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Strategies to Reduce Sodium Intake in the United States
Current Dietary Reference Intake (DRI) Components
Estimated Average Requirement (EAR): Reflects the estimated median requirement.
Recommended Dietary Allowance (RDA): Derived from the EAR; covers the requirements for 97 percent of the population.
Adequate Intake (AI): Used when an EAR or RDA cannot be developed; reflects an average intake level based on observed or experimental intakes or on other scientific judgments.
Tolerable Upper Intake Level (UL): Highest average intake that is likely to pose no risk.
A DRI reference value was established for sodium for the first time in 2005. The sodium reference value is now established as an AI of 1,500 mg (approximately, varying somewhat by age group) and a Tolerable Upper Intake Level (UL) of 2,300 mg (approximately, varying somewhat by age group) (IOM, 2005).26
FDA is in the process of preparing to update all DVs based on the 1997–2005 IOM effort to establish DRIs and has issued an Announcement of Proposed Rulemaking (HHS/FDA, 2007). In that announcement the agency asked the following question: “Should the Daily Reference Value (DRV) [note: basis for the DV for sodium] be based on the UL (2,300 mg/d) as suggested by the 2005 Dietary Guidelines for Americans or should it be based on the AI (1,500 mg/d using the population-coverage approach)?”
If the DV were changed to the lower AI value from the current value, which is closer to the current UL, the quantitative amount of a nutrient (500 mg, for example) per serving for a particular food would still be listed in the Nutrition Facts panel and would not change as a result of the DV change. However, the percentage of the DV as listed would change. Currently, if there were 500 mg of sodium in a serving, the label would reflect that a serving of the food contains about 20 percent of the DV, while an updated DV of 1,500 mg would result in the label indicating that a serv-
Unlike AIs for other nutrients intended to reflect observed intake, the AI for sodium was set at a value that ensures that the overall diet would provide an adequate intake of important nutrients (that is, setting the reference value closer to the body’s functional requirement for sodium would be too restrictive given today’s food supply and preclude meeting other nutritional needs) and also covers sodium sweat losses in unacclimated individuals who are exposed to high temperatures or who become physically active (IOM, 2005).