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Strategies to Reduce Sodium Intake in the United States (2010)

Chapter: Appendix C: International Efforts to Reduce Sodium Consumption

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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Appendix C
International Efforts to Reduce Sodium Consumption

It is estimated that worldwide, 62 percent of cardiovascular disease and 49 percent of ischemic heart disease are the result of elevated blood pressure (WHO, 2002). Because of this, worldwide efforts have been made to set dietary guidance for sodium intake and to encourage sodium reduction. A World Health Report, published by the World Health Organization (WHO) in 2002, concluded that implementing salt reduction strategies population-wide would be the most cost-effective way to lower the risks associated with cardiovascular disease (WHO, 2002). In 2003, a technical report by WHO and the Food and Agriculture Organization (FAO) of the United Nations (UN) recommended a population-wide daily salt intake of no more than 5 g (2,000 mg sodium) (WHO, 2003).

In 2006 a WHO Forum and Technical Meeting was held to discuss implementation strategies and develop recommendations for population-wide salt reduction interventions. A report released after the meeting stated that participants agreed on the following points: there is a strong scientific link between high salt consumption and a number of chronic diseases; intervention programs repeatedly prove to be cost-effective; salt alternatives need to be explored further (with a continued focus on iodization); and stakeholders (namely, the food industry) must be involved in salt reduction strategies to ensure success (WHO, 2007).

A number of nations have also taken steps to reduce the sodium intake of their populations. This appendix summarizes sodium reduction efforts in several areas outside the United States.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

CANADA

The 2004 Canadian Community Health Survey, a self-reported dietary recall survey, showed that among people 19 to 70 years of age, more than 85 percent of men and more than 60 percent of women consumed more than 2,300 mg sodium daily (the maximum intake level recommended in Canada) (Garriguet, 2007). Among children, 77 percent ages 1 to 3 years and 93 percent ages 4 to 8 years exceeded Tolerable Upper Intake Levels (ULs) of 1,500 and 1,900 mg/d, respectively (as established by the Institute of Medicine). Average sodium intake for both genders combined was 3,236 mg for ages 9 to 13 years; 3,534 mg for ages 14 to 18 years; 3,430 for ages 19 to 30 years; 3,207 mg for ages 31 to 50 years; and 2,954 mg for ages 51 to 70 years.

In 2006, the first Chair in Hypertension Prevention and Control was appointed. The chair, with support from health-related and science organizations, works to lobby the government to implement policies aimed at reducing the addition of salt to food (Campbell, 2007). A year later, the Minister of Health established a working group tasked with developing and implementing a strategy for reducing sodium intake among Canadians.

The Multi-Stakeholder Working Group on Sodium Reduction

Health Canada oversees the sodium working group, which consists of 23 representatives from the following areas: government (6), scientific and health-professional community (5), health-focused and consumer nongovernmental organizations (5), and food manufacturing or foodservice industry (7). The strategy employed by the group is multistaged and based on a three-pronged approach (education, voluntary reduction of sodium levels [in processed foods and foods sold by foodservice operations], and research). The preparatory stage allowed the group to gather baseline data on sodium levels from sources of sodium in Canadian diets. Next, the group moved into the assessment stage, which focused on gathering data on the following: (1) current efforts to educate/inform consumers and health professionals about sodium consumption and health-related consequences; (2) voluntary efforts to reduce sodium in foods; (3) consumers’ perspectives on sodium and its relation to hypertension; (4) sodium, taste, and food choices; (5) functional uses of sodium; and (6) regulatory barriers or disincentives to reduce sodium in foods. During the third stage—development of a strategic framework—the working group used input from the wider stakeholder community to set goals and develop action plans and time lines for the implementation and assessment process. Currently, the working group is in the implementation stage (which

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

began in April 2009) and is overseeing implementation of its strategies and monitoring progress.1

As the working group proceeds, it is expected to use input from several stakeholders, as well as data from sources such as the Total Diet Study (an ongoing research program that has provided Canadian dietary intake data since 1969) and the Canadian Community Health Survey.

In the interim, Health Canada’s revised Eating Well with Canada’s Food Guide advises Canadians to use the Nutrition Facts table on prepackaged food to choose foods that are lower in sodium.2

THE EUROPEAN UNION3

In 2008 a common framework was developed by the European Union (EU) to advance reduction in salt intake at the population level.4 A goal of this initiative is to achieve WHO’s strategies for a 16 percent reduction in salt intake during the next 4 years (against individual country baseline levels in 2008). The framework focuses on 12 categories of food that have been identified as priorities, of which each member state will choose at least 5 for its national plans. The first monitoring report is due in 2010.

FINLAND

Finland’s National Nutrition Council first initiated a salt reduction campaign in the late 1970s, when salt intake was estimated to be approximately 12 g/d (4,800 mg/d sodium), making it one of the first countries to attempt to systematically reduce the sodium intake of its population (He and MacGregor, 2009; Laatikainen et al., 2006). From 1979 to 1982, a community-based intervention called the North Karelia project was conducted to reduce mortality associated with cardiovascular disease by reducing population-wide sodium intake. Several stakeholders were involved with the project (health service organizations, schools, non-governmental organizations, media outlets, and the food industry) (European Commission, 2008). After 3 years, the project was expanded to include the entire

1

Available online: http://www.hc-sc.gc.ca/fn-an/nutrition/sodium/sodium_report_rapport_20080722-eng.php (accessed March 24, 2010).

2

Available online: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php (accessed October 15, 2009).

3

The European Union consists of 27 sovereign member states: Austria, Belgium, Bulgaria, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, The Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the United Kingdom.

4

Available online: http://ec.europa.eu/health/ph_determinants/life_style/nutrition/nutrition_salt_en.htm (accessed October 14, 2009).

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

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.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

also high contributors for men, as were fish, vegetable dishes, and savory baked goods for women (Reinivuo et al., 2006).

More recently a Finnish study (n = 2,007) estimated that if the entire Finnish adult population chose only products labeled as low salt (as determined by the requirements in Table C-1) as opposed to highly salted products, the mean salt intake could be reduced by 1.8 g (720 mg/d sodium) in men and 1.0 g (400 mg/d sodium) in women, whereas choosing only high-salt products could increase mean salt intake by 2.1 g (840 mg/d sodium) and 1.4 g (560 mg/d sodium), respectively (Pietinen et al., 2007).

During the time the initiative has been in place, sodium excretion levels, as well as blood pressure levels, have decreased. It has been reported that food companies either dropped products (to avoid selling products with a high-salt label) or began to reduce the sodium content of their foods by using alternatives such as mineral salts (European Commission, 2008; He and MacGregor, 2009).

FRANCE

In 2001 the Ministry of Health implemented the National Nutrition and Health Program (Programme National Nutrition Santé [PNNS]) with the goal of improving the health of the entire French population through nutrition interventions informed by input from several stakeholders in public and private sectors. One of the nine priority nutrition objectives of the program was to reduce the systolic blood pressure among adults (general population) by 10 mm Hg, which could partly be achieved by one of the 10 specific nutrition objectives to reduce the average consumption of sodium chloride to less than 8 g/d (3,200 mg/d sodium), which is equivalent to a 4 percent reduction in salt intake per year by the entire population over 5 years (Hercberg et al., 2008). The program implemented several strategies that were targeted to occur during a given year or over a period of time. The first set of activities included providing and promoting comprehensive nutrition communication for all consumers, which was done by disseminating information about the program and its objectives and publishing dietary reference guidelines and physical activity guidelines for the public, as well as food-based guides that offered advice on meeting PNNS recommendations (Hercberg et al., 2008). Mass media campaigns were launched to support the guides.

The next phase of action included ensuring a more healthful food supply and involving the food industry. One way of achieving this was to engage the food industry in formal commitments to improve the nutritional composition and quality of existing food products and to develop new products with higher nutritional standards, particularly in the areas of salt, sugar, and fat. The program also worked toward developing public health

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

measures targeted at specific population groups; orienting actions toward health-care professionals and health services; mobilizing local authorities; establishing surveillance systems that monitor food consumption and the nutritional situation of the population; and developing epidemiological, behavioral, and clinical research in human nutrition (Hercberg et al., 2008). A national study to be released in 2010 will review the PNNS and report on the success of the program.

