Experts hope sugar, salt are next on FDA's target list

Now that the Food and Drug Administration has moved to banish most trans fats from the nation’s diet, some public health advocates are hopeful that two other beloved ingredients — sugar and salt — will be subject to similar scrutiny.

“Sodium is next,” said Dr. Dariush Mozaffarian, a Harvard University epidemiologist and cardiologist at Boston’s Brigham and Women’s Hospital.

In acting to remove artificial trans fats from the food supply, Mozaffarian said, the FDA has acknowledged a scientific consensus that they are hazardous to the public’s health. The same case could be said about excess dietary sodium, and that should be an equally powerful prod to FDA action, he said.

Tom Neltner, an analyst with the Natural Resources Defense Council in Washington, D.C., said that sugar, too, may become a target in the wake of the recent FDA action.

In regulating food additives, the FDA has historically focused on removing chemicals that cause death and acute injury, Neltner said. Now the agency has demonstrated that it’s ready to step in when a food additive contributes to chronic diseases that kill many people slowly.

“I hope this presages a new willingness to regulate with an eye to these chronic illnesses,” Neltner said.

Even compared with saturated fat - a frequent fellow traveler - trans fatty acid is a bad actor, knocking the blood’s lipid levels into dangerous territory on two fronts. Not only does it raise levels of LDL cholesterol, the bad kind; trans fat consumption depresses levels of HDL cholesterol, which is considered protective against heart disease.

Harvard University public health professor Walter Willett and colleagues estimated in 1994 that consumption of trans fatty acids caused 30,000 Americans to die prematurely of coronary heart disease each year. Other estimates have soared as high as 100,000 premature deaths per year.

In a more recent update of trans fat’s toll, the Centers for Disease Control and Prevention reckoned that eliminating the remaining trans fat from American diets would prevent the premature cardiovascular deaths of 7,000 Americans and head off three times as many nonfatal heart attacks.

In an interview, Willett cautioned that regulating sodium and sugar as additives would hardly be as easy as making a decision to ban trans fats.

While trans fats have no nutritional value, salt is an essential nutrient. And sugar, when consumed at reasonable levels, is not harmful, he said. If it is to act on mounting scientific concern about dietary sodium and sugar, the FDA will have to rethink the assumption that an additive it considers safe “is safe in any amount,” Willett said.

The FDA’s regulation of food additives has come under growing criticism in recent years, and again on Nov. 7 with the release of a three-year assessment of the FDA’s program by the Pew Charitable Trusts.