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.
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 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 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.
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 cautioned Tuesday 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 to be as 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 Thursday with the release of a three-year assessment of the FDA's program by the Pew Charitable Trusts.
As the number and variety of substances added to food in the United States has exploded, the agency's resources — as well as its regulatory powers under the 1958 Food Additives Amendment — have been overwhelmed.