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Strategies to Reduce Sodium Intake in the United States
This comment is consistent with the Food and Drug Administration (FDA) action to suspend the planned decrease in the levels of sodium per serving that a food product must have to bear the claim “healthy” (HHS/FDA, 2005).
In sum, food industry representatives report challenges associated with marketing products with substantially lower sodium—and hence a less acceptable taste profile—compared to competitors’ products. It is known that food taste is an important determinant of food choice, and to alter salt taste preferences will likely require a level playing field approach in which salt reductions are made across the food supply. Luft et al. (1997) offered the following observation:
The food industry has made a genuine effort to introduce low-salt food products; however, the public has not been willing to purchase the products and many have been withdrawn because they could not be sold (C.S. Khoo, personal communication, 1994). Pietinen et al. (1984) also observed that during their intervention (in Finland), low-salt bread, margarine, sausage, and mineral water were available. However, by the end of the study, only the mineral water and the margarine were selling well and were still available. Thus, the conclusion that compliance to a low-salt diet is difficult solely because of an uncooperative and nefarious food industry is overstated and not supported by the evidence. Public tastes continue to dictate the marketplace.
Given the need for food products to be “palatably competitive,” the food industry lacks a level playing field for reduction of sodium in foods.
In view of these findings, the evidence presented in Chapter 3 regarding salt taste provides a foundation for identifying strategies to reduce sodium intake. An important consideration is that while the preference for salt taste, if not addressed, will be a barrier to success in lowering the sodium content of the food supply, salt taste preference is mutable and can be lowered. The preference for salt beyond physiological need may be due to evolutionary pressures to consume salt that have shaped an innate liking for its taste, or, alternatively and perhaps concomitantly, be due to learning, particularly early learning. Continued exposure to high levels of salt in the food supply likely reinforces the preference for a higher level of intake. Kumanyika (1991) noted that the environment promotes adaptation to a higher salt preference, even for individuals who prefer a low sodium dietary pattern, because it is difficult for them to sustain avoidance of inadvertent consumption of foods with high amounts of added salt.
Existing experience with lowering the taste preference for salt (Engstrom