Sept. 15, 2006 -- In the past, fierce wars have been fought over salt, a popular seasoning and important food preservative.
Now the American Medical Association has asked the Food and Drug Administration to regulate the amount of salt that food manufacturers can put in their products.
Specifically, the AMA wants the FDA to withdraw salt from the list of foods that are "generally recognized as safe."
In its recommendations, the AMA called for a "50 percent reduction in sodium in processed foods, fast food products, and restaurant meals to be achieved over the next decade."
The American Heart Association recommends that consumers choose and prepare foods with little or no salt to reduce the risk of cardiovascular disease. Additionally, the Association says Americans should aim to eat less than 1,500 mg of sodium per day.
Sodium, which occurs naturally in many foods, is not a poison and is actually considered an essential nutrient. It is a mineral that helps maintain fluid balance in the body, and it is commonly consumed in salt.
For those with hypertension, a form of heart disease, numerous health organizations recommend lowering sodium intake.
However, Dr. Stephen A. Siegel, clinical assistant professor or medicine New York University School of Medicine's division of cardiology, is concerned that general recommendations for an entire population are not appropriate, because just as people have different metabolisms, they have different sodium excretion rates.
"Salt excretion during the day is influenced by many factors -- daily activity, environmental conditions," like heat and humidity, "renal function and overall fluid intake," he said.
Anecdotally, Siegel has seen some young vegetarians who maintain low-salt diets and exercise vigorously outdoors during the summer months who complain of headaches and muscle fatigue. Often, adding salt to their diet improves their symptoms.
Additionally, Siegel said, people who suffer from neuro-cardiogenic syncope, or vaso-vagal fainting, require excessive amounts of salt or hormones to restrict sodium excretion to decrease the frequency of fainting episodes.
Although sodium occurs naturally in foods, at issue is its addition to food through substances called "salt," "soda" (sodium bicarbonate or baking soda) and antacids.
Some argue that salt is an easy way to add flavor to foods. And as far as food safety, foods are best preserved in salty or sugary mediums.
Table salt is not the predominant source of added salt in the American diet. Processed foods contain the greatest quantity of added salt. These foods also tend to contain more calories and higher levels of fat, and dietary guidelines suggest eating less of these foods.
Restaurant food can sometimes be a culprit. Many of the foods that are prepared commercially have higher levels of salt than the AMA would recommend.
For those looking to avoid salt, there are a variety of sodium-free salt substitutes that mainly contain potassium chloride. Cooking aficionados often suggest adding more herbs to foods to add flavor instead of salt, and many popular spice blends now have sodium-free varieties.
According to Ron Tanner, vice president of communications and education for the National Association for the Specialty Food Trade, there were 1,100 different salt products available at the recent New York Fancy Food Show.
Sea salt is becoming more popular in processed foods as well.
"There's less sodium in sea salt," Tanner said.
The United States Department of Agriculture does make dietary recommendations for Americans, but individuals control what they put in their mouths, not the government.
Dr. Keith Ayoob, an associate professor at the Albert Einstein College of Medicine's department of pediatrics, said, "Many companies are reducing the sodium in their products, very gradually and silently, so that consumers don't even notice."
"Snacks in particular, are often loaded with salt," Ayoob said. "Just having healthier snacks like fresh fruit, unsalted nuts and yogurt, would go a long way toward reducing our salt intake."
Nutrition experts have long suggested that if everyone ate according to the U.S. Department of Agriculture's dietary guidelines, which emphasize more fruits, vegetables, whole grains and low-fat dairy products, they'd be getting the appropriate salt intake.
Game over -- without regulation.