a concern relevant only to persons who (1) are “salt sensitive,” (2) have hypertension, or (3) are middle-aged or elderly. The adverse effects of sodium occur at all stages of the lifespan, and a lower sodium intake is a public health goal for every segment of the population (see Chapter 1). Second, consumers must be more cognizant that sodium is present in a broad range of foods, not only those that taste salty or contain visible salt. In the absence of this understanding, consumers misinterpret the effectiveness of their food choices in avoiding sodium. Evidence presented in Chapter 2 reveals that in one survey approximately three-quarters of persons exceeding the recommended intake believed that their intake was “about right.” This is, of course, in marked contrast to current estimates showing that virtually all persons exceed the recommended intake level. In the absence of a simple clinical measure for sodium similar to the serum measures used for cholesterol determinations, a know-your-number campaign is not possible. However, it does provide a segue into the third concern, which is developing better label-reading skills among consumers so that the sodium values of foods are understood and used to choose foods comprising a healthful diet. For example, many consumers may believe that if they avoid foods that are considered to be “salty” (i.e., potato chips, popcorn, and pretzels), they will reduce their sodium intake. In actuality, these foods only contribute about three percent of sodium to the diet, where as meats and grains contribute approximately 16 and 11 percent, respectively (NHANES 2003–2006; also see Chapter 5). This is especially important because the goal is not a diet free of sodium—as may be the case for a substance such as trans fat produced through partial hydration of vegetable oil—but rather that consumers avoid excessive intake while achieving a nutritionally adequate diet.
The development of appropriate messages will require an extensive breadth of expertise and related research. Attention will be needed to ensure that messages are consistent in describing the risks of excess sodium intake and actions consumers can take to modify their sodium consumption (see Recommendation 4). The consistency of these messages will hopefully help to prevent consumer misunderstanding about whom should be concerned about sodium and the best methods for reducing intake. While messages should be consistent, tailoring messages to the behaviors and interests of specific cultural groups and dispersing these messages through communication channels that are known to reach specific groups may also be beneficial.
It is likely that the focus of coordinated messaging should extend beyond developing specific messages for sodium by integrating the issues important for sodium intake reduction into existing, broad messages about diet and