The deadliest additive.

Salt is added to thousands of processed foods and sits in shakers in practically every kitchen in the country. Yet plain old sodium chloride may be the most dangerous food additive of all.

Eating too much sodium raises blood pressure, which increases the risk of heart attack and stroke. For 25 years, top government officials have advised the public to opt for lower-sodium foods and have urged food processors and restaurants to add less salt to their foods. Yet Americans are eating more sodium than ever.

Average sodium intake rose from around 2,800 milligrams (mg) per day in 1980 to around 3,000 mg in 1990 to 3,300 mg in 2000, according to government surveys. While all diet surveys underestimate what people eat, those numbers are especially low because they don't count what we got from the salt shaker.

Still, even 3,300 mg exceeds the 2,400 mg daily recommendation on food labels. And it dwarfs the latest recommended intake--1,500 mg a day--set by the National Academy of Sciences. What does it take to get 1,500 mg of sodium? Try one grilled cheese sandwich, chicken burrito, or spaghetti with marinara or meat sauce at a typical restaurant. An order of beef with broccoli, General Tso's chicken, or shrimp in garlic sauce at a Chinese restaurant delivers an astounding 3,000 mg.

Any way you look at it, we're swallowing far more sodium than we should. And at least 75 to 85 percent of that sodium is added to foods by manufacturers or restaurants. So even if you banish your salt shaker, you're still swimming in sodium.

And the cost is huge: if Americans could cut their sodium intake in half, 150,000 fewer people would die every year from cardiovascular disease, estimates Claude Lenfant, former director of the National Heart, Lung, and Blood Institute. Tens of thousands more would avoid nonfatal but debilitating strokes and heart attacks, and millions more could discard their high blood pressure pills.

In the United Kingdom, the government has begun a highly visible campaign to cut sodium levels in food, including naming some of the highest-sodium brands. Some companies are responding. Kraft, for instance, has cut the sodium in its Lunchables by 20 percent ... in the U.K., not the U.S.

It's time that American health officials mounted their own anti-salt campaign, threatening makers of high-sodium foods with legal action and setting limits on the sodium levels in soups, processed meats, and other major sources.

No one would argue that salt should be banned. Rather, the amounts added to foods need to be reduced gradually. The American Public Health Association has suggested that levels be halved over a ten-year period. That would give industry time to reformulate and help people become accustomed to the taste of lower-sodium foods.

Some 25 years ago, the Center for Science in the Public Interest (publisher of Nutrition Action Healthletter) urged the Food and Drug Administration to ratchet down sodium levels. The FDA added sodium to the voluntary nutrition labels then in use and said it would consider doing more if its actions didn't help solve the problem. Guess what? They didn't.

In the coming months, you'll be hearing more from CSPI about salt. Until the government acts, what can you do? Add less salt than recipes call for, rely less on prepared foods, and read food labels.

Michael F. Jacobson, Ph.D.

Executive Director

Center for Science in the Public Interest