In addition, a working group convened by the French Food Standard Agency (AFSSA) released a report in 2002 that recommended a 20 percent reduction in the average salt intake over a 5-year period, which would bring the average intake from 10 g/d (4,000 mg/d sodium) to 7–8 g/d (2,800–3,200 mg/d sodium). To achieve this intake level, the working group developed initiatives for consumers, the food and catering industry, and medical professionals. Efforts were also initiated to encourage the food industry to adopt optional food labeling. Such labels, which are still in development, include listing sodium content in grams per 100 g or 100 mL and per serving (if necessary) and including the statement, “The salt (sodium) content of this product has been carefully studied; there is no need to add salt.”5 To date, no significant changes have been reported in the salt content of processed food or food labeling efforts.

IRELAND

The Food Safety Authority of Ireland (FSAI) began efforts in 2003 to reduce salt consumption by issuing a set of seven main objectives. The Salt Reduction Programme’s objectives included the goal of raising the food industry’s awareness about salt and health issues, working with manufacturers to gradually reduce the salt content of foods, and working on voluntary universal labeling of salt in packaged foods.6 The long-term goal of the program was to “reduce the average population intake of salt from 10 g/d to 6 g/d (from 4,000 to 2,400 mg/d sodium) by 2010 through partnership with the food industry and State bodies charged with communicating the salt and health message to consumers.”7

Further, in a 2005 report entitled “Salt and Health: Review of the Scientific Evidence and Recommendation for Public Policy in Ireland,” subcommittees of the FSAI concluded that there was a scientific link between salt consumption and high blood pressure and that reducing the average in-

5

Available online: http://www.worldactiononsalt.com/action/france.doc (accessed October 26, 2009).

6

Available online: http://www.fsai.ie/science_and_health/salt_and_health/objectives_of_salt_programme.html (accessed October 13, 2009).

7

Available online: http://www.fsai.ie/science_and_health/salt_and_health.html (accessed October 13, 2009).

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

take to 6 g/d (2,400 mg/d sodium) could result in significantly fewer deaths from stroke and heart disease (He and MacGregor, 2009).

To track progress, the FSAI chronicles salt reduction commitments by food manufacturers, retailers, foodservice suppliers, and caterers on its website.8 At present, 63 companies and trade associations have registered with the FSAI’s Salt Reduction Programme. As reported by the FSAI, the program has resulted in large bread bakers’ reducing salt in all bread to levels below 1.14 g/100 g, representing a minimum 10 percent reduction in 5 years. Further, the agency reports that large and small meat product manufacturers have reduced salt in key products such as burgers and sausages and states that they are on course to meet FSAI targets for meat products by 2010. In addition, campaigns by the Irish Heart Foundation and the Food Safety Promotion Board are targeting the public to raise awareness about the health effects of a high salt intake.

THE UNITED KINGDOM

In 2003, the UK Scientific Advisory Committee on Nutrition (SACN) recommended that the public reduce salt intake to an average of 6 g/d (2,400 mg/d sodium) (SACN, 2003). The SACN used data from three national surveys to establish the 6 g target: (1) a 1990 24-hour urine collection reporting average daily salt intake of 9 g by adults; (2) a 1997 dietary intake survey of people 4–18 years of age that reported daily salt intake ranging from 4.7 to 8.3 g; and (3) a 1994–1995 dietary assessment survey of people 65-plus years of age with average daily salt intake of 6 g (SACN, 2003).

To help consumers reach the 6 g target, the UK government undertook a salt reduction program focused on three areas:

  1. cooperation with the food industry to voluntarily reduce salt in foods;

  2. a public campaign to raise awareness of why a high salt intake is detrimental to health and what the public can do to reduce intake; and

  3. voluntary nutrition labeling placed on the front of food packages to provide information on the amount of salt and other nutrients in foods.

8

Available online: http://www.fsai.ie/science_and_health/salt_commitments_and_updates.html (accessed October 13, 2009).

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

The following pages provide information on the three components of the UK salt reduction initiative as reported by the Food Standard Agency (FSA).9

Salt Reduction Program: Focus Areas

Involvement with the Food Industry

Recognizing that approximately three-quarters of dietary salt intake comes from processed food, FSA established voluntary targets for salt in a number of processed food categories.10 The targets are a means to track and report progress toward salt intake reductions and to provide guidance to industry. Starting with discussions that began in 2003, FSA developed a set of calculations to look at the potential impact of salt reductions in different food categories on population salt intake. The calculations were based on average sodium levels in foods within categories, weighted to account for varying consumption levels of different foods. The calculations were used to forecast how changes in the average salt content of various food categories can help the population reach the daily target of 6 g salt.11 After soliciting and considering public comments, the final calculation spreadsheet was published in February 2005.12

Also in 2005, FSA Strategic Plan 2005–2010 was completed, which aimed to reduce the average population salt intake to 6 g/d (2,400 mg/d) by 2010 and to establish targets for salt content of key food categories by 2006. FSA consulted with the public and stakeholders to develop the final, voluntary salt targets for 2010, which were published in March 2006.12 Eighty-five processed food categories including bread, bacon, breakfast cereals, and cheese were included among the target foods. FSA reported that it aimed to set challenging levels that would have a meaningful impact on consumer salt intake, while being mindful of food safety and technical issues and acknowledging that major processing changes would be necessary for certain foods to meet the targets.13

FSA reports that all sectors of the food industry have responded posi-

9

Available online: http://www.food.gov.uk/consultations/ukwideconsults/2008/saltreductiontargets (accessed October 5, 2009).

10

Available online: http://www.food.gov.uk/multimedia/spreadsheets/saltcommitmentsum.xls (accessed October 15, 2009).

11

Available online: http://www.food.gov.uk/consultations/ukwideconsults/2003/saltmodellingconsult (accessed October 15, 2009).

12

Available online: http://www.food.gov.uk/healthiereating/salt/salttimeline (accessed March 24, 2010).

13

Available online: http://www.food.gov.uk/multimedia/pdfs/saltreductioninitiatives.pdf (accessed March 24, 2010).

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

tively to the appeals to reduce salt in foods. To gauge progress, FSA uses a Processed Food Databank, a reference tool that provides information about the levels of sodium (and other nutrients) in processed foods based on data collected from product labels. The agency also purchases proprietary data listing sales figures and sodium levels in more than 130,000 products sold in the United Kingdom, using them to inform its review of salt targets.14 In addition, FSA maintains commitment documents from companies in the catering industry, such as restaurants, coffee shops, and workplace caterers. The commitment documents are updated annually and provide an overview of the company’s actions to support the Agency’s nutrition priorities, including sections on procurement, menu planning, kitchen practices, and customer information.15

FSA conducted a review in 2008 to gauge progress toward the 2010 salt targets and used the information it gathered to aid the process of setting revised targets for a limited range of food categories by 2010 and new targets for most foods by 2012. The review process included consultation by way of sector-specific meetings during which industry representatives reported on their progress, challenges, and potential future efforts to further reduce salt. FSA considered this industry input and other public comments as well as technical and safety issues, current salt intake, and public acceptance when proposing revised targets. Sixty responses were received from a range of stakeholders and were considered by the agency in revising the 2010 targets and establishing new targets for 2012. In May 2009, FSA published revised, voluntary salt reduction targets for 80 categories of food, for the industry to meet by 2012 (see Table C-2 at the end of this appendix). A small number of revisions were made for the 2010 targets (set forth in 2006) for foods that had already achieved the target or were close to doing so. The revised 2012 targets reflect the progress made thus far and are considered by FSA to serve as a continued challenge to industry to achieve salt levels that will help attain population salt intake of 6 g.16 In March 2010, the agency published documents listing commitments from a range of retailers, manufacturers, trade associations, and caterers highlighting progress made on salt reduction; these documents will be updated regularly to show progress.17

14

Ibid.

15

Available online: http://www.food.gov.uk/healthiereating/healthycatering/cateringbusiness/commitments (accesed March 25, 2010).

