Sodium controversy

Dietary sodium levels in the food supply are presently the subject of major controversy. On the one hand, sodium is absolutely essential for health and at least 500 milligrams per day are needed as part of a healthy diet. On the other hand, the average level of sodium consumption in Canada is 3,400 milligrams per person per day.
Where is Sodium found?
A common misperception is that sodium and salt are the same thing; they are not. Regular salt is sodium chloride, which is 40% sodium by weight. Some high-sodium condiments include baking powder, baking soda, and monosodium glutamate. Other examples include onion salt, celery salt, meat tenderizer, and barbecue sauce. The free metal, elemental sodium, does not occur in nature but must be prepared from sodium compounds. Elemental sodium was first isolated by Humphry Davy in 1807 by the electrolysis of sodium hydroxide.
History and Worldwide Use
Salt is the major contributor to sodium intake. For several million years the ancestors of humans, like all other mammals, ate a diet that contained less than 0.25 g of salt per day. About 5000 years ago, the Chinese discovered that salt could be used to preserve food. Salt then became of great economic
importance as it was possible to preserve food during the winter and allowed the development of
settled communities. Salt was the most taxed and traded commodity in the world, with intake reaching a peak around the 1870s. However, with the invention of the deep freezer and the refrigerator salt was no longer required as a preservative. Salt intake
had been declining, but with the recent large increase in consumption of highly salted processed food, salt intake is now increasing towards levels similar to those of the 1870s, and is approximately 9-12 g/day (that is, 50 times more than our
evolutionary salt intake) in most countries in the world.
Generally Recognized As Safe (GRAS)
The legal status of sodium as a food additive component is "Generally Recognized As Safe" (GRAS). This means that sodium has been grandfathered into the food supply as a food additive component because it has been in use for so long; today over 70% of dietary sodium is added during food processing and in commercially prepared foods (i.e. restaurants). This state of affairs is called "hidden sodium". Sodium from ordinary table salt (sodium chloride) added to food by consumers when cooking and eating represents less than 10% of sodium in the diet.
Since sodium is a GRAS product component, it has never been tested for safety. As a result, there are very few scientific studies of high sodium intake and its effects on a large population. While there are many GRAS "grandfathered" products which have recently had their status changed (i.e. Dental amalgam controversy which has recently been changed from GRAS to Class II), sodium continues to remain untested as a food additive component.
Voluntary Reduction of Sodium Levels
Any person or group who decides to reduce their sodium levels is considered to be a "volunteer". Since sodium is GRAS, any benefits of reducing sodium intake are classified as "anecdotal". This is at the heart of the sodium controversy: Any benefits from reducing sodium intake voluntarily, either by consumers or sellers, are not considered to be "scientific". If you reduce sodium intake and your health improves (i.e. blood pressure reduction or weight loss), as a volunteer this information is only for your own use and is not recognized widely. Because of the GRAS status of sodium, everyone is free to sell, consume, and add as much sodium to food as they want to.
Barriers to Reducing Sodium Levels
Since over 70% of sodium in the food supply comes from processed and commercially prepared foods, reducing sodium levels during manufacturing and distribution of food (packaged foods, restaurant foods, etc...) would have the biggest impact on sodium reduction. However, removing sodium from processed and prepared foods generally makes them unpalatable, and replacing sodium with other ingredients raises the price of food.
The total share of consumer spending on food outside the home continues to grow, and is today over 50% of total consumer food budget. The amount of sodium in foods also varies from country to country, with North American processed and prepared foods sometimes having two or three times as much sodium as in, for example, Europe.
Today, Americans consume 55% more sodium than they did a generation ago. However, major public health agencies do not realistically believe individuals can control how much sodium is in the food they eat. The emphasis today is on voluntary reduction through the stakeholder process (government, industry, health professionals, educational campaigns), which has worked successfully in some countries and is still being debated in others.
Sodium and Health
Many people who try to reduce dietary sodium intake feel fatigue as dietary levels drop below 2,400 milligrams per day. This is due to the fact that sodium is a major electrolyte cation in the body, and is present almost solely in the bloodstream. As such, it needs constant replacement. Any attempts to reduce calorie intake that also cause sodium intake to drop lead to fatigue as well. Most major packaged weight loss foods have 500mg of sodium (or more) per 350 calories of food serving for this reason.
The sodium controversy has reached epidemic proportions, as end-consumers now rarely add sodium (as salt) to their foods at the table; instead sodium is added for them, to foods that are either commercially prepared or sold in restaurants. These prepared and restaurant foods are typically much higher in fat and overall calories than meals that in the past were prepared at home. The heart of the controversy is "who governs how much sodium is put on your food?". In a self-care system, end-consumers would be responsible for their own sodium intake, and would add sodium to lower-fat, high complex carbohydrate foods which are reduced in calories (aka home-cooking). Allowing others to add sodium, which is hidden, to higher-fat and higher-calorie foods to make them more palatable is the essence of the sodium controversy.
Sodium and History
Sodium's ability to preserve food without refrigeration was a foundation of civilization. It eliminated the dependence on the seasonal availability of food and it allowed people and food to travel over long distances. It was also a desirable food seasoning. However, sodium (as salt) was difficult to obtain, and so it was a highly valued trade item, which followed the pull of economics along salt roads such as the Via Salaria in Italy, some of which had been established in the Bronze Age. Until the twentieth century, salt was one of the prime movers of national economies and wars.
Historically, foods that had sodium added to them tended to be lower in fat. This changed with the development of modern fast food and junk food, which combines salt, fat, and sweet tastes to make foods which are highly palatable, high in empty calories, and low in nutritional value. As end-consumers have lost the ability to determine their own healthy sodium intake, which is normally found by eating a healthy low-fat diet high in complex carbohydrates with salt added at the table for flavor and health (energy from the sodium-potassium pump), obesity has skyrocketed. Many people blame added salt for the obesity epidemic; however, it is the addition of salt to fast food and junk food which is at the heart of the sodium controversy, as this is a historical change which defines the modern food era.

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