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

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. "7 The Regulatory Framework: A Powerful and Adaptable Tool for Sodium Intake Reduction." 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

so-called nutrient content claims and health claims on their food labels. In doing so, the NLEA gave FDA the mandate and authority to protect consumers from misleading nutrition claims and to help consumers make more healthful food choices through better access to credible nutrition information. The NLEA was also intended, in part, to establish a level playing field for nutrition information, presumably decreasing both the need and the opportunity for marketing “hype.” Additionally, by providing the opportunity to make positive claims about their products, it sought to encourage manufacturers to formulate foods with improved nutrient profiles, such as foods lower in sodium or saturated fat (Taylor and Wilkening, 2008b). It strengthened FDA’s authority to ensure truthful and non-misleading nutrition information on foods. The NLEA focused on information needed by the general population to follow general dietary recommendations. The result was the Nutrition Facts panel, established in 1993 and now found on most packaged foods, as well as the establishment of a framework for making nutrient-related claims and health claims.

Thus, the NLEA was directed to the labeling of foods, primarily packaged foods, regulated by FDA. In addition, FDA established a voluntary labeling program for raw fruits, vegetables, and fish.17 However, the NLEA exempted nutrition labeling for restaurant foods as well as packaged foods products sold only to restaurant/foodservice operations.18 Despite the exemption, and in light of the growing proportion of American meals consumed outside the home, FDA has sought to enlist the assistance and support of restaurants in addressing national obesity concerns by urging them to provide point-of-purchase nutrition information to consumers (HHS/FDA, 2004). As signed into law in March 2010, the Patient Protection and Affordable Care Act19 contains provisions to address nutrition labeling of menu items. Restaurants with 20 or more outlets are required to post calories on menus, menu boards (including drive-thrus) and food display tags, with additional information (fat, saturated fat, carbohydrates, sodium, protein and fiber) available in writing upon request.

Further, the NLEA did not address advertising, which is under the authority of the Federal Trade Commission, nor did it cover foods regulated by USDA, which are primarily meat and poultry products. However, USDA voluntarily put in place nutrition labeling regulations consistent with those adopted by FDA.20 USDA has in place guidelines for the voluntary nutrition labeling of single-ingredient, raw products and ground or chopped meat and

17

21 CFR 101.45.

18

21 CFR 101.9(j)(2)(ii),(iv).

19

Patient Protection and Affordable Care Act, HR 3590, Title IV, Subtitle C, §4205; 111th Congress, 2nd session, March 2010.

20

USDA, 1993; 9 CFR 317.300.

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224
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)