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Strategies to Reduce Sodium Intake in the United States (2010)
Food and Nutrition Board (FNB)

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. "6 The Food Environment: Key to Formulating Strategies for Change in Sodium Intake." Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press, 2010.

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Strategies to Reduce Sodium Intake in the United States

of a priority than trans fat elimination, saturated fat reduction, the addition of whole grains, the use of more fresh fruit and vegetables, and perhaps even other challenges, such as portion sizes and the perceived overreliance on sales of soda and other sugary beverages.38

LARGE-SCALE GOVERNMENT FOOD PROCUREMENT AND FOOD ASSISTANCE PROGRAMS

Federal government agencies as well as state and local governments are providers of food and should not be overlooked as part of the food environment. Various government programs procure food for their own restaurant/foodservice operations or provide assistance to allow others to do so. These programs range from food purchases for military operations to foods sold in vending machines in city parks. Because of the large scale of such operations, they warrant consideration in regard to strategies to reduce sodium intake.

As shown in Table 6-7, there are a number of federal programs that use government funds for the purchase of food (GAO, 2000).

The committee focused on four programs that reflect the spectrum of possibilities: a reimbursement program (the National School Lunch Program and School Breakfast Program), two assistance programs (the Supplemental Nutrition Assistance Program [SNAP] and the Special Supplemental Nutrition Program for Women, Infants, and Children [WIC]), and one direct procurement program (the military). Each federal program may have different abilities to institute sodium reduction efforts, given its purpose, operating constraints, and reach. It is notable that sodium intake has been a concern for some federal programs, and, as described below, limited efforts have been taken to reduce sodium in some programs.

National School Lunch Program and School Breakfast Program

Operating under the aegis of the Food and Nutrition Service of USDA, the National School Lunch Program and the School Breakfast Program provide meals for the nation’s children. The National School Lunch Program offers nutritious lunches in 99 percent of U.S. public schools and in 83 percent of private and public schools combined (Fox et al., 2004). The School Breakfast Program offers breakfasts in approximately 85 percent of public schools that offer the National School Lunch Program (Gordon and Fox, 2007). In fiscal year (FY) 2009, an average of 31.2 million schoolchildren participated in the National School Lunch Program on each school day,

38

Personal communication, G. Drescher, Culinary Institute of America, St. Helena, CA, November 2009.

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184
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)