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

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. "Front Matter." 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

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

Page
IX
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)