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messages on social media networks; and working group reports. NHLBI also produces materials for physicians to help them guide patients to more healthful lifestyles, another critical area of focus (NHLBI, 2004).

Further, although there is evidence that health professionals and their associations support initiatives to reduce sodium intake, there is less evidence that physicians actively incorporate sodium intake awareness as part of primary care. Health-care professionals, including physicians, need to counsel patients about the health risks associated with high sodium intake and how to reduce sodium intake (Mohan et al., 2009). Therefore, it is necessary to incorporate sodium reduction strategies and their importance to reducing the risk of chronic disease into health professional training curricula and standards of care (WHO, 2007).

The U.S. Centers for Disease Control and Prevention (CDC) supports state efforts to enable public health changes, including efforts to address high blood pressure as a cardiovascular risk. Under the State Heart Disease and Stroke Prevention Program, CDC funds health departments in 41 states and Washington, DC, to plan, monitor, and sustain population-based interventions that address cardiovascular disease (CVD) and related risk factors.11 The strategies focus on a specific population or geographic area. Of the broad activities that states are funded to carry out, several could incorporate sodium strategies. These programs include developing and updating state plans for CVD prevention, assessing existing population strategies for CVD prevention, emphasizing policies to create heart-healthy environments, increasing adherence to guidelines related to hypertension, increasing awareness and education about risk factors and lifestyle changes, and implementing and evaluating community interventions to promote cardiovascular health. In fact, a recent IOM committee (IOM, 2010) recommended that CDC’s Division of Heart Disease and Stroke Prevention take active leadership in convening other partners in the federal, state, and local government, and industry, to advocate for and implement strategies to reduce sodium in the American diet. That committee also recommended that all state and local public health jurisdictions immediately begin to consider developing a portfolio of dietary sodium reduction strategies that make the most sense for early action in their jurisdictions. The committee report also concluded that because some evidence indicates that taste preferences develop early and excess sodium intake is a problem across the lifespan, early education may be key to reducing intake in future generations. It points out that such programs may also be critical for reaching groups, such as adolescent males, that have some of the highest sodium intakes.

Finally, the question of the role of food product advertising in a set

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Available online: http://www.cdc.gov/DHDSP/state_program/index.htm (accessed October 27, 2009).



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