In a report that may bolster public policy efforts to get Americans to reduce the amount of salt in their diets, scientists writing in The New England Journal of Medicine conclude that lowering the amount of salt people eat by even a small amount could reduce cases of heart disease, stroke and heart attacks as much as reductions in smoking, obesity and cholesterol levels.
If everyone consumed half a teaspoon less salt per day, there would be between 54,000 and 99,000 fewer heart attacks each year and between 44,000 and 92,000 fewer deaths, according to the study, which was conducted by scientists at University of California San Francisco, Stanford University Medical Center and Columbia University Medical Center.
The report comes as health authorities at federal, state and municipal levels are considering policies that would have the effect of pressuring food companies to reduce salt in processed foods, which are considered to be the source of much of the salt Americans eat.
Last week, New York City announced an initiative to urge food manufacturers and restaurant chains to reduce salt in their products nationwide by 25 percent over the next five years. California, according to an author of the study, Kirsten Bibbins-Domingo, an associate professor of medicine and epidemiology at University of California, San Francisco, is considering setting salt limits on food the state purchase for schools, prisons and other public institutions.
A panel appointed by the Institute of Medicine, the widely respected independent research arm of the National Academies of Science, is close to issuing a report that will make recommendations about reducing salt intake, including actions government and manufacturers can take.
Dr. Bibbins-Domingo also said the Food and Drug Administration was considering whether to change the designation of salt from a food additive that is generally considered safe to a category that would require companies to give consumers more information alerting them to high levels of salt in food. An F.D.A. spokesman was unable to say Wednesday whether such discussions were taking place. "We are actively looking at how to improve the nutrition content of the American content," he said.
"For 40 years in this country we've been trying to get individuals to reduce the amount of sodium we consume and it hasn't worked," said Cheryl A. M. Anderson, an assistant professor of epidemiology and international health at Johns Hopkins University and a member of the Institute of Medicine panel.
"We need to collectively come together and approach the problem with a combination of efforts, including changing the food supply," said Dr. Anderson, who also is a co-author of an editorial about the study in The New England Journal of Medicine. "This type of evidence really helps us support that movement toward not just relying on the individual to do something that is really difficult, limit salt."