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

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. "1 Introduction." 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

both processed food manufacturers and restaurant/foodservice operations. “Salt taste preference” is used to mean the preference for foods to which salt has been added. Terms used in this report are defined in the Glossary (Appendix A).

The committee began its work by reviewing the past and current major national public health initiatives and international efforts (see Appendix C) targeted to the reduction of sodium intake, and integrated summaries of the key outcomes so as to provide an overall but focused picture of the current situation. This effort, as presented in Chapter 2, along with considerations of the special nature of salt taste and flavor (Chapter 3), sets the stage for the committee’s more in-depth examination of factors important to recommending strategies to reduce sodium intake

Importantly, these long-standing public health activities have been oriented primarily toward affecting the behaviors of consumers through consumer education and motivating consumers to alter food behaviors. However, these initiatives included calls for supporting activities in the form of (1) efforts by members of the food industry to voluntarily reduce sodium in their products and (2) information about the sodium content of foods to be made available at the point of purchase. As a sequel to its initial consideration of past and current initiatives, the committee next examined the taste and flavor effects of salt, as well as the nature of salt taste and the preference for foods to which salt has been added, notably in the context of the high levels of salt in the food supply and the role that preference for foods to which salt has been added may play in impacting the success of strategies to reduce sodium intake. In this way, Chapters 2 and 3 served as stage-setting activities for the committee.

The committee next turned to an in-depth review of the data underlying the outcomes, as well as additional background information, reviewing the following topics: the nature of the roles of sodium in food beyond taste and flavor effects (Chapter 4); current estimates of sodium intake and characterization of dietary sources of sodium (Chapter 5); the food environment as it relates to the processed food and restaurant/foodservice industries and consumers (Chapter 6); and the regulatory environment and legal provisions that pertain to the addition of salt to foods and related labeling information (Chapter 7). The committee also considered international experiences related to the reduction of sodium intake, compiled in Appendix C.

This information allowed the committee to fully consider the lessons learned and provided a basis upon which to consider relevant strategies (Chapter 8). The committee targeted this integrative discussion to focus first on the status quo and then on the potential for economic incentives, technological advances, and for leverages from large-scale government procurement and assistance programs. Regulatory options were considered as were potential roles for consumers. Recommendations are presented in

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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)