High intake of dietary sodium is associated with elevated blood pressure, which increases the risk of heart disease and stroke.1 Heart disease and stroke are the first and fourth leading causes of death in the United States2; from a public health perspective, this makes controlling hypertension an important issue. An analysis of 2009–2010 National Health and Nutrition Examination Survey data of US individuals aged 2 years and older found that the mean sodium intake was more than 3,400 mg per day.3 Most sodium consumed by Americans comes from processed and restaurant foods. Because these sources make up a large part of the American diet and because consumers have little control over the level of sodium in these foods, it is often difficult for consumers to reduce their sodium intake.4
Reducing sodium intake to levels consistent with the 2010 Dietary Guidelines for Americans is a priority for the Centers for Disease Control and Prevention (CDC). The agency is working in multiple areas to reduce sodium intake by (1) promoting local, state, and national nutrition strategies; (2) enhancing the monitoring of sodium intake and changes in the food supply; and (3) expanding the practice-based and scientific literature on sodium.
2013–2016 Sodium Reduction in Communities Program (SRCP). In 2013, CDC awarded funds to support 10 communities (two state coordinated programs and 5 large municipalities) to decrease sodium consumption in the population. The program aims to increase access to and accessibility of lower sodium food options, to reduce sodium intake, and to continue to build practice-based evidence around effective population-based strategies to reduce sodium consumption at the community level.
Program outcomes are
- Increased availability of lower sodium food products.
- Increased accessibility of lower sodium food products.
- Increased purchase and/or selection of lower sodium food products.
- Reduced sodium intake.
Primary sodium reduction strategies include
- Developing and implementing food service guidelines and nutrition standards.
- Putting into action menu changes to reduce sodium.
- Working with food distributors to increase availability and identify lower sodium products.
- Instituting strategies that may enhance selection of lower sodium foods.
- Offering complementary consumer information.
While focused on sodium reduction, awardees are putting into action interventions as part of sustainable comprehensive strategies aimed at improving the food environment in targeted venues such as government and private work sites, hospitals, independent restaurants, and distributive meal programs for older adults and preschool children.
What Are the 2013–2016 Communities Doing?
Los Angeles County, California
- Increase the availability of lower sodium foods by implementing nutrition standards in government distributive meal programs and government departments with cafeterias, snack shops, and vending machines.
- Work with public and/or private hospitals to increase the availability of lower sodium foods in cafeterias and snack shops.
Marion County, Indiana
- Reduce sodium content in foods served to children and staff at Head Start sites in Indianapolis and throughout the county.
- Reduce sodium content in foods offered in vending machines at community health centers and foods served in cafeterias to employees and visitors within the county's public hospital system.
New York City, New York
- Create and implement a labeling system for food distributors to identify lower sodium products that meet the New York City Food Standards.
- Provide technical assistance to New York City agencies and public and private hospitals using the new labeling system to ensure lower sodium products are easily accessible to help support their efforts to implement the New York City Food Standards.
New York State
New York State is coordinating the work of Albany and Steuben counties (three additional counties Schuyler, Yates, and Seneca are joining in Year 2 of SRCP) to
- Reduce sodium content in congregate meals and home-delivered meals for older adults by implementing menu and meal modifications.
- Put into action comprehensive food service guidelines or standards for foods and meals served to employees, patients, and visitors in public and private hospitals.
- Work with independent Chinese take-out restaurants to increase the availability and accessibility of lower sodium dishes via recipe development, cooking skills training, individual technical assistance, and distributor engagement.
- Put into action comprehensive nutrition standards for city government vending and food contracts.
San Antonio, Texas
- Put into action a comprehensive nutrition guidelines in city contracts serving congregate meals to older adults, youth in the summer meal program, and pre-kindergarten children.
- Reduce sodium content in meals served at private work sites by implementing comprehensive nutrition criteria.
Washington State is coordinating the work of Clark, Spokane, and Thurston counties to
- Increase availability of lower sodium foods at non-chain independent restaurants.
- Implement food service guidelines to increase the availability of lower sodium foods in public and private work site cafeterias.
2010–2013 Sodium Reduction in Communities Program (SRCP). To promote local and state sodium reduction strategies, in 2010 CDC launched the Sodium Reduction in Communities Program (SRCP), a 3-year demonstration program to increase the availability and accessibility of lower-sodium foods for consumers and decrease sodium intake.5 This program provided funding and technical assistance to six communities across the United States to explore the feasibility of reducing sodium consumption to limits recommended by the 2010 Dietary Guidelines for Americans and to build practice-based evidence around effective strategies (the 2010-2013 community efforts are described below). Each SRCP community collaborated with complementary nutrition and chronic disease prevention programs to be more effective while maximizing resources and preventing duplication of efforts.
To learn more about the methods, progress, and lessons learned go to supplemental edition of the Journal of Public Health Management and Practice titled, "Public Health Interventions to Reduce Sodium Intake" which features articles from the 2010 SRCP sites. In addition, individual success stories from the 2010 funded sites are available.
- Institute of Medicine. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: National Academies Press; 2005.
- Minino AM. Death in the United States, 2011. Hyattsville, MD: Centers for Disease Control and Prevention, National Center for Health Statistics; 2013; NCHS Data Brief No. 115.
- US Department of Agriculture, Agricultural Research Service. 2012. Nutrient Intakes from Food: Mean Amounts Consumed per Individual, by Gender and Age: What We Eat in America Web site http://www.ars.usda.gov/ba/bhnrc/fsrg. Accessed February 26, 2014.
- Institute of Medicine. Strategies to Reduce Sodium Intake in the United States. Washington, DC: National Academies Press; 2010.
- Mugavero K, Losby JL, Gunn JP, Levings JL, Lane RI. Reducing sodium intake at the community level: the Sodium Reduction in Communities Program. Prev Chron Dis. 2012;9:E168.
- CDC's Salt Web Site
- Evaluating the Sodium Reduction in Communities Program: Lessons Learned from Planning and Early Implementation [PDF-819K]
- Sodium Reduction in Communities Program (SRCP) Overview [PDF-185K]
- Improving the Food Environment Through Nutrition Standards: A Guide for Government Procurement [PDF-653K]
- New Institute of Medicine Report Finds National Action Imperative to Reduce Sodium Content of Foods