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

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. "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

criteria for sodium in foods, including a revision to base the Daily Value (DV) for sodium on the Adequate Intake (AI).

The current provisions for nutrition labeling, related claims about sodium, and disclosure/disqualifying criteria for sodium on the labels of food products were established at a time when less was known about how consumers effectively interpret and use label information and about relevant technologies and potential unintended consequences related to reducing sodium levels in foods. Overall, the existing regulatory provisions would benefit from review and updating as appropriate in order to provide useful information to consumers and to enhance the food industry’s motivation to reformulate foods relative to sodium content. It is anticipated that such activities would be undertaken through notice-and-comment rulemaking in a timely fashion. USDA should move forward with proposed nutrition labeling regulations for single-ingredient, raw meat and poultry to ensure that the sodium content—as would be relevant in the case of meat and poultry enhanced with sodium solutions—is made known to consumers. Similarly, FDA should review its approach to seafood labeling. Further, given a 2005 report from the Institute of Medicine that identifies an AI for sodium—a reference value that had not been established at the time the current regulations for nutrition labeling were finalized—the AI should serve as the basis for the Daily Value for sodium, a component of the Nutrition Facts panel on foods. The AI, from the perspective of public health, provides a truer picture for the consumer of the contribution of the particular food in assembling a healthful diet and is preferable to use of the Tolerable Upper Intake Level (UL). To avoid unintended consequences and disincentives to the food industry given this recommendation, the basis for claims related to “low sodium” and “very low sodium” is worthy of review.

Strategy 3.2 FDA should extend provisions for sodium content and health claims to restaurant/foodservice menu items and adjust the provisions as needed for use within each sector.

The Nutrition Labeling and Education Act established a framework for providing information about the nutrient content of packaged foods, but its provisions for nutrient-related food label claims were not specifically limited to packaged foods. However, in implementing the act, FDA limited its claims regulations to packaged foods. FDA should now undertake activities to provide for sodium content claims (e.g., low sodium, reduced sodium) and related health claims (e.g., “diets low in sodium are associated with a low prevalence of hypertension”) on menu items offered by restaurant/food-service operations that are sufficiently standardized for implementation to be practically accomplished. There will be a need for preliminary activities

Page
289
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)