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Strategies to Reduce Sodium Intake in the United States
have little control over the nutrient content, including the sodium content, of the foods they purchase. Although they can substitute among prepared foods and select foods with lower sodium content, they may lack the information or knowledge to do so. Prepared foods have nutrition labels stating sodium content, but the set of choices may all have relatively high levels of sodium. In addition, away-from-home meals are rarely labeled with sodium content, so individuals can only infer sodium content based on the type of food. Thus, as households have allocated less time to meal preparation in the home, they have ceded some degree of control over the foods they consume to food manufacturers and restaurant/foodservice operations.
It is also important to highlight the relationship between time allocation and changes in the food environment. As households have changed their allocation of time away from food preparation, the food environment has changed in response. Correspondingly, changes in the food environment have likely also facilitated changes in the way households allocate their time by reducing the time required to prepare foods and increasing the availability and ease of access to prepared foods and restaurant and other foodservice foods.
Between the 1970s and the 1980s the percentage of the household food dollar spent on food purchases away from home increased (Tippett et al., 1999). Total expenditures on food away from home increased within all racial/ethnic groups and at all income levels. Households with higher incomes spent more on food away from home than those with lower incomes. About one-third more Americans (57 percent total) ate away from home daily between 1994–1996 than between 1977–1978. The most likely age group to eat away from home were adolescent boys, whereas persons ages 60 years and older were the least likely. Sixty-five percent of persons with higher incomes ate away from home, while only 45 percent of those with lower incomes did so (Briefel and Johnson, 2004). Popular items consumed away from home include French-fried potatoes, sandwiches (especially burgers), lettuce salads (with salad dressings and other additions), pizza, and Mexican dishes—items that contain significant sodium. In 1994–1996 and 1998, 37 percent of adults and 42 percent of children consumed fast food. This was associated with significantly higher intake of sodium, energy, and fat, and significantly lower intake of fruits and vegetables (Paeratakul et al., 2003).
Consumption of larger portion sizes is common when foods are consumed away from home. National data from 1995 show that 34 percent of calories were consumed outside of the home, while only 27 percent of eating occasions took place away from home. This indicates that consumers either eat larger portions away from home or consume more energy-dense foods (Lin et al., 1999). Rolls (2003) found that consumers typically eat 30 to 50 percent more when offered large portions at restaurants. Continu-