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Preface

In 1969, the White House Conference on Food, Nutrition, and Health issued recommendations that, among other important nutrition concerns, highlighted the role of sodium in hypertension and marked the starting point of public health initiatives to address the high levels of sodium intake among the U.S. population. Forty years later, in January 2009, the first meeting of the Institute of Medicine (IOM) Committee on Strategies to Reduce Sodium Intake convened. In the intervening years, much had changed—what we eat, where we eat, and who prepares our food. However, in spite of the attempts of many in both the public health community and the food industry, what did not change is the amount of sodium we consume each day, largely in the form of salt. High sodium intake puts the whole population—young and old, male and female, all ethnic groups—at risk for hypertension and subsequent cardiovascular events such as heart failure and stroke.

Hypertension is extraordinarily common: 32 percent of adult Americans have hypertension, and roughly another third have pre-hypertension. The costs of these health conditions are staggering. Estimates place the direct and indirect costs of hypertension at $73.4 billion in 2009.

The committee’s charge was to recommend strategies to reduce Americans’ intake of sodium to levels consistent with the Dietary Guidelines for Americans. In the wake of the many unsuccessful and/or unsustainable efforts, this was no small task, but—in light of the potential public health benefit that could be achieved if the goal was met—it was a worthy one. Simply put, the task of the committee was broad, far-reaching, and complex. I am delighted that the assembled committee had the individual



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