How does United States Lower Dietary Intake of Sodium?

How does United States Lower Dietary Intake of Sodium?

YY TSANG

(CMA Testing and Certification Laboratories)

Many peoples consume more salt (key concern is sodium) than they need. This can raise blood pressure and lead to serious health consequences (e.g. heart disease, kidney disease & stroke). In United States, about 75% of Americans’ total salt intake comes from salt added to processed foods by manufacturers and salt that cooks add to foods at restaurants and other food service establishments.

Top 10 Sources of Sodium

Over 40% of the sodium Amercians eat each day comes from 10 types of food.

• Breads and rolls

• Cold cuts and cured meats (e.g. deli or packaged ham or turkey)

• Pizza

• Fresh and processed poultry

• Soups

• Sandwiches (e.g. hot dogs, hamburgers & submarine sandwiches)

• Cheese (natural and processed)

• Mixed pasta dishes (e.g. lasagne, spaghetti with meat sauce & pasta salad)

• Mixed meat dishes (e.g. meat loaf with tomato sauce & beef stew)

• Snacks (e.g. chips, pretzels, popcorn & crackers)

(Image Source: FDA, 2015)

http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm315393.htm

Regulate Pre-packaged Food

United States Food and Drug Administration (FDA) stipulates that sodium content must be stated on “Nutrition Facts Label” of food and beverage packages. Moreover, criteria for sodium-related nutrition claims that manufacturers make about foods must be met.

Food label shall also list the Percent Daily Value (%DV) of sodium in one serving of a food. This tells a consumer whether the food contributes a little or a lot to his/her total daily diet.

Regulate Restaurant Foods

FDA has published a menu labeling rule to help consumers make informed and healthier dietary choices. Calorie information on standard menu items must be listed out on menus and menu boards, and a succinct statement about suggested daily caloric intake shall be made. However, sodium content of food will have to be made available in writing only on request.

Limit Sodium Added to Processed Food

Some peoples criticize the aforementioned practices are neither effective to promote lower sodium intake nor reduce salt consumption in United States. FDA has therefore been urged to limit the amount of salt added to processed foods by laws, rather than only encouraging food manufacturers to bring sodium levels down voluntarily. However, some peoples do object using regulatory approach to limit salt amount in processed foods. For example, they worry that food companies are already under pressure to reduce other undesirable nutrients (e.g. sugars & saturated fats) and sodium reduction will make the situation even worse. FDA has conducted research in this area but the final decision is pending.

Recommendation on Daily Sodium Intake

Last year World Health Organization (WHO) recommended a reduction to < 2 g sodium intake per day (5 g salt per day) in adults. WHO added that a lower maximum level of sodium intake should be established for children. This echoes with the Dietary Guidelines for Amercians which recommend 1.5 g sodium intake per day for susceptible population groups (e.g. peoples with high blood pressure, diabetes or chronic kidney disease). The ultimate WHO goal is to reduce salt intake by the average population by 30% by 2025.

What Hong Kong Should Do Then

In Hong Kong, it was once estimated that adults consume about 10 g salt (4 g sodium) daily on average. According to the U.S. experiences, Hong Kong definitely cannot achieve the WHO goal by 2025 if the government solely relies on the consumers to read nutrition labels and choose pre-packaged food with lower sodium content themselves; and encouraging food trade to re-formulate food recipes with reduced use of sodium on a voluntary basis.

In order accelerate a change in population dietary intake of sodium, I think the government must establish legal tolerance level of sodium in processed foods. Past experiences already show that only few food traders will do what the government suggests unless there’s an immediate profit or a penalty in return.

It is also noted that many local consumers seldom read nutrition label and then use the relevant information to make a healthier dietary choice. This is possibly due to limited customer understanding of numeric values presented on the label and their uses. As such, a color-coded, eye catching & easy-to-understand symbol indicating a food with lower amount of sodium which is healthier should be used, like the heathier choice symbol (HCS) adopted by the Singapore government.

(Image Source: Health Promotion Board, 2012)

http://www.hpb.gov.sg/HOPPortal/health-article/7498

Food products carrying HCS allow consumers to rapidly identify healthier food choices when grocery shopping. In addition, mandatory provision of %DV in food label also helps the citizens avoid excessive intake of sodium.

Last but not least, since Hong Kong people love to dine out, menu labelling of sodium content in local restaurants is required to help consumers to make informed and healthier dietary choices.

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