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

Citation Manager

. "9 Recommended Strategies to Reduce Sodium Intake and to Monitor Their Effectiveness." 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

Supporting strategies target a range of stakeholders and serve to underpin and augment the primary strategies. Strategies related to monitoring and surveillance are also included so that essential data about sodium intake, salt taste preference, related consumer knowledge and attitudes, and the sodium content of the food supply are available.

PRIMARY STRATEGIES

RECOMMENDATION 1: The Food and Drug Administration (FDA) should expeditiously initiate a process to set mandatory national standards for the sodium content of foods.


Strategy 1.1 FDA should modify the generally recognized as safe (GRAS) status of salt added to processed foods in order to reduce the salt content of the food supply in a stepwise manner.

FDA should expeditiously undertake regulatory activities to establish conditions of use for salt in processed food to assist in achieving population intakes of sodium that are consistent with the Dietary Guidelines for Americans. The justification for modifying the GRAS status of salt is based on changes in the body of evidence for the health effects of salt that have emerged since it was first recognized as GRAS in 1959.

Reductions in the levels of salt added to foods under the modified GRAS provisions should be accomplished in a stepwise manner to allow time for adaptation of consumer taste preference for salt added to foods and for industry to deal with technical challenges. Moreover, specific and extensive ongoing monitoring is needed to further inform the stepwise process. Implementation of new provisions for the GRAS status of salt should include initial analysis and data gathering by FDA in collaboration with stakeholders. The decisions made should be transparent and science-based. The available array of options for implementation should be considered; special labeling/disclosure statements or informational labeling regarding sodium content, if appropriate, should be incorporated into the implementation process.

Strategy 1.2 FDA should likewise extend its stepwise application of the GRAS modification, adjusted as necessary, to encompass salt added to menu items offered by restaurant/foodservice operations that are sufficiently standardized so as to allow practical implementation.

The significant contribution to sodium intake made by restaurant/foodservice menu items warrants targeted attention to this sector of the food supply. The strategy is based on the application of the Federal Food,

Page
286
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)