Salt-reduction activist and member of the international salt reduction advocacy group WASH (World Action on Salt and Health), Dr. Norm Campbell, president of Blood Pressure Canada said, "This is a wonderful demonstration of the government's leadership in forming collaborations to improve the health of Canadians to prevent stroke, heart and kidney disease -- three of the major causes of death and disability in Canada," says. "Here we have everyone working together for common cause."
Focus In establishing the Sodium Working Group, Health Canada included representatives from food manufacturing and food service industry groups, health-focused non-governmental organizations, the scientific community, consumer advocacy groups, health professional organizations and government representatives. The mandate of the Working Group was to develop and oversee the implementation of a strategy for reducing dietary sodium intake among Canadians.
Members Member Organization Dr. Mary L'Abbé (Chair) Health Canada Scientific and Health-Professional Community Dr. Peter Liu Canadian Institutes of Health Research Dr. Kevin Willis Canadian Stroke Network Dr. Katherine Gray-Donald Canadian Nutrition Society Dr. Susan I. Barr Dietitians of Canada Dr. Eric Young Council of Chief Medical Officers of Health Health-Focused and Consumer Non-Governmental Organizations (NGOs) Dr. Norm Campbell Blood Pressure Canada Ms. Bretta Maloff Heart & Stroke Foundation of Canada Ms. Francy Pillo-Blocka The Canadian Council of Food and Nutrition Mr. Bill Jeffery Centre for Science in the Public Interest Dr. Nathalie Jobin Extenso - Reference Centre for Human Nutrition Food Manufacturing and Food-Service Industry Mr. Paul Hetherington Baking Association of Canada Ms. Mary Ann Binnie Canadian Meat Council Mr. Don Jarvis Dairy Processors of Canada Ms. Phyllis Tanaka Food and Consumer Products of Canada Mr. Colin Farnum Food Processors of Canada Ms. Jeanne Cruikshank Canadian Council of Grocery Distributors Mr. Ron Reaman Canadian Restaurant and Foodservices Association Government Ms. Chantal Martineau Office of Nutrition Policy and Promotion, Health Canada Ms. Lianne Vardy Public Health Agency of Canada Ms. Nora Lee Food Directorate, Health Canada Ms. Lisa Forster-Coull Federal Provincial Territorial Group on Nutrition Ms. Patti Wunsch Agriculture and Agri-Food Canada Ms. Charmaine Kuran Canadian Food Inspection Agency
The Working Group has met on several occasions to establish a common knowledge base and to develop strategies for reducing dietary sodium consumption among Canadians. The process that Health Canada is following is patterned after that carried out by the Food Standards Agency in the UK – that is, no discussion of the science, but rather an immediate move to sodium reduction programs and policies. The concerns over salt are chiefly based upon its ability to affect blood pressure.
Debate There is some debate on the impact of sodium reduction upon blood pressure. The salt industry and some food and beverage producers emphasize the heterogeneous impact of sodium on individuals. For example, they observe that about 30% of normotensive individuals experience a drop in blood pressure, while about 20% of normotensive individuals experience an increase in blood pressure - the remaining population showing no effect.Luft, F.C., Rankin, L.I., Block, R. et al. Cardiovascular and humoral responses to extremes of sodium intake in normal black and white men, Circulation, 1979; 60: 697–706.Miller, J.Z., Weinberger, M.H., Daugherty, S.A. et al. Heterogeneity of blood pressure responses to dietary sodium restriction in normotensive adults, Journal of Chronic Diseases, 1987; 40: 245–250.Luft, F.C., McCarron, D.A., Heterogeneity of hypertension: the diverse role of electrolyte intake, Annual Review of Medicine, 1991; 42: 347–355. As a consequence, some argue that programs to reduce salt will not hold the same benefits for everyone and policies to arbitrarily promote salt reduction will discriminate against a certain segment of the population. They argue that an across the board reduction in dietary sodium may not be the right approach Alderman, M.H., et al., Low urinary sodium associated with greater risk of myocardial infarction among treated hypertensive men, Hypertension, 25, 1144-1152, (1995).Alderman, M.H., et al., Dietary sodium intake and mortality: the National Health and Nutrition Examination Survey (NHANES I), Lancet, 351, 781-785, (1998).Cohen, H., et al., Sodium intake and mortality in the NHANES II follow-up study, American Journal of Medicine, 119, 275, (2006).Cohen, H.W., Hallpern, S. M., and Alderman, M. H., Sodium Intake and Mortality Follow-Up in the Third National Health and Nutrition Examination Survey (NHANES III), J Gen Intern Med., , May 18, (2008).Paterna S; Gaspare P; Fasullo S; Sarullo FM; Di Pasquale P., Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend? Clin Sci (Lond). 2008; 114(3):221-30 ().Paterna, S., et al., Medium Term Effects of Different Dosage of Diuretic, Sodium, and Fluid Administration on Neurohormonal and Clinical Outcome in Patients With Recently Compensated Heart Failure, American J. Cardiol 2009;103:93–102. and the outcome may lead to unintended consequences for Canadian consumers.
On the other hand, groups concerned with cardiovascular health and nutrition emphasize the overall negative effects of high levels of sodium in the North American diet. Based upon a study carried out in the US in 1991 on a total of 62 people, the presumption made is that most of the sodium Canadians consume (77%) comes from processed foods sold in grocery stores and in food service outlets. Only about 11% is added during preparation or at the table, with the remainder occurring naturally in foods.Mattes RD, Donnelly D. "Relative contributions of dietary sodium source." Journal of the American College of Nutrition 1991;10(4):383-93. And while the individual benefits of reducing sodium intake are variable, it has been theorized that dietary sodium reduction could eliminate hypertension for over a million Canadians, with a resulting savings of at least 430 million dollars annually in direct high blood pressure management costs (although this has never been confirmed through clinical trials). In other words, while not all Canadians need to reduce their intake of dietary sodium, many have been urged to. Moreover, theoretical estimates have projected that we may be better off because of a possible reduction of tax-supported health care.Joffres MR, Campbell NRC, Manns B, Tu K. Estimate of the benefits of a population-based reduction in dietary sodium additives on hypertension and its related health care costs in Canada. Canadian Journal of Cardiology 2007;23(6):437-43.
Disbandment On February 4, 2011, the Ottawa Citizen reported that the Health Canada Sodium Working Group had been disbanded. The Group had been charged with tracking whether companies were reducing the level of salt in processed foods over the next five years. This follows actions in the United Kingdom to abolish the dietary mandate of the FSA (Food Standards Agency) the government unit most actively involved in salt reduction advocacy.
References
External links Member list