16

Available online: http://www.food.gov.uk/healthiereating/salt/saltreduction (accessed October 5, 2009).

17

Available online: http://www.food.gov.uk/news/newsarchive/2010/mar/saltcommitments (accessed March 25, 2010).

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×
FSA-Sponsored Awareness Campaign

Concurrent with the food industry plan, FSA launched a media campaign as part of the government salt reduction initiative.18 The first phase aimed to raise consumers’ awareness of the adverse health consequences of excessive salt consumption and ran from September to November 2004. It featured a character called “Sid the Slug” in poster, web, and print ads, with tag lines such as, “I’ve always known it: Too much salt is bad for your heart.” The second phase ran from October to November 2005; its key messages were to raise awareness of the goal to eat no more than 6 g salt per day and to encourage consumers to check the salt content on food labels. A series of short TV ads ran during the following summer to maintain awareness of the key messages.19 The third phase of the campaign commenced in March 2007, with the intent to inform consumers that most of the salt they eat is in everyday foods and to encourage them to chose lower-salt products. The fourth phase of consumer messaging began in October 2009 and highlighted the positive changes consumers could make to reduce salt intake, such as checking food labels to compare products and choosing the lower-salt option. The messages from the campaign have been disseminated through television and radio, print media, and on the web.17 In addition, the British Heart Foundation contributed to the awareness campaign by producing a booklet on the salt content of foods and the effect of a high salt intake on heart health (British Heart Foundation, 2007).

Voluntary Front-of-Package Nutrition Labeling

During the implementation of the salt reduction campaign, there have also been efforts to improve nutrition labeling for packaged foods. Salt content has been one area of focus for voluntary changes in labeling. Some supermarkets and manufacturers are voluntarily displaying front-of-package labeling of individual nutrients with a traffic light color system. The labeling scheme shows red, amber, or green colors to indicate that a product contains high, medium, or low levels of total fat, saturated fat, sugar, and salt.20 Other supermarkets and manufacturers are using front-of-package labeling that provides the percentage of the Guideline Daily Amount (GDA) (an established recommended amount similar to the U.S.

18

Available online: http://www.food.gov.uk/healthiereating/salt/campaign (accessed March 22, 2010).

19

Available online: http://www.food.gov.uk/healthiereating/salt/salttimeline (accessed March 24, 2010).

20

Available online: http://www.eatwell.gov.uk/foodlabels/trafficlights/ (accessed October 15, 2009).

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Daily Value) for selected nutrients, but without the traffic light color system (Malam et al., 2009).

Manufacturers and retailers may vary the label format, but certain core elements must be retained. The nutritional criteria determining the color coding for these voluntary labeling schemes were set by the government’s independent scientific advisory committees on nutrition. To qualify for a green light, a product must have ≤ 300 mg sodium per 100 g or 100 mL. A sodium content > 1,500 mg per 100 g or 100 mL receives a red light, and anything between 300 and 1,500 mg sodium per 100 g or 100 mL receives an amber light.21 This system was adopted based on consumer research showing that multiple traffic light colors were preferred over a single traffic light color, which would indicate only overall product healthfulness rather than amounts of a number of specific nutrients, such as sodium.22

Recently, a study was conducted to determine how these labels are understood and used by consumers (Malam et al., 2009). The results of this study indicate that the use of different labeling formats by different retailers and manufacturers is confusing to consumers, suggesting that a uniform format may be preferable. It was also found that consumers interpret colors differently, and some did not realize that the colors had meaning. Overall, labels combining the words high, medium, and low in addition to traffic light colors and percentage of GDAs were found to be the easiest for consumers to understand, with approximately 70 percent of consumers comprehending the label meaning.

There is also some evidence to suggest that manufacturers have reformulated products to make their products qualify for a better traffic light profile (British Retail Consortium, 2009).

Impact of the Salt Reduction Program

Thus far, FSA has reported decreases in the average daily salt consumption of the UK population. A 2008 UK survey23 indicated that average daily sodium consumption decreased by almost 360 mg since the 2000–2001 National Diet and Nutrition Survey. The decrease was from an average of 9.5 g/d to 8.6 g/d salt (3,800 mg/d to 3,440 mg/d sodium) for both genders combined (National Centre for Social Research, 2008). This suggests that the United Kingdom’s estimated consumption of sodium is now very similar to that reported for the U.S. population, which is 3,435 mg per day

21

Available online: http://www.food.gov.uk/multimedia/pdfs/frontofpackguidance2.pdf (accessed December 8, 2009).

22

Available online: http://www.food.gov.uk/foodlabelling/signposting/devfop/siognpostlabelresearch/ (accessed December 8, 2009).

23

Available online: http://www.food.gov.uk/science/dietarysurveys/urinary (accessed October 13, 2009).

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

for persons 2 or more years of age (USDA/ARS, 2008). Whether consumption will continue to decrease below U.S. levels of intake is of considerable interest.

FSA plans to review progress toward the 6 g target in early 2011 and then again every 2 years. The 2011 review will look for “continuing trends of gradual salt reductions in foods and progress across the whole industry in a way that maintains consumer acceptability as people’s palates adjust to less salty foods.”24 FSA will also examine the costs involved with the program.

REFERENCES

British Heart Foundation. 2007. Salt: Facts for a healthy heart. London: British Heart Foundation.

British Retail Consortium. 2009. British retailing: A commitment to health. Edited by A. Martinez-Inchausti and A. Gardiner. London: British Retail Consortium.

Campbell, N. R. C. 2007. Canada Chair in hypertension prevention and control: A pilot project. Canadian Journal of Cardiology 23(7):557-560.

EC (European Commission). 2008. Collated information on salt reduction in the EU. http://ec.europa.eu/health/ph_determinants/life_style/nutrition/documents/compilation_salt_en.pdf (accessed December 15, 2009).

Garriguet, D. 2007. Sodium consumption at all ages. Health reports/statistics Canada 18(2):47-52.

He, F. J., and G. A. MacGregor. 2009. A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. Journal of Human Hypertension 23(6):363-384.

Hercberg, S., S. Chat-Yung, and M. Chauliac. 2008. The French national nutrition and health program: 2001-2006-2010. International Journal of Public Health 53(2):68-77.

Karppanen, H., and E. Mervaala. 2006. Sodium intake and hypertension. Progress in Cardiovascular Diseases 49(2):59-75.

Laatikainen, T., P. Pietinen, L. Valsta, J. Sundvall, H. Reinivuo, and J. Tuomilehto. 2006.2006. Sodium in the Finnish diet: 20-year trends in urinary sodium excretion among the adult population. European Journal of Clinical Nutrition 60(8):965-970.

Malam, S., S. Clegg, S. Kirwin, and S. McGinigal. 2009. Comprehension and use of UK nutrition signpost labelling schemes (Prepared for the Food Standards Agency). British Market Research Bureau. http://www.food.gov.uk/multimedia/pdfs/pmpreport.pdf (accessed March 10, 2010).

National Centre for Social Research. 2008. An assessment of dietary sodium levels among adults (aged 19-64) in the UK general population in 2008, based on analysis of dietary sodium in 24 hour urine samples. http://www.food.gov.uk/multimedia/pdfs/08sodiumreport.pdf (accessed February 2, 2010).

Pietinen, P., L. M. Valsta, T. Hirvonen, and H. Sinkko. 2007. Labelling the salt content in foods: A useful tool in reducing sodium intake in Finland. Public Health Nutrition 11(4):335-340.

24

Available online: http://www.food.gov.uk/healthiereating/salt/saltreduction (accessed October 5, 2009).

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Reinivuo, H., L. M. Valsta, T. Laatikainen, J. Tuomilehto, and P. Pietinen. 2006. Sodium in the Finnish diet: II Trends in dietary sodium intake and comparison between intake and 24-h excretion of sodium. European Journal of Clinical Nutrition 60(10):1160-1167.

Scientific Advisory Committee on Nutrition. 2003. Salt and health. London, UK: Department of Health, Food Standards Agency (UK).

USDA (U.S. Department of Agriculture)/ARS (Agricultural Research Service). 2008. Nutrient intakes from food: Mean amounts consumed per individual, one day, NHANES 2005-2006. Washington, DC: Agricultural Research Service.

