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Strategies to Reduce Sodium Intake in the United States
to educate consumers, a side benefit may be efforts by manufacturers to reformulate foods in order to achieve a higher rating.27
Front-of-package and shelf tag scoring systems vary in their thresholds and scoring methods for the content of sodium and other nutrients, which has created debate within the nutrition community as to whether the nutrient criteria are adequate. There have also been questions about the effectiveness of these programs in helping consumers make positive dietary changes. As a result, FDA recently announced steps to address the use of front-of-package and shelf label claims concerning the nutritional quality of a food.28
It is clear that food manufacturers and retailers have taken some steps to help the American public reduce sodium intake; however, such efforts have been limited. Not all companies have dedicated resources to this concern, and the intensity of sodium reduction efforts appears to have fluctuated over time.
PRODUCTION AND DELIVERY OF RESTAURANT/FOODSERVICE FOODS WITHIN THE FOOD ENVIRONMENT
Characteristics of the Restaurant/Foodservice Industry
The restaurant/foodservice industry plays a major role in providing food to the U.S. population. As described in Chapter 5, the amount of food eaten away from home has grown in recent years and now accounts for 48.5 percent of total food expenditures29 in the United States and one-third of the calories consumed by Americans (Lin et al., 1999). Estimates from the National Restaurant Association indicate that in 2009, more than 130 million Americans per day consumed restaurant/foodservice items from 945,000 restaurant/foodservice locations throughout the country.30
The U.S. Department of Agriculture (USDA) defines foodservice as the dispensing of prepared meals and snacks intended for on-premise or immediate consumption (Harris et al., 2002). The committee considers this definition to include “take-out foods” that are consumed in the home or another location outside the restaurant/foodservice establishment and to