Americans eat too much salt. Scientists know it. Food company nutritionists know it. Even some Americans know it. But how do you get people to cut down their salt intake, especially when more than 70 percent of the salt in the average American’s diet comes prepackaged in processed foods?

Too much salt is thought to cause high blood pressure, which can damage the cardiovascular system.

Three experts discussed "Science to Practice: Salt as a Case Study" on Thursday, May 3 in Snyder Auditorium as part of the Future of Public Health series hosted by Dean Barry Bloom. Jane Brody, New York Times health and science correspondent, moderated the panel, which was organized by the Department of Nutrition. The Robert Wood Johnson Foundation provided funding for the event.

The daily allowance of salt recommended by the Food and Drug Administration is 2,400 milligrams. The average American eats between 3,500 and 4,000 milligrams a day, said Margo Wootan, director of nutrition policy, Center for Science in the Public Interest, and HSPH alumna. To some degree, that amount is out of Americans’ hands and put into their mouths, with 73 percent added by food manufacturers and restaurateurs and another 12 percent inherent in the foods themselves. About 15 percent is actually added by Americans, either when cooking or with the salt shaker.

Americans also eat salt at restaurants, where the amounts of sodium are hard to track because the food does not come with nutrition labels, said Wootan.

Panelist Lawrence Appel, associate professor of medicine at Johns Hopkins University, demonstrated why Americans should eat less salt. Using data from several studies, Appel showed that people who eat a lot of salt also have higher blood pressure levels. High blood pressure can lead to hypertension and cause heart attacks and cardiovascular disease.

To lower blood pressure, people should eat a diet rich in fruits, vegetables and low-fat dairy products and eat less salt, according to the DASH (Dietary Approaches to Stop Hypertension) diet. Appel was a contributor to the DASH study, which was led by Frank Sacks, professor in the Department of Nutrition.

Appel stressed that Americans need help from industry if they are to eat less salt. He called for a gradual, silent reduction in sodium in processed foods to get Americans eating salt in amounts below recommended levels.

"It won’t be done otherwise," said Appel, "even if Americans reduce their intake as individuals."

To illustrate just how much salt is present in foods while still in their packages, Wootan showed several slides listing sodium amounts in common foods. A 12 oz. package of Stouffer’s macaroni and cheese has 1,490 milligrams of salt. McDonald’s super-sized fries have 390 milligrams of salt. A handful of Nabisco crackers–380 milligrams.

She pointed out that one cannot always judge the amount of salt in a product simply by taste. Consumers may find variations of sodium amounts within a food group, she said, such as pasta sauces where salt amounts in different products range greatly.

"A lot is out of our control and without our knowledge," said Wootan, who stressed that consumers should read the labels on food and seek out low-sodium alternatives.

Americans continue to eat salt at levels higher than recommended in part because they can taste the ingredient, and they savor the flavor, said Brody. Cutting it out is not as easy as decreasing cholesterol, which the taste buds could care less about. Added Brody, there is hope. Taste is malleable, and people can get accustomed to less salt quickly if they give it a chance.

But Americans also have never received as clear-cut a message to reduce salt intake as they did cholesterol and saturated fat, said Brody. The cries of dissenters against reducing salt speak loudly and carry a big stick, she said. Food manufacturers, in particular a lucrative snack industry, have repeatedly poked holes in studies that show too much salt can be unhealthy, or they have drawn attention to other studies that are less definitive.

Food companies are quietly reducing salt in their products, said Victor Fulgoni, president of Nutrition Impact and former vice president of nutrition for Kellogg Corporation. But don’t expect a lot of fanfare. When Kellogg’s announced a few years ago low-sodium versions of their popular Rice Krispies and Corn Flakes products, sales tanked and the low-sodium versions were yanked from the market.

"Taste rules," said Fulgoni. When consumers read "low sodium," they assume less taste, he said, and don’t buy the products. Now, Kellogg’s and others like it employ a stealth strategy, silently decreasing sodium amounts in their products.

"Some companies are making changes, but they’re not telling anybody," said Fulgoni.

Fulgoni said the best way to get industry to buy into the low-sodium diet is to approach the idea as part of an overall healthy diet. He said focusing on one nutrient at a time is not the way to go. Make the message a positive one, part of a total diet, and companies will sign on.

More than once, the panelists described the importance of industry representatives, consumer advocates, and researchers working together to educate the public on the salt content in their food and the health effects of eating too much sodium.