offering consumers more options.

"It is very much needed," she said. "People only try to restrict salt once they have a health problem, but we’re doing nothing in terms of prevention."

Elizabeth Westbrooks, leader of Sunshine Seniors, a Gainesville wellness group for elderly people, said she doesn’t think government regulation is the answer. But she’s glad that the subject is being discussed.

"My doctor told me I need to cut back on salt. It’s not good for you once you reach a certain age," she said. "But if you get in the habit of not eating salt, you won’t miss it. Little by little, things will change. But it takes time."