WHO (World Health Organization). 2002. Reducing risks, promoting healthy life. World Health Report, 2002. Geneva: World Health Organization.

WHO. 2003. Diet, nutrition, and the prevention of chronic diseases. WHO technical report series, No. 916. Geneva: World Health Organization.

WHO. 2007. Reducing salt intake in populations: Report of a WHO forum and technical meeting. Paris: World Health Organization.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

TABLE C-2 Food Standards Agency Salt Reduction Targets for 2010 and 2012

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

1. MEAT PRODUCTS

 

 

 

 

1.1 Bacon Includes all types of injection cured bacon, e.g., sliced back, streaky, smoked and unsmoked bacon, bacon joints, etc. Excludes all dry and immersion cured bacon.

3.5 g salt or 1,400 mg sodium (average)

3.13 g salt or 1,250 mg sodium (average)

2.88 g salt or 1,150 mg sodium (average p)

The FSA recognizes the difficulties in attaining an even dispersal of salt in bacon and the impact of legislation restricting the addition of nitrates and has set an average range target. Consultation comments indicate that the revised proposed level is achievable whilst maintaining a safe product. However it remains the responsibility of individual manufacturers to ensure the safety of any reformulated product throughout the shelf life it is allocated.

1.2 Ham/other cured meats Includes hams, cured pork loin and shoulder etc. Excludes “Protected Designation of Origin” and traditional specialty guaranteed products, e.g., Parma ham. Also excludes specialty products produced using traditional methods such as immersion and dry cured processes including cured tongue.

2.5 g salt or 1,000 mg sodium (average)

2.0 g salt or 800 mg sodium (average)

1.63 g salt or 650 mg sodium (average p)

The FSA recognizes that attaining an even dispersal of salt in ham causes similar problems as in bacon. An average target is set to reflect this. Many companies have however met or exceeded the current target for cured meats and the Agency expects industry to aim for the lowest level possible whilst maintaining product safety. Category now excludes cured tongue.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

1.3 Sausages

 

 

 

 

1.3.1 Sausages Includes all fresh, chilled and frozen meat sausages, e.g., pork, beef, chicken, turkey, etc.

1.4 g salt or 550 mg sodium (maximum)

 

1.13 g salt or 450 mg sodium (maximum)

Maintaining product binding and succulence in sausages has proved challenging whilst reducing levels of sodium. However, levels of 500 mg sodium per 100 g have already been achieved across a range of products.

1.3.2 Cooked sausages and sausage meat products Includes all cooked sausages and sausage meat products, e.g., stuffing, turkey roll with stuffing, etc. Excludes Scotch eggs (see category 22.1).

1.8 g salt or 700 mg sodium (maximum)

1.63 g salt or 650 mg sodium (maximum)

1.5 g salt or 600 mg sodium (maximum)

As above, product binding and succulence is recognized as an issue; however, product data shows that levels at or below 600 mg sodium per 100 g are achievable. The Agency recognizes concerns around problems with end extrusion and will monitor progress toward the 2012 target.

1.4 Meat Pies

 

 

 

 

1.4.1 Delicatessen, pork pies and sausage rolls Includes all delicatessen pies, pork pies and sausage rolls, e.g., game pie, cranberry topped pork pie, Melton Mowbray pork pie, etc.

1.5 g salt or 600 mg sodium (maximum)

1.38 g salt or 550 mg sodium (maximum)

1.13 g salt or 450 mg sodium (maximum)

 

1.4.2 Cornish and meat-based pasties

Includes all Cornish and meat-based pasties only.

1.3 g salt or 500 mg sodium (maximum)

1.13 g salt or 450 mg sodium (maximum)

1.0 g salt or 400 mg sodium (maximum)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

1.4.3 Other meat-based pastry products including pies and slices, canned and frozen products Includes all meat-based pastry products, pies, slices, etc. whether chilled, canned, frozen etc. Excludes pork pies and sausage rolls (see category 1.4.1) and Cornish and meat-based pasties (see category 1.4.2)

1.1 g salt or 450 mg sodium (maximum)

1.0 g salt or 400 mg sodium (maximum)

0.75 g salt or 300 mg sodium (maximum)

 

1.5 Cooked uncured meat

Includes all roast meat, sliced meat, etc. Excludes ham (see category 1.2 above)

1.5.1 Whole muscle Includes all chilled, frozen and canned whole muscle, e.g., beef, lamb, chicken, turkey, etc. Also includes rotisserie and roasted products.

 

 

0.75 g salt or 300 mg sodium (maximum)

Target is believed to be achievable for the majority of products, the Agency understands that it may be more difficult to achieve for some flavored products. We expect industry to aim for the lowest possible levels whilst maintaining food safety.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

1.5.2 Reformed whole muscle Includes all reformed whole muscle, e.g., beef, lamb, chicken, turkey, etc.

 

 

1.0 g salt or 400 mg sodium (maximum)

A new sub-category has been set with a salt level appropriate for binding and tenderizing reformed whole muscle.

1.5.3 Comminuted or chopped reformed meat Includes all comminuted or chopped reformed and shaped uncured meats, e.g., beef, lamb, chicken, turkey, etc.

 

 

1.5 g salt or 600 mg sodium (maximum)

 

1.6 Burgers, grillsteaks, etc.

 

 

 

 

1.6.1 Standard fresh and frozen burgers and grillsteak products Includes beef burgers, hamburgers, pork/bacon burgers, chicken burgers, turkey burgers and all kebabs. Excludes canned burgers (see category 1.7.1)

1.0 g salt or 400 mg sodium (maximum)

 

0.75 g salt or 300 mg sodium (maximum)

The Agency recognizes that sodium plays a role in binding in thick burgers. However, it is also aware that for thin burgers and frozen burgers far lower levels of sodium are required. We are aware that the 2012 target levels are currently being trialed and we will review this target in 2010 based on any information that has identified as being achievable for these products.

1.6.2 Specialty and topped burgers and grillsteaks Includes all flavored products.

1.3 g salt or 500 mg sodium (maximum)

 

0.88 g salt or 350 mg sodium (maximum)

We are aware that the 2012 target levels are currently being trialed and we will review this target in 2010 based on any information that has identified as being achievable for these products.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

1.7 Frankfurters, hotdogs, and burgers

1.7.1 Canned frankfurters, canned hotdogs and canned burgers only. Excludes fresh and frozen burgers (see category 1.6), sausages (see category 1.3) and chilled frankfurters (see category 1.7.2)

1.4 g salt or 550 mg sodium (maximum)

 

1.38 g salt or 550 mg sodium (maximum)

 

1.7.2 Fresh chilled frankfurters

None

 

1.63 g salt or 650 mg sodium (maximum)

A new category has been included for fresh chilled frankfurters. These products require higher levels of salt than canned products for food safety and technological reasons.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

2. BREAD

 

 

 

 

2.1 Bread and rolls Includes all bread and rolls: pre-packed, part-baked and freshly baked (including retailer in-store bakery) white, brown, malted grain and whole meal bread or rolls including seeded products, French bread, ciabatta, focaccia, pitta, naan, chappattis, tortillas etc. without additions (e.g., cheese, olives, sundried tomatoes, etc., see category 2.2)

1.1 g salt or 430 mg sodium (average)

 

1.0 g salt or 400 mg sodium (average r)

The Agency welcomes the commitment that the industry has shown to reducing levels, including the major retailers who have been particularly successful with achieving levels of between 300 and 400 mg sodium per 100 g. However the Agency also notes that premium breads have levels above this although manufacturers have reduced levels of salt on a sales weighted basis by 16% over the last 4 years. Plant bakers are committed to meeting the 2010 target but responses to the consultation on revised targets indicate that reducing to 370 mg/100 g by 2012 would not be achievable. The Agency will continue to work closely with the bread sector to ensure that salt reductions are made as quickly as is practicable as bread contributes around one-fifth of sodium to dietary intake and it is important to maintain and improve on reductions in this area.

