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

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. "2 Sodium Intake Reduction: An Important But Elusive Public Health Goal." 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
FIGURE 2-12 Annual per capita sodium disappearance based on salt disappearance, 1978–2008.

FIGURE 2-12 Annual per capita sodium disappearance based on salt disappearance, 1978–2008.

NOTES: Sodium (milligrams) shown on y-axis was determined by the following calculation: Salt disappearance data (tons of food-grade salt per year) was converted to grams of salt per day. That number was then divided by census-based per capita population estimates used by USDA’s Economic Research Service in developing nutrient availability databases, 1978–2008, and grams of salt consumed per day was converted to milligrams sodium by multiplying by 39.3 percent.

SOURCE: Based on Salt Institute salt disappearance data (tons of food-grade salt per year) and USDA census data.

The results in Figure 2-13 suggest that intake increased between 1971–1974 and 1988–1994 and then plateaued between 1988–1994 and 2005–2006. Whether the early increases are real or due to methodological artifacts is uncertain. There were improvements in interview methodologies during that time that were associated with more complete reporting of intake (Loria et al., 2001). However, even with the caveat that intake by individuals tends to be underestimated and caution as to possible methodological sources of underestimation in the early surveys, the mean intakes, except for adult women in the first two survey periods, are all in excess of Dietary Guidelines for Americans recommendations.

One way of crudely evaluating whether or not underreporting biases have influenced time trends in estimates of sodium intake is to evaluate whether the differences in sodium intake over time and among subgroups are negated or minimized when the results are expressed as sodium densities. Using the same database as in Figure 2-13, Figure 2-14 provides data on the sodium densities for the same surveys.

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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)