As recently reported on Croakey, a New York City initiative to tackle salty foods has drawn admiration and longing from some public health campaigners in Australia.

Now our North American correspondent, Dr Lesley Russell, reports that the NYC Mayor, Michael Bloomberg, is gaining something of a reputation as a public health crusader. She writes:

“America is a great country, full of the most amazing contradictions, nowhere more so than in the area of health.  While conservatives rail about government interventions into health care and abortion opponents (often the same people) look to intervene even further in women’s reproductive choices, the Republican mayor of New York City, Michael Bloomberg, is busy turning his fiefdom into what some might call a mommy state and others a bastion of enlightened public health.

New York City’s smoking ban, which took effect in 2003, has resulted in the city’s lowest smoking rate on record (15.8%), with less than 1 million adult smokers in the city – 350,000 fewer than in 2002.  The ban means that cigarette and cigar puffers are driven outdoors.  But soon the outdoors – or at least much of it – may no longer be an option. The city’s health commissioner, Dr Thomas Farley, announced late last year that the Bloomberg administration will seek to ban smoking in city parks and beaches.

In December 2006, the city required that artery-clogging, artificial trans fats be phased out of restaurant food. By November 2008, the restriction was in full effect in all New York City restaurants and estimated restaurant use of artificial trans fat for frying, baking, or cooking or in spreads had decreased from 50% to less than 2%. Preliminary analyses suggest that replacement of artificial trans fat has resulted in products with more healthful fatty acid profiles. For example, in major restaurant chains, total saturated fat plus trans fat in French fries has decreased by more than 50%.

Meanwhile however New York City residents are growing obese at a rate nearly three times that of other Americans, prompting some to cite a link between weight gain and smoking cessation, and to question whether the city’s crackdown on smoking may have had an unexpected result.

To combat obesity, Mayor Bloomberg has successfully implemented calorie labeling on restaurant menus, and proposed a tax on sugary soft drinks.

Now this crusader for healthy living, who has just begun his third term, wants to protect people from another health scourge: salt.

On January 11, the National Salt Initiative, a New York City-led a partnership between states, municipalities and national health organizations, shook up the food service and packaged goods industries with an ambitious, but voluntary, salt reduction plan.

The initiative has developed two- and four-year targets to reduce salt levels in 86 categories of packaged goods and restaurant food, putting the onus on the food industry rather than the consumer. The foods range from canned chili and barbecue sauce to breaded seafood and burritos.

The proposed four-year targets, which include sodium reductions of up to roughly 35 percent for classes of packaged foods and up to around 25 percent for restaurant categories, were the result of a year-long series of meetings with food industry leaders. Targets are posted here, and the food industry, consumer organizations and other interested parties have until February 1 to comment. The initiative will adopt final targets in the (northern hemisphere) spring.

According to the New York City Department of Health and Mental Hygiene, only 11 percent of Americans’ sodium intake comes from their own saltshakers, while close to 80 percent comes from foods in which high levels of sodium already exist before purchase.  Every year 23,000 New Yorkers and more than 800,000 Americans lose their lives to sodium-related health risks like high blood pressure, heart disease and stroke.

Because of the voluntary nature of the reductions, and the fact that industry insiders were included in the planning, the New York State Restaurant Association is applauding the initiative.  Some national food companies also appear to be ready to embrace the city’s salt reduction goals.

Interestingly, a recent Wall Street Journal article outlined how some food makers have been gradually reducing the salt in some of their most popular items, while not making a big fuss about it on the label.  However, despite these individual efforts, overall there has been little change in the average number of milligrams of salt per pound in packaged food sold in the US over the past 18 years.”

• Dr Lesley Russell is the Menzies Foundation Fellow at the Menzies  Center for Health Policy, University of Sydney/ Australian National  University and a Research Associate at the US Studies Centre, University of Sydney.  She is currently a Visiting Fellow at the Center for American Progress in Washington DC.

The question on Croakey’s lips is: what will Bloomberg and his team do next?

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