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

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. "Appendix C: International Efforts to Reduce Sodium Consumption." 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

country. Soon after, Finnish media, particularly the leading newspaper Helsingin Sanomat, began releasing numerous reports on the harmful health effects of salt and helped to raise public (and government) awareness of salt and salt alternatives (Karppanen and Mervaala, 2006).

In 1993, salt-labeling legislation was implemented by the Ministry of Trade and Industry and the Ministry of Social Affairs and Health for food categories that contribute high amounts of sodium to the diet, such as manufactured food items and meals, requiring that such foods be labeled with the percentage of “salt (NaCl) by fresh weight of the product” (Pietinen et al., 2007). The legislation also requires a “high salt content” label on foods that contain high levels of sodium and allows foods low in sodium to carry a “low salt” label (see Table C-1). Other labels in use include the Pansalt logo (used on products with sodium-reduced, potassium- and magnesium-enriched mineral salts) and the “Better Choice” label that was put in use by the Finnish Heart Association in 2000 (He and MacGregor, 2009; Karppanen and Mervaala, 2006).

Monitoring of salt intake is conducted as part of FINRISK, a survey conducted every 5 years that includes an assessment of urinary sodium excretion. A study conducted between 1997 and 1999, using FINRISK surveys, estimated that 21 percent of sodium intake in households came from table salt (down from 30 percent in 1980) and about 70 percent came from processed foods (Reinivuo et al., 2006). By 2002, mean sodium intake was 3,900 mg/d for men and 2,700 mg/d for women. At that time, the most significant sources of sodium in Finnish diets (> 40 percent of intake) were meat dishes and bread. Fish, sausage dishes, and savory baked goods were

TABLE C-1 “High Salt Content” and “Low Salt” Label Requirements in Finland

Food Category

NaCl Content of Food Item (%)

High Salt Content Label Required

Low Salt Label Allowed

Bread

> 1.3

≤ 0.7

Sausages

> 1.8

≤ 1.2

Cheese

> 1.4

≤ 0.7

Butter (voluntary)

> 2.0

≤ 1.0

Breakfast cereals

> 1.7

≤ 1.0

Crisp bread

> 1.7

≤ 1.2

Fish products

≤ 1.0

Soups, sauces, ready-made dishes

≤ 0.5

SOURCE: Karppanen and Mervaala, 2006.

Page
360
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)