Strategies to Reduce Sodium Intake in the United States

This report focuses on strategies to reduce the sodium intake of the U.S. population. In Fall 2008, a 14-member committee was convened at the request of Congress and supported by several agencies within the HHS. The committee’s work was predicated on the importance of reducing sodium intake and the agreement that achieving lower intakes is a critical public health focus for all Americans. No segment of the population is immune from the adverse health effects, despite the common misunderstanding that sodium intake is a concern only for the “salt sensitive” and the elderly. Consistent with its charge, the committee relied upon consensus conclusions from numerous authoritative bodies as support for the health benefits related to population-based sodium reductions.

The committee was asked to make recommendations about various means that could be employed to reduce dietary sodium intake to levels recommended by the Dietary Guidelines for Americans—currently, less than 2,300 mg/d (see Box 1-1, Statement of Task). The recommended strategies were to include actions by food manufacturers, government approaches such as regulations and legislation, and public and professional outreach and education. Figure S-1 illustrates the committee’s approach to its task.

The committee began its study by evaluating the outcomes of past and current efforts to reduce sodium intake. It explored knowledge about sensory preferences for salt and its role in modulating overall food flavor, key factors in strategies to reduce sodium intake. Preservation and physical property roles of sodium in food were reviewed. Background information was obtained on food manufacturing and restaurant/foodservice operations and on factors important to understanding consumer food choices and behaviors. Given that regulatory options were to be considered, the committee also characterized the current regulatory framework. Further, the committee reviewed the possibility of leveraging activities through food specifications set by large government food purchasers, explored economic incentives such as a salt tax, and noted sodium reduction activities in other countries. It also considered the potential of innovative technologies for salt substitutes and enhancers as well as culinary advances.

Finally, the committee integrated the information into a series of discussions that led to conclusions about the strategies to be recommended, implementation tasks, and information gaps.