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

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. "Appendix E: Background on the National Health and Nutrition Examination Surveys and Data Analysis Methods." 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

month are combined to estimate a daily amount of sodium from supplements per person. Antacids are included in the estimates of sodium intake from dietary supplements.

Usual Sodium Intake Comparison to Dietary Reference Intakes

As part of describing current sodium intake, means and distributions of usual intake from foods and from all dietary sources in NHANES 2003–2006 were compared to the Dietary Reference Intakes (DRIs) (IOM, 2005)—that is, the Adequate Intake (AI) and the Tolerable Upper Intake Level (UL) for sodium. If the usual mean intake exceeds the AI, the group is assumed to have adequate intake levels (Murphy, 2003). The proportion of the population that exceeds the UL is determined to be at risk of adverse effects from an excessive intake (Murphy, 2003). The statistical method for estimating the proportion below or above defined DRI cutoff values developed at Iowa State University was used (Carriquiry and Camano-Garcia, 2006).

Special Subgroups

The NHANES collects information on race/ethnicity on the basis of self-reported categories as follows: non-Hispanic whites, non-Hispanic African Americans, and Mexican Americans. Income for the survey is also reported on a category basis and is analyzed consistent with standards for reporting nutrition and statistical data for the evaluation of nutrition assistance programs: low-income is defined as an annual household income level of 130 percent of poverty or less, the income eligibility for the Supplemental Nutrition Assistance Program, formerly called the food stamp program; higher-income is defined as an annual household income above 185 percent of poverty, the eligibility cut-off for free- or reduced-price school meals and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and intermediate income is between 130 and 185 percent of the poverty line. Mean sodium intake from foods is highest among low- and higher-income adults ages 19–30 years and higher-income adults ages 31–50 years (Appendix F, Table F-6). Hypertension was defined as an elevated blood pressure (systolic pressure ≥ 140 mm Hg and diastolic pressure ≥ 90 mm Hg) and/or the taking of antihypertensive medications at the time of the individual’s medical examination in the NHANES Medical Examination Center (NCHS, 2009).

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413
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)