Most sodium we take in doesn't come from the salt shaker but in processed foods and restaurant meals. (Julia Kilpatrick/CBC)

The idea of regulating food companies to get them to gradually reduce the amount of salt added to foods is on the U.S. Food and Drug Administration's table.

The FDA responded to a call Tuesday from the Institute of Medicine, an independent organization that advises the U.S. government. An institute panel advised the move was needed to help Americans cut their high sodium intake, which can lead to high blood pressure, kidney failure and strokes.

Voluntary reductions by food makers haven't gone far enough, the institute said.

The FDA hasn't decided whether to regulate sodium levels, but "no options are off the table," said spokeswoman Meghan Scott.

"A lot would have to be done before any decision is made to regulate sodium levels," she said, adding there's little debate any longer over the impact sodium has.

The expert panel said companies should be allowed to reduce sodium in foods gradually to avoid turning off consumers with a major change in flavour.

Reduce salt in food supply

"For 40 years, we have known about the relationship between sodium and the development of hypertension and other life-threatening diseases, but we have had virtually no success in cutting back the salt in our diets," Jane Henney, of the University of Cincinnati College of Medicine in Ohio, who chaired the Institute of Medicine panel, said in a statement.

"The best way to accomplish this is to provide companies the level playing field they need so they are able to work across the board to reduce salt in the food supply."

It is important to get started on the gradual reduction but it will "probably take years to accomplish," Henney said.

Last fall, Health Canada's sodium working group, comprised of government and industry representatives, agreed to an interim goal of reducing sodium in the Canadian diet to 2,300 mg per person per day by 2016.

The goal is based on reducing the amount of sodium consumed by Canadians by five per cent each year.

The Heart and Stroke Foundation suggests Canadian adults consume no more than five millilitres of salt (2,300 milligrams of sodium or a teaspoon of salt) per day. However, most adults consume far more than that — a little more than 3,000 milligrams on average.

The U.S. Center for Science in the Public Interest executive director Michael Jacobson called on food manufacturers and restaurant chains to step up their efforts at salt reduction, while the FDA and U.S. Department of Agriculture implement the institute's recommendations.

A representative from the Salt Institute disagreed with the U.S. institute's recommendations, saying a balanced diet is the best way to control blood pressure.

With files from The Associated Press and The Canadian Press