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salt content of key food categories to efforts to track progress toward the goal to government-sponsored awareness campaigns. Further, supermarkets and manufacturers are requested to voluntarily display front-of-package labeling of sodium and other nutrients using a traffic light color system. While a review of progress and the salt targets is planned for 2011,3 the UK government reported reductions in sodium intake among the general population from an average of 3,800 mg/d in 2000–2001 to 3,440 mg/d in 2008 based on urine analysis of approximately 700 adults (National Centre for Social Research, 2008). The latter estimate is in line with the current U.S. dietary estimates. The 2011 review is planned to include information about the costs of the program.

In 2007, the Canadian government launched a multistakeholder working group on sodium reduction. The group intends to work in stages and should shortly be issuing a strategic framework that is slated for implementation in 2010. In 2003, Ireland began its work with a program intended to raise the food industry’s awareness about the relationship between salt and health, and to work with the industry to voluntarily reduce sodium levels in foods. The Irish government reports that 72 companies have registered with the program, and reductions of approximately 20 percent in the sodium content of key foods such as breads and sausages have been reported. Similar to the situation in the United Kingdom, Irish intake estimates for sodium have been reported to be higher than U.S. estimates, but no recent national estimates subsequent to the implementation of the program are available. The French government released a report in 2002 that recommended a 20 percent reduction in sodium intake for its population and developed initiatives for consumers, the food/catering industry, and medical professions. To date, no significant changes have been reported in the salt content of processed foods or in the level of food labeling incorporated. Finally, the European Union has developed a so-called common framework approach to reducing salt intake among the populations of its member countries. The framework will focus on 12 categories of food identified as priorities.

No information on the cost effectiveness of these international strategies could be gleaned from the available data, although the United Kingdom plans to release information about the cost of its program in 2011.

Clearly, reducing sodium intake is a public health priority beyond the United States. The ability to directly relate existing reports from other countries to strategies that would be workable in the United States is somewhat difficult, given differences in food patterns, regulatory provisions, government resource capabilities, and consumers’ perspectives on the food supply as well as the perceived importance of reducing sodium intake. In particular,


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