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Currently, collection and analysis of 24-hour urine provides the most accurate estimates of sodium intake and should be a component of national monitoring. Its inclusion in the national surveys will require pilot testing and innovative techniques. In addition, these surveys should continue to collect estimates of dietary sodium intake by multiple 24-hour recalls.

Strategy 5.3 CDC should, as a component of NHANES or another appropriate nationally representative survey, begin work immediately with NIH to develop an appropriate assessment tool for salt taste preference, obtain baseline measurements, and track salt taste preference over time.

Change in salt taste preference on a population basis is an important goal. However, salt taste preference has not been measured or tracked for the population. It is important to immediately initiate activities to develop and, in turn, incorporate these measurements into national surveys to establish baseline measures and to conduct ongoing monitoring.

Strategy 5.4 CDC in cooperation with other relevant HHS agencies, USDA, and the Federal Trade Commission should strengthen and expand its activities to measure population knowledge, attitudes, and behavior about sodium among consumers.

Monitoring changes in consumers’ (1) understanding of the importance of reducing sodium intake, (2) ability to estimate sodium intake, (3) intention to reduce sodium intake, and (4) related attitudes and behaviors is needed to evaluate the effectiveness of health communication strategies and to make the necessary adjustments in the related national initiatives to reduce sodium intake.

Strategy 5.5 FDA should modify and expand its existing Total Diet Study and its Food Label and Package Survey to ensure better coverage of information about sodium content in the diet and sodium-related information on packaged and prepared foods.

Continuous and systematic market basket and labeling studies of the food supply that incorporate approaches relevant to sodium are important and efficient components of monitoring sodium content and the related labeling of foods.

Strategy 5.6 USDA should enhance the quality and comprehensiveness of sodium content information in its tables of food composition.

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