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seminated relevant information to consumers as well as health professionals and other stakeholders. The activities generally focused on informing consumers about the health consequences of high sodium intake and included attempts to motivate consumers to make changes. Efforts to put in place point-of-purchase information about the sodium content of foods and to encourage the food industry to voluntarily reduce the sodium content of foods were included as adjunct activities to assist consumers. Given that sodium intake estimates from national surveys beginning in 1971 have not shown a decline, and suggest that sodium intake has increased, the goal has not been achieved.

Despite 40 years of efforts to reduce sodium intake in the United States, intakes remain much higher than recommended levels.

The committee first considered the possibility that the failure to reduce intake was due to basic flaws or inadequate implementation of the efforts to educate and motivate consumers. Although it is likely there is room for improvement in these consumer-based initiatives, the explanation appears to rest with the nature of the public health problem itself. In the case of sodium intake reduction, at least two factors limit the success of efforts based on consumer education and motivation alone.

  1. Many of the foods consumed by Americans—from breads to entire meals—are processed in ways that include the addition of salt and contribute significant amounts of sodium to the diet. Sodium is relatively ubiquitous in the food supply, and it is challenging for the average consumer to avoid consuming sodium.

  2. Americans have become accustomed to high-salt taste preference. When coupled with consumer surveys indicating that taste is a primary influence on food selection and consumption, often overriding other reasons such as health motivations and even cost, this acquired taste preference warrants special attention. Further, because a high-salt diet may actually enhance the liking of salty foods, the U.S. food supply—which is high in added salt—may work against consumers’ successfully lowering their taste preferences for salt and therefore handicap the acceptance of lower-sodium foods.

On balance, consumer-based initiatives without a concomitant change in the overall food supply and without considerations related to changing salt taste preference are likely to be inadequate to address the public health problem.

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