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Sodium Reduction in Communities Program (SRCP)

Sodium Reduction in Communities Program.

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 States.2 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 two state coordinated programs and five large municipalities to decrease sodium consumption in the population. In 2014, CDC expanded the program and awarded three additional grantees: two state coordinated programs and one large municipality.

2014 Sodium Reduction in Communities Program Map. The SRCP communities are Lost Angeles County, CA; Bangor and Portland, ME; Marion County, IN; New York City, NY; Albany and Steuben counties, NY; Benton, Jackson, Lane and Linn counties, OR; Philadelphia, PA; San Antonio, TX; San Diego, CA; Clark, Spokane, and Thurston counties, WA.

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.

What Are the SRCP Communities Doing?

While focused on sodium reduction, awardees are working with multiple partners to implement 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. Each grantee has been awarded between $200,000 and $350,000 for FY 2014.

Los Angeles County, California ($240,983)

  • 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.

Maine* ($350,000)

Maine is coordinating the work of Cumberland and Penobscot counties to

  • Develop and implement food service guidelines and nutrition standards that increase the availability of lower sodium foods in health system and member hospitals.
  • Increase availability of lower sodium foods at food pantries that serve low income individuals and families.

Marion County, Indiana ($250,000)

  • 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 ($240,982)

  • 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 ($350,000)

New York State is coordinating the work of Albany and Steuben counties 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.

Oregon* ($350,000)

Oregon is coordinating the work of Benton, Jackson, Lane and Linn counties to

  • Implement nutrition standards in government worksites that are piloting strategies that may enhance selection of lower sodium foods.
  • Work with hospitals to promote and implement food service guidelines to increase the availability of and access to lower sodium foods in the cafeterias and vending machines.

Philadelphia, Pennsylvania ($250,000)

  • 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 ($208,508)

  • 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.

San Diego, California* ($250,000)

  • Increase the accessibility to and availability of lower sodium foods and meals to vulnerable populations fed through the county Senior Nutrition Program, detention facilities, and Child Welfare Services, by instituting food service standards and implementing menu or meal modifications.
  • Create and implement venue-specific nutrition standards in government worksite cafeterias that increase the availability of lower sodium foods.

Washington State ($350,000)

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.

*New Sites added in FY 2014.

Program History

Demonstration Sodium Reduction in Communities Program (SRCP). CDC launched the Sodium Reduction in Communities Program (SRCP) in 2010 to promote local and state sodium reduction strategies—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. 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.

References

  1. Institute of Medicine. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: National Academies Press; 2005.
  2. 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.
  3. 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.
  4. Institute of Medicine. Strategies to Reduce Sodium Intake in the United States. Washington, DC: National Academies Press; 2010.
  5. 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.

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