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consumers given the chronic disease risks associated with sodium intake for all population segments. To succeed, however, the approach must be supported by a strong federal government commitment to sodium reduction and leadership from the Department of Health and Human Services (HHS) in cooperation with other agencies and groups to ensure coordination with all stakeholders including the food industry and consumers. The goal is to carefully achieve over time, and without loss of consumers’ acceptance of foods, the “safe” levels of sodium in the diet that are consistent with public health recommendations. Implementation will be challenging and will require both resources and a sustained, high-level commitment to making these important changes a reality. The effort must include more effective ways of reaching consumers about the importance of sodium intake reduction and approaches for selecting healthful diets.

APPROACHING THE TASK

This report focuses on strategies to reduce the sodium intake of the U.S. population. In Fall 2008, a 14-member committee was convened at the request of Congress and supported by several agencies within the HHS. The committee’s work was predicated on the importance of reducing sodium intake and the agreement that achieving lower intakes is a critical public health focus for all Americans. No segment of the population is immune from the adverse health effects, despite the common misunderstanding that sodium intake is a concern only for the “salt sensitive” and the elderly. Consistent with its charge, the committee relied upon consensus conclusions from numerous authoritative bodies as support for the health benefits related to population-based sodium reductions.

The committee was asked to make recommendations about various means that could be employed to reduce dietary sodium intake to levels recommended by the Dietary Guidelines for Americans—currently, less than 2,300 mg/d (see Box 1-1, Statement of Task). The recommended strategies were to include actions by food manufacturers, government approaches such as regulations and legislation, and public and professional outreach and education. Figure S-1 illustrates the committee’s approach to its task.

The committee began its study by evaluating the outcomes of past and current efforts to reduce sodium intake. It explored knowledge about sensory preferences for salt and its role in modulating overall food flavor, key factors in strategies to reduce sodium intake. Preservation and physical property roles of sodium in food were reviewed. Background information was obtained on food manufacturing and restaurant/foodservice operations and on factors important to understanding consumer food choices and behaviors. Given that regulatory options were to be considered, the



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