If a new food additive had the same effects as salt, promoting high blood pressure in a large fraction of the population, it is doubtful the additive would be approved by the Food and Drug Administration (FDA). Yet, the official status of salt in federal regulations is "GRAS" or "Generally Recognized as Safe" -- a broad category that includes food ingredients such as vinegar that were grandfathered at the time that modern regulation of food additives began.
Nobody seems to know the right way to regulate salt. Strict regulation as a food additive raises concerns about Orwellian government overreach. Doing nothing leads to thousands of deaths from stroke and heart disease each year. Consumer education is a weak response, because most salt in the diet comes from processed and restaurant food, not salt from shakers. The American Medical Association recommends warning labels.
An Institute of Medicine (IOM) committee of experts is preparing a new report on Strategies to Reduce Sodium Intake. The three presentations from federal agencies at the committee's first meeting were very different in tone, ranging from ambitious to nearly complacent. The next open meeting of the IOM committee, on March 30 in Washington, DC, will be an important venue for policy debate about salt and sodium.