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

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. "8 Committee's Considerations and Basis for Recommendations." 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

focus for front-of-package labeling is often calories, but other substances including sodium are also considered candidates for such labeling. To the extent that the discussion is expanded to other nutrients, it would be appropriate to include sodium. Should research show that information about sodium can be incorporated into front-of-package labeling to the benefit of consumers, it would be worthwhile to provide this added tool to help consumers reduce their sodium intake.

Daily Value for Sodium

Another aspect of the Nutrition Facts panel worthy of attention is the Daily Value (DV) for sodium as described in Chapter 7. FDA has asked whether the DV for sodium should be updated based on a reference value of adequacy as opposed to a reference value of safety (HHS/FDA, 2007). The committee considered the following:

  • The purpose of the DV declaration is to help consumers set the contribution of the nutrient in a serving of that particular food within the context of a total daily diet.

  • The DV generally is:

    • based on a reference value of adequacy when the nutrient is an essential nutrient; and

    • based on a reference value of safety when the nutrient is nonessential (e.g., saturated fat and cholesterol).

  • Despite the fact that sodium meets all scientific criteria as an essential nutrient, a reference value of safety instead of a reference value of adequacy was used for sodium in 1993 because there was no available reference value for adequacy at the time.

  • In 2005, a reference value of adequacy was established for sodium, known as the Adequate Intake (AI).

  • Use of the AI could better inform consumers of the actual contribution of sodium content to total sodium needs as an essential nutrient and avoid misleading consumers into thinking that the sodium content of foods is more favorable than is actually the case.

    • As discussed in Chapter 2, consumers think that their sodium intake is better than it actually is, and intake has not decreased in association with current nutrition labeling. This indirect evidence supports the use of the AI; however, studies that provide direct evidence are needed.

The basis for the DV for sodium should be the AI. Given a 2005 report from the Institute of Medicine that has now identified a reference value of adequacy for sodium intake (i.e., the AI) (IOM, 2005), this reference value

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269
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)