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Press Briefing Transcript

CDC Telebriefing on Vital Signs Report: Sodium Consumption

Tuesday, February 7, 2012 at Noon ET

TOM SKINNER: Thank you, Shirley.  Thank you for joining us today for the CDC telebriefing vital signs report entitled “Food Categories Contributing to the Most Sodium Consumption, United States 2007 to 2008”.  Today joining us is the director of the CDC Dr. Thomas Frieden who is going to give some opening remarks. When we get to your questions and answers we'll also be joined by Janelle, a public health analyst in our division of heart disease and stroke prevention.  I'll turn the call over to Dr. Frieden who will provide opening remarks and when we get to your question and answers we'll also be joined by Janelle Peralez, a public health analyst in our Division of Heart Disease and Stroke Prevention. So I will turn the call over to Dr. Frieden who′s going to provide some opening remarks and we will get to your questions. 

THOMAS FRIEDEN:  Good afternoon, everybody.  Thank you for joining us.  Heart disease and stroke are leading causes of death in the United States and are largely dependent on the high rate of high blood pressure.  One in three American adults has high blood pressure and one of the things that's driving our blood pressure up is the fact that most adults in this country eat or drink about twice the amount of sodium as is recommended.  And most of that extra sodium comes from common grocery store and restaurant items and only a very small proportion comes from the salt shaker at the table.  The study we are releasing today which is based on a unique data set from the National Health and Nutrition Examination survey finds that ten types of food are responsible for more than 40% of people's sodium intake.  Bread and rolls, lunch meats (like deli ham or turkey), pizza, poultry, soups, cheeseburgers and sandwiches, cheese, pasta dishes, meat dishes, snack foods come at the very bottom of that top ten.  Potato chips, pretzels and popcorn which we think are the saltiest foods in the diet are only number ten in the list of top ten and only account for about 3% of all of the sodium consumed.  Sixty-five percent of sodium we consume comes from processed food sold in grocery stores and 25% comes from foods served in restaurants.  The average person consumes about 3,300 milligrams of sodium every day excluding salt added at the table.  The united states dietary guidelines recommends limiting sodium intake to less than 2,300 milligrams per day and less than 1,500 milligrams per day for everyone over the age of 51, anyone with high blood pressure or diabetes or chronic kidney disease and all African Americans.  That means nearly 60% of all adults in this country should be consuming 1,500 milligrams or less.  That's less than half the amount we are actually consuming.  Excess sodium increases blood pressure which is a major risk factor for both heart disease and stroke as well as other health problems.  Heart disease and stroke alone kill more than 800,000 Americans each year and contribute an estimated 273 billion dollars a year in health care costs.  Reducing the sodium content of the ten leading sodium sources by just 25% would lower total dietary sodium by more than 10% and prevent an estimated 28,000 deaths per year.  Reducing sodium consumption is not easy because it is in so many different foods.  People can lower their sodium intake by eating more fresh or frozen fruits and vegetables and by limiting the amount of processed foods they consume.  People can also check grocery nutrition facts panels; foods labels, and choose products lowest in sodium.  Reducing sodium across the food supply can increase consumer choice.  It's feasible it can save thousands of lives and billions of dollars in health care costs each year by reducing the amount of sodium in restaurant and processed foods we can put choice into the consumer's hand.  People can choose how much salt to add to their food at the table.  They can't take it out once it's there.  The mean sodium values for different brands of the same food types vary substantially.  For example, a single piece of pizza may vary by as much as two or three fold between different brands.  So consumers can check labels and choose to lower sodium brands and producers can provide a wider array of lower sodium products and can work to reduce sodium levels across a broad range of foods.  Gradual voluntary reductions in sodium, we believe, are possible and would save billions of dollars and tens of thousands of lives.  I'll stop there and look forward to answering your questions. 

TOM SKINNER:  Shirley, we're ready for questions, please.

