Sodium reduction message not getting through

by Keith Nunes
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Anyone seeking to gain an understanding of the sodium reduction trend may quickly become confused by the contradictory data that are emerging. While national and municipal public health agencies as well as public health groups like the American Heart Association (A.H.A.) have made sodium reduction in the diet a priority, it does not appear the message has reached consumers.

Part of the reason may be due to the fact the trend toward reducing sodium in the diet is not new.

“It started back in the ‘70s, that was the first cycle when it came through,” said Janice Johnson, applications and technical services leader for Cargill Salt, Minneapolis. “It is something that we see run in cycles in a variety of geographies. It is always in the background.”

Contrary to initial spec-ulation, the U.S. Department of Agriculture’s 2010 Dietary Guidelines for Americans did not alter the recommendation for the amount of sodium consumers should intake on average per day. The D.G.A. committee left its overall recommendation at 2,300 mg per day and highlighted that people 51 and older, those of any age group who are African American or have hypertension, diabetes or chronic kidney disease reduce their consumption to 1,500 mg per day. The only difference between the 2005 and 2010 recommendations is the 2010 D.G.A.s defined the 2005 recommendation of “middle-age and older adults” to “people 51 and older.”

But in the Dietary Guidelines for Americans, 2010 final report, the authors noted that “Virtually all Americans consume more sodium than they need. The estimated average intake of sodium for all Americans ages 2 years and older is approximately 3,400 mg per day.”

The fact has been supported by market research firms such as The NPD Group, Chicago, which published a report earlier this year showing all generations of consumers are consuming too much sodium. Specifically, The NPD Group said seniors, those born before 1946, and older boomers, born 1946 to 1955, are on average consuming 2,912 mg and 3,199 mg of sodium daily, respectively. While still above the dietary guidelines, they were the lowest levels seen among the generations tracked by the research company.

Younger boomers, those individuals born between 1956 and 1964, consume an average of 3,280 mg of sodium daily, and millennials, which consists of adults primarily in their 20s, consume the most sodium — on average 3,485 mg of sodium per day.

The fact consumers on average are getting too much sodium in their diets is one reason the A.H.A. called the D.G.A.’s recommendation a backwards step from the dietary guidelines released in 2005.

“By specifying ‘age 51’ for the population recommendation of 1,500 mg, the American Heart Association believes these guidelines do not address the very real issue of excess sodium consumption across the population, and in fact, these guidelines actually take an unfortunate step backwards,” the A.H.A. said. “In 2005, this level of sodium intake was specified for ‘middle-aged and older-aged,’ which is generally interpreted as above age 40. When this age is used, as it was in the Centers for Disease Control and Prevention statement in the 2010 M.M.W.R. (Morbidity and Mortality Weekly Report), fully 69% of the adult population meets the 2005 criteria for the 1,500 mg level. Now the guidelines only address older-aged Americans.”

Do consumers care?

Consumer interest in health and wellness is frequently cited as a primary food and beverage industry trend, but for the trend to have an impact consumers must respond. A recent survey conducted by the American Dietetic Association showed that despite the public health focus, many consumers are not reacting to the message that they should reduce the amount of sodium in their diet.

Respondents to the A.D.A.’s survey were read a list of foods and nutrients that may have an effect on people’s health and were asked, on a scale of 1-to-5, how much they had heard about them. In 2011, 66% of the survey respondents said they had heard “a lot” about low sodium foods. The figure was up slightly compared to 2008, the last year the survey was conducted, when 61% of the survey respondents said they had heard a lot about low sodium foods.

“The relatively small increase since 2008 in the amount that people have heard about sodium is somewhat surprising given the attention sodium has received by public health authorities, the food industry and the media,” said Jeannie Gazzaniga-Moloo, a spokesman for the A.D.A.

The A.D.A.’s survey, titled “Nutrition and you: Trends 2011,” included 754 adults age 18 and older who were not employed in the food, nutrition dietetics or market research industries. Interviews were conducted in May 2011 by telephone by Mintel International Group Ltd.

Another recent study conducted by the International Food Information Council found that 59% of Americans said they were not concerned about their sodium intake. The percentage was consistent with IFIC’s 2009 sodium survey findings. In addition, 70% of Americans in the survey said they do not know how much sodium they should consume in a day.

The findings were published in IFIC’s 2011 sodium survey.

“With all the attention sodium has received in the last few years, including in the 2010 Dietary Guidelines for Americans, it’s surprising that Americans are still not well aware of sodium guidelines,” said Marianne Smith Edge, senior vice-president of nutrition and food safety for IFIC. “Particularly for the at-risk populations, such as those with high blood pressure, these results show there’s a great educational opportunity available to highlight the variety of ways to manage blood pressure.”

The survey, which randomly sampled 1,003 adults, found 56% of people with high blood pressure did not know how much sodium they should consume in a day or overestimated the amount.

When prompted, 50% to 63% of people in the study said they were interested in topics regarding recommended intakes, food sources and health impacts. When asked where they want information on sodium primarily to come from, they said the medical community (55%), the food label (46%), the government (31%) and food manufacturers (30%). About 4 in 10 survey respondents said taste will suffer if they limit sodium intake.

When asked to rate the three most important elements of a healthful diet, the respondents ranked eating fruits and vegetables, at 70%, as the top choice. Limiting sodium was ranked as one of the most important factors by 38%.

“Because there are a variety of factors and approaches that go into building a healthful diet, it’s not surprising that limiting sodium is trumped by other dietary factors,” Ms. Smith Edge said. “It is clear Americans understand positive messages that involve foods versus just nutrients — like eat more fruits and vegetables — as a good way to consume less sodium and more potassium.”

Dr. Johnson of Cargill Salt added that part of the consumer malaise around sodium reduction may stem from lingering memories of other reduction efforts.

“The ‘70s was not the greatest time for reduced sodium solutions,” she said. “Many of the reduced sodium products available did not taste good, and consumers who experienced those products may avoid the newer ones today, even though sodium replacement technologies have improved dramatically.”

‘Designer salts’ emerge

In late August, Technomic, Inc., Chicago, released a study that showed that sodium remains a staple in the food service sector. Through the company’s MenuMonitor program, Technomic found that “salt mentions” on major chain and independent restaurant menus have increased 144% over the past five years. The analysis included 2,000 food service operators and noted that not only have operators included salt on the menu with greater frequency, but the evolution of salt use across menu categories has shifted.

“Salt and pepper has always been prevalent on the menu,” said Darren Tristano, executive vice-president. “How-ever, we are seeing more artisan, spice blended and designer finishing salts being introduced broadly across appetizers, entrees and dessert menus. Although the roots of this trend originate in fine dining establishments, it’s catching on in mainstream casual dining, fast casual and quick-service restaurant chains.”

Mr. Tristano said the addition of the menu descriptors does not necessarily indicate a conflict with the food service industry’s efforts to lower the overall sodium content in food, and that the salt not included in menu descriptions has been consistently lessened in recent years, even as the artisanal uses of the spice have increased.

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