Cardiovascular disease (CVD) – coronary heart disease and stroke – is the leading cause of death in the United States. The federal government’s response to that health crisis is disappointing and, despite that enormous toll, nonprofit groups have not been pressuring government to invest in non-medical approaches to prevent and treat CVD.

In 2004, the Center for Science in Public Assistance (CSPI) with CECHE support stepped into that vacuum and is working with CVD experts to advocate policy changes to reduce CVD. Our first efforts have been to pursue a ban of trans fat – a metabolic poison – in the American food supply and to press for a reduction in the level of sodium in prepared and processed foods. These two measures alone could save 150,000 lives from CVD. The following provides an update on our progress in 2005.


A 10-year effort by CSPI culminated in 2003 when the Food and Drug Administration (FDA) announced it will require labeling of artery-clogging trans fat on Nutrition Facts labels by January 2006. While that is a step in the right direction, the project is pressing for a full ban of trans fat. The project accomplished the following during 2005:

  • Petitioned the FDA to limit trans fat to 2 percent of the fat content of foods, which is tantamount to a ban on partially hydrogenated vegetable oils (PHVO).
  • Issued “Trans Fats – Going…Going” – a report that details the findings of its survey on trans fat amounts in popular foods and industry’s efforts to replace them with more salubrious oils. Chain restaurants lag behind as they are exempt from the new rule. A New York Newsday article December 5, 2005, used data extensively from the report.
  • While the FDA ponders the petition, CSPI has kept the pressure on the food and restaurant industries to voluntarily switch to liquid oils like canola, soy, and corn, and using as little butter, palm, and coconut oil as possible. The effort is proving to be effective. To date, Frito-Lay has stopped using PHVO in most of its products; Kraft has announced its intentions to reduce levels of trans fat in its products; and smaller companies have announced similar intentions. Even Crisco now comes in a trans-free version.
  • Launched an interactive web site www.transfreeamerica.com , the hub of CSPI’s campaign to eliminate trans fat from the American food supply. The site serves as a valuable resource on the nature and harms of trans fat and encourages visitors to join CSPI’s petition drive and e-activism campaign.
  • Petitioned the FDA to require restaurants to disclose which offerings contain trans fat. Most notable change to date is Ruby Tuesday’s decision to fry foods in canola oil instead of PHVO.
  • Reached out to the media such as The New York Times, USA Today and others to bring information to consumers on the lifesaving benefit of that new labeling requirement.
  • Tested frying oils used in about 20 leading hospitals and several government agencies. We expect the results to be great fodder for further trans fat media coverage in early 2006.


Found in every kitchen, restaurant, and food-production facility in the country, salt may well be the most dangerous food ingredient of all. Eating too much salt raises blood pressure which increases the risk of heart attack and stroke. Beginning 25 years ago, CSPI pressured the FDA to require better labeling of sodium. But even with labeling now on all food packages, sodium consumption remains at a dangerously high level. This year, in an effort to press for a reduction in salt levels in the American food supply, the project undertook the following:

  • Released “Salt – the Forgotten Killer”, a report that identifies trends in sodium consumption, highlights some of the processed foods and restaurant meals that have the highest sodium content, and makes policy recommendations designed to reduce Americans' sodium intake. The goal of the report is to lay out the case for the need for government involvement to lower salt levels in processed foods.
  • Challenged the FDA for failure to set reasonable upper limits on the salt content of processed foods or require special labeling for sodium content. Despite estimates from health experts that halving sodium levels in processed foods would prevent about 150,000 unnecessary deaths annually, the FDA still designates salt as “Generally Recognized as Safe” and has done nothing to regulate it.
  • Petitioned the FDA to limit salt in processed food.
  • Released “Salt Assault” (see attachment 4) – a brand-name comparison of the salt content of popular processed food items. The report found that some manufacturers are recklessly loading up their products with two, three, or even four times as much salt as their competitors within a food category. The dramatic differences in sodium from brand to brand are proof positive that many companies could easily achieve significant reductions without sacrificing taste. The report served as the basis of a major Wall Street Journal article.
  • Met with several Members of Congress to try to get them to commission a General Accounting Office study of the FDA’s and the United States Department of Agriculture’s handling of salt over the past 25 years. The report would serve as a foundation for further regulatory or legislative action.

More recently, the partners have expanded their healthy hearts campaign through outreach to physician networks, pressing Congress to correct governmental failures to lower sodium content in foods, investigating labeling initiatives to support consumer interests, and assessing recommended diets by the nation’s leading heart disease prevention advocates.

Regarding trans fats, CSPI is enhancing its campaign to press the food industry to voluntarily switch to liquid oils like soy, canola and corn, and not to substitute butter, palm oil and other artery-clogging fats.   It is also generating congressional pressure to persuade the FDA to take regulatory actions to reduce trans-fat consumption, and is working at the city and state levels to limit amounts of trans fat in schools and government facilities.  (So far, the boards of health in New York City, Philadelphia, Brookline (MA), and Montgomery County (MD) have banned trans fat in restaurants, and other states and cities are considering similar measures).  

On the salt reduction front, CSPI’s July 2006 letter urging Health and Human Services Secretary Michael Leavitt to take specific steps to lower the salt content in foods was co-signed by 21 respected physicians and public health experts.  (That letter followed CSPI’s November 2005 petition to set ceilings on the amount of sodium in processed foods, to require a health warning on packaged salt, and to reduce the daily value for sodium.)

The partners work closely with World Action on Salt and Health, an international coalition of medical experts who have joined forces to launch a global campaign against salt.  CSPI also has enlisted the support of national professional associations, such as the American College of Cardiology, the American Public Health Association (APHA) and the National Medical Association (NMA).  And at CSPI’s urging, the American Medical Association passed a resolution emphasizing the need to achieve 50 percent sodium reductions for processed and restaurant foods and urging the FDA to revoke the “generally regarded as safe,” or GRAS status, of salt.

In July 2007, several health care organizations, including the APHA, NMA and the National Hypertension Association, co-signed a letter with CSPI to Rep. Frank Pallone (D-NJ), chairman of the Energy and Commerce Health Subcommittee, urging him to hold a hearing on salt reduction in the American diet.

Most recently, CSPI co-sponsored a major conference with the largest U.S. food-industry trade association.  At the meeting, health advocates and industry representatives explored ways to reduce sodium in packaged and prepared foods, and laid the groundwork for further efforts to reduce sodium and improve the healthfulness of the food supply.  Perhaps in response, a long-overdue hearing on sodium reduction was held by the FDA in November 2007.



In Focus, CECHE's new online publication, brings into focus lifestyle-related chronic diseases and environmental issues worldwide. It reaches health professionals and policy-makers in over 50 countries

Latest Issue | All Issues

MONITOR Quicklinks
- Latest Issue
- New Dietary Guidelines
- Global AIDS action
- Obesity Spreads
- WHO tackles epidemic
- Anti-Tobacco Forces
MONITOR Subscription subscribe




Questions? Comments? Concerns? E-mail CECHE at CECHE@comcast.net
CECHE LogoGo back to the CECHE home page