OPERATOR: Thank you.  At this time we're ready to begin the question and answer session.  If you would like to ask a question, please press star one and record your name clearly.  To withdraw your request you press star two.  Again, press star one to ask a question.  One moment for our first question.  Our first question is from Evan Brown with Fox News Radio.  You may ask your question.

Evan Brown: Hi. Good morning.  The new statistic that we have seen in the e-mails of nine out of ten adults, can you contrast that with last time the studies have been done and how much of an increase or decrease that maybe and what that really means? 

Dr. Frieden: We know that consumption is way too high now.  What it has done over time is something we don't have a great handle on because we don't have the data going back as well as we would like 10, 20 or  30 years.  But we do know that across the entire age spectrum from young to old Americans are eating way too much sodium.  It's raising their blood pressure and we know high blood pressure is a major risk factor for heart attack and stroke. 

TOM SKINNER: Next question, Shirley.

OPERATOR: Thank you.  Our next question is from Heidi Splete with Internal Medicine News.  You may ask your question.

HEIDI SPLETE:  Hi, thanks for taking my call.  Obviously reading the labels is a good way to help cut down on sodium.  What would be the take-home message for doctors about what else they can do to encourage patients, especially those who are at increased risk in some of the higher risk groups you mentioned to help them cut down? 

THOMAS FRIEDEN:  Physicians can work with nutritionists and other health professionals to help patients understand what the sources of sodium are in their own diets.  They may be surprised to find out their breakfast cereal contains the equivalent of eight or ten shakes of salt in it and may find in cereals, in meals, in snacks they may find options that have half or less the amount of sodium and taste every  bit as good.  There are plenty of spices other than sodium that can make food taste great. 

HEIDI SPLETE: Thank you. 

OPERATOR:  If you have a question press star one.  Our next question comes from Caramel Maloney. 

CARAMEL MALONEY:  I′m calling from the Daily in New York.  I just wanted to ask what is the most common source of sodium in food?  Is it bread and rolls?  Is that number one on the list? 

THOMAS FRIEDEN:  Yes.  If you look at table one of the MMWR, bread and rolls is the leading single source, partly because we eat so much bread and rolls.  Cold cuts and cured meats are number two.  Close behind are pizza.  If you look at the source of the foods, most of the foods are primarily purchased in stores with the exception of pizza and sandwiches.  Sandwiches are premade sandwiches and pizza is primarily from pizza restaurants, fast food restaurants, as well as other restaurants.  Poultry is about half and half between stores and restaurants.  So most of these are from common foods that we consume and that we can choose lower sodium versions of. 

CARAMEL MALONEY:  So with the bread, rolls and sandwiches, I wanted to ask you, would you recommend that people stop eating premade sandwiches at work? 

THOMAS FRIEDEN:  No.  I think the key is to find lower sodium options of the foods you love. 

CARAMEL MALONEY:  Thank you. 

TOM SKINNER:  Next question? 

OPERATOR:  Again, if you have a question press star one.  Our next question comes from Glen Berkins from Q City Metro.com.

GLEN BERKINS:  This report isn't very encouraging from a standpoint of consumers.  It seems just about every food we eat is on the list that's high sodium.  My question is, and perhaps you have touched on it in some ways, other than becoming label readers what can we do to literally cut down on the amount of sodium we consume without standing and looking at labels everywhere we go. 

THOMAS FRIEDEN:  Thank you.  First off, all the fresh fruits and vegetables you eat are going to be very low in sodium.  Any frozen fruits and vegetables you eat, if it doesn't have a sauce on it that has a lot of sodium is going to be low in sodium.  Eating more fruits and vegetables is really a key thing you can do.  You can also -- don't have to do it every day but you can once look at the foods that you consume and then maybe think about whether you want to shift whether it's the brand of cereal you buy or the kind of soup you eat or look at whether the meat that you're eating has been so-called enhanced with sodium.  There are things you can do as a one-time shift in your purchasing power.  You can ask your grocer to carry more lower sodium food choices.  I think this can make a big difference.  Clearly increasing your consumption of fruits and vegetables and although it's challenging because we are all busy, increasing the amount of food you prepare yourself.  Because when people prepare food themselves they add a very -- much less salt than the average that is in restaurants or grocery stores.  So fruits and vegetables, preparing your own food.  Only about a 5 or 6% of all of our sodium comes from what we add in the kitchen and only about 5 or 6% what we add at the table.  So it's not what we're doing.  That's why we are so encouraged that companies such as Kraft and Leprino foods have come out with great tasting lower sodium products across the product line.  This shows that it's possible to make real progress.  We're confident more and more companies will be making those healthier choices available to Americans. 

