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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