Strategies to Reduce Sodium Intake in the United States

TABLE 5-5 Mean 1-Day Sodium Intake (mg/d; SE) from Foods^a by Age and Gender

	NHANES I 1971–1974	NHANES II 1976–1980	NHANES III 1988–1994	NHANES 1999–2000	NHANES 2003–2006^b^,^c
Both Sexes
1–2 years	1,631 (38)	1,828 (31)	1,983 (29)	2,148 (69)	1,929 (26)
3–5 years	1,925 (32)	2,173 (27)	2,594 (47)	2,527 (84)	2,483 (34)
6–11 years	2,393 (38)	2,716 (34)	3,164 (67)	3,255 (125)	3,119 (30)
Males
12–15 years	2,923 (75)	3,405 (85)	4,240 (158)	3,858 (171)	3,947 (69)
16–19 years	3,219 (97)	4,030 (92)	4,904 (138)	4,415 (206)	4,367 (67)
20–39 years	3,043 (64)	3,760 (59)	4,680 (68)	4,334 (103)	4,558 (58)
40–59 years	2,681(57)	3,413 (79)	4,177 (88)	4,132 (112)	4,119 (52)
60–74 years	2,318 (46)	2,934 (34)	3,513 (82)	3,557 (110)	3,487 (52)
20–74^c years	2,780 (40)	3,486 (45)	4,288 (53)	4,127 (74)	4,300 (34)
Females
12–15 years	2,094 (49)	2,567 (49)	3,200 (127)	3,034 (123)	2,952 (45)
16–19 years	1,812 (60)	2,336 (58)	3,160 (91)	3,048 (95)	2,995 (45)
20–39 years	1,883 (26)	2,383 (40)	3,167 (53)	3,161 (75)	3,136 (35)
40–59 years	1,754 (25)	2,256 (37)	2,852 (52)	2,978 (87)	2,932 (38)
60–74 years	1,529 (34)	2,053 (29)	2,543 (53)	2,633 (79)	2,628 (38)
20–74^c years	1,774 (17)	2,278 (27)	2,939 (34)	3,002 (62)	3,003 (22)
NOTE: d = day; mg = milligram; NHANES = National Health and Nutrition Examination Survey; SE = standard error. ^aIncludes salt used in cooking and food preparation, but not salt added to food at the table. ^bEstimated on basis of 1-day intake in order to be consistent with earlier surveys. ^cAge-adjusted to the 2000 Census. SOURCES: Briefel and Johnson (2004) for 1971–2000 data (reproduced with permission of Annual Reviews, Inc. from “Secular trends in dietary intake in the United States,” Vol 24; permission conveyed through Copyright Clearance Center, Inc.); NHANES for 2003–2006 data.

NHANES beginning in 1971–1974 (see Table 5-6). More detailed information can be found on NHANES 2003–2006 in Appendix F (Table F-4).

The differences in sodium intake that are observed among children and adult men and women disappear to a large degree when expressed as measures of sodium intake density. This suggests that on a calorie-per-calorie basis, age and gender subgroups within the U.S. population are taking in equivalent amounts of sodium and larger intake among men, for example, when compared to women is primarily a function of consuming more food, not different foods. Further, the difference in measures of sodium intake density for virtually all population groups between 1971–1974 and 2003–2006 also suggest that foods, as consumed, may have had an increase in the amount of sodium on a per 1,000 calories basis during this time period. As

Table of Contents

Front Matter R1-R12

Summary 1-16

1 Introduction 17-28

2 Sodium Intake Reduction: An Important But Elusive Public Health Goal 29-66

3 Taste and Flavor Roles of Sodium in Foods: A Unique Challenge to Reducing Sodium Intake 67-90

4 Preservation and Physical Property Roles of Sodium in Foods 91-118

5 Sodium Intake Estimates for 2003–2006 and Description of Dietary Sources 119-152

6 The Food Environment: Key to Formulating Strategies for Change in Sodium Intake 153-212

7 The Regulatory Framework: A Powerful and Adaptable Tool for Sodium Intake Reduction 213-234

8 Committee's Considerations and Basis for Recommendations 235-284

9 Recommended Strategies to Reduce Sodium Intake and to Monitor Their Effectiveness 285-296

10 Next Steps 297-316

Committee Member Biographical Sketches 317-324

Appendix A: Acronyms, Abbreviations, and Glossary 325-334

Appendix B: Government Initiatives and Past Recommendations of the National Academies, the World Health Organization, and Other Health Professional Organizations 335-356

Appendix C: International Efforts to Reduce Sodium Consumption 357-404

Appendix D: Salt Substitutes and Enhancers 405-408

Appendix E: Background on the National Health and Nutrition Examination Surveys and Data Analysis Methods 409-416

Appendix F: Sodium Intake Tables 417-442

Appendix G: National Salt Reduction Initiative Coordinated by the New York City Health Department 443-452

Appendix H: Federal Rulemaking Process 453-456

Appendix I: Nutrition Facts Panel 457-458

Appendix J: State and Local Sodium Labeling Initiatives 459-466

Appendix K: Approach to Linking Universal Product Code (UPC) Sales Data to the Nutrition Facts Panel 467-468

Appendix L: Public Information-Gathering Workshop Agenda 469-472

Index 473-494