2.2 Bread and rolls with additions Includes all bread and rolls (as listed at category 2.1 above) with “high salt” additions, e.g., cheese, olives, sundried tomatoes, etc. Also includes cheese scones.

1.3 g salt or 500 mg sodium (average)

 

1.2 g salt or 480 mg sodium (average)

See comments above.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

2.3 Morning goods Includes plain and fruit scones, crumpets, pikelets, English muffins, Scotch pancakes, bagels, croissants, brioche, soda farls and waffles, etc. Also includes all buns, e.g., hot cross, teacakes, etc., except iced finger buns (see category 12.1 Cakes). Excludes cheese scones (see category 2.2)

1.3 g salt or 500 mg sodium (average)

 

0.75 g salt or 300 mg sodium (average r) 1.0 g salt or 400 mg sodium (maximum)

The Agency is aware that much of the sodium in some of these products comes from sodium bicarbonate. We are also aware of developments in processing allowing lower levels of raising agents to be used without using replacers. We recognize the diverse range of products included in this category and that some companies will make only a limited number of these so may find the average difficult to achieve across their individual ranges. However, the target has been set at a level that will give companies a level to work toward. As a guide for those companies making a small range of these type of products the lowest levels of sodium on the market (2007) were crumpets 320 mg; scones 320 mg; pancakes 280 mg; croissants 360 mg; teacakes 120 mg; English muffins 300 mg; potato cakes/soda farls 400 mg; pain au chocolate 200 mg; waffles 300 mg. Buns have now been moved to this category with the exception of iced finger buns as these can achieve lower levels and are included in the category for Cakes (12.1). As a guide: hotcross buns were available (2007) at 200 mg; other fruited buns 170 mg and other unfruited buns at 300 mg.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

3. BREAKFAST CEREALS

 

 

 

 

3.1 Breakfast cereals Includes all breakfast cereals, e.g., muesli, cornflakes, hot oat cereals, etc.

0.8 g salt or 300 mg sodium (average)

 

0.68 g salt or 270 mg sodium (average) 1.0 g salt or 400 mg sodium (maximum)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

4. CHEESE

 

 

 

 

4.1 Natural cheese Cheddar and other similar “hard pressed” cheeses, e.g., Cheshire, Lancashire, Wensleydale, Caerphilly, Double Gloucester, Leicester, Derby, etc.

Mild: 1.7 g salt or 670 mg sodium (average) Mature: 1.95 g salt or 750 mg sodium (average)

 

1.8 g salt or 720 mg sodium (average r)

There is now just one target for mild and mature cheeses, as a range average. The Agency has been advised that for cheddar, which is the biggest selling cheese in the United Kingdom, there are problems with the structure and texture of the cheese once levels of sodium start to fall below 720 mg per 100 g. This may not be the case for some other hard cheeses. Cheese contributes significantly to sodium intake and manufacturers are encouraged to reduce the sodium in their cheeses both by making absolute reductions, where possible, and by improving their process control to minimize variation in sodium content. The Agency will be looking further into the technical issues associated with salt reduction in these products and the issues raised in consultation responses. We will be funding research in this area and will review progress in 2010. However, label data indicates that products are currently available at and below the level of the 2012 target for both mature and mild cheddars—which should make a range average achievable.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

4.2 “Fresh” cheeses Excludes fromage frais as no salt is added to this product. Also excludes Brie, Camembert, and other similar soft rinded cheeses.

 

 

 

In addition, the Agency recognizes the difficulties small cheesemakers face in reducing salt levels in their products, and is aware that some producers are looking at the ways they can reduce the variation in salt levels in their products. We encourage this work as a way of minimizing salt levels, and would like to hear from producers about their experiences and the opportunities for salt reduction.

4.2.1 Soft white cheese, e.g., Philadelphia. Includes all soft white cheese, flavored or unflavored, including reduced fat products. Excludes cottage cheese (see categories 4.2.2 and 4.2.3)

0.8 g salt or 320 mg sodium (maximum)

 

0.55 g salt or 220 mg sodium (average r) 0.75 g salt or 300 mg sodium (maximum)

4.2.2 Cottage cheese, plain. Includes all unflavored cottage cheese. Excludes flavored products (see category 4.2.3)

0.54 g salt or 215 mg sodium (average)

 

0.55 g salt or 220 mg sodium (average r) 0.63 g salt or 250 mg sodium (maximum)

 

4.2.3 Cottage cheese, flavored. Includes all flavored cottage cheese (onion and chive, pineapple)

0.64 g salt or 250 mg sodium (average)

 

 

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

4.3 Mozzarella (used in food products). Includes mozzarella products for food industry use only. Excludes fresh mozzarella sold in retail outlets.

1.8 g salt or 700 mg sodium (average)

 

1.5 g salt or 600 mg sodium (average p)

This target is for hard block type mozzarellas used in the food industry to manufacture pizzas, ready meals, etc. Fresh mozzarella sold in retail outlets has higher water content and much lower levels of sodium should be attainable. The Agency will review progress in 2010.

4.4 Blue cheese UK produced blue cheeses only

No target

 

2.1 g of salt or 840 mg sodium (average p)

The Agency recognizes that the Stilton Cheese Makers Association has undertaken a program of work in the past 4 years to better understand the salt levels in their product, to reduce the standard deviation of levels within and between products and to reduce overall levels. The Agency commends this approach to other cheese manufacturers. In addition to working toward the 2012 target the SCMA has committed to working toward a further 20% reduction in the standard deviation in the levels of sodium in their products and to go further if possible.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

4.5 Processed Cheese

 

 

 

 

4.5.1 Cheese spreads

2.0 g salt or 800 mg sodium (average)

 

1.63 g salt or 650 mg sodium (average r) 2.25 g salt or 900 mg sodium (maximum)

The level of sodium in cheese spreads is largely influenced by the amount of cheese present which inturn dictates the amount of emulsifiers used (which are currently sodium-based).

4.5.2 Other processed cheese (e.g., slices, strings, etc.)

2.9 g salt or 1,170 mg sodium (average)

2.13 g salt or 850 mg sodium (average)

2.0 g salt or 800 mg sodium (average r)

This category covers a wide range of products from cheese that has been processed with nothing added, to cheese which has been processed with sodium based emulsifiers. As above those products with more cheese and therefore more emulsifiers will find it more difficult to reduce sodium content. In addition the types of packaging used will have an impact on the levels of salt reduction that can be achieved for example cheese slices packaged slice on slice may not be able to reach the same levels as those hot filled into individual packages. The Agency is aware that there is significant research in this are and will review progress in 2012.

5. BUTTER

 

 

 

 

5.1 Butter

 

 

 

 

5.1.1 Welsh and other regional butter Includes all Welsh and other regional UK butters, e.g., Cornish

3.0 g salt or 1,200 mg sodium (average)

 

2.0 g salt or 800 mg sodium (average r)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

5.1.2 Salted butter Includes all other “standard” salted butters

1.7 g salt or 670 mg sodium (average)

 

1.68 g salt or 670 mg sodium (average p)

Salt is the main controlling factor for microbial growth in this product which may also be subject to a considerable amount of cross contamination in the home. The Agency will review this target in the light of any future research.

5.1.3 Lightly salted butter Includes all lightly salted butters (made using different processes to that used for salted butters at 5.1.2, e.g., Lurpak)

1.2 g salt or 470 mg sodium (average)

 

1.13 g salt or 450 mg sodium (average p)

 

5.1.4 Unsalted butter Includes all unsalted butters apart from whey butters.

0.1 g salt or 40 mg sodium (average)

 

0.1 g salt or 40 mg sodium (average p)

 

6. FAT SPREADS

 

 

 

 

6.1 Margarines/other spreads Includes all margarines and spreadable butters which include an oil element and spreads, e.g., sunflower, olive oil, buttermilk enriched, sterol/stanol containing, etc.