TOM SKINNER: Next question, Shirley. 

OPERATOR: Thank you.  Our next question is from Monica Eng with the Chicago Tribune.  You may ask your question.

MONICA ENG:  Hi.  Part of my job is to cover the food eaten in Chicago public schools.  In the last couple of years in the name of sodium reduction they have kept all of their processed foods but stopped salting any of the fresh vegetables.  This has led to, from my observations, a real drop in any kids taking the vegetables because they have said we will not have a single crystal of salt on those vegetables.  Do you think given that only 6% of our sodium consumption comes from cooking in the kitchen like that this is a wise move? 

THOMAS FRIEDEN:   School systems can do quite a bit to encourage kids to eat healthy foods.  An example is the let's move salad bar program.  Turns out salad bars are really popular with kids.  They like to make their own choices.  I think one of the things many creative school districts are doing across the country is not just assuming what kids are going to like, but trying it.  And then adjusting what they offer kids based on what kids are actually taking and eating.  I think there are many examples of food -- big improvements in school foods.  The new USDA regulations, I think, are a big step forward and include significant reduction in sodium and planned future reductions in sodium I think will be very important.  So school food is an important issue.  We did look at it in this report and found it to be about the same as a proportion of the sodium as it was years back.  No one entity -- not schools, not restaurants, not grocery stores -- is going to be able to do this on its own.  Reducing sodium is going to require collaboration and increasing choices to put choices into people's hands by gradually reducing sodium in food that has been processed or prepared so people can salt to taste.

MONICA ENG: So my question is do you think the smartest move is to take all the sodium out of the vegetables and not let kids even shake a little salt on vegetables or might it be more productive, according to your research, to remove all the processed foods that are laden with sodium that they are giving the kids, like nachos, the burgers and the pizza.

THOMAS FRIEDEN:  We think reducing sodium in processed foods is critically important.  We encourage salting to taste.  We are not saying to take away anybody′s salt shaker.  Quite the opposite.  We want people to have the option of adding salt at the table but fundamentally want to ensure that they′ve got  the options to have low sodium food by not having that come to the table heavily salted.

MONICA ENG: Great.  Thank you. 

TOM SKINNER: Next question, please. 

OPERATOR: Thank you.  I'm showing no further questions.  Again, if you would like to ask a question press star one at this time. 

THOMAS FRIEDEN:  Okay.  So, I want to thank everyone for participating in today's telebriefing.  You will see the MMWR, our four-page fact sheet and press release.  The bottom line here is that heart disease and stroke are leading causes of death, disability and health care spending in this country.  It's possible to greatly reduce the number of people with high blood pressure by reducing the amount of sodium in our diets.  That's possible by building on the positive steps that have been taken by many parts of the restaurant and grocery industry to reduce sodium levels, to put choice into people's hands.  Nine out of Ten Americans today consume too much sodium and on average more than twice as much as we are recommended to.  Today's report identifies ten top food types that are accounting for nearly half, 44%, of the sodium that Americans consume by adjusting what we eat, choosing lower sodium versions, increasing the amount of fruits and vegetables we consume.  We can substantially reduce sodium intake, save lives and save money.  Thank you very much for participating. 

OPERATOR: Thank you.  This does conclude today's conference.  Thank you for your participation.  At this time you may disconnect your lines. 

###
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