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

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. "8 Committee's Considerations and Basis for Recommendations." 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

The need for changes in the food supply is not a conclusion unique to this committee, nor are the challenges associated with consuming a low-sodium diet, given the general nature of the food supply as experienced by the average American. Rather, as documented in Chapter 2, the major public health initiatives beginning in 1969 called on the food industry to reduce the sodium content of foods. Table 8-1 lists some examples of related comments from study authors.

Despite long-standing efforts by government, public health groups, and food industry leaders to encourage reformulation of foods to lower-sodium content and thus reduce sodium in the food supply, the U.S. food supply remains high in sodium as described in Chapter 2. Between 1984 and 2004, the sodium content of a number of McDonald’s products was reduced by an average of 9 percent; the content of a number of Quaker products was reduced by an average of 23 percent; and the amount of sodium in 13 Campbell’s soup products declined by an average of 10 percent (CSPI, 2005). A tracking survey of a relatively small sample of foods carried out by a public interest group beginning in 1983, indicates that of the 69 products still marketed in 2004, the average sodium content

TABLE 8-1 Examples of Comments Concerning the Need for Change in the Food Supply

Reference

Comment

Fodor et al., 2009a

“The DASH [Dietary Approaches to Stop Hypertension] diet was successful as long as food was provided to the study participants … as soon as the respondents had to take care of their diet themselves … the beneficial effects of this diet diminished or disappeared.”

Kumanyika et al., 2005b

“Sodium reduction sufficient to favorably influence the population blood pressure distribution will be difficult to achieve without food supply changes.”

Loria et al., 2001

“[In the context] of the overwhelming lack of adherence to dietary sodium guidelines … [there is a] need for a multifaceted approach….”

Cleveland et al., 1993c

“The results [of the study] document the advantage of a change in the food supply—toward convenience foods with less sodium.”

aCopyright © 2009 Journal of Clinical Hypertension. Reproduced with permission from John Wiley & Sons.

bReprinted by permission from Macmillan Publishers Ltd: Journal of Human Hypertension 19(1):33–45, Copyright © 2005.

cReprinted from Journal of the American Dietetic Association, 93(5), Cleveland et al., Method for identifying differences between existing food intake patterns and patterns that meet nutrition recommendations, pp. 556–560, Copyright © 1993, with permission from Elsevier.

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237
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)