1.5 g salt or 600 mg sodium (average)

1.25 g salt or 500 mg sodium (average) 1.88 g salt or 750 mg sodium (maximum)

1.13 g salt or 450 mg sodium (average r) 1.63 g salt or 650 mg sodium (maximum)

The Agency is aware of industry concerns that margarines should not be put at a disadvantage to butter in terms of salt content. However, products which blend butter with oil to give a spreadable product are likely to be the products in direct competition to margarines, and data shows they are currently on the market at levels of around 400 mg.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

7. BAKED BEANS

 

 

 

 

7.1 Baked beans in tomato sauce without accompaniments

0.8 g salt or 300 mg sodium (maximum)

 

0.63 g salt or 250 mg sodium (maximum)

The Agency recognizes the significant reductions that have already been achieved in these products and the difficulties with achieving the 2012 target within the timeframe set. We will therefore review progress in both 2010 and 2012.

7.2 Baked beans and canned pasta with accompaniments Includes baked beans or canned pasta in tomato sauce with sausages, meatballs, other meats and cheese, macaroni cheese, etc.

1.0 g salt or 400 mg sodium (maximum)

 

0.75 g salt or 300 mg sodium (maximum)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

8. READY MEALS AND MEAL CENTERS

8.1 Chinese/Thai/Indian—ready meals Includes all Chinese, Thai, and Indian ready meals with accompaniment (potato, rice, noodles, etc.) made from meat, poultry, fish or vegetables, e.g., sweet and sour chicken with rice, thai green curry with noodles, chicken tikka massala, etc.

0.8 g salt or 300 mg sodium (average)

 

0.63 g salt or 250 mg Sodium (average) 1.13 salt or 450 mg sodium (maximum)

The revised category also now includes all coated poultry products, as well as coated fish products, and all non-meat pies (e.g., cheese and onion pasties). Some vegetarian products based on meat analogue products, e.g., Quorn, tofu, etc., are included in category 25, although meal centers and ready meals remain in category 8. We recognize that some manufacturers will make a small range of products that are naturally high in sodium, for example, those based on cheese and pastry. In these circumstances the Agency would expect companies to achieve the lowest salt levels possible and as a minimum to fall within the maximum target. The Agency also recognizes that the maximum target will be challenging for some specific products and some ranges of ready meals. However at this level a meal will deliver approximately 4.5 g salt per 400 g portion which equates to 75% of the recommended maximum daily intake.

8.2 Chinese/Thai/Indian—meal centers Includes all Chinese, Thai, and Indian meal centers without accompaniment (potato, rice, noodles, etc.) made with meat, poultry, fish or vegetables, e.g., sweet and sour chicken, Thai green curry, chicken tikka massala, etc.

1.0 g salt or 400 mg sodium (average)

 

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

8.3 Italian/Traditional/other—ready meals Includes all Italian, traditional, and other ready meals with accompaniment (potato, rice, noodles, etc.) not covered in 8.1, made with meat, poultry, fish, or vegetables, e.g., lasagne, chili con carne with rice, coq au vin with potato, cottage pie. Includes fresh stuffed pasta with sauce.

0.6 g salt or 250 mg sodium (average)

 

 

 

8.4 Italian/Traditional/other—meal centers Includes all Italian, traditional, and other ready meals without accompaniment (potato, rice, noodles, etc.) not covered in 8.1, made with meat, poultry, fish, or vegetables, e.g., chili con carne, coq au vin, beef stew. Also includes fresh stuffed pasta without sauce.

0.8 g salt or 300 mg sodium (average)

 

 

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

9. SOUPS

 

 

 

 

9.1 Dried soups (as consumed) Includes all soups in a cup and other dried soups as consumed, i.e., once rehydrated.

0.6 g salt or 250 mg sodium (average)

 

0.58 g salt or 230 mg sodium (average r) 0.73 g salt or 290 mg sodium (maximum)

It is proposed that just one target is set for soups. This would continue to apply to dried soups as consumed (made up according to manufacturers instructions). The Agency is aware that a number of manufacturers are looking at the feasibility of this target for dried soup and we will review progress in 2010.

9.2 “Wet” soups Includes all canned, condensed (as consumed), ambient packed and fresh (chilled) soups.

0.6 g salt or 250 mg sodium (average)

 

 

 

10. PIZZAS

 

 

 

 

10.1 Pizzas with higher salt toppings, e.g., cured meat (ham, bacon, pastrami, chorizo, salt beef), olives, anchovies and smoked fish, hard cheese, prawns, crayfish, crab, tuna, and “Cheese Feast” or similar toppings.

1.2 g salt or 470 mg sodium (average)

 

1.0 g salt or 400 mg sodium (average r) 1.25 g salt or 500 mg sodium (maximum)

 

10.2 Without high salt toppings, e.g., chicken, vegetables, etc.

1.0 g salt or 400 mg sodium (maximum)

 

 

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

11. CRISPS AND SNACKS

 

 

 

 

11.1 Standard potato crisps All standard potato crisps, all flavors except salt and vinegar. Includes products aimed at the adult market.

1.5 g salt or 600 mg sodium (average)

 

1.38 g salt or 550 mg sodium (average r) 1.63 g salt or 650 mg sodium (maximum)

The Agency recognizes that the snack sector has removed a considerable amount of salt from their products and has been removing artificial additives, monosodium glutamate and working on reducing saturated fat. Predict further progress on salt reduction is difficult over the next 4 years, but the revised targets have been set at levels that should be achievable in that time frame. The Agency will review progress towards these targets in 2010.

11.2 Extruded snacks All extruded snacks, e.g., cheese flavor corn puffs, potato hoops, all flavors except salt and vinegar

2.8 g salt or 1,100 mg sodium (average)

2.25 g salt or 900 mg sodium (average)

1.88 g salt or 750 mg sodium (average r) 2.5 g salt or 1,000 mg sodium (maximum)

The target set appears achievable but the Agency recognizes that companies work will be dependant on consumer acceptance of lower salt products.

11.3 Pelleted snacks All snacks made from pellets, e.g., prawn cocktail flavor shell, crispy bacon flavor corn snacks, curly cheese snacks, all flavors except salt and vinegar.

3.4 g salt or 1,400 mg sodium (average)

2.5 g salt or 1,000 mg sodium (average)

2.25 g salt or 900 mg sodium (average r)

The Agency will keep progress towards achieving this target under close review following the technical issues raised during the consultation.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

11.4 Salt and Vinegar products All crisps, snacks, etc. salt and vinegar flavour only.

3.1 g salt or 1,200 mg sodium (average)

2.38 g salt or 950 mg sodium (average)

2.13 g salt or 850 mg sodium (average r) 3 g salt or 1,200 mg sodium (maximum)

The Agency will keep progress towards achieving this target under close review following the technical issues raised during the consultation.

12. Cakes, pastries, fruit pies and other pastry-based desserts. NB Buns have now moved to categories 12.1 Cakes or 2.3 Morning goods.

 

 

 

 

12.1 Cakes includes all sponge cakes, cake bars, malt loaf, American muffins, doughnuts, flapjacks, brownies, etc. Also includes iced finger buns. All other buns are now included in Morning goods (category 2.3).

0.6 g salt or 240 mg sodium (average)

 

0.5 g salt or 200 mg sodium (average r) 1 g salt or 400 mg sodium (maximum)

Cakes include all chemically raised products. This category also now includes iced finger buns which are yeast-raised but can achieve similarly low levels. All other buns are now included in category 2.3 Morning goods.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

12.2 Pastries Includes all puff pastry based and laminated pastries, such as Danish pastries, maple and pecan plait, etc. Excludes all sweet shortcrust and choux pastry-based products (see category 12.3).

0.5 g salt or 185 mg sodium (average)

 

0.5 g salt or 200 mg sodium (average r)

The Agency is aware that pastries that are based on puff pastry, and/or laminated, will require higher levels of salt than those that are based on shortcrust pastry. For this reason, the Agency has redefined categories 12.2 and 12.3. 12.2 includes all puff and laminated products whilst all shortcrust-based products are now covered by 12.3.

12.3 Fruit pies and other shortcrust and choux pastry-based desserts Includes all fruit pies and other desserts made with shortcrust and choux pastry, e.g., apple pie, tarte au citron, tarte au chocolate, treacle tart, lemon meringue pie, custard tart, banoffee pie, eclairs, profiteroles, choux buns, etc. Excludes all puff pastry and laminated pastries (see category 12.2).

0.4 g salt or 130 mg sodium (average)

 

0.33 g salt or 130 mg sodium (maximum)

Some products now included here have moved from category 20.4. The Agency is aware that there is a wide range of products in this category and that the target may be more challenging for some products such as treacle tart. However, the target is already being met by many products on the market and we will review progress again in 2010 and 2012.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

13. BOUGHT SANDWICHES

 

 

 

 

13.1 With high salt fillings Includes sandwiches where the filling includes cured meat (ham, bacon, pastrami, chorizo, salt beef), olives, anchovies and smoked fish, hard cheese, prawns, crayfish, crab, and tuna.

1.3 g salt or 500 mg sodium (average)

 

1.0 g salt or 400 mg sodium (average r)

The average set is a range average, which means it applies across the product range made by each producer. It is used to allow for variety in the types of products on offer in this category. Individual products do not, therefore, need to meet the target set.

13.2 Without high salt fillings Sandwiches including all lower salt fillings, e.g., chicken, vegetables, egg, etc.—e.g., where ingredients are other than those specified in category 13.1 (see above).

1.0 g salt or 400 mg sodium (average)

 

0.75 g salt or 300 mg sodium (average r)

The average set is a range average, which means it applies across the product range made by each producer. It is used to allow for variety in the types of products on offer in this category.

14. TABLE SAUCES

 

 

 

 

14.1 Tomato ketchup

2.4 g salt or 1,000 mg sodium (maximum)

2.25 g salt or 900 mg sodium (maximum)

1.83 g salt or 730 mg sodium (maximum)

 

14.2 Brown sauce Includes all brown, BBQ, curry-flavored, etc.

1.5 g salt or 600 mg sodium (maximum)

 

1.5 g salt or 600 mg sodium (maximum)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

14.3 Salad cream

1.8 g salt or 700 mg sodium (maximum)

 

1.75 g salt or 700 mg sodium (maximum)

 

14.4.1 Mayonnaise (not reduced fat/calorie)

1.5 g salt or 600 mg sodium (maximum)

 

1.25 g salt or 500 mg sodium (maximum)

 

14.4.1 Mayonnaise (reduced fat/calorie only)

2.5 g salt or 1,000 mg sodium (maximum)

2.13 g salt or 850 mg sodium (maximum)

1.88 g salt or 750 mg sodium (maximum)

We are aware that the 2012 target is considered achievable but that this level may be difficult to reach within the required timescale due to microbiological and technical (stability) issues raised. We will review progress in view of these comments in 2010 and 2012.

14.5 Salad dressing Includes all oil and vinegar based dressings.

2.5 g salt or 1,000 mg sodium (maximum)

 

1.75 g salt or 700 mg sodium (maximum)

15. COOK-IN AND PASTA SAUCES, THICK SAUCES AND PASTES

15.1 All cook in and pasta sauces (except pesto and other thick sauces and pastes) Includes all cooking sauces, e.g., pasta sauce, curry, Mexican, etc. Excludes thick varieties—for pesto and other thick sauces see category 15.2; for thick pastes see category 15.3)

1.1 g salt or 430 mg sodium (average)

 

0.83 g salt or 330 mg sodium (average r)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

15.2 Pesto and other thick sauces Includes thick cooking sauces intended to be used in smaller quantities, e.g., pesto, stir fry sauces, etc. (e.g., a portion size of under 90 g)

3.0 g salt or 1,200 mg sodium (average)

 

1.5 g salt or 600 mg sodium (average r), 2.0 g salt or 800 mg sodium (maximum)

 

15.3 Thick pastes Includes all thick pastes used in very small quantities (e.g., 15–20 g) such as curry and Thai.

n/a

 

5.0 g salt or 2,000 mg sodium (maximum)

 

16. BISCUITS

 

 

 

 

16.1 Sweet biscuits—unfilled Includes all unfilled sweet biscuits.

1.1 g salt or 416 mg sodium (average)

 

0.68 g salt or 270 mg sodium (average) 1.13 g salt or 450 mg sodium (maximum)

We are aware that it may be difficult for some products to meet the 2012 target within the required timescale and will review progress in 2010 and 2012.

16.2 Sweet biscuits—filled Includes all sweet biscuits with fillings, e.g., fig rolls, custard creams, etc.

0.5 g salt or 205 mg sodium (average)

 

 

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

16.3 Savory biscuits—unfilled Includes all unfilled savory biscuits, e.g., cream crackers, oatcakes, water biscuits, breadsticks, melba toast, etc.

2.2 g salt or 860 mg sodium (average)

 

1.38 g salt or 550 mg sodium (average) 2.0 g salt or 800 mg sodium (maximum)

This category includes bagged savory snacks (e.g., cheesy biscuits and flavored crisp breads). We are aware that some bagged snacks have higher salt contents than their larger packeted equivalents because of the method of manufacture. Whilst we recognize that it may be difficult for some products to meet the 2012 target within the required timescale and will review progress in 2010.

16.4 Savory biscuits—filled Includes all savory biscuits with fillings.

1.9 g salt or 740 mg sodium (average)

 

1.25 g salt or 500 mg sodium (maximum)

There are very few filled savory biscuits—these have been retained in a separate category to savory biscuits, unfilled. We are aware that it may be difficult for some products to meet the 2012 target within the required timescale and will review progress in 2010 and 2012.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

17. PASTA

 

 

 

 

17.1 Pasta and noodles, plain and flavored Includes dried, fresh, canned, frozen pasta (including spaghetti/hoops in tomato sauce) and noodles. Also includes dry flavored noodles and pasta with flavor or sauce sold as a snack or meal—in these circumstances, the target is for the products as consumed (made up according to manufacturers instructions) and not as sold. Excludes stuffed pasta and pasta ready meals (see category 8) and canned pasta in tomato sauce with accompaniments (see category 7.2)

0.5 g salt or 200 mg sodium (maximum)

 

0.38 g salt or 150 mg sodium (maximum)

This category now includes flavored noodles and dry pasta sold as a snack or meal (made up according to manufacturers instructions).

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

18. RICE

 

 

 

 

18.1 Rice (unflavored), as consumed Includes all unflavored rice (dried, cooked, frozen cooked, pouched, etc.), as consumed (made up according to manufacturers instructions, where appropriate).

0.2 g salt or 87 mg sodium (maximum)

 

0.2 g salt or 80 mg sodium (maximum)

 

18.2 Flavored rice, as consumed Includes all pouched flavored rice, including ambient and dried products, as consumed (made up according to manufacturers instructions, where appropriate).

0.8 g salt or 300 mg sodium (average)

 

0.45 g salt or 180 mg sodium (average r) 0.63 g salt or 250 mg sodium (maximum)

We appreciate that it may be difficult for some products to meet the 2012 target within the required timescale and will review progress in 2010 and 2012.

19. OTHER CEREALS

 

 

 

 

19.1 Other cereals Includes ready made Yorkshire pudding, ready made pastry, batter and pancake mix, etc.

0.8 g salt or 300 mg sodium (maximum)

 

0.63 g salt or 250 mg sodium (maximum)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

20. Processed puddings, Mousses, crème caramel, jelly, rice pudding, ready to eat custard, and custard powder are not included as these contain no added salt. Sodium present is that naturally occurring in the ingredients. Jelly crystals are also excluded for technical reasons.

 

 

 

 

20.1 Dessert mixes, as consumed Includes dehydrated dessert mixes (made up according to manufacturers instructions). Excludes custard powder and jelly crystals.

0.5 g salt or 200 mg sodium (maximum)

 

0.5 g salt or 200 mg sodium (maximum)

 

20.2 Cheesecake Includes ambient, chilled, frozen and dehydrated (as consumed, made up according to manufacturers instructions).

0.5 g salt or 200 mg sodium (maximum)

 

0.35 g salt or 140 mg sodium (maximum)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

20.3 Sponge-based processed puddings Includes jam rolypoly, spotted dick, sticky toffee pudding, etc. Excludes canned versions

1.0 g salt or 400 mg sodium (maximum)

 

0.5 g salt or 200 mg sodium (average), 0.75 g salt or 300 mg sodium (maximum)

 

20.4 All other processed puddings Includes all other processed and preprepared puddings, e.g., bread and butter pudding, brownie desserts, crumbles, trifle etc. Excludes fruit pies and all other desserts made with shortcrust and choux pastry (see category 12.4).

0.3 g salt or 120 mg sodium (maximum)

 

0.18 g salt or 70 mg sodium (average) 0.3 g salt or 120 mg sodium (maximum)

Category 12.4 now includes all shortcrust and choux pastry based desserts, so these are no longer included in category 20.4.

21. QUICHE

 

 

 

 

21.1 Quiches Includes all quiches and flans

0.8 g salt or 300 mg sodium (maximum)

 

0.75 g salt or 300 mg sodium (maximum)

 

22. SCOTCH EGGS

 

 

 

 

22.1 Scotch eggs

1.0 g salt or 400 mg sodium (maximum)

 

0.88 g salt or 350 mg sodium (maximum)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

23. CANNED FISH

 

 

 

 

23.1 Canned tuna Includes all tuna canned in oil, brine, spring water, etc. Excludes fish with sauce products (see category 23.3).

1.0 g salt or 400 mg sodium (average)

 

1.0 g salt or 400 mg sodium (average p)

 

23.2 Canned salmon Includes all standard canned salmon. Excludes fish with sauce products (excludes category 23.3).

1.2 g salt or 470 mg sodium (average)

 

0.93 g salt or 370 mg sodium (average p)

The Agency recognizes that the salt levels in these products are largely within the control of the U.S. and Canadian canneries and any reduction will depend on influencing them.

23.3 Other canned fish Includes sardines, mackerel, pilchards in brine, oil etc and canned fish with sauces, e.g., tomato, barbeque, mustard, etc. Also includes canned shellfish, e.g., prawns, crab, mussels, etc. Excludes anchovies, smoked fish, lumpfish caviar and fish roe.

1.5 g salt or 600 mg sodium (average)

 

0.93 g salt or 370 mg sodium (average r)

The range of products covered by this target makes it difficult to set a meaningful maximum target. The Agency has therefore set a range average target.

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

24. CANNED VEGETABLES

24.1 Canned vegetables Includes all canned vegetables and pulses. Excludes processed/marrowfat/mushy peas (see category 24.2) and sauerkraut.

0.13 g salt or 50 mg sodium (maximum) 0.13 g salt or

 

50 mg sodium (maximum)

 

24.2 Canned processed/marrowfat/mushy peas. Includes these products only.

0.5 g salt or 200 mg sodium (maximum)

 

0.45 g salt or 180 mg sodium (maximum)

 

25. MEAT ALTERNATIVES (PREVIOUSLY PROCESSED VEGETABLE-BASED PRODUCTS)

25.1 Plain meat alternatives Includes plain tofu, Quorn ingredients (e.g., mince, plain pieces and fillets), meat free mince and other similar products

0.7 g salt or 280 mg sodium (maximum)

 

0.7 g salt or 280 mg sodium (maximum)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

25.2 Meat free products Includes all meat and fish alternative products, e.g., sausages, burgers, bites, pies, en croute products, sausage rolls, nut cutlets, falafel, flavored “meat” pieces, e.g., chicken fillets, “meatballs,” all meatfree “meats,” e.g., ham, turkey, etc., including “beanburgers,” “veggieburgers,” and other similar products. Excludes bacon (see category 25.3), baked beans (category 7), canned vegetables (category 24), ready meals and meal centers (category 8) and takeaways.

 

 

0.93 g salt or 370 mg sodium (average r) 1.5 g salt or 600 mg sodium (maximum)

 

25.3 Meat-free bacon. Includes all meat-free bacon type products, whether made from soya, Quorn, or other ingredients.

n/a

 

2.13 g salt or 850 mg sodium (average r)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

26. OTHER PROCESSED POTATOES

26.1 Dehydrated instant mashed potato, as consumed Includes all instant mashed potato products, as consumed (as made up according to manufacturers instructions).

0.25 g salt or 100 mg sodium (maximum)

0.2 g salt or 80 mg sodium (maximum)

0.18 g salt or 70 mg sodium (maximum)

 

26.2 Other processed potato products Includes all other processed potato products, including frozen and chilled chips with coatings, potato waffles, shaped potato, wedges, etc. Excludes oven chips with no added salt.

0.5 g salt or 195 mg sodium (maximum)

0.49 g salt or 195 mg sodium (average) 0.88 g salt or 350 mg sodium (maximum)

0.49 g salt or 195 mg sodium (average r) 0.75 g salt or 300 mg sodium (maximum)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

Main Product Category and Sub Categories (where relevant)

Current 2010 Targets (g salt or mg sodium per 100 g)*

Revised 2010 Targets (g salt or mg sodium per 100 g)*

Targets for 2012 (g salt or mg sodium per 100 g)*

Comments

27. BEVERAGES

27.1 Dried beverages, as consumed Includes drinking chocolate, instant chocolate drinks, instant malted drinks, instant cappuccino drinks, etc., as consumed (made up according to manufacturers instructions). Excludes tea and coffee.

0.25 g salt or 100 mg sodium (maximum)

 

0.15 g salt or 60 mg sodium (maximum)

The 2012 target for dried beverages has been maintained at a maximum of 60 mg sodium per 100 g, as consumed. An analysis of the dried beverage products on the market indicates that this is an achievable target.

28. TAKEAWAY, MEAT BASED

28.1 Take away, meat based Includes curries, Chinese dishes, etc. Does not include beef burgers, pies.

0.6 g salt or 250 mg sodium (maximum)

 

0.63 g salt or 250 mg sodium (maximum)

The targets for takeaway foods have been maintained at their 2006 levels. The Agency has a separate program of engagement with the catering sector underway to promote salt reduction in these foods.

29. TAKEAWAY, FISH BASED

29.1 Take away, fish based Includes curries, Chinese dishes, etc.

0.5 g salt or 200 mg sodium (maximum)

 

0.5 g salt or 200 mg sodium (maximum)

 

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

30. TAKEAWAY, VEGETABLE AND POTATO BASED

30.1 Take away, vegetable and potato based Includes takeaway chips, curries, Chinese dishes, etc.

0.5 g salt or 200 mg sodium (maximum)

 

0.5 g salt or 200 mg sodium (maximum)

 

NOTES: Some categories have been revised and there is no equivalent 2010 target. As a result, the “Current 2010 targets” column has been left blank. There are two types of average used within the targets table. The first is a processing average (average p) and is used to account for ranges of salt levels that occur in a single product, e.g., bacon and tuna. The second is a range average (average r), which is used to take into account a range of differing flavors (e.g., standard potato crisps) or products (e.g., morning goods) covered by a single target. All range averages should be calculated on a sales weighted basis.

*Revised targets for 2010 and 2012 have been set according to mg sodium that should be present. This figure has then been multiplied by 2.5 to give the salt equivalent. The targets that were published in 2006 have not changed in this way as this is currently the method proposed in the draft Food Information Regulation for labeling salt content.

SOURCE: Food Standards Agency. Available online: http://www.food.gov.uk/healthiereating/salt/saltreduction (accessed October 14, 2009).

Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
×

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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Suggested Citation:"Appendix C: International Efforts to Reduce Sodium Consumption." Institute of Medicine. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press. doi: 10.17226/12818.
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Reducing the intake of sodium is an important public health goal for Americans. Since the 1970s, an array of public health interventions and national dietary guidelines has sought to reduce sodium intake. However, the U.S. population still consumes more sodium than is recommended, placing individuals at risk for diseases related to elevated blood pressure.

Strategies to Reduce Sodium Intake in the United States evaluates and makes recommendations about strategies that could be implemented to reduce dietary sodium intake to levels recommended by the Dietary Guidelines for Americans. The book reviews past and ongoing efforts to reduce the sodium content of the food supply and to motivate consumers to change behavior. Based on past lessons learned, the book makes recommendations for future initiatives. It is an excellent resource for federal and state public health officials, the processed food and food service industries, health care professionals, consumer advocacy groups, and academic